Science.gov

Sample records for afford maximum protection

  1. Development of Basic Housing Systems for Maximum Affordability

    SciTech Connect

    Aglan, H.; Gibbons, A.; McQueen, T.M.; Morris, C.; Raines, J.; Wendt, R.L.

    1999-04-19

    The ability to provide safe, habitable, comfortable housing for very low income residents within the target budget of $10,000 presents unique design and construction challenges. However, a number of preliminary conclusions have been inferred as being important concepts relative to the study of affordable housing. The term affordable housing can have many meanings and research is needed to define this explicitly. As it is most often used, affordable housing refers to an economic relationship between the price of housing, household income and current interest rates available from a lending institution. There is no direct relationship between architectural style, construction technology or user needs and the concept of affordability. For any home to be affordable, the home owner must balance the combination of housing needs and desires within the limits of an actual budget. There are many misconceptions that affordable housing must be defined as housing for those who cannot afford the free-market price. The concept of affordable housing must also include a component that recognizes the quality of the housing as an important element of the design and construction. In addition, responses to local climate impacts are necessary and are always part of a regional expression of architectural design. By using careful planning and design it may be possible to construct a limited dwelling unit today for a sum of approximately $10,000. Since the organization of the construction process must involve the owner/occupants as well as other volunteers, the project must not only be well conceived, but well developed and coordinated.

  2. Crashworthy Seats Would Afford Superior Protection

    NASA Technical Reports Server (NTRS)

    Gohmert, Dustin

    2009-01-01

    Seats to prevent or limit crash injuries to astronauts aboard the crew vehicle of the Orion spacecraft are undergoing development. The design of these seats incorporates and goes beyond crash-protection concepts embodied in prior spacecraft and racing-car seats to afford superior protection against impacts. Although the seats are designed to support astronauts in a recumbent, quasi-fetal posture that would likely not be suitable for non-spacecraft applications, parts of the design could be adapted to military and some civilian aircraft seats and to racing car seats to increase levels of protection. The main problem in designing any crashworthy seat is to provide full support of the occupant against anticipated crash and emergency-landing loads so as to safely limit motion, along any axis, of any part of the occupant s body relative to (1) any other part of the occupant s body, (2) the spacecraft or other vehicle, and (3) the seat itself. In the original Orion spacecraft application and in other applications that could easily be envisioned, the problem is complicated by severe limits on space available for the seat, a requirement to enable rapid egress by the occupant after a crash, and a requirement to provide for fitting of the seat to a wide range of sizes and shapes of a human body covered by a crash suit, space suit, or other protective garment. The problem is further complicated by other Orion-application-specific requirements that must be omitted here for the sake of brevity. To accommodate the wide range of crewmember body lengths within the limits on available space in the original Orion application, the design provides for taller crewmembers to pull their legs back closer toward their chests, while shorter crewmembers can allow their legs to stretch out further. The range of hip-support seat adjustments needed to effect this accommodation, as derived from NASA s Human Systems Integration Standard, was found to define a parabolic path along which the knees

  3. Patient Protection and Affordable Care Act

    THOMAS, 111th Congress

    Rep. Rangel, Charles B. [D-NY-15

    2009-09-17

    03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

  4. New affordable options for infrastructure and asset protection

    SciTech Connect

    2009-09-15

    Securitas is one of the leaders evolving with technology and delivering new forms of affordable security for mining facilities. It was called in to protect a large mothballed coal mine in the central USA, the victim of repeated thefts. First, Mobile Surveillance Units (MSUs) were installed but thefts continued. Later, a new wireless video security system called Videofied which used MotionViewers which use infrared detectors to detect movement and send a 10 second clip of the intrusion to an operator. This led to the thieves being caught. 2 photos.

  5. 77 FR 31513 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-29

    ... HUMAN SERVICES 45 CFR Parts 155, 156, and 157 RIN 0938-AQ67 Patient Protection and Affordable Care Act... Federal Register on March 27, 2012, entitled ``Patient Protection and Affordable Care Act; Establishment... rule regarding the codification of section 1413(c) of the Affordable Care Act. To align the...

  6. 16 CFR 1061.8 - Information on the heightened degree of protection afforded.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... protection afforded. 1061.8 Section 1061.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL APPLICATIONS FOR EXEMPTION FROM PREEMPTION § 1061.8 Information on the heightened degree of protection afforded... State or local requirement provides a significantly higher degree of protection from the risk of...

  7. Paper-Thin Coating Offers Maximum Protection

    NASA Technical Reports Server (NTRS)

    2001-01-01

    Wessex Incorporated has recently taken a technology that was originally developed for NASA as a protective coating for ceramic materials used in heatshields for space vehicles, and modified it for use in applications such as building materials, machinery, and transportation. The technology, developed at NASA Ames Research Center as a protective coating for flexible ceramic composites (PCC), is environmentally safe, water-based, and contains no solvents. Many other flame-retardant materials contain petroleum-based components, which can produce toxic smoke under flame. Wessex versions of PCC can be used to shield ceramics, wood, plasterboard, steel, plastics, fiberglass, and other materials from catastrophic fires. They are extraordinarily tough and exhibit excellent resistance to thermal shock, vibration, abrasion, and mechanical damage. One thin layer of coating provides necessary protection and allows for flexibility while avoiding excessive weight disadvantages. The coating essentially reduces the likelihood of the underlying material becoming so hot that it combusts and thus inhibits the "flashover" phenomenon from occurring.

  8. Learning to throw to maximum distances: do changes in release angle and speed reflect affordances for throwing?

    PubMed

    Zhu, Qin; Dapena, Jesus; Bingham, Geoffrey P

    2009-12-01

    Bingham, Schmidt, and Rosenblum (Bingham, G. P., Schmidt, R. C., & Rosenblum, L. D. (1989). Hefting for a maximum distance throw: A smart perceptual mechanism. Journal of Experimental Psychology: Human Perception and Performance, 15, 507-528) found that skilled throwers could heft objects and select the weight in each size that they could throw to a maximum distance. Bingham et al. hypothesized that this affordance affects hefting and throwing in the same way so that hefting provides a window on throwing. Zhu and Bingham (Zhu, Q., & Bingham, G. P. (submitted for publication). Learning to perceive the affordance for long distance throwing: Smart mechanism or function learning? Journal of Experimental Psychology: Human Perception and Performance) found that unskilled throwers could not perceive this affordance, but they acquired the ability to perceive it as they acquired skill at throwing. The affordance property consists of a relation between object size and weight. We now investigated whether object size and weight come to affect throwing as it is learned and if so, how? Three groups of unskilled adults practiced throwing for a month, each with a different set of objects: constant size, constant weight, or constant density. Release angle and speed became more consistent as distances of throws improved, but only speeds exhibited mean changes. Object weight affected mean release speeds, following a power law, as found by Cross (Cross, R. (2004). Physics of overarm throwing. American Journal of Physics, 72, 305-312). Speeds decreased as weight increased. These findings showed that the affordance was not reflected directly in throwing performance and the hypothesis of Bingham et al. (1989) about how the affordance is perceived was not supported. An alternative account is now proposed.

  9. Patient Protection and Affordable Care Act; establishment of the multi-state plan program for the Affordable Insurance Exchanges.

    PubMed

    2013-03-11

    The U.S. Office of Personnel Management (OPM) is issuing a final regulation establishing the Multi-State Plan Program (MSPP) pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will offer at least two multi-State plans (MSPs) on each of the Affordable Insurance Exchanges (Exchanges). One of the issuers must be non-profit. Under the law, an MSPP issuer may phase in the States in which it offers coverage over 4 years, but it must offer MSPs on Exchanges in all States and the District of Columbia by the fourth year in which the MSPP issuer participates in the MSPP. This rule aims to balance adhering to the statutory goals of MSPP while aligning its standards to those applying to qualified health plans to promote a level playing field across health plans.

  10. 78 FR 25591 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-02

    ... MANAGEMENT 45 CFR Part 800 RIN 3206-AM47 Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges; Correction AGENCY: U.S. Office of... Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

  11. Bioassay of thermal protection afforded by candidate flight suit fabrics.

    PubMed

    Knox, F S; Wachtel, T L; McCahan, G R

    1979-10-01

    The United States Army Aeromedical Research Laboratory (USAARL) porcine cutaneous bioassay technique was used to determine what mitigating effect four thermally protective flight suit fabrics would have on fire-induced skin damage. The fabrics were 4.8-ox twill weave Nomex aramide, 4.5-oz stabilized twill weave polybenzimidazole, 4.8-oz plain weave experimental high-temperature polymer (HT4), and 4.8-oz plain weave Nomex aramide (New Weave Nomex or NWN). Each fabric sample was assayed 20 times in each of four configurations: as a single layer in contact with the skin; as a single layer with a 6.35 mm (0.25 in) air gap between fabric and skin; in conjuction with a cotton T-shirt with no air gaps; and, finally, in conjuction with a T-shirt with a 6.35 mm air gap between T-shirt and fabric. Bare skin was used as a control. A JP-4 fueled furnace was used as a thermal source and was adjested to deliver a mean heat flux of 3.07 cal/cm2/s. The duration of exposure was 5 s. Four hundred burn sites were graded using clinical observation and microscopic techniques. Used as single layers, none of the fabrics demonstrated superiority in providing clinically significant protection. When used with a cotton T-shirt, protection was improved. Protection improved progressively for all fabrics and configuration when an air gap was introduced. The experimental high-temperature polymer consistently demonstrated lower heat flux transmission in all configurations, but did not significantly reduce clinical burns. PMID:518445

  12. 76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...

  13. 78 FR 66653 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-06

    ...-04902 (78 FR 15410), the final rule entitled, ``Patient Protection and Affordable Care Act; HHS Notice... Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014''. This correcting amendment... section reference to the Affordable Care Act. On page 15495, in our discussion of estimating the value...

  14. 78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-12

    ... MANAGEMENT Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the... Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges... Act of 2008; Technical Amendment to External Review for Multi-State Plan Program'' (78 FR 68240)....

  15. 78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-30

    ... Programs, and Market Standards'' (78 FR 37032), which was published in the Federal Register on June 19... Federal Register on March 11, 2013 (78 FR 15541), related to risk corridors and cost-sharing reduction..., 77 FR 18310 (March 27, 2012). \\2\\ Patient Protection and Affordable Care Act; Standards Related...

  16. 78 FR 37031 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ... Qualified Health Plans; Exchange Standards for Employers, 77 FR 18310 (March 27, 2012). \\2\\ Patient... FR 17220 (March 23. 2012). \\3\\ Patient Protection and Affordable Care Act; HHS Notice of Benefit and..., 78 FR 15410 and 15541 (Mar. 11, 2013). Table of Contents I. Background A. Legislative Overview...

  17. 77 FR 28790 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-16

    ... Patient Protection and Affordable Care Act (75 FR 34538) published on June 17, 2010, it was estimated that... on May 5, 2010 (75 FR 24470) relating to the Federal health care reform insurance Web Portal... Federal Register on April 14, 2010 (75 FR 19297). On December 1, 2010, the Department of Health and...

  18. 78 FR 42823 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-17

    ... CHIP, and Medicaid Premiums and Cost Sharing, 78 FR 4594 (proposed Jan. 22, 2013). \\2\\ Patient... Personnel, 78 FR 20581 (proposed April 5, 2013). A. Introduction The Patient Protection and Affordable Care... Exchange). States may also assume both of these types of responsibilities. \\3\\ See 77 FR 18310,...

  19. The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement

    ERIC Educational Resources Information Center

    Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…

  20. 16 CFR 1061.8 - Information on the heightened degree of protection afforded.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Information on the heightened degree of protection afforded. 1061.8 Section 1061.8 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION GENERAL... comparing available test results for the Commission statute, standard, or regulation and the State or...

  1. Women’s Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act

    PubMed Central

    Mitchell, Julie L.; Velott, Diana L.; Legro, Richard S.; Lehman, Erik B.; Confer, Lindsay; Weisman, Carol S.

    2015-01-01

    The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration–approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential. PMID:26447910

  2. Women's Awareness of Their Contraceptive Benefits Under the Patient Protection and Affordable Care Act.

    PubMed

    Chuang, Cynthia H; Mitchell, Julie L; Velott, Diana L; Legro, Richard S; Lehman, Erik B; Confer, Lindsay; Weisman, Carol S

    2015-11-01

    The Patient Protection and Affordable Care Act mandates that there be no out-of-pocket cost for Food and Drug Administration-approved contraceptive methods. Among 987 privately insured reproductive aged Pennsylvania women, fewer than 5% were aware that their insurance covered tubal sterilization, and only 11% were aware that they had full coverage for an intrauterine device. For the Affordable Care Act contraceptive coverage mandate to affect effective contraception use and reduce unintended pregnancies, public awareness of the expanded benefits is essential.

  3. Protecting the Student: A Critique of the Procedural Protection Afforded to American and English Students in University Disciplinary Hearings.

    ERIC Educational Resources Information Center

    Saurack, Walter

    1995-01-01

    This paper argues that natural justice principles animating English procedural law and due process jurisprudence playing the same role in American law should be interpreted to protect the intrinsic values associated with fair disciplinary hearing. This approach demands that college students facing expulsion or suspension be afforded an impartial…

  4. The Patient Protection and Affordable Care Act: opportunities for prevention and public health.

    PubMed

    Shaw, Frederic E; Asomugha, Chisara N; Conway, Patrick H; Rein, Andrew S

    2014-07-01

    The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.

  5. The Patient Protection and Affordable Care Act - The Role of the School Nurse: Position Statement.

    PubMed

    2015-07-01

    It is the position of the National Association of School Nurses that the registered professional school nurse (hereinafter referred to as the school nurse) serves a vital role in the delivery of health care to our nation’s students within the health care system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as the Affordable Care Act (ACA). This law presents an opportunity to transform the health care system through three primary goals: expanding access, improving quality, and reducing cost (U.S. Government Printing Office, 2010). School nurses stand at the forefront of this system change and continue to provide evidence-based, quality interventions and preventive care that, according to recent studies, actually save health care dollars (Wang et al., 2014). NASN supports the concept that school nursing services receive the same financial parity as other health care providers to improve overall health outcomes, including insurance reimbursement for services provided to students. PMID:25926418

  6. How the Patient Protection and Affordable Care Act affects Texas dentists.

    PubMed

    Oneacre, Lee P

    2012-10-01

    President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law March 23, 2010 (P.L. 111-148), as arguably the most significant legislative health reform since the creation of Medicare and Medicaid in 1965 (1). Several PPACA provisions will impact dentists as both health care providers and small business owners and employers (2). Overall, the law significantly changes health care financing and facilitates competition in the health insurance market place through the creation of health insurance exchanges (HIX). PMID:23311030

  7. Implementing the Patient Protection and Affordable Care Act: the time is now.

    PubMed

    Wojcik, Steven E

    2013-01-01

    Employers all across the country should be in full swing as they prepare to implement the tougher parts of the Patient Protection and Affordable Care Act's (ACA) employer provisions, which are about to come online and take effect in 2014. This article reviews these more challenging requirements and their complications, including how employer calculations over whether to continue to offer coverage might vary by industry characteristics. The author then looks further ahead to the "Cadillac" tax and discusses how this liability may affect every employer's decision about its health care strategy leading up to 2018. PMID:23943954

  8. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.

    PubMed

    Quadagno, Jill

    2014-02-01

    On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible.

  9. Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.

    PubMed

    Quadagno, Jill

    2014-02-01

    On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible. PMID:24193605

  10. The Patient Protection and Affordable Care Act: what every provider of gynecologic oncology care should know.

    PubMed

    Duska, Linda R; Engelhard, Carolyn L

    2013-06-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, affordable, and comprehensive across different parts of the country. For our cancer patients and our practices, the ACA has implications that are both positive and negative. The Medicaid expansion and access to insurance exchanges are intended to increase the number of insured patients and thus improve access to care, but many states have decided to opt out of the Medicaid program and in these states access problems will persist. Screening programs will be put in place for insured patients but may supplant federally funded programs that are currently in place for uninsured patients and may not follow current screening guidelines. Both hospice and home health providers will be asked to provide more services with less funding, and quality measures, including readmission rates, will factor into reimbursement. Insured patients will have access to all phases of clinical trial research. There is a need for us as providers of Gynecologic Oncology care to be active in the implementation of the ACA in order to ensure that our patients and our practices can survive and benefit from the changes in health care reimbursement, with the ultimate goals of improving access to care and quality while reducing unsustainable costs. PMID:23500090

  11. Post-acute care and vertical integration after the Patient Protection and Affordable Care Act.

    PubMed

    Shay, Patrick D; Mick, Stephen S

    2013-01-01

    The anticipated changes resulting from the passage of the Patient Protection and Affordable Care Act-including the proposed adoption of bundled payment systems and the promotion of accountable care organizations-have generated considerable controversy as U.S. healthcare industry observers debate whether such changes will motivate vertical integration activity. Using examples of accountable care organizations and bundled payment systems in the American post-acute healthcare sector, this article applies economic and sociological perspectives from organization theory to predict that as acute care organizations vary in the degree to which they experience environmental uncertainty, asset specificity, and network embeddedness, their motivation to integrate post-acute care services will also vary, resulting in a spectrum of integrative behavior.

  12. The Patient Protection and Affordable Care Act of 2010: impact on otolaryngology practice and research.

    PubMed

    Sun, Gordon H; Davis, Matthew M

    2012-05-01

    The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Barack Obama on March 23, 2010. Since its passage, the PPACA has led to increased health insurance coverage for millions more Americans, and it includes provisions leading to new avenues for clinical and health services research funding. The legislation also favors development of the primary care specialties and general surgery, increased training of midlevel health care providers, and medical training and service in underserved areas of the United States. However, the PPACA does not effectively engage otolaryngologists in quality improvement, despite modifications to the Physician Quality Reporting System. The legislation also levies a tax on cosmetic procedures, affecting both clinicians and patients. This article reviews the sections of the PPACA that are most pertinent to otolaryngologists and explains how these components of the bill will affect otolaryngologic practice and research over the coming decade. PMID:22282865

  13. The Patient Protection and Affordable Care Act and Reproductive Health: Harnessing Data to Improve Care

    PubMed Central

    Stulberg, Debra

    2013-01-01

    The Patient Protection and Affordable Care Act (PPACA) has great potential to improve reproductive health through several components: expanded coverage of people of reproductive age; required coverage of many reproductive health services; and insurance exchange structures that encourage individuals and states to hold plans and providers accountable. These components can work together to improve reproductive health. But in order for this to work, consumers and states need information with which to assess plans. This review article summarizes state contracting theory and argues that states should use this structure to require health plans to collect and report meaningful data that patients, providers, plans, payers, and third-party researchers can access. Now that the Supreme Court has upheld the PPACA and states must set up health insurance exchanges, populations can benefit from improved care and outcomes through data transparency. PMID:23262767

  14. Chemical induction of cellular antioxidants affords marked protection against oxidative injury in vascular smooth muscle cells.

    PubMed

    Cao, Zhuoxiao; Li, Yunbo

    2002-03-22

    Extensive evidence suggests that reactive oxygen species are critically involved in the pathogenesis of cardiovascular diseases, such as atherosclerosis and myocardial ischemia-reperfusion injury. Consistent with this concept, administration of exogenous antioxidants has been shown to be protective against oxidative cardiovascular injury. However, whether induction of endogenous antioxidants by chemical inducers in vasculature also affords protection against oxidative vascular cell injury has not been extensively investigated. In this study, using rat aortic smooth muscle A10 cells as an in vitro system, we have studied the induction of cellular antioxidants by the unique chemoprotector, 3H-1,2-dithiole-3-thione [corrected] (D3T) and the protective effects of the D3T-induced cellular antioxidants against oxidative cell injury. Incubation of A10 cells with micromolar concentrations of D3T for 24 h resulted in a significant induction of a battery of cellular antioxidants in a concentration-dependent manner. These included reduced glutathione (GSH), GSH peroxidase, GSSG reductase, GSH S-transferase, superoxide dismutase, and catalase. To further examine the protective effects of the induced endogenous antioxidants against oxidative cell injury, A10 cells were pretreated with D3T and then exposed to either xanthine oxidase (XO)/xanthine, 4-hydroxynonenal, or cadmium. We observed that D3T pretreatment of A10 cells led to significant protection against the cytotoxicity induced by XO/xanthine, 4-hydroxynonenal or cadmium, as determined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium reduction assay. Taken together, this study demonstrates for the first time that a number of endogenous antioxidants in vascular smooth muscle cells can be induced by exposure to D3T, and that this chemical induction of cellular antioxidants is accompanied by markedly increased resistance to oxidative vascular cell injury.

  15. The Patient Protection and Affordable Care Act's Effect on Emergency Medicine: A Synthesis of the Data.

    PubMed

    Medford-Davis, Laura N; Eswaran, Vidya; Shah, Rohan M; Dark, Cedric

    2015-11-01

    This review synthesizes the existing literature to provide evidence-based predictions for the future of emergency care in the United States as a result of the Patient Protection and Affordable Care Act, with a focus on emergency department (ED) visit volume, acuity, and reimbursement. Patient behavior will likely be quite different for patients gaining Medicaid than for those gaining private insurance through the Marketplaces. Despite the threat of the individual mandate, not all uninsured patients will enroll, and those who choose to enroll will likely be a different population from those who remain uninsured. New Medicaid enrollees will be a sicker population and will likely increase their number of ED visits substantially. Their acuity will be higher at first but will then revert to the traditionally high number of low-acuity visits made by Medicaid patients. Most patients enrolling through the Marketplace are choosing high-deductible health plans, and they will initially avoid the ED because of high out-of-pocket costs but may present later and sicker after self-rationing their care. Most patients gaining health coverage through the Affordable Care Act will be shifting from uninsured to either Medicaid or private insurance, both of which reimburse more than self-pay, so ED collections should increase. Because of the differences between Medicaid and Marketplace plans, there will be a difference in ED volume, acuity, and financial outcomes, depending on states' current demographics, whether states expand Medicaid, and how aggressively states advertise new options for coverage in Medicaid or state health insurance Marketplaces. PMID:25976250

  16. The Patient Protection and Affordable Care Act's Effect on Emergency Medicine: A Synthesis of the Data.

    PubMed

    Medford-Davis, Laura N; Eswaran, Vidya; Shah, Rohan M; Dark, Cedric

    2015-11-01

    This review synthesizes the existing literature to provide evidence-based predictions for the future of emergency care in the United States as a result of the Patient Protection and Affordable Care Act, with a focus on emergency department (ED) visit volume, acuity, and reimbursement. Patient behavior will likely be quite different for patients gaining Medicaid than for those gaining private insurance through the Marketplaces. Despite the threat of the individual mandate, not all uninsured patients will enroll, and those who choose to enroll will likely be a different population from those who remain uninsured. New Medicaid enrollees will be a sicker population and will likely increase their number of ED visits substantially. Their acuity will be higher at first but will then revert to the traditionally high number of low-acuity visits made by Medicaid patients. Most patients enrolling through the Marketplace are choosing high-deductible health plans, and they will initially avoid the ED because of high out-of-pocket costs but may present later and sicker after self-rationing their care. Most patients gaining health coverage through the Affordable Care Act will be shifting from uninsured to either Medicaid or private insurance, both of which reimburse more than self-pay, so ED collections should increase. Because of the differences between Medicaid and Marketplace plans, there will be a difference in ED volume, acuity, and financial outcomes, depending on states' current demographics, whether states expand Medicaid, and how aggressively states advertise new options for coverage in Medicaid or state health insurance Marketplaces.

  17. Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

    PubMed

    Strong, Jessica; Hanson, Carl L; Magnusson, Brianna; Neiger, Brad

    2016-03-01

    The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted. PMID:26272884

  18. The Patient Protection and Affordable Care Act: The Impact on Urologic Cancer Care

    PubMed Central

    Keegan, Kirk A.; Penson, David F.

    2012-01-01

    In March 2010, the Patient Protection and Affordable Care Act as well as its amendments were signed into law. This sweeping legislation was aimed at controlling spiraling healthcare costs and redressing significant disparities in healthcare access and quality. Cancer diagnoses and their treatments constitute a large component of rising healthcare expenditures and, not surprisingly, the legislation will have a significant influence on cancer care in the United States. Because genitourinary malignancies represent an impressive 25% of all cancer diagnoses per year, this legislation could have a profound impact on urologic oncology. To this end, we will present key components of this landmark legislation, including the proposed expansion to Medicaid coverage, the projected role of Accountable Care Organizations, the expected creation of quality reporting systems, the formation of an independent Patient-Centered Outcomes Research Institute, and enhanced regulation on physician-owned practices. We will specifically address the anticipated effect of these changes on urological cancer care. Briefly, the legal ramifications and current barriers to the statutes will be examined. PMID:22819697

  19. Health Education Specialists' Knowledge, Attitudes, and Perceptions of the Patient Protection and Affordable Care Act.

    PubMed

    Strong, Jessica; Hanson, Carl L; Magnusson, Brianna; Neiger, Brad

    2016-03-01

    The changing landscape of health care as a result of the Patient Protection and Affordable Care Act (ACA) may provide new opportunities for health education specialists (HES). The purpose of this study was to survey HES in the United States on their knowledge and attitudes of the ACA and assess their perceptions of job growth under the law. A random sample of 220 (36% response rate) certified HES completed a 53-item cross sectional survey administered online through Qualtrics. Findings were compared to public opinion on health care reform. HES are highly favorable of the law (70%) compared to the general public (23%). A total of 85% of respondents were able to list a provision of the ACA, and most (81%) thought the ACA would be successful at increasing insured Americans. Over half (64.6%) believe job opportunities will increase. Those who viewed the law favorably were significantly more likely to score better on a knowledge scale related to the ACA. HES understand publicized provisions but are uncertain about common myths and specific provisions related to Title IV, "Prevention of Chronic Disease and Improving Public Health." Directed and continuing education to HES regarding the ACA is warranted.

  20. Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act

    PubMed Central

    Abdus, Salam; Mistry, Kamila B.

    2015-01-01

    Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920

  1. Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists.

    PubMed

    Manchikanti, Laxmaiah; Hirsch, Joshua A

    2012-03-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law on 23 March 2010. It represents the most significant transformation of the American healthcare system since Medicare and Medicaid. Essentials of ACA include: (1) a mandate for individuals and businesses requiring as a matter of law that nearly every American has an approved level of health insurance or pay a penalty; (2) a system of federal subsidies to completely or partially pay for the now required health insurance for ∼34 million Americans who are currently uninsured-subsidized through Medicaid and Exchanges; (3) extensive new requirements on the health insurance industry and (4) changes in the practice of medicine. The Act is divided into 10 titles. It contains provisions that went into effect starting on 21 June 2010 with many of the provisions going into effect in 2014 and later. The ACA goes well beyond insurance and payment reform. Practicing physicians will potentially be impacted by the Independent Payment Advisory Board and the Patient Centered Outcomes Research Institute. PMID:21990501

  2. Protection against Acute Hepatocellular Injury Afforded by Liver Fibrosis Is Independent of T Lymphocytes

    PubMed Central

    Lacoste, Benoit; Raymond, Valérie-Ann; Lapierre, Pascal; Bilodeau, Marc

    2016-01-01

    Collagen produced during the process of liver fibrosis can induce a hepatocellular protective response through ERK1 signalling. However, the influence of T cells and associated cytokine production on this protection is unknown. In addition, athymic mice are frequently used in hepatocellular carcinoma xenograft experiments but current methods limit our ability to study the impact of liver fibrosis in this setting due to high mortality. Therefore, a mouse model of liver fibrosis lacking T cells was developed using Foxn1 nu/nu mice and progressive oral administration of thioacetamide (TAA) [0.01–0.02%] in drinking water. Fibrosis developed over a period of 16 weeks (alpha-SMA positive area: 20.0 ± 2.2%, preCol1a1 mRNA expression: 11.7 ± 4.1 fold changes, hydroxyproline content: 1041.2 ± 77μg/g of liver) at levels comparable to that of BALB/c mice that received intraperitoneal TAA injections [200 μg/g of body weight (bw)] (alpha-SMA positive area: 20.9 ± 2.9%, preCol1a1 mRNA expression: 13.1 ± 2.3 fold changes, hydroxyproline content: 931.6 ± 14.8μg/g of liver). No mortality was observed. Athymic mice showed phosphorylation of ERK1/2 during fibrogenesis (control 0.03 ± 0.01 vs 16 weeks 0.22 ± 0.06AU; P<0.05). The fibrosis-induced hepatoprotection against cytotoxic agents, as assessed histologically and by serum AST levels, was not affected by the absence of circulating T cells (anti-Fas JO2 [0.5μg/g bw] for 6h (fibrotic 4665 ± 2596 vs non-fibrotic 13953 ± 2260 U/L; P<0.05), APAP [750 mg/kg bw] for 6 hours (fibrotic 292 ± 66 U/L vs non-fibrotic 4086 ± 2205; P<0.01) and CCl4 [0.5mL/Kg bw] for 24h (fibrotic 888 ± 268 vs non-fibrotic 15673 ± 2782 U/L; P<0.001)). In conclusion, liver fibrosis can be induced in athymic Foxn1 nu/nu mice without early mortality. Liver fibrosis leads to ERK1/2 phosphorylation. Finally, circulating T lymphocytes and associated cytokines are not involved in the hepatocellular protection afforded by liver fibrosis. PMID

  3. 78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    .... HHS Audit Authority (Sec. 156.606) e. Eligibility for Minimum Essential Coverage III. Collection of...; Exchange Standards for Employers'' (77 FR 18309). The provisions of the final rule, herein referred to as... affordability programs. We note that we expect to modify the proposed language in Sec. 155.227 (78 FR 4711)...

  4. 78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ... a State Consumer Partnership Exchange (Consumer Partnership Exchange). \\1\\ See 77 FR 18310, 18325-26... 27, 2012 (77 FR 18310), and is codified at 45 CFR Sec. 155.210. Section 1311(i)(3) of the Affordable... Eligibility and Enrollment for Exchanges, Medicaid and CHIP, and Medicaid Premiums and Cost Sharing, 78...

  5. The Patient Protection and Affordable Care Act: A Primer for Hand Surgeons

    PubMed Central

    Adkinson, Joshua M.; Chung, Kevin C.

    2014-01-01

    The Affordable Care Act is the largest and most comprehensive overhaul of the United States healthcare industry since the inception of the Medicare and Medicaid. Contained within the 10 Titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals. PMID:25066853

  6. The patient protection and Affordable Care Act: a primer for hand surgeons.

    PubMed

    Adkinson, Joshua M; Chung, Kevin C

    2014-08-01

    The Affordable Care Act is the largest and most comprehensive overhaul of the United States health care industry since the inception of the Medicare and Medicaid. Contained within the 10 titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals.

  7. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; exchange standards for employers. Final rule, Interim final rule.

    PubMed

    2012-03-27

    This final rule will implement the new Affordable Insurance Exchanges ("Exchanges"), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors. The Exchanges, which will become operational by January 1, 2014, will help enhance competition in the health insurance market, improve choice of affordable health insurance, and give small businesses the same purchasing clout as large businesses.

  8. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; exchange standards for employers. Final rule, Interim final rule.

    PubMed

    2012-03-27

    This final rule will implement the new Affordable Insurance Exchanges ("Exchanges"), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly compare available private health insurance options on the basis of price, quality, and other factors. The Exchanges, which will become operational by January 1, 2014, will help enhance competition in the health insurance market, improve choice of affordable health insurance, and give small businesses the same purchasing clout as large businesses. PMID:22479737

  9. A Healthy New World: Emergent Opportunities for Clinical Psychologists in the Patient Protection and Affordable Care Act

    PubMed Central

    Beidas, Rinad S.; Manderscheid, Ronald W.

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) is radically transforming the health and mental health care landscape. Emergent opportunities exist for clinical psychologists to redefine their role in healthcare. We reflect on the Chor and colleagues article (this issue) elucidating key issues for psychologists, and present additional recommendations for consideration. Specifically, we highlight three points: (1) moving beyond just training and hoping; (2) recovery, not just symptom reduction; and (3) it’s a healthy new world. Under each of these points, we suggest tactics for how to achieve these goals. PMID:24954983

  10. 30 CFR 75.601-3 - Short circuit protection; dual element fuses; current ratings; maximum values.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Short circuit protection; dual element fuses... Trailing Cables § 75.601-3 Short circuit protection; dual element fuses; current ratings; maximum values. Dual element fuses having adequate current-interrupting capacity shall meet the requirements for...

  11. 30 CFR 75.601-3 - Short circuit protection; dual element fuses; current ratings; maximum values.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Short circuit protection; dual element fuses... Trailing Cables § 75.601-3 Short circuit protection; dual element fuses; current ratings; maximum values. Dual element fuses having adequate current-interrupting capacity shall meet the requirements for...

  12. Plastic surgery practice models and research aims under the Patient Protection and Affordable Care Act.

    PubMed

    Giladi, Aviram M; Yuan, Frank; Chung, Kevin C

    2015-02-01

    As the health care landscape in the United States changes under the Affordable Care Act, providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the health care funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes to dictate adequate compensation in the future. In this article, the authors discuss bundle payments and accountable care organizations, and how plastic surgeons might best engage in these new system designs. In addition, the authors review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty.

  13. Biochemical analysis of plant protection afforded by a nonpathogenic endophytic mutant of Colletotrichum magna

    SciTech Connect

    Redman, R.S.; Rodriguez, R.J. Univ. of Washington, Seattle, WA . Dept. of Botany); Clifton, D.R.; Morrel, J.; Brown, G. ); Freeman, S. . Dept. of Plant Pathology)

    1999-02-01

    A nonpathogenic mutant of Colletotrichum magna (path-1) was previously shown to protect watermelon (Citrullus lanatus) and cucumber (Cucumis sativus) seedlings from anthracnose disease elicited by wild-type C. magna. Disease protection was observed in stems of path-1-colonized cucurbits but not in cotyledons, indicating that path-1 conferred tissue-specific and/or localized protection. Plant biochemical indicators of a localized and systemic (peroxidase, phenylalanine ammonia-lyase, lignin, and salicylic acid) plant-defense response were investigated in anthracnose-resistant and-susceptible cultivars of cucurbit seedlings exposed to four treatments: (1) water (control), (2) path-1 conidia, (3) wild-type conidia, and (4) challenge conditions (inoculation into path-1 conidia for 48 h and then exposure to wild-type conidia). Collectively, these analyses indicated that disease protection in path-1-colonized plants was correlated with the ability of these plants to mount a defense response more rapidly and to equal or greater levels than plants exposed to wild-type C. magna alone. Watermelon plants colonized with path-1 were also protected against disease caused by Colletotrichum orbiculare and Fusarium oxysporum. A model based on the kinetics of plant-defense activation is presented to explain the mechanism of path-1-conferred disease protection.

  14. Biochemical analysis of plant protection afforded by a nonpathogenic endophytic mutant of Colletotrichum magna

    USGS Publications Warehouse

    Redman, R.S.; Freeman, S.; Clifton, D.R.; Morrel, J.; Brown, G.; Rodriguez, R.J.

    1999-01-01

    A nonpathogenic mutant of Colletotrichum magna (path-1) was previously shown to protect watermelon (Citrullus lanatus) and cucumber (Cucumis sativus) seedlings from anthracnose disease elicited by wild-type C. magna. Disease protection was observed in stems of path-1-colonized cucurbits but not in cotyledons, indicating that path-1 conferred tissue-specific and/or localized protection. Plant biochemical indicators of a localized and systemic (peroxidase, phenylalanine ammonia-lyase, lignin, and salicylic acid) 'plant-defense' response were investigated in anthracnose-resistant and -susceptible cultivars of cucurbit seedlings exposed to four treatments: (1) water (control), (2) path-1 conidia, (3) wild-type conidia, and (4) challenge conditions (inoculation into path-1 conidia for 48 h and then exposure to wild-type conidia). Collectively, these analyses indicated that disease protection in path-1 colonized plants was correlated with the ability of these plants to mount a defense response more rapidly and to equal or greater levels than plants exposed to wild-type C. magna alone. Watermelon plants colonized with path-1 were also protected against disease caused by Colletotrichum orbiculare and Fusarium oxysporum. A model based on the kinetics of plant-defense activation is presented to explain the mechanism of path-1-conferred disease protection.

  15. The tertiary structure of the four-way DNA junction affords protection against DNase I cleavage.

    PubMed Central

    Murchie, A I; Carter, W A; Portugal, J; Lilley, D M

    1990-01-01

    The accessibility of phosphodiester bonds in the DNA of four-way helical junctions has been probed with the nuclease DNase I. Regions of protection were observed on all four strands of the junctions, that tended to be longer on the strands that are exchanged between the coaxially stacked pairs of helices. The protected regions on the continuous strands of the stacked helices were not located exactly at the junction, but were displaced towards the 3' side of the strand. This is the region of backbone that becomes located in the major groove of the opposed helix in the non-crossed, right-handed structure for the junction, and might therefore be predicted to be protected against cleavage by an enzyme. However, the major grooves of the structure remain accessible to the much smaller probe dimethyl sulphate. Images PMID:2339051

  16. Patient Protection and Affordable Care Act; exchange and insurance market standards for 2015 and beyond. Final rule.

    PubMed

    2014-05-27

    This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (``Exchanges''), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio

  17. Env-Expressing Autologous T Lymphocytes Induce Neutralizing Antibody and Afford Marked Protection against Feline Immunodeficiency Virus ▿

    PubMed Central

    Pistello, Mauro; Bonci, Francesca; Zabogli, Elisa; Conti, Francesca; Freer, Giulia; Maggi, Fabrizio; Stevenson, Mario; Bendinelli, Mauro

    2010-01-01

    The envelope (Env) glycoproteins of HIV and other lentiviruses possess neutralization and other protective epitopes, yet all attempts to induce protective immunity using Env as the only immunogen have either failed or afforded minimal levels of protection. In a novel prime-boost approach, specific-pathogen-free cats were primed with a plasmid expressing Env of feline immunodeficiency virus (FIV) and feline granulocyte-macrophage colony-stimulating factor and then boosted with their own T lymphocytes transduced ex vivo to produce the same Env and interleukin 15 (3 × 106 to 10 × 106 viable cells/cat). After the boost, the vaccinees developed elevated immune responses, including virus-neutralizing antibodies (NA). Challenge with an ex vivo preparation of FIV readily infected all eight control cats (four mock vaccinated and four naïve) and produced a marked decline in the proportion of peripheral CD4 T cells. In contrast, five of seven vaccinees showed little or no traces of infection, and the remaining two had reduced viral loads and underwent no changes in proportions of CD4 T cells. Interestingly, the viral loads of the vaccinees were inversely correlated to the titers of NA. The findings support the concept that Env is a valuable immunogen but needs to be administered in a way that permits the expression of its full protective potential. PMID:20130057

  18. High School Youth and Suicide Risk: Exploring Protection Afforded through Physical Activity and Sport Participation

    ERIC Educational Resources Information Center

    Taliaferro, Lindsay A.; Rienzo, Barbara A.; Miller, M. David; Pigg, R. Morgan, Jr.; Dodd, Virginia J.

    2008-01-01

    Background: Suicide ranks as the third leading cause of death for adolescents. Recent data from the Centers for Disease Control and Prevention (CDC) indicate that the adolescent suicide rate increased 18% between 2003 and 2004. Sport may represent a promising protective factor against adolescent suicide. This study examined the relative risk of…

  19. Contribution of antibody production against neuraminidase to the protection afforded by influenza vaccines

    PubMed Central

    Marcelin, Glendie; Sandbulte, Matthew R.; Webby, Richard J.

    2012-01-01

    SUMMARY Vaccines are instrumental in controlling the burden of influenza virus infection in humans and animals. Antibodies raised against both major viral surface glycoproteins, hemagglutinin (HA) and neuraminidase (NA), can contribute to protective immunity. Vaccine-induced HA antibodies have been characterized extensively, and they generally confer protection by blocking the attachment and fusion of a homologous virus onto host cells. Though not as well characterized, some functions of NA antibodies in influenza vaccine-mediated immunity have been recognized for many years. In this review we summarize the case for NA antibodies in influenza vaccine-mediated immunity. In the absence of well-matched HA antibodies, NA antibodies can provide varying degrees of protection against disease. NA proteins of seasonal influenza vaccines have been shown in some instances to elicit serum antibodies with cross-reactivity to avian- and swine-origin influenza strains, in addition to HA drift variants. NA-mediated immunity has been linked to [i] conserved NA epitopes amongst otherwise antigenically distinct strains, partly attributable to the segmented influenza viral genome; [ii] inhibition of NA enzymatic activity; and [iii] the NA content in vaccine formulations. There is potential to enhance the effectiveness of existing and future influenza vaccines by focusing greater attention on the antigenic characteristics and potency of the NA protein. PMID:22438243

  20. Carnosic Acid Affords Mitochondrial Protection in Chlorpyrifos-Treated Sh-Sy5y Cells.

    PubMed

    de Oliveira, Marcos Roberto; Peres, Alessandra; Ferreira, Gustavo Costa; Schuck, Patrícia Fernanda; Bosco, Simone Morelo Dal

    2016-10-01

    Carnosic acid (CA; C20H28O4) is a phenolic diterpene found in rosemary (Rosmarinus officinalis L.) and exhibits protective properties, e.g., antioxidant, anti-inflammatory, antitumor, and antimicrobial activities. In this context, CA has been viewed as a neuroprotective agent due to its ability in rescuing neuronal cells from pro-oxidant and pro-apoptotic challenges. In the present work, we found that CA pretreatment at 1 µM for 12 h suppressed the mitochondria-related pro-oxidant and mitochondria-dependent pro-apoptotic effects of chlorpyrifos (CPF) in human neuroblastoma SH-SY5Y cells. CA prevented mitochondrial membrane potential disruption and decreased the levels of oxidative stress markers in mitochondrial membranes obtained from cells exposed to CPF. CA also inhibited cytochrome c release and activation of the caspases-9 and -3, as well as decreased DNA fragmentation, in CPF-treated cells. CA upregulated the content of glutathione (GSH) in mitochondria by a mechanism involving the activation of the phosphoinositide-3-kinase (PI3K)/Akt/nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway, since inhibition of PI3K/Akt or silencing of Nrf2 using siRNA strategy abolished the protection exerted by CA in SH-SY5Y cells. Therefore, CA protected mitochondria of SH-SY5Y cells through the activation of the PI3K/Akt/Nrf2 axis, causing upregulation of the mitochondrial GSH content and consequent antioxidant and anti-apoptotic effects. PMID:27083155

  1. 77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-05

    ... Care Act; Establishment of the Multi- State Plan Program for the Affordable Insurance Exchanges... Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance Exchanges AGENCY... Affordable Insurance Exchanges (Exchanges). Under the law, an MSPP issuer may phase in the States in which...

  2. In-tank shutoff valve is provided with maximum blast protection

    NASA Technical Reports Server (NTRS)

    Holden, C. F.

    1966-01-01

    In-tank shutoff valve is installed with the valve poppet and actuator inside the tank to provide maximum blast protection during rocket engine test operation. This valve design is applicable wherever explosive fuels are used and is currently being used in lox and liquid hydrogen tanks at a rocket engine test site.

  3. KCNMA1 Encoded Cardiac BK Channels Afford Protection against Ischemia-Reperfusion Injury

    PubMed Central

    Soltysinska, Ewa; Bentzen, Bo Hjorth; Barthmes, Maria; Hattel, Helle; Thrush, A. Brianne; Harper, Mary-Ellen; Qvortrup, Klaus; Larsen, Filip J.; Schiffer, Tomas A.; Losa-Reyna, Jose; Straubinger, Julia; Kniess, Angelina; Thomsen, Morten Bækgaard; Brüggemann, Andrea; Fenske, Stefanie; Biel, Martin; Ruth, Peter; Wahl-Schott, Christian

    2014-01-01

    Mitochondrial potassium channels have been implicated in myocardial protection mediated through pre-/postconditioning. Compounds that open the Ca2+- and voltage-activated potassium channel of big-conductance (BK) have a pre-conditioning-like effect on survival of cardiomyocytes after ischemia/reperfusion injury. Recently, mitochondrial BK channels (mitoBKs) in cardiomyocytes were implicated as infarct-limiting factors that derive directly from the KCNMA1 gene encoding for canonical BKs usually present at the plasma membrane of cells. However, some studies challenged these cardio-protective roles of mitoBKs. Herein, we present electrophysiological evidence for paxilline- and NS11021-sensitive BK-mediated currents of 190 pS conductance in mitoplasts from wild-type but not BK−/− cardiomyocytes. Transmission electron microscopy of BK−/− ventricular muscles fibres showed normal ultra-structures and matrix dimension, but oxidative phosphorylation capacities at normoxia and upon re-oxygenation after anoxia were significantly attenuated in BK−/− permeabilized cardiomyocytes. In the absence of BK, post-anoxic reactive oxygen species (ROS) production from cardiomyocyte mitochondria was elevated indicating that mitoBK fine-tune the oxidative state at hypoxia and re-oxygenation. Because ROS and the capacity of the myocardium for oxidative metabolism are important determinants of cellular survival, we tested BK−/− hearts for their response in an ex-vivo model of ischemia/reperfusion (I/R) injury. Infarct areas, coronary flow and heart rates were not different between wild-type and BK−/− hearts upon I/R injury in the absence of ischemic pre-conditioning (IP), but differed upon IP. While the area of infarction comprised 28±3% of the area at risk in wild-type, it was increased to 58±5% in BK−/− hearts suggesting that BK mediates the beneficial effects of IP. These findings suggest that cardiac BK channels are important for proper oxidative energy supply

  4. KCNMA1 encoded cardiac BK channels afford protection against ischemia-reperfusion injury.

    PubMed

    Soltysinska, Ewa; Bentzen, Bo Hjorth; Barthmes, Maria; Hattel, Helle; Thrush, A Brianne; Harper, Mary-Ellen; Qvortrup, Klaus; Larsen, Filip J; Schiffer, Tomas A; Losa-Reyna, Jose; Straubinger, Julia; Kniess, Angelina; Thomsen, Morten Bækgaard; Brüggemann, Andrea; Fenske, Stefanie; Biel, Martin; Ruth, Peter; Wahl-Schott, Christian; Boushel, Robert Christopher; Olesen, Søren-Peter; Lukowski, Robert

    2014-01-01

    Mitochondrial potassium channels have been implicated in myocardial protection mediated through pre-/postconditioning. Compounds that open the Ca2+- and voltage-activated potassium channel of big-conductance (BK) have a pre-conditioning-like effect on survival of cardiomyocytes after ischemia/reperfusion injury. Recently, mitochondrial BK channels (mitoBKs) in cardiomyocytes were implicated as infarct-limiting factors that derive directly from the KCNMA1 gene encoding for canonical BKs usually present at the plasma membrane of cells. However, some studies challenged these cardio-protective roles of mitoBKs. Herein, we present electrophysiological evidence for paxilline- and NS11021-sensitive BK-mediated currents of 190 pS conductance in mitoplasts from wild-type but not BK-/- cardiomyocytes. Transmission electron microscopy of BK-/- ventricular muscles fibres showed normal ultra-structures and matrix dimension, but oxidative phosphorylation capacities at normoxia and upon re-oxygenation after anoxia were significantly attenuated in BK-/- permeabilized cardiomyocytes. In the absence of BK, post-anoxic reactive oxygen species (ROS) production from cardiomyocyte mitochondria was elevated indicating that mitoBK fine-tune the oxidative state at hypoxia and re-oxygenation. Because ROS and the capacity of the myocardium for oxidative metabolism are important determinants of cellular survival, we tested BK-/- hearts for their response in an ex-vivo model of ischemia/reperfusion (I/R) injury. Infarct areas, coronary flow and heart rates were not different between wild-type and BK-/- hearts upon I/R injury in the absence of ischemic pre-conditioning (IP), but differed upon IP. While the area of infarction comprised 28±3% of the area at risk in wild-type, it was increased to 58±5% in BK-/- hearts suggesting that BK mediates the beneficial effects of IP. These findings suggest that cardiac BK channels are important for proper oxidative energy supply of cardiomyocytes at

  5. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.

    PubMed

    2012-02-15

    These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.

  6. Health insurance coverage in the Houston-Galveston area under the patient protection and affordable care act.

    PubMed

    Begley, Charles; Deshmukh, Ashish; Eschbach, Karl; Fouladi, Negin; Liu, Qian June; Reynolds, Thomas

    2012-11-01

    This study projects the number of nonelderly people who could gain coverage under the Patient Protection and Affordable Care Act (PPACA) for the period from 2014 through 2020 in the 13-county Houston-Galveston area region. The major PPACA provisions aimed at expanding coverage as well as the populations targeted by those provisions are described. Projections of the impact of PPACA on coverage in the area are based on estimates of growth in the size of targeted populations in each county and the anticipated responses of those populations to the major provisions of PPACA. The projections indicate that, if fully implemented, PPACA could cut the uninsurance rate in the region by half, from 26% in 2010 to 13% in 2020. This change translates into health insurance coverage for approximately 2 million additional people, from the current 4.2 million to a projected 5.9 million. The number of Medicaid enrollees could increase by an estimated 600,000 (a 79% increase), although private insurance coverage, which could increase by as much as 1 million enrollees (a 30% increase), will remain the primary source of coverage for most people. Coverage gains from PPACA will vary considerably by county, depending on the age-income-citizenship characteristics of the population, current uninsurance rates, and the rate of population growth.

  7. Keeping up with the Cadillacs: What Health Insurance Disparities, Moral Hazard, and the Cadillac Tax Mean to The Patient Protection and Affordable Care Act.

    PubMed

    Fletcher, Rebecca Adkins

    2016-03-01

    A major goal of The Patient Protection and Affordable Care Act is to broaden health care access through the extension of insurance coverage. However, little attention has been given to growing disparities in access to health care among the insured, as trends to reduce benefits and increase cost sharing (deductibles, co-pays) reduce affordability and access. Through a political economic perspective that critiques moral hazard, this article draws from ethnographic research with the United Steelworkers (USW) at a steel mill and the Retail, Wholesale and Department Store Union (RWDSU) at a food-processing plant in urban Central Appalachia. In so doing, this article describes difficulties of health care affordability on the eve of reform for differentially insured working families with employer-sponsored health insurance. Additionally, this article argues that the proposed Cadillac tax on high-cost health plans will increase problems with appropriate health care access and medical financial burden for many families.

  8. Swim training does not protect mice from skeletal muscle oxidative damage following a maximum exercise test.

    PubMed

    Barreto, Tatiane Oliveira; Cleto, Lorena Sabino; Gioda, Carolina Rosa; Silva, Renata Sabino; Campi-Azevedo, Ana Carolina; de Sousa-Franco, Junia; de Magalhães, José Carlos; Penaforte, Claudia Lopes; Pinto, Kelerson Mauro de Castro; Cruz, Jader dos Santos; Rocha-Vieira, Etel

    2012-07-01

    We investigated whether swim training protects skeletal muscle from oxidative damage in response to a maximum progressive exercise. First, we investigated the effect of swim training on the activities of the antioxidant enzymes, superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), in the gastrocnemius muscle of C57Bl/6 mice, 48 h after the last training session. Mice swam for 90 min, twice a day, for 5 weeks at 31°C (± 1°C). The activities of SOD and CAT were increased in trained mice (P < 0.05) compared to untrained group. However, no effect of training was observed in the activity of GPx. In a second experiment, trained and untrained mice were submitted to a maximum progressive swim test. Compared to control mice (untrained, not acutely exercised), malondialdehyde (MDA) levels were increased in the skeletal muscle of both trained and untrained mice after maximum swim. The activity of GPx was increased in the skeletal muscle of both trained and untrained mice, while SOD activity was increased only in trained mice after maximum swimming. CAT activity was increased only in the untrained compared to the control group. Although the trained mice showed increased activity of citrate synthase in skeletal muscle, swim performance was not different compared to untrained mice. Our results show an imbalance in the activities of SOD, CAT and GPx in response to swim training, which could account for the oxidative damage observed in the skeletal muscle of trained mice in response to maximum swim, resulting in the absence of improved exercise performance.

  9. Final Rules for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, and Patient Protections Under the Affordable Care Act. Final rules.

    PubMed

    2015-11-18

    This document contains final regulations regarding grandfathered health plans, preexisting condition exclusions, lifetime and annual dollar limits on benefits, rescissions, coverage of dependent children to age 26, internal claims and appeal and external review processes, and patient protections under the Affordable Care Act. It finalizes changes to the proposed and interim final rules based on comments and incorporates subregulatory guidance issued since publication of the proposed and interim final rules.

  10. 77 FR 73117 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ... Premium Stabilization Rule (77 FR 17220), we laid out a regulatory framework for these three programs. In... and Affordable Care Act,'' (75 FR 74864) that established standards for the MLR program. Since then... proposed regulation was published in the Federal Register on July 15, 2011 (76 FR 41930) to...

  11. 78 FR 15541 - Patient Protection and Affordable Care Act; Amendments to the HHS Notice of Benefit and Payment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... Register, we expanded upon these standards, and stated that we are publishing this ] interim final rule... requirement in section 1312(c) of the Affordable Care Act, we are modifying our interpretation of the... the corresponding regulatory definition accordingly. We are also making certain conforming changes...

  12. Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade.

    PubMed

    Manchikanti, Laxmaiah; Caraway, David L; Parr, Allan T; Fellows, Bert; Hirsch, Joshua A

    2011-01-01

    The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama's signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured - subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system - neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and

  13. Affordable Care Act.

    PubMed

    Rak, Sofija; Coffin, Janis

    2013-01-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA), although a subject of much debate in the Unites States, was enacted on March 23, 2010, and upheld by the Supreme Court on June 28, 2012. This act advocates that "healthcare is a right, not a privilege." The main goals of PPACA are to minimize the number of uninsured Americans and make healthcare available to everyone at an affordable price. The Congressional Budget Office has determined that 94% of Americans will have healthcare coverage while staying under the $900 billion limit that President Barack Obama established by bending the healthcare cost curve and reducing the deficit over the next 10 years. PMID:23767130

  14. 75 FR 60482 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-30

    ... Comment; Affordable Care Act Enrollment Opportunity Notice Relating to Dependent Coverage; Affordable Care Act Grandfathered Health Plan Disclosure and Recordkeeping Requirement; Affordable Care Act Rescission Notice; Affordable Care Act Patient Protections Notice; Affordable Care Act......

  15. Protective efficacy afforded by live Pasteurella multocida vaccines in chickens is independent of lipopolysaccharide outer core structure.

    PubMed

    Harper, Marina; John, Marietta; Edmunds, Mark; Wright, Amy; Ford, Mark; Turni, Conny; Blackall, P J; Cox, Andrew; Adler, Ben; Boyce, John D

    2016-03-29

    Pasteurella multocida is a major animal pathogen that causes a range of diseases including fowl cholera. P. multocida infections result in considerable losses to layer and breeder flocks in poultry industries worldwide. Both killed whole-cell and live-attenuated vaccines are available; these vaccines vary in their protective efficacy, particularly against heterologous strains. Moreover, until recently there was no knowledge of P. multocida LPS genetics and structure to determine precisely how LPS structure affects the protective capacity of these vaccines. In this study we show that defined lipopolysaccharide (LPS) mutants presented as killed whole-cell vaccines elicited solid protective immunity only against P. multocida challenge strains expressing highly similar or identical LPS structures. This finding indicates that vaccination of commercial flocks with P. multocida killed cell formulations will not protect against strains producing an LPS structure different to that produced by strains included in the vaccine formulation. Conversely, protective immunity conferred by vaccination with live P. multocida strains was found to be largely independent of LPS structure. Birds vaccinated with a range of live mutants belonging to the L1 and L3 LPS genotypes, each expressing a specific truncated LPS structure, were protected against challenge with the parent strain. Moreover, birds vaccinated with any of the five LPS mutants belonging to the L1 LPS genotype were also protected against challenge with an unrelated strain and two of the five groups vaccinated with live LPS mutants belonging to the L3 genotype were protected against challenge with an unrelated strain. In summary, vaccination with live P. multocida aroA mutants producing full-length L1 or L3 LPS or vaccination with live strains producing shortened L1 LPS elicited strong protective immunity against both homologous and heterologous challenge.

  16. Protection Afforded by Fluoroquinolones in Animal Models of Respiratory Infections with Bacillus anthracis, Yersinia pestis, and Francisella tularensis.

    PubMed

    Peterson, Johnny W; Moen, Scott T; Healy, Daniel; Pawlik, Jennifer E; Taormina, Joanna; Hardcastle, Jason; Thomas, John M; Lawrence, William S; Ponce, Cindy; Chatuev, Bagram M; Gnade, Bryan T; Foltz, Sheri M; Agar, Stacy L; Sha, Jian; Klimpel, Gary R; Kirtley, Michelle L; Eaves-Pyles, Tonyia; Chopra, Ashok K

    2010-01-01

    Successful treatment of inhalation anthrax, pneumonic plague and tularemia can be achieved with fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, and initiation of treatment is most effective when administered as soon as possible following exposure. Bacillus anthracis Ames, Yersinia pestis CO92, and Francisella tularensis SCHU S4 have equivalent susceptibility in vitro to ciprofloxacin and levofloxacin (minimal inhibitory concentration is 0.03 μg/ml); however, limited information is available regarding in vivo susceptibility of these infectious agents to the fluoroquinolone antibiotics in small animal models. Mice, guinea pig, and rabbit models have been developed to evaluate the protective efficacy of antibiotic therapy against these life-threatening infections. Our results indicated that doses of ciprofloxacin and levofloxacin required to protect mice against inhalation anthrax were approximately 18-fold higher than the doses of levofloxacin required to protect against pneumonic plague and tularemia. Further, the critical period following aerosol exposure of mice to either B. anthracis spores or Y. pestis was 24 h, while mice challenged with F. tularensis could be effectively protected when treatment was delayed for as long as 72 h postchallenge. In addition, it was apparent that prolonged antibiotic treatment was important in the effective treatment of inhalation anthrax in mice, but short-term treatment of mice with pneumonic plague or tularemia infections were usually successful. These results provide effective antibiotic dosages in mice, guinea pigs, and rabbits and lay the foundation for the development and evaluation of combinational treatment modalities. PMID:21127743

  17. Protection Afforded by Fluoroquinolones in Animal Models of Respiratory Infections with Bacillus anthracis, Yersinia pestis, and Francisella tularensis

    PubMed Central

    Peterson, Johnny W; Moen, Scott T; Healy, Daniel; Pawlik, Jennifer E; Taormina, Joanna; Hardcastle, Jason; Thomas, John M; Lawrence, William S; Ponce, Cindy; Chatuev, Bagram M; Gnade, Bryan T; Foltz, Sheri M; Agar, Stacy L; Sha, Jian; Klimpel, Gary R; Kirtley, Michelle L; Eaves-Pyles, Tonyia; Chopra, Ashok K

    2010-01-01

    Successful treatment of inhalation anthrax, pneumonic plague and tularemia can be achieved with fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, and initiation of treatment is most effective when administered as soon as possible following exposure. Bacillus anthracis Ames, Yersinia pestis CO92, and Francisella tularensis SCHU S4 have equivalent susceptibility in vitro to ciprofloxacin and levofloxacin (minimal inhibitory concentration is 0.03 μg/ml); however, limited information is available regarding in vivo susceptibility of these infectious agents to the fluoroquinolone antibiotics in small animal models. Mice, guinea pig, and rabbit models have been developed to evaluate the protective efficacy of antibiotic therapy against these life-threatening infections. Our results indicated that doses of ciprofloxacin and levofloxacin required to protect mice against inhalation anthrax were approximately 18-fold higher than the doses of levofloxacin required to protect against pneumonic plague and tularemia. Further, the critical period following aerosol exposure of mice to either B. anthracis spores or Y. pestis was 24 h, while mice challenged with F. tularensis could be effectively protected when treatment was delayed for as long as 72 h postchallenge. In addition, it was apparent that prolonged antibiotic treatment was important in the effective treatment of inhalation anthrax in mice, but short-term treatment of mice with pneumonic plague or tularemia infections were usually successful. These results provide effective antibiotic dosages in mice, guinea pigs, and rabbits and lay the foundation for the development and evaluation of combinational treatment modalities. PMID:21127743

  18. Bispecific Antibody Affords Complete Post-Exposure Protection of Mice from Both Ebola (Zaire) and Sudan Viruses

    PubMed Central

    Frei, Julia C.; Nyakatura, Elisabeth K.; Zak, Samantha E.; Bakken, Russell R.; Chandran, Kartik; Dye, John M.; Lai, Jonathan R.

    2016-01-01

    Filoviruses (Ebola and Marburg) cause severe hemorrhagic fever. There are five species of ebolavirus; among these, the Ebola (Zaire) and Sudan viruses (EBOV and SUDV, respectively) are highly pathogenic and have both caused recurring, large outbreaks. However, the EBOV and SUDV glycoprotein (GP) sequences are 45% divergent and thus antigenically distinct. Few antibodies with cross-neutralizing properties have been described to date. We used antibody engineering to develop novel bispecific antibodies (Bis-mAbs) that are cross-reactive toward base epitopes on GP from EBOV and SUDV. These Bis-mAbs exhibit potent neutralization against EBOV and SUDV GP pseudotyped viruses as well as authentic pathogens, and confer a high degree (in one case 100%) post-exposure protection of mice from both viruses. Our studies show that a single agent that targets the GP base epitopes is sufficient for protection in mice; such agents could be included in panfilovirus therapeutic antibody cocktails. PMID:26758505

  19. Achieving public health goals through Medicaid expansion: opportunities in criminal justice, homelessness, and behavioral health with the Patient Protection and Affordable Care Act.

    PubMed

    DiPietro, Barbara; Klingenmaier, Lisa

    2013-12-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system--particularly when they struggle with behavioral health diagnoses--are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care.

  20. Achieving Public Health Goals Through Medicaid Expansion: Opportunities in Criminal Justice, Homelessness, and Behavioral Health With the Patient Protection and Affordable Care Act

    PubMed Central

    Klingenmaier, Lisa

    2013-01-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system—particularly when they struggle with behavioral health diagnoses—are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care. PMID:24148039

  1. Achieving public health goals through Medicaid expansion: opportunities in criminal justice, homelessness, and behavioral health with the Patient Protection and Affordable Care Act.

    PubMed

    DiPietro, Barbara; Klingenmaier, Lisa

    2013-12-01

    States are currently discussing how (or whether) to implement the Medicaid expansion to nondisabled adults earning less than 133% of the federal poverty level, a key aspect of the Patient Protection and Affordable Care Act. Those experiencing homelessness and those involved with the criminal justice system--particularly when they struggle with behavioral health diagnoses--are subpopulations that are currently uninsured at high rates and have significant health care needs but will become Medicaid eligible starting in 2014. We outline the connection between these groups, assert outcomes possible from greater collaboration between multiple systems, provide a summary of Medicaid eligibility and its ramifications for individuals in the criminal justice system, and explore opportunities to improve overall public health through Medicaid outreach, enrollment, and engagement in needed health care. PMID:24148039

  2. The Protective Effect against Extracellular Histones Afforded by Long-Pentraxin PTX3 as a Regulator of NETs

    PubMed Central

    Daigo, Kenji; Takamatsu, Yuichiro; Hamakubo, Takao

    2016-01-01

    Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that plays critical roles in innate immunity. Its fundamental functions include recognition of microbes, activation of complement cascades, and opsonization. The findings that PTX3 is one of the component proteins in neutrophil extracellular traps (NETs) and binds with other NET proteins imply the importance of PTX3 in the NET-mediated trapping and killing of bacteria. As NETs play certain critically important host-protective roles, aberrant NET production results in tissue damage. Extracellular histones, the main source of which is considered to be NETs, are mediators of septic death due to their cytotoxicity toward endothelial cells. PTX3 protects against extracellular histones-mediated cytotoxicity through coaggregation. In addition to the anti-bacterial roles performed in coordination with other NET proteins, PTX3 appears to mitigate the detrimental effect of over-activated NETs. A better understanding of the role of the PTX3 complexes in NETs would be expected to lead to new strategies for maintaining a healthy balance between the helpful bactericidal and undesirable detrimental activities of NETs.

  3. The Protective Effect against Extracellular Histones Afforded by Long-Pentraxin PTX3 as a Regulator of NETs.

    PubMed

    Daigo, Kenji; Takamatsu, Yuichiro; Hamakubo, Takao

    2016-01-01

    Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that plays critical roles in innate immunity. Its fundamental functions include recognition of microbes, activation of complement cascades, and opsonization. The findings that PTX3 is one of the component proteins in neutrophil extracellular traps (NETs) and binds with other NET proteins imply the importance of PTX3 in the NET-mediated trapping and killing of bacteria. As NETs play certain critically important host-protective roles, aberrant NET production results in tissue damage. Extracellular histones, the main source of which is considered to be NETs, are mediators of septic death due to their cytotoxicity toward endothelial cells. PTX3 protects against extracellular histones-mediated cytotoxicity through coaggregation. In addition to the anti-bacterial roles performed in coordination with other NET proteins, PTX3 appears to mitigate the detrimental effect of over-activated NETs. A better understanding of the role of the PTX3 complexes in NETs would be expected to lead to new strategies for maintaining a healthy balance between the helpful bactericidal and undesirable detrimental activities of NETs.

  4. The Protective Effect against Extracellular Histones Afforded by Long-Pentraxin PTX3 as a Regulator of NETs

    PubMed Central

    Daigo, Kenji; Takamatsu, Yuichiro; Hamakubo, Takao

    2016-01-01

    Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that plays critical roles in innate immunity. Its fundamental functions include recognition of microbes, activation of complement cascades, and opsonization. The findings that PTX3 is one of the component proteins in neutrophil extracellular traps (NETs) and binds with other NET proteins imply the importance of PTX3 in the NET-mediated trapping and killing of bacteria. As NETs play certain critically important host-protective roles, aberrant NET production results in tissue damage. Extracellular histones, the main source of which is considered to be NETs, are mediators of septic death due to their cytotoxicity toward endothelial cells. PTX3 protects against extracellular histones-mediated cytotoxicity through coaggregation. In addition to the anti-bacterial roles performed in coordination with other NET proteins, PTX3 appears to mitigate the detrimental effect of over-activated NETs. A better understanding of the role of the PTX3 complexes in NETs would be expected to lead to new strategies for maintaining a healthy balance between the helpful bactericidal and undesirable detrimental activities of NETs. PMID:27656184

  5. The Protective Effect against Extracellular Histones Afforded by Long-Pentraxin PTX3 as a Regulator of NETs.

    PubMed

    Daigo, Kenji; Takamatsu, Yuichiro; Hamakubo, Takao

    2016-01-01

    Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that plays critical roles in innate immunity. Its fundamental functions include recognition of microbes, activation of complement cascades, and opsonization. The findings that PTX3 is one of the component proteins in neutrophil extracellular traps (NETs) and binds with other NET proteins imply the importance of PTX3 in the NET-mediated trapping and killing of bacteria. As NETs play certain critically important host-protective roles, aberrant NET production results in tissue damage. Extracellular histones, the main source of which is considered to be NETs, are mediators of septic death due to their cytotoxicity toward endothelial cells. PTX3 protects against extracellular histones-mediated cytotoxicity through coaggregation. In addition to the anti-bacterial roles performed in coordination with other NET proteins, PTX3 appears to mitigate the detrimental effect of over-activated NETs. A better understanding of the role of the PTX3 complexes in NETs would be expected to lead to new strategies for maintaining a healthy balance between the helpful bactericidal and undesirable detrimental activities of NETs. PMID:27656184

  6. 40 CFR Table 1 to Subpart A of... - Maximum Concentration of Constituents for Groundwater Protection

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites Pt. 192, Subpt. A, Table 1 Table 1 to Subpart A of Part 192—Maximum.... Molybdenum 0.1 Combined radium-226 and radium-228 5 pCi/liter Combined uranium-234 and uranium-238 2 30...

  7. 40 CFR Table 1 to Subpart A of... - Maximum Concentration of Constituents for Groundwater Protection

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites Pt. 192, Subpt. A, Table 1 Table 1 to Subpart A of Part 192—Maximum.... Molybdenum 0.1 Combined radium-226 and radium-228 5 pCi/liter Combined uranium-234 and uranium-238 2 30...

  8. 40 CFR Table 1 to Subpart A of... - Maximum Concentration of Constituents for Groundwater Protection

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites Pt. 192, Subpt. A, Table 1 Table 1 to Subpart A of Part 192—Maximum.... Molybdenum 0.1 Combined radium-226 and radium-228 5 pCi/liter Combined uranium-234 and uranium-238 2 30...

  9. 40 CFR Table 1 to Subpart A of... - Maximum Concentration of Constituents for Groundwater Protection

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites Pt. 192, Subpt. A, Table 1 Table 1 to Subpart A of Part 192—Maximum.... Molybdenum 0.1 Combined radium-226 and radium-228 5 pCi/liter Combined uranium-234 and uranium-238 2 30...

  10. 40 CFR Table 1 to Subpart A of... - Maximum Concentration of Constituents for Groundwater Protection

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... URANIUM AND THORIUM MILL TAILINGS Standards for the Control of Residual Radioactive Materials from Inactive Uranium Processing Sites Pt. 192, Subpt. A, Table 1 Table 1 to Subpart A of Part 192—Maximum.... Molybdenum 0.1 Combined radium-226 and radium-228 5 pCi/liter Combined uranium-234 and uranium-238 2 30...

  11. Sun protection preferences and behaviors among young adult males during maximum ultraviolet radiation exposure activities.

    PubMed

    Wickenheiser, Marilyn; Baker, Mary Kate; Gaber, Rikki; Blatt, Hanz; Robinson, June K

    2013-07-31

    This study explores sun protection attitudes, preferences, and behaviors among young adult males participating in an open-field activity with extreme ultraviolet radiation exposure. Male drum corps members (n = 137) responded to survey questions regarding their behavior and willingness to engage in sun protection and barriers to sunscreen usage. A subset of members (n = 31) participated in cognitive interviews exploring various sunscreen products and intervention techniques. Participants were knowledgeable about health risks and protection benefits regarding sun exposure. Generally, males had positive attitudes and normative beliefs about using sunscreen. A barrier to sunscreen re-application was lack of adequate time to reapply sunscreen during the open field activity. Males preferred a towelette application method, but were unfamiliar with its efficacy and proper use. Thus, they were more likely to use the more familiar sunscreen spray. To increase sun protection behaviors and lower skin cancer risk for males participating in open-field activities, breaks must be allotted every 2 h and have sufficient time to allow sunscreen application. Future development and research into delivery systems that rapidly and evenly apply sunscreen may help lower exposure in this population.

  12. Sun protection preferences and behaviors among young adult males during maximum ultraviolet radiation exposure activities.

    PubMed

    Wickenheiser, Marilyn; Baker, Mary Kate; Gaber, Rikki; Blatt, Hanz; Robinson, June K

    2013-08-01

    This study explores sun protection attitudes, preferences, and behaviors among young adult males participating in an open-field activity with extreme ultraviolet radiation exposure. Male drum corps members (n = 137) responded to survey questions regarding their behavior and willingness to engage in sun protection and barriers to sunscreen usage. A subset of members (n = 31) participated in cognitive interviews exploring various sunscreen products and intervention techniques. Participants were knowledgeable about health risks and protection benefits regarding sun exposure. Generally, males had positive attitudes and normative beliefs about using sunscreen. A barrier to sunscreen re-application was lack of adequate time to reapply sunscreen during the open field activity. Males preferred a towelette application method, but were unfamiliar with its efficacy and proper use. Thus, they were more likely to use the more familiar sunscreen spray. To increase sun protection behaviors and lower skin cancer risk for males participating in open-field activities, breaks must be allotted every 2 h and have sufficient time to allow sunscreen application. Future development and research into delivery systems that rapidly and evenly apply sunscreen may help lower exposure in this population. PMID:23912201

  13. A role for lipid rafts in the protection afforded by docosahexaenoic acid against ethanol toxicity in primary rat hepatocytes.

    PubMed

    Aliche-Djoudi, Fatiha; Podechard, Normand; Collin, Aurore; Chevanne, Martine; Provost, Emilie; Poul, Martine; Le Hégarat, Ludovic; Catheline, Daniel; Legrand, Philippe; Dimanche-Boitrel, Marie-Thérèse; Lagadic-Gossmann, Dominique; Sergent, Odile

    2013-10-01

    Previously, we demonstrated that eicosapentaenoic acid enhanced ethanol-induced oxidative stress and cell death in primary rat hepatocytes via an increase in membrane fluidity and lipid raft clustering. In this context, another n-3 polyunsaturated fatty acid, docosahexaenoic acid (DHA), was tested with a special emphasis on physical and chemical alteration of lipid rafts. Pretreatment of hepatocytes with DHA reduced significantly ethanol-induced oxidative stress and cell death. DHA protection could be related to an alteration of lipid rafts. Indeed, rafts exhibited a marked increase in membrane fluidity and packing defects leading to the exclusion of a raft protein marker, flotillin. Furthermore, DHA strongly inhibited disulfide bridge formation, even in control cells, thus suggesting a disruption of protein-protein interactions inside lipid rafts. This particular spatial organization of lipid rafts due to DHA subsequently prevented the ethanol-induced lipid raft clustering. Such a prevention was then responsible for the inhibition of phospholipase C-γ translocation into rafts, and consequently of both lysosome accumulation and elevation in cellular low-molecular-weight iron content, a prooxidant factor. In total, the present study suggests that DHA supplementation could represent a new preventive approach for patients with alcoholic liver disease based upon modulation of the membrane structures.

  14. 75 FR 81659 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Enrollment Opportunity Notice--Prohibition on Lifetime Limits ACTION: Notice. SUMMARY... Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Enrollment... INFORMATION: The Patient Protection and Affordable Care Act (the Affordable Care Act)......

  15. 75 FR 32480 - Funding Opportunity: Affordable Care Act Medicare Beneficiary Outreach and Assistance Program...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-08

    ... HUMAN SERVICES Administration on Aging Funding Opportunity: Affordable Care Act Medicare Beneficiary...: Availability of funding opportunity announcement. Funding Opportunity Title/Program Name: Affordable Care Act... Protection and Affordable Care Act of 2010 (Affordable Care Act). Catalog of Federal Domestic...

  16. Meeting the Tobacco Cessation Coverage Requirement of the Patient Protection and Affordable Care Act: State Smoking Cessation Quitlines and Cost Sharing

    PubMed Central

    Bailey, Linda; Leischow, Scott J.

    2015-01-01

    Objectives. We explored whether various key stakeholders considered cost sharing with state telephone-based tobacco cessation quitlines, because including tobacco cessation services as part of the required essential health benefits is a new requirement of the Patient Protection and Affordable Care Act (ACA). Methods. We analyzed qualitative data collected from interviews conducted in April and May of 2014 with representatives of state health departments, quitline service providers, health plans, and insurance brokers in 4 US states. Results. State health departments varied in the strategies they considered the role their state quitline would play in meeting the ACA requirements. Health plans and insurance brokers referred to state quitlines because they were perceived as effective and free, but in 3 of the 4 states, the private stakeholder groups did not consider cost sharing. Conclusions. If state health departments are going to initiate cost-sharing agreements with private insurance providers, then they will need to engage a broad array of stakeholders and will need to overcome the perception that state quitline services are free. PMID:26447918

  17. Essential role of PD-L1 in regulatory T cell-afforded protection against blood-brain barrier damage after stroke

    PubMed Central

    Li, Peiying; Mao, Leilei; Liu, Xiangrong; Gan, Yu; Zheng, Jing; Thomson, Angus W.; Gao, Yanqin; Chen, Jun; Hu, Xiaoming

    2014-01-01

    Background and Purpose Our recent research revealed that adoptively-transferred regulatory T cells (Tregs) reduced acute ischemic brain injury by inhibiting neutrophil-derived MMP-9 and protecting against blood-brain barrier (BBB) damage. The mechanisms underlying Treg interactions with neutrophils remain elusive. This study evaluates the contribution of program death 1-ligand 1 (PD-L1) to Treg-mediated neutrophil inhibition and neuroprotection after cerebral ischemia. Methods In vitro experiments were carried out using a transwell system or a coculture system allowing cell-to-cell contact. Focal cerebral ischemia was induced in mice for 60min. Tregs (2×106) isolated from donor animals (wild-type or PD-L1−/−) were intravenously injected into ischemic recipients 2 h post-MCAO. MMP-9 production, BBB permeability and brain infarct were assessed at 1 or 3 days post-MCAO. Results In vitro experiments reveal that Treg-mediated inhibition of neutrophil MMP-9 required direct cell-to-cell contact. The suppression of MMP-9 was abolished when Tregs were pretreated with PD-L1 neutralizing Abs or when neutrophils were pre-treated with PD-1 Abs. In vivo studies confirmed that intravenous administration of Tregs pre-treated with PD-L1 Abs or Tregs isolated from PD-L1-deficient mice failed to inhibit MMP-9 production by blood neutrophils 1 day after 60 min middle cerebral artery occlusion (MCAO). Furthermore, the BBB damage after MCAO was greatly ameliorated in PD-L1-competent Treg-treated mice, but not in PD-L1-compromised Treg-treated mice. Consequently, PD-L1 dysfunction abolished Treg-mediated brain protection and neurological improvements 3 days after MCAO. Conclusions PD-L1 plays an essential role in the neuroprotection afforded by Tregs against cerebral ischemia by mediating the suppressive effect of Tregs on neutrophil-derived MMP-9. PMID:24496394

  18. Assessing Protection Afforded to the Microbiological Quality of Bedrock Groundwater from the Impacts of Septic Tank Effluent by Irish Glacial Till: A Field Study

    NASA Astrophysics Data System (ADS)

    Orr, Alison; McCarthy, Valerie; Meehan, Robert; Flynn, Raymond

    2010-05-01

    The rural population of Ireland relies almost exclusively on on-site treatment systems for disposal of waste water. Septic tank systems, which discharge effluent to ground, constitute the dominant means of waste water disposal. Many of the areas that employ this technology rely on private or small group groundwater supplies, often located in close proximity of septic tanks. Since many of these water supplies provide raw groundwater to consumers, septic tank effluent (STE) can pose a significant hazard to the microbiological quality of drinking water. T-tests (infiltration testing) carried out prior to tank installation aim to assess the capacity of subsoils to receive STE. Tests completed across Ireland indicate that many existing septic tank systems are located in low permeability subsoils. These subsoils are assumed to afford significant protection to the microbiological quality of groundwater in the underlying bedrock units. A two year investigation in the Lough Muckno Catchment in Co. Monaghan, investigating the impact of STE on water quality, involved carrying out T-tests at three sites where effluent discharged to a dense, silty, ‘fractured' glacial till derived from the underlying bedrock and containing clasts of low grade metamorphic Ordovician and Silurian sandstone and shale. Analysis of groundwater samples collected from 28 piezometers straddling the water table within the till, down-gradient of septic tank systems at two sites, permitted faecal indicator microorganism (FIO) levels in near-surface groundwater to be established. Associated hydraulic conductivity tests (slug tests) at all three sites permitted an evaluation of the levels of horizontal hydraulic conductivity heterogeneity present in the till. Slug test results suggest that till median hydraulic conductivities range from 1.1x10-4 cm/s to 1.1x10-5 cm/s, with variability of up to 2 orders of magnitude across each site. On the other hand no significant differences in properties existed

  19. Patient Protection and Affordable Care Act; program integrity: exchange, premium stabilization programs, and market standards; amendments to the HHS notice of benefit and payment parameters for 2014. Final rule.

    PubMed

    2013-10-30

    This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated Exchanges (FFEs), and States with regard to the operation of risk adjustment and reinsurance programs. It also establishes additional standards for special enrollment periods, survey vendors that may conduct enrollee satisfaction surveys on behalf of QHP issuers, and issuer participation in an FFE, and makes certain amendments to definitions and standards related to the market reform rules. These standards, which include financial integrity provisions and protections against fraud and abuse, are consistent with Title I of the Affordable Care Act. This final rule also amends and adopts as final interim provisions set forth in the Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 interim final rule, published in the Federal Register on March 11, 2013, related to risk corridors and cost-sharing reduction reconciliation.

  20. Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded

    PubMed Central

    Dua, Kulwinder; Surapaneni, Sri Naveen; Kuribayashi, Shiko; Hafeezullah, Muhammad

    2011-01-01

    Aerodigestive reflexes triggered by pharyngeal stimulation can protect the airways by clearing fluid from the pharynx. The objective of this study was to determine the relationship between the maximum capacity of fluid that can safely dwell in the hypopharynx [hypopharyngeal safe volume (HPSV)] before spilling into the larynx and the threshold volumes required to trigger pharyngoglottal closure reflex (PGCR), pharyngo-upper esophageal sphincter contractile reflex (PUCR), and reflexive pharyngeal swallow (RPS). Twenty-five healthy volunteers (mean age 24 yr, 8 males) were studied in the semi-inclined supine position. PGCR, PUCR, and RPS were elicited using techniques of concurrent upper esophageal sphincter manometry and pharyngo-laryngoscopy. The hypopharynx was then anesthetized to abolish RPS. HPSV was determined by infusing water in the pharynx, and perfusion was stopped when the infusate reached the superior margin of the interarytenoid fold. The threshold volumes for triggering PGCR, PUCR, and RPS by slow and rapid injections before pharyngeal anesthesia were 0.18 ± 0.02 and 0.09 ± 0.02 ml; 0.20 ± 0.020 and 0.13 ± 0.04 ml; and 0.61 ± 0.04 and 0.4 ± 0.06 ml, respectively. All of the above volumes were significantly smaller than the HPSV (0.70 ± 0.06 ml, P < 0.01) except for the threshold volume to elicit RPS during slow perfusion, which was not significantly different (P = 0.23). We conclude that pharyngeal aerodigestive reflexes are triggered by both slow and rapid pharyngeal perfusion of water at significantly smaller volumes than the maximum capacity of the hypopharynx to safely hold contents without spilling into the airway. These reflexes thereby aid in prevention of aspiration. PMID:21566013

  1. Evaluating the adequacy of maximum contaminant levels as health-protective cleanup goals: an analysis based on Monte Carlo techniques.

    PubMed

    Finley, B L; Scott, P; Paustenbach, D J

    1993-12-01

    At many sites in the United States, health-based remediation goals for contaminated groundwater have been set at levels far below USEPA's drinking water standards (i.e., maximum contaminant levels or MCLs). This is due to the fact that, while the USEPA must often consider technical and economic factors (e.g., cost of compliance, risk/benefit analysis) when setting MCLs for public water systems, cleanup goals for contaminated groundwater are often based solely on conservative "point" estimates of exposure. One of the more recent refinements in the risk assessment process is the use of ranges of exposure estimates or "probability density functions" (PDFs), rather than fixed point estimates, to estimate exposure and chemical uptake. This approach provides a more thorough description of the range of potential risks, rather than a single "worst-case" value, and allows one to understand the conservatism inherent in assessments based on regulatory default parameters. This paper uses a number of PDFs and the Monte Carlo technique to assess whether the USEPA's MCLs for drinking water are sufficiently low to protect persons exposed to these levels. A case study involving daily exposure to tapwater containing MCL concentrations of tetrachloroethylene, chloroform, bromoform, and vinyl chloride is presented. Several direct and indirect exposure pathways are evaluated, including inhalation and dermal contact while showering, direct ingestion, and inhalation of emissions from household fixtures and appliances. PDFs for each exposure factor are based on the most recent and applicable data available. Our analysis indicates that the estimated increased cancer risks at the 50th and 95th percentile of exposure are within the range of increased cancer risks typically considered acceptable at Superfund sites (10(-4)-10(-6)). These results suggest that, at least for some chemicals, groundwater need not be cleaned-up to concentrations less than drinking water standards (i.e., MCLs) to

  2. Maximum sustainable work rate for five protective clothing ensembles with respect to moisture vapor transmission rate and air permeability.

    PubMed

    Gonzalez, Nancy W; Bernard, Thomas E; Carroll, Nora L; Bryner, Michael A; Zeigler, James P

    2006-02-01

    The fabrics associated with protective clothing affect heat stress, which influences productivity and risks of heat-related disorders. This study compared the work limiting effects of five protective coveralls and a semiclothed condition (t-shirt and shorts). Two fabric characteristics determined from bench tests, moisture vapor transmission rate (MVTR), and air permeability were also examined as possible predictors of ensemble performance. A progressive metabolic rate protocol was used where environmentalconditions (T(db) = 32 degrees C; T(pwb) = 26 degrees C) were held constant while treadmill speed was slowly increased. The limiting metabolic rate to just maintain thermal equilibrium was the critical point. At this point, critical speed and critical metabolic rate were noted and total evaporative resistance was calculated for each ensemble. Five acclimatized subjects wore each of the six clothing conditions in a random order. Statistically significant differences were found among the five protective garments and a semiclothed ensemble for critical treadmill speed (S(crit)), critical metabolic rate (M(crit)), and total evaporative resistance (R(e-t)). The semiclothed condition (S(crit) = 1.77 m/sec; M(crit) = 580 W; R(e-t) = 0.0099 kPa m2/W) and ensembles made from spunbonded, melt blown, spunbonded polypropylene (SMS) (1.72 m/sec; 560 W; 0.0135 kPa m2/W) and spunbonded polypropylene (1.67 m/sec; 550 W; 0.0126 kPa m2/W) were able to support higher work rates than fabrics made from Tyvek 1422-A (a nonwoven spunbonded olefin) (1.48 m/sec; 470 W; 0.0183 kPa m2/W) and a microporous film supported by spunbonded polypropylene (1.34 m/sec; 420 W; 0.0231 kPa m2/W). A tightly woven polyester ensemble (1.59 m/sec; 510 W; 0.0130 kPa m2/W) had intermediate values and was not significantly different from either group. Air permeability was a better predictor of fabric work limiting performance than MVTR. An air permeability on the order of 10,000 L/min cm2 bar would have

  3. Affordable Vehicle Avionics Overview

    NASA Technical Reports Server (NTRS)

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters

  4. Affordable Vehicle Avionics Overview

    NASA Technical Reports Server (NTRS)

    Cockrell, James J.

    2015-01-01

    Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters.

  5. Capture zone delineation methodology based on the maximum concentration: Preventative groundwater well protection areas for heat exchange fluid mixtures

    NASA Astrophysics Data System (ADS)

    Okkonen, Jarkko; Neupauer, Roseanna M.

    2016-05-01

    Capture zones of water supply wells are most often delineated based on travel times of water or solute to the well, with the assumption that if the travel time is sufficiently large, the concentration of chemical at the well will not exceed the drinking water standards. In many situations, the likely source concentrations or release masses of contamination from the potential sources are unknown; therefore, the exact concentration at the well cannot be determined. In situations in which the source mass can be estimated with some accuracy, the delineation of the capture zone should be based on the maximum chemical concentration that can be expected at the well, rather than on an arbitrary travel time. We present a new capture zone delineation methodology that is based on this maximum chemical concentration. The method delineates capture zones by solving the adjoint of the advection-dispersion-reaction equation and relating the adjoint state and the known release mass to the expected chemical concentration at the well. We demonstrate the use of this method through a case study in which soil heat exchange systems are potential sources of contamination. The heat exchange fluid mixtures contain known fluid volumes and chemical concentrations; thus, in the event of a release, the release mass of the chemical is known. We also demonstrate the use of a concentration basis in quantifying other measures of well vulnerability including exposure time and time to exceed a predefined threshold concentration at the well.

  6. 75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Patient Protection Notice ACTION: Notice. SUMMARY: The Department of Labor (DOL) hereby... collection request (ICR) titled, ``Affordable Care Act Patient Protection Notice,'' to the Office of... Security Administration (EBSA). Title of Collection: Affordable Care Act Patient Protection Notice....

  7. Protection Afforded by a Recombinant Turkey Herpesvirus-H5 Vaccine Against the 2014 European Highly Pathogenic H5N8 Avian Influenza Strain.

    PubMed

    Steensels, M; Rauw, F; van den Berg, Th; Marché, S; Gardin, Y; Palya, V; Lambrecht, B

    2016-05-01

    A highly pathogenic avian influenza (HPAI) H5N8 (clade 2.3.4.4) virus, circulating in Asia (South Korea, Japan, and southern China) since the beginning of 2014, reached the European continent in November 2014. Germany, the Netherlands, the United Kingdom, Italy, and Hungary confirmed H5N8 infection of poultry farms of different species and of several wild bird species. Unlike the Asian highly pathogenic (HP) H5N1, this HP H5N8 also went transatlantic and reached the American West Coast by the end of 2014, affecting wild birds as well as backyard and commercial poultry. This strain induces high mortality and morbidity in Galliformes, whereas wild birds seem only moderately affected. A recombinant turkey herpesvirus (rHVT) vector vaccine expressing the H5 gene of a clade 2.2 H5N1 strain (rHVT-H5) previously demonstrated a highly efficient clinical protection and reduced viral excretion against challenge with Asian HP H5N1 strains of various clades (2.2, 2.2.1, 2.2.1.1, 2.1.3, 2.1.3.2, and 2.3.2.1) and was made commercially available in various countries where the disease is endemic. To evaluate the protective efficacy of the rHVT-H5 vaccine against the first German H5N8 turkey isolate (H5N8 GE), a challenge experiment was set up in specific-pathogen-free (SPF) chickens, and the clinical and excretional protection was evaluated. SPF chickens were vaccinated subcutaneously at 1 day old and challenged oculonasally at 4 wk of age with two viral dosages, 10(5) and 10(6) 50% egg infective doses. Morbidity and mortality were monitored daily in unvaccinated and vaccinated groups, whereas viral shedding by oropharyngeal and cloacal routes was evaluated at 2, 5, 9, and 14 days postinoculation (dpi). Serologic monitoring after vaccination and challenge was also carried out. Despite its high antigenic divergence of the challenge H5N8 strain, a single rHVT-H5 vaccine administration at 1 day old resulted in a full clinical protection against challenge and a significant reduction

  8. Induction of endogenous glutathione by the chemoprotective agent, 3H-1,2-dithiole-3-thione, in human neuroblastoma SH-SY5Y cells affords protection against peroxynitrite-induced cytotoxicity.

    PubMed

    Cao, Zhuoxiao; Hallur, Seema; Qiu, Harry Z; Peng, Xingxiang; Li, Yunbo

    2004-04-16

    Substantial evidence suggests that peroxynitrite generated from the bi-radical reaction of nitric oxide and superoxide is critically involved in the pathogenesis of neurodegenerative disorders, such as Parkinson's disease. Reaction with sulfhydryl (SH)-containing molecules has been proposed to be a major detoxification pathway of peroxynitrite in biological systems. This study was undertaken to determine if chemically elevated intracellular reduced glutathione (GSH), a major SH-containing biomolecule, affords protection against peroxynitrite-mediated toxicity in cultured neuronal cells. Incubation of human neuroblastoma SH-SY5Y cells with the unique chemoprotectant, 3H-1,2-dithiole-3-thione (D3T), led to a significant elevation of cellular GSH in a concentration-dependent fashion. To examine the protective effects of D3T-induced GSH on peroxynitrite-mediated toxicity, SH-SY5Y cells were pretreated with D3T and then exposed to either the peroxynitrite generator, 3-morpholinosydnonimine (SIN-1), or the authentic peroxynitrite. We observed that D3T-pretreated cells showed a markedly increased resistance to SIN-1- or authentic peroxynitrite-induced cytotoxicity, as assessed by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium reduction assay. Conversely, depletion of cellular GSH by buthionine sulfoximine (BSO) caused a marked potentiation of SIN-1- or authentic peroxynitrite-mediated cytotoxicity. To further demonstrate the causal role for GSH induction in D3T-mediated cytoprotection, SH-SY5Y cells were co-treated with BSO to abolish D3T-induced GSH elevation. Co-treatment of the cells with BSO was found to significantly reverse the protective effects of D3T on SIN-1- or authentic peroxynitrite-elicited cytotoxicity. Taken together, this study demonstrates for the first time that D3T can induce GSH in cultured SH-SY5Y cells, and that the D3T-augmented cellular GSH defense affords a marked protection against peroxynitrite-induced toxicity in cultured human neuronal

  9. Characterization of Protection Afforded by a Bivalent Virus-Like Particle Vaccine against Bluetongue Virus Serotypes 1 and 4 in Sheep

    PubMed Central

    Pérez de Diego, Ana Cristina; Athmaram, Thimmasandra N.; Stewart, Meredith; Rodríguez-Sánchez, Belén; Sánchez-Vizcaíno, José Manuel; Noad, Robert; Roy, Polly

    2011-01-01

    Background Bluetongue virus (BTV) is an economically important, arthropod borne, emerging pathogen in Europe, causing disease mainly in sheep and cattle. Routine vaccination for bluetongue would require the ability to distinguish between vaccinated and infected individuals (DIVA). Current vaccines are effective but are not DIVA. Virus-like particles (VLPs) are highly immunogenic structural mimics of virus particles, that only contain a subset of the proteins present in a natural infection. VLPs therefore offer the potential for the development of DIVA compatible bluetongue vaccines. Methodology/Principal Findings Merino sheep were vaccinated with either monovalent BTV-1 VLPs or a bivalent mixture of BTV-1 VLPs and BTV-4 VLPs, and challenged with virulent BTV-1 or BTV-4. Animals were monitored for clinical signs, antibody responses, and viral RNA. 19/20 animals vaccinated with BTV-1 VLPs either alone or in combination with BTV-4 VLPs developed neutralizing antibodies to BTV-1, and group specific antibodies to BTV VP7. The one animal that showed no detectable neutralizing antibodies, or group specific antibodies, had detectable viral RNA following challenge but did not display any clinical signs on challenge with virulent BTV-1. In contrast, all control animals' demonstrated classical clinical signs for bluetongue on challenge with the same virus. Six animals were vaccinated with bivalent vaccine and challenged with virulent BTV-4, two of these animals had detectable viral levels of viral RNA, and one of these showed clinical signs consistent with BTV infection and died. Conclusions There is good evidence that BTV-1 VLPs delivered as monovalent or bivalent immunogen protect from bluetongue disease on challenge with virulent BTV-1. However, it is possible that there is some interference in protective response for BTV-4 in the bivalent BTV-1 and BTV-4 VLP vaccine. This raises the question of whether all combinations of bivalent BTV vaccines are possible, or if

  10. 75 FR 77002 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-10

    ... for Public Comment; Affordable Care Act Internal Claims and Appeals and External Review Procedures for... Patient Protection and Affordable Care Act (Affordable Care Act) that are discussed below. A copy of the... collection requests (ICRs) contained in the rule described below that relates to the Affordable Care......

  11. Assessment of protection from systemic infection or disease afforded by low to intermediate titers of passively acquired neutralizing antibody against bovine viral diarrhea virus in calves.

    PubMed

    Bolin, S R; Ridpath, J F

    1995-06-01

    Colostrum-deprived calves (n = 24) were fed various amounts of colostrum, colostrum substitute, or milk replacer to establish a range in titer of passively acquired viral neutralizing antibody in serum. The calves were then challenge exposed intranasally with a virulent, noncytopathic bovine viral diarrhea virus (BVDV-890). After viral challenge exposure, calves were monitored for fever, leukopenia, thrombocytopenia, and diarrhea. In addition, viral isolation and viral titration were performed on specimens of nasal secretions, buffy coat cells, and serum obtained from the calves. Fever and systemic spread of virus were detected in calves that had viral neutralizing titer of 256 or lower. Calves that had viral neutralizing titer lower than 16 developed severe clinical disease manifested by fever, leukopenia, thrombocytopenia, and diarrhea. Severity and duration of signs of disease decreased as titers of passively acquired viral neutralizing antibody increased. These results indicate that low to intermediate titers of passively acquired viral neutralizing antibody were not sufficient to fully protect calves from virulent bovine viral diarrhea virus.

  12. Friendly protection of houses by affordable isolation

    SciTech Connect

    Mazzolani, Federico M.; Mandara, Alberto; Froncillo, Salvatore

    2008-07-08

    The paper deals with a case of seismic isolation carried out in Campania (Italy), referring to the construction of a house building. The concerned case is a three-storey reinforced concrete frame building, in which the isolation system has been applied between the basement top and the first floor deck. The paper reports the main steps of this work, starting from the design, carried out according to the latest Italian seismic code, going throughout the construction stage, up to the extensive on-site testing program performed to evaluate the dynamic response of the building. Relevant technological solutions are illustrated and discussed. Both theoretical calculation and experimental measurements demonstrate the effectiveness of the solution adopted, not only from the technical point of view, but also in an economic perspective.

  13. Ergonomics: Injury Protection You Can Afford.

    ERIC Educational Resources Information Center

    Sturgeon, Julie

    1998-01-01

    Examines the physical health risks attributed to poor furniture and equipment ergonomics and looks at ways to help assure that furniture and equipment purchases and practices are ergonomically sound. Cautions to be wary wary of marketing hype that a company's furniture is ergonomically set, and acquire adjustable furniture and encourage students…

  14. Maximum likelihood.

    PubMed

    Yang, Shuying; De Angelis, Daniela

    2013-01-01

    The maximum likelihood method is a popular statistical inferential procedure widely used in many areas to obtain the estimates of the unknown parameters of a population of interest. This chapter gives a brief description of the important concepts underlying the maximum likelihood method, the definition of the key components, the basic theory of the method, and the properties of the resulting estimates. Confidence interval and likelihood ratio test are also introduced. Finally, a few examples of applications are given to illustrate how to derive maximum likelihood estimates in practice. A list of references to relevant papers and software for a further understanding of the method and its implementation is provided.

  15. Absolute vs. Weight-Related Maximum Oxygen Uptake in Firefighters: Fitness Evaluation with and without Protective Clothing and Self-Contained Breathing Apparatus among Age Group

    PubMed Central

    Perroni, Fabrizio; Guidetti, Laura; Cignitti, Lamberto; Baldari, Carlo

    2015-01-01

    During fire emergencies, firefighters wear personal protective devices (PC) and a self-contained breathing apparatus (S.C.B.A.) to be protected from injuries. The purpose of this study was to investigate the differences of aerobic level in 197 firefighters (age: 34±7 yr; BMI: 24.4±2.3 kg.m-2), evaluated by a Queen’s College Step field Test (QCST), performed with and without fire protective garments, and to analyze the differences among age groups (<25 yr; 26-30 yr, 31-35 yr, 36-40 yr and >40 yr). Variance analysis was applied to assess differences (p < 0.05) between tests and age groups observed in absolute and weight-related values, while a correlation was examined between QCST with and without PC+S.C.B.A. The results have shown that a 13% of firefighters failed to complete the test with PC+S.C.B.A. and significant differences between QCST performed with and without PC+S.C.B.A. in absolute (F(1,169) = 42.6, p < 0.0001) and weight-related (F(1,169) = 339.9, p < 0.0001) terms. A better correlation has been found in L•min-1 (r=0.67) than in ml•kg-1•min-1 (r=0.54). Moreover, we found significant differences among age groups both in absolute and weight-related values. The assessment of maximum oxygen uptake of firefighters in absolute term can be a useful tool to evaluate the firefighters' cardiovascular strain. PMID:25764201

  16. Absolute vs. weight-related maximum oxygen uptake in firefighters: fitness evaluation with and without protective clothing and self-contained breathing apparatus among age group.

    PubMed

    Perroni, Fabrizio; Guidetti, Laura; Cignitti, Lamberto; Baldari, Carlo

    2015-01-01

    During fire emergencies, firefighters wear personal protective devices (PC) and a self-contained breathing apparatus (S.C.B.A.) to be protected from injuries. The purpose of this study was to investigate the differences of aerobic level in 197 firefighters (age: 34±7 yr; BMI: 24.4±2.3 kg.m-2), evaluated by a Queen's College Step field Test (QCST), performed with and without fire protective garments, and to analyze the differences among age groups (<25 yr; 26-30 yr, 31-35 yr, 36-40 yr and >40 yr). Variance analysis was applied to assess differences (p < 0.05) between tests and age groups observed in absolute and weight-related values, while a correlation was examined between QCST with and without PC+S.C.B.A. The results have shown that a 13% of firefighters failed to complete the test with PC+S.C.B.A. and significant differences between QCST performed with and without PC+S.C.B.A. in absolute (F(1,169) = 42.6, p < 0.0001) and weight-related (F(1,169) = 339.9, p < 0.0001) terms. A better correlation has been found in L•min-1 (r=0.67) than in ml•kg-1•min-1 (r=0.54). Moreover, we found significant differences among age groups both in absolute and weight-related values. The assessment of maximum oxygen uptake of firefighters in absolute term can be a useful tool to evaluate the firefighters' cardiovascular strain. PMID:25764201

  17. Use of the Maximum Cumulative Ratio As an Approach for Prioritizing Aquatic Coexposure to Plant Protection Products: A Case Study of a Large Surface Water Monitoring Database.

    PubMed

    Vallotton, Nathalie; Price, Paul S

    2016-05-17

    This paper uses the maximum cumulative ratio (MCR) as part of a tiered approach to evaluate and prioritize the risk of acute ecological effects from combined exposures to the plant protection products (PPPs) measured in 3 099 surface water samples taken from across the United States. Assessments of the reported mixtures performed on a substance-by-substance approach and using a Tier One cumulative assessment based on the lowest acute ecotoxicity benchmark gave the same findings for 92.3% of the mixtures. These mixtures either did not indicate a potential risk for acute effects or included one or more individual PPPs that had concentrations in excess of their benchmarks. A Tier Two assessment using a trophic level approach was applied to evaluate the remaining 7.7% of the mixtures. This assessment reduced the number of mixtures of concern by eliminating the combination of endpoint from multiple trophic levels, identified invertebrates and nonvascular plants as the most susceptible nontarget organisms, and indicated that a only a very limited number of PPPs drove the potential concerns. The combination of the measures of cumulative risk and the MCR enabled the identification of a small subset of mixtures where a potential risk would be missed in substance-by-substance assessments. PMID:27057923

  18. Use of the Maximum Cumulative Ratio As an Approach for Prioritizing Aquatic Coexposure to Plant Protection Products: A Case Study of a Large Surface Water Monitoring Database.

    PubMed

    Vallotton, Nathalie; Price, Paul S

    2016-05-17

    This paper uses the maximum cumulative ratio (MCR) as part of a tiered approach to evaluate and prioritize the risk of acute ecological effects from combined exposures to the plant protection products (PPPs) measured in 3 099 surface water samples taken from across the United States. Assessments of the reported mixtures performed on a substance-by-substance approach and using a Tier One cumulative assessment based on the lowest acute ecotoxicity benchmark gave the same findings for 92.3% of the mixtures. These mixtures either did not indicate a potential risk for acute effects or included one or more individual PPPs that had concentrations in excess of their benchmarks. A Tier Two assessment using a trophic level approach was applied to evaluate the remaining 7.7% of the mixtures. This assessment reduced the number of mixtures of concern by eliminating the combination of endpoint from multiple trophic levels, identified invertebrates and nonvascular plants as the most susceptible nontarget organisms, and indicated that a only a very limited number of PPPs drove the potential concerns. The combination of the measures of cumulative risk and the MCR enabled the identification of a small subset of mixtures where a potential risk would be missed in substance-by-substance assessments.

  19. 77 FR 10781 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... Comment; Affordable Care Act Internal Claims and Appeals and External Review Procedures for Non... . SUPPLEMENTARY INFORMATION: I. Background The Patient Protection and Affordable Care Act, Public Law 111-148, (the Affordable Care Act) was enacted by President Obama on March 23, 2010. As part of the...

  20. 78 FR 71667 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-29

    ...; Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier..., ``Affordable Care Act Grandfathered Health Plan Disclosure, Recordkeeping Requirement, and Change in Carrier... Protection and Affordable Care Act (ACA), Public Law 111-148, section 1251 provides that certain plans...

  1. 75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-28

    ...; Affordable Care Act Advance Notice of Rescission ACTION: Notice. SUMMARY: The Department of Labor (DOL... information collection request (ICR) titled, ``Affordable Care Act Advance Notice of Rescission,'' to the..._PRA_PUBLIC@dol.gov . SUPPLEMENTARY INFORMATION: The Patient Protection and Affordable Care Act...

  2. Why the affordable care act needs a better name: 'Americare'.

    PubMed

    Sage, William M

    2010-08-01

    The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.

  3. Contraceptive Coverage and the Affordable Care Act.

    PubMed

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. PMID:26598303

  4. Breastfeeding and the Affordable Care Act.

    PubMed

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding.

  5. Contraceptive Coverage and the Affordable Care Act.

    PubMed

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception.

  6. Breastfeeding and the Affordable Care Act.

    PubMed

    Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice

    2015-10-01

    Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding. PMID:26318941

  7. Maximum Jailbreak

    NASA Astrophysics Data System (ADS)

    Singleton, B.

    First formulated one hundred and fifty years ago by the heretical scholar Nikolai Federov, the doctrine of cosmism begins with an absolute refusal to treat the most basic factors conditioning life on Earth ­ gravity and death ­ as necessary constraints on action. As manifest through the intoxicated cheers of its early advocates that humans should storm the heavens and conquer death, cosmism's foundational gesture was to conceive of the earth as a trap. Its duty was therefore to understand the duty of philosophy, economics and design to be the creation of means to escape it. This could be regarded as a jailbreak at the maximum possible scale, a heist in which the human species could steal itself from the vault of the Earth. After several decades of relative disinterest new space ventures are inspiring scientific, technological and popular imaginations, this essay explores what kind of cosmism might be constructed today. In this paper cosmism's position as a means of escape is both reviewed and evaluated by reflecting on the potential of technology that actually can help us achieve its aims and also through the lens and state-ofthe-art philosophy of accelerationism, which seeks to outrun modern tropes by intensifying them.

  8. The influence of athletic experience and kinematic information on skill-relevant affordance perception.

    PubMed

    Weast, Julie A; Shockley, Kevin; Riley, Michael A

    2011-04-01

    Humans can perceive affordances both for themselves and for others, and affordance perception is a function of perceptual-motor experience involved in playing a sport. Two experiments investigated the enhanced affordance perception of athletes. In Experiment 1, basketball players and nonbasketball players provided perceptual reports for sports-relevant (maximum standing-reach and reach-with-jump heights) and non-sports-relevant (maximum sitting height) affordances for self and other. Basketball players were more accurate at perceiving maximum reach-with-jump for another person than were nonbasketball players, but were no better at perceiving maximum reach or sitting heights. Experiment 2 investigated the informational basis for this enhanced perceptual ability of basketball players by evaluating whether kinematics inform perceivers about action-scaled (e.g., force-production dependent), but not body-scaled (i.e., geometrically determined), affordances for others, and whether basketball experience enhances sensitivity to kinematic information. Only basketball players improved at perceiving an action-scaled affordance (maximum reach-with-jump), but not body-scaled affordances (maximum standing-reach and sit) with exposure to kinematic information, suggesting that action-scaled affordances may be specified by kinematic information to which athletes are already attuned by virtue of their sport experience.

  9. 76 FR 52663 - Notice of Intent To Award Affordable Care Act Funding, DP-09-001

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-23

    ... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Centers (U48).'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective...

  10. An affordable humanitarian mine detector

    NASA Astrophysics Data System (ADS)

    Daniels, David J.; Curtis, Paul; Amin, Rajan; Dittmer, Jon

    2004-09-01

    This paper describes the further development of the MINETECT affordable humanitarian mine detector produced by ERA Technology with sponsorship from the UK Department for International Development. Using a radically different patented approach from conventional ground penetrating radar (GPR) designs in terms of the man machine interface, MINETECT offers simplicity of use and affordability, both key factors in humanitarian demining operations. Following trials in 2002 and reported at SPIE 2002, further development work including research on classifying mines, based on data from planned trials in the United Kingdom, is presented. MINETECT has the capability of detecting completely non-metallic mines and offers a considerable improvement in hand-held mine detection.

  11. The ethics of the affordability of health insurance.

    PubMed

    Saloner, Brendan; Daniels, Norman

    2011-10-01

    In this essay we argue that the concept of affordable health insurance is rooted in a social obligation to protect fair equality of opportunity. Specifically, health insurance plays a limited but significant role in protecting opportunity in two ways: it helps keep people functioning normally and it protects their financial security. Together these benefits enable household members to exercise reasonable choices about their plans of life. To achieve truly affordable coverage, society must be able to contain the overall cost of health care, and health insurance must be progressively financed, meaning that those who are best able to pay for coverage should pay the largest share. While the recently passed Patient Protection and Affordable Care Act (ACA) falls short on both of these counts, we argue that it makes important contributions toward household affordability through the use of subsidies and regulations. The main shortcoming of the ACA is an insufficient protection against burdensome cost sharing, which we illustrate using several hypothetical scenarios. We conclude with recommendations about how to make opportunity-enhancing expansions to the current coverage subsidies.

  12. The ethics of the affordability of health insurance.

    PubMed

    Saloner, Brendan; Daniels, Norman

    2011-10-01

    In this essay we argue that the concept of affordable health insurance is rooted in a social obligation to protect fair equality of opportunity. Specifically, health insurance plays a limited but significant role in protecting opportunity in two ways: it helps keep people functioning normally and it protects their financial security. Together these benefits enable household members to exercise reasonable choices about their plans of life. To achieve truly affordable coverage, society must be able to contain the overall cost of health care, and health insurance must be progressively financed, meaning that those who are best able to pay for coverage should pay the largest share. While the recently passed Patient Protection and Affordable Care Act (ACA) falls short on both of these counts, we argue that it makes important contributions toward household affordability through the use of subsidies and regulations. The main shortcoming of the ACA is an insufficient protection against burdensome cost sharing, which we illustrate using several hypothetical scenarios. We conclude with recommendations about how to make opportunity-enhancing expansions to the current coverage subsidies. PMID:22065686

  13. Developing Strategies for Affordable Bandwidth.

    ERIC Educational Resources Information Center

    Educause Quarterly, 2000

    2000-01-01

    Written by Educause's Net@EDU Broadband Pricing Working Group, this article discusses what institutions of higher education can do to develop good partnerships with broadband vendors in order to negotiate affordable pricing for increased bandwidth. Describes problems with the marketplace, examples from a few universities, and points to remember…

  14. Global affordability of fluoride toothpaste

    PubMed Central

    Goldman, Ann S; Yee, Robert; Holmgren, Christopher J; Benzian, Habib

    2008-01-01

    Objective Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries. Methods Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head. Results The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g) of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head. Conclusion Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed. PMID:18554382

  15. Patient Protection and Affordable Care Act; Exchange functions: standards for Navigators and non-Navigator assistance personnel; consumer assistance tools and programs of an Exchange and certified application counselors. Final rule.

    PubMed

    2013-07-17

    This final rule addresses various requirements applicable to Navigators and non-Navigator assistance personnel in Federally-facilitated Exchanges, including State Partnership Exchanges, and to non-Navigator assistance personnel in State Exchanges that are funded through federal Exchange Establishment grants. It finalizes the requirement that Exchanges must have a certified application counselor program. It creates conflict-of-interest, training and certification, and meaningful access standards; clarifies that any licensing, certification, or other standards prescribed by a state or Exchange must not prevent application of the provisions of title I of the Affordable Care Act; adds entities with relationships to issuers of stop loss insurance to the list of entities that are ineligible to become Navigators; and clarifies that the same ineligibility criteria that apply to Navigators apply to certain non-Navigator assistance personnel. The final rule also directs that each Exchange designate organizations which will then certify their staff members and volunteers to be application counselors that assist consumers and facilitate enrollment in qualified health plans and insurance affordability programs, and provides standards for that designation.

  16. Federal Home Visiting under the Affordable Care Act

    ERIC Educational Resources Information Center

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  17. Making personalized medicine more affordable.

    PubMed

    Aronson, Naomi

    2015-06-01

    Precision medicine holds promise to solve the conundrums of clinical care. Foremost is the well-known but vexing problem of heterogeneity and the tyranny of the mean. Who will respond to a treatment? How can patients avoid the harms of treatments that will not work for them? And if we know who to treat, will that make care more efficient and less costly? But the converse can also be true: treatments become more expensive as the costs of development must be distributed across smaller populations. Next-generation sequencing is making genetic testing radically cheaper. But the costs of medical tests also include false-positive results, incidental findings, and the cascade of follow-up. The affordability of precision medicine is intertwined with the broader issue of affordability of our healthcare system, and will require all stakeholders to assume stewardship for access and sustainability. PMID:25728478

  18. Optics learning through affordable kit

    NASA Astrophysics Data System (ADS)

    P, Anusha N.; Shaji, Chitra; Sharan, Alok

    2014-10-01

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  19. Optics learning through affordable kit

    SciTech Connect

    P, Anusha N E-mail: chitrashaji@gmail.com Shaji, Chitra E-mail: chitrashaji@gmail.com Sharan, Alok E-mail: chitrashaji@gmail.com

    2014-10-15

    An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.

  20. Spacecraft Maximum Allowable Concentrations for Airborne Contaminants

    NASA Technical Reports Server (NTRS)

    James, John T.

    2008-01-01

    The enclosed table lists official spacecraft maximum allowable concentrations (SMACs), which are guideline values set by the NASA/JSC Toxicology Group in cooperation with the National Research Council Committee on Toxicology (NRCCOT). These values should not be used for situations other than human space flight without careful consideration of the criteria used to set each value. The SMACs take into account a number of unique factors such as the effect of space-flight stress on human physiology, the uniform good health of the astronauts, and the absence of pregnant or very young individuals. Documentation of the values is given in a 5 volume series of books entitled "Spacecraft Maximum Allowable Concentrations for Selected Airborne Contaminants" published by the National Academy Press, Washington, D.C. These books can be viewed electronically at http://books.nap.edu/openbook.php?record_id=9786&page=3. Short-term (1 and 24 hour) SMACs are set to manage accidental releases aboard a spacecraft and permit risk of minor, reversible effects such as mild mucosal irritation. In contrast, the long-term SMACs are set to fully protect healthy crewmembers from adverse effects resulting from continuous exposure to specific air pollutants for up to 1000 days. Crewmembers with allergies or unusual sensitivity to trace pollutants may not be afforded complete protection, even when long-term SMACs are not exceeded. Crewmember exposures involve a mixture of contaminants, each at a specific concentration (C(sub n)). These contaminants could interact to elicit symptoms of toxicity even though individual contaminants do not exceed their respective SMACs. The air quality is considered acceptable when the toxicity index (T(sub grp)) for each toxicological group of compounds is less than 1, where T(sub grp), is calculated as follows: T(sub grp) = C(sub 1)/SMAC(sub 1) + C(sub 2/SMAC(sub 2) + ...+C(sub n)/SMAC(sub n).

  1. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in...

  2. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in...

  3. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in...

  4. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise “of any right afforded by this Act.” Certain rights are explicitly provided in...

  5. Essential kinematic information, athletic experience, and affordance perception for others.

    PubMed

    Weast, Julie A; Walton, Ashley; Chandler, Braylen C; Shockley, Kevin; Riley, Michael A

    2014-06-01

    The present study investigated the role of different types of movement in affordance perception, as well as the influence of sports experience. Perception of another actor's maximum vertical jumping height and horizontal long-jumping distance was evaluated for basketball players, soccer players, and nonplayer controls after viewing point-light representations of the actors' movements. Perceptual reports were more accurate after jumping-related movements (walking and squatting) were viewed than after nonrelated movements (standing and twisting). Vertical jump reports were more accurate than horizontal jump reports. Basketball and soccer players demonstrated higher accuracy than did controls. This research establishes that point-light displays contain essential kinematic information sufficient to support accurate affordance perception, and athletes appear better attuned to kinematic information specifying affordances for others as a result of their sports experience.

  6. Smoking Bans in Affordable Housing Benefit All

    MedlinePlus

    ... 160501.html Smoking Bans in Affordable Housing Benefit All: Study Secondhand exposure lowered, and smokers more likely ... residents of eight affordable housing properties in Minnesota. All the properties prohibited smoking indoors and three also ...

  7. Can China afford rapid aging?

    PubMed

    Jiang, Quanbao; Yang, Shucai; Sánchez-Barricarte, Jesús J

    2016-01-01

    China's rapid aging has caused widespread concern, but it seems that the situations and consequences of rapid aging are not adequately acknowledged. This study analyzed the problem of ageing in China from the aspects of elderly people's health status, income source, daily care, suicide, the weak social security system in terms of pension, health expenses, and long-term care costs as well as incoming accelerating ageing process in China. All these factors indicate that it is difficult for China to afford the issue of a rapidly aging population. PMID:27478724

  8. Perceiving Affordances for Fitting through Apertures

    ERIC Educational Resources Information Center

    Ishak, Shaziela; Adolph, Karen E.; Lin, Grace C.

    2008-01-01

    Affordances--possibilities for action--are constrained by the match between actors and their environments. For motor decisions to be adaptive, affordances must be detected accurately. Three experiments examined the correspondence between motor decisions and affordances as participants reached through apertures of varying size. A psychophysical…

  9. The Affordable Care Act: The Value of Systemic Disruption

    PubMed Central

    2013-01-01

    It is important to recognize the political and policy accomplishments of the Patient Protection and Affordable Care Act (ACA), anticipate its limitations, and use the levers it provides strategically to address the problems it does not resolve. Passage of the ACA broke the political logjam that long stymied national progress toward equitable, quality, universal, affordable health care. It extends coverage for the uninsured who are disproportionately low income and people of color, curbs health insurance abuses, and initiates improvements in the quality of care. However, challenges to affordability and cost control persist. Public health advocates should mobilize for coverage for abortion care and for immigrants, encourage public-sector involvement in negotiating health care prices, and counter disinformation by opponents on the right. PMID:23409911

  10. Nesting in perception of affordances for stepping and leaping.

    PubMed

    Wagman, Jeffrey B; Bai, Jiuyang; Smith, Peter J K

    2016-08-01

    Perception of affordances for a given behavior typically reflects the task-specific action capabilities of the perceiver. However, many experiments have shown a discrepancy between the perceptual and behavioral boundaries for a given behavior. One possibility for such a discrepancy is that the context of many experimental tasks transformed what is typically a dynamic perception-action task into an analytical or reflective judgment. We investigated this hypothesis with respect to perception of maximum stepping and leaping distance. For both behaviors, perception of these affordances more closely reflected action capabilities when the perceptual task was nested within a superordinate task than when it was not (regardless of whether the behavior itself was performed). Additionally, verbal reports of perception of maximum leaping distance more closely reflected action capabilities when there was an explicit time limit on such reports. The results are discussed in the context of the ecological principle of nesting and in attentional focus during motor control tasks. PMID:27220935

  11. The Affordable Care Act: a primer for plastic surgeons.

    PubMed

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.

  12. The Affordable Care Act: a primer for plastic surgeons.

    PubMed

    Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K

    2014-11-01

    The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change. PMID:25347659

  13. Induction of cellular glutathione-linked enzymes and catalase by the unique chemoprotective agent, 3H-1,2-dithiole-3-thione in rat cardiomyocytes affords protection against oxidative cell injury.

    PubMed

    Peng, Xingxiang; Li, Yunbo

    2002-06-01

    Considerable evidence suggests that reactive oxygen species (ROS) are crucially involved in the pathogenesis of cardiovascular diseases, such as myocardial ischemia-reperfusion injury. Consistent with this notion, administration of exogenous antioxidative compounds has been shown to provide protection against oxidative cardiac injury. However, whether induction of endogenous cellular antioxidants by chemicals (drugs) also offers protection against oxidative cardiac injury has not been extensively investigated. In the present study, with rat cardiomyocyte H9C2 cells as an in vitro model, we have investigated the induction of cellular antioxidants by the unique chemoprotective agent, 3 H -1,2-dithiole-3-thione (D3T) and the protective effects of the D3T-induced cellular antioxidants against ROS-mediated injury in cardiac cells. Incubation of H9C2 cells with micromolar concentrations of D3T for 24 h resulted in a significant induction of a battery of cellular antioxidants, including reduced glutathione (GSH), GSH peroxidase, GSSG reductase, GSH S-transferase and catalase. To further examine the protective effects of the induced endogenous antioxidants against oxidative cell injury, H9C2 cells were pre-treated with D3T and then incubated with xanthine oxidase (XO) plus xanthine, a system that generates ROS. We observed that D3T pre-treatment of H9C2 cells led to significant protection against XO/xanthine-induced cytotoxicity as determined by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) reduction and morphological changes. Taken together, this study demonstrates for the first time that a number of endogenous antioxidants in cardiomyocytes can be induced by exposure to D3T, and that this chemical (drug) induction of cellular antioxidants is accompanied by markedly increased resistance to ROS-mediated cardiac cell injury.

  14. Affordable In-Space Transportation

    NASA Technical Reports Server (NTRS)

    Curtis, L. A.; VanDyke, M. K.; Lajoie, R. M.; Woodcock, G. R.

    1996-01-01

    Current and proposed launch systems will provide access to low-Earth orbit (LEO), and destinations beyond LEO, but the cost of delivering payloads will preclude the use of these services by many users. To develop and encourage revolutionary commercial utilization of geosynchronous orbit (GEO) and to provide an affordable means to continue NASA space science and exploration missions, the transportation costs to in-space destinations must be reduced. The principal objective of this study was to conceptually define three to four promising approaches to in-space transportation for delivery of satellites and other payloads, 3,000- to 10,000-lb class, to GEO destinations. This study established a methodology for evaluating in-space transportation systems based on life-cycle cost. The reusable concepts seemed to fare better in the evaluation than expendable, since a major driver in the life-cycle cost was the stage production cost.

  15. Small businesses and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof

    2010-09-01

    The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program. PMID:20812427

  16. Affordable underwater wireless optical communication using LEDs

    NASA Astrophysics Data System (ADS)

    Pilipenko, Vladimir; Arnon, Shlomi

    2013-09-01

    In recent years the need for high data rate underwater wireless communication (WC) has increased. Nowadays, the conventional technology for underwater communication is acoustic. However, the maximum data rate that acoustic technology can provide is a few kilobits per second. On the other hand, emerging applications such as underwater imaging, networks of sensors and swarms of underwater vehicles require much faster data rates. As a result, underwater optical WC, which can provide much higher data rates, has been proposed as an alternative means of communication. In addition to high data rates, affordable communication systems become an important feature in the development requirements. The outcome of these requirements is a new system design based on off-the-shelf components such as blue and green light emitting diodes (LEDs). This is due to the fact that LEDs offer solutions characterized by low cost, high efficiency, reliability and compactness. However, there are some challenges to be met when incorporating LEDs as part of the optical transmitter, such as low modulation rates and non linearity. In this paper, we review the main challenges facing the incorporation of LEDs as an integral part of underwater WC systems and propose some techniques to mitigate the LED limitations in order to achieve high data rate communication

  17. Scaling affordances for human reach actions.

    PubMed

    Choi, Hyeg Joo; Mark, Leonard S

    2004-12-01

    A methodology developed by Cesari and Newell [Cesari, P., & Newell, K. M. (1999). The scaling of human grip configuration. Journal of Experimental Psychology: Human Perception and Performance 25, 927-935; Cesari, P., & Newell, K. M. (2000). The body-scaling of grip configurations in children aged 6-12 years. Developmental Psychobiology 36, 301-310] was used to delineate the roles of an object's weight (W) and distance (D) as well as the actor's strength (S) in determining the macroscopic action used to reach for the object. Participants reached for objects of five different weights placed at 10 distances. The findings of a single discriminant analysis revealed that when object weight is scaled in terms of each individual's strength and reach distance is scaled in terms of each individual's maximum-seated reach distance, a single discriminant analysis was able to predict 90% of the reach modes used by both men and women. The result of the discriminant analysis was used to construct a body-scaled equation, K=lnD+ln(W/S)/36, similar in form to the one derived by Cesari and Newell, accurately predicted the reach action used. Our findings indicate that Cesari and Newell's method can identify a complex relationship between geometric and dynamic constraints that determine the affordances for different reach actions. PMID:15664673

  18. Dopamine, affordance and active inference.

    PubMed

    Friston, Karl J; Shiner, Tamara; FitzGerald, Thomas; Galea, Joseph M; Adams, Rick; Brown, Harriet; Dolan, Raymond J; Moran, Rosalyn; Stephan, Klaas Enno; Bestmann, Sven

    2012-01-01

    The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal) cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions) about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order) in which cues are presented. These simulations provide a (Bayes-optimal) model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors) to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level.

  19. Can consumers make affordable care affordable? The value of choice architecture.

    PubMed

    Johnson, Eric J; Hassin, Ran; Baker, Tom; Bajger, Allison T; Treuer, Galen

    2013-01-01

    Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

  20. Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture

    PubMed Central

    Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen

    2013-01-01

    Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a “smart” default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484

  1. Burros: Simple, affordable, effective space transportation

    SciTech Connect

    Canavan, G.H.

    1992-05-01

    This note argues that space is the best place to put not only the sensors, but also the SBIs Spare Based Interceptors and DEWs Directed-Energy Weapons needed to address long-range, intra- and inter-theater missiles efficiently. There are real threats; they are likely to worsen. Ground-based defenses cannot handle them all affordably. Mixes are generally appropriate. There is a role for SBIs, but it doesn't appear to require all of the capabilities built into the current SBIs at the outset. The SBIs that are needed now could be no more than cheap burros that were amenable to joint development and robust command for the protection of all. Their deployment for (GPALs) Global Protection Against Limited Strikes should not adversely impact the arms control or crisis stability of the strategic balance with the Soviet Union in any rational, concrete calculus, including that used by the Soviet Union. Deployment at low latitudes should give them adequate capability against theater launches but none against Soviet (ICMBs) International Ballist Missiles and only marginal, residual impact on (SLBMs) Submarine-Launched Ballistics Missiles. They should not either leave hot production capability of anything threatening or provoke untoward responses. We have a hot production line on Chevrolets that would pose more of a threat to the Soviet Union. Their inability to overcome even crude Soviet countermeasures would be an asset in this light. A companion effort could develop the brilliant eyes needed to guide them. A similar logic is possible with DEWs, but they are less developed and hence less at issue. 57 refs.

  2. Burros: Simple, affordable, effective space transportation

    SciTech Connect

    Canavan, G.H.

    1992-05-01

    This note argues that space is the best place to put not only the sensors, but also the SBIs Spare Based Interceptors and DEWs Directed-Energy Weapons needed to address long-range, intra- and inter-theater missiles efficiently. There are real threats; they are likely to worsen. Ground-based defenses cannot handle them all affordably. Mixes are generally appropriate. There is a role for SBIs, but it doesn`t appear to require all of the capabilities built into the current SBIs at the outset. The SBIs that are needed now could be no more than cheap burros that were amenable to joint development and robust command for the protection of all. Their deployment for (GPALs) Global Protection Against Limited Strikes should not adversely impact the arms control or crisis stability of the strategic balance with the Soviet Union in any rational, concrete calculus, including that used by the Soviet Union. Deployment at low latitudes should give them adequate capability against theater launches but none against Soviet (ICMBs) International Ballist Missiles and only marginal, residual impact on (SLBMs) Submarine-Launched Ballistics Missiles. They should not either leave hot production capability of anything threatening or provoke untoward responses. We have a hot production line on Chevrolets that would pose more of a threat to the Soviet Union. Their inability to overcome even crude Soviet countermeasures would be an asset in this light. A companion effort could develop the brilliant eyes needed to guide them. A similar logic is possible with DEWs, but they are less developed and hence less at issue. 57 refs.

  3. College Affordability: Implications for College Opportunity

    ERIC Educational Resources Information Center

    Perna, Laura W.; Li, Chunyan

    2006-01-01

    By examining trends in college affordability, this article explores the extent to which the public perception that college is not affordable is justified. First, the article describes trends in national indicators that contribute to ability to pay, including income growth, health care costs, debt burden, and personal savings rates. Trends in…

  4. Affordability Funding Models for Early Childhood Services

    ERIC Educational Resources Information Center

    Purcal, Christiane; Fisher, Karen

    2006-01-01

    This paper presents a model of the approaches open to government to ensure that early childhood services are affordable to families. We derived the model from a comparative literature review of affordability approaches taken by government, both in Australia and internationally. The model adds significantly to the literature by proposing a means to…

  5. Affordability Approaches for Human Space Exploration

    NASA Technical Reports Server (NTRS)

    Holladay, Jon; Smith, David Alan

    2012-01-01

    The design and development of historical NASA Programs (Apollo, Shuttle and International Space Station), have been based on pre-agreed missions which included specific pre-defined destinations (e.g., the Moon and low Earth orbit). Due to more constrained budget profiles, and the desire to have a more flexible architecture for Mission capture as it is affordable, NASA is working toward a set of Programs that are capability based, rather than mission and/or destination specific. This means designing for a performance capability that can be applied to a specific human exploration mission/destination later (sometime years later). This approach does support developing systems to flatter budgets over time, however, it also poses the challenge of how to accomplish this effectively while maintaining a trained workforce, extensive manufacturing, test and launch facilities, and ensuring mission success ranging from Low Earth Orbit to asteroid destinations. NASA Marshall Space Flight Center (MSFC) in support of Exploration Systems Directorate (ESD) in Washington, DC has been developing approaches to track affordability across multiple Programs. The first step is to ensure a common definition of affordability: the discipline to bear cost in meeting a budget with margin over the life of the program. The second step is to infuse responsibility and accountability for affordability into all levels of the implementing organization since affordability is no single person s job; it is everyone s job. The third step is to use existing data to identify common affordability elements organized by configuration (vehicle/facility), cost, schedule, and risk. The fourth step is to analyze and trend this affordability data using an affordability dashboard to provide status, measures, and trends for ESD and Program level of affordability tracking. This paper will provide examples of how regular application of this approach supports affordable and therefore sustainable human space exploration

  6. Affordable Care Organizations and Bundled Pricing: A New Philosophy of Care.

    PubMed

    Barinaga, Gonzalo; Chambers, Monique C; El-Othmani, Mouhanad M; Siegrist, Richard B; Saleh, Khaled J

    2016-10-01

    Under the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services' Innovation was chartered to develop new models of health care delivery. The changes meant a drastic need to restructure the health care system. To minimize costs and optimize quality, new laws encourage continuity in health care delivery within an integrated system. Affordable care organizations provided a model of high-quality care while reducing costs. Bundled payments can have a substantial effect on the national expenditures. This article examines new developments in bundle payments, affordable care organizations, and gainsharing agreements as they pertain to arthroplasty. PMID:27637657

  7. Affordable Care Organizations and Bundled Pricing: A New Philosophy of Care.

    PubMed

    Barinaga, Gonzalo; Chambers, Monique C; El-Othmani, Mouhanad M; Siegrist, Richard B; Saleh, Khaled J

    2016-10-01

    Under the Patient Protection and Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services' Innovation was chartered to develop new models of health care delivery. The changes meant a drastic need to restructure the health care system. To minimize costs and optimize quality, new laws encourage continuity in health care delivery within an integrated system. Affordable care organizations provided a model of high-quality care while reducing costs. Bundled payments can have a substantial effect on the national expenditures. This article examines new developments in bundle payments, affordable care organizations, and gainsharing agreements as they pertain to arthroplasty.

  8. Navigating the Affordable Care Act and the Patient with Inflammatory Bowel Disease.

    PubMed

    Isaacs, Kim L; Arora, Shifali

    2015-12-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) is a critically important yet complex piece of legislation with far reaching impacts on patient care especially for those with chronic diseases such as inflammatory bowel disease. The tenets of the Affordable Care Act affect not only those purchasing new plans through the marketplaces but also Americans across the country as it sets baseline standards for many aspects of coverage. This review will address the fundamental goals that drove the inception of the legislation, the impact of the Affordable Care Act on day-to-day patient care, and the key components of the marketplace plans and potential subsidies.

  9. MISSE-X: Affordable Space Environment Testing

    NASA Video Gallery

    MISSE–X is a robotically serviceable ISS external facility providing government, industry and academia experimenters with affordable access to space for materials durability testing of potential ...

  10. To repeal the Patient Protection and Affordable Care Act.

    THOMAS, 111th Congress

    Rep. King, Steve [R-IA-5

    2010-03-25

    06/16/2010 Motion to Discharge Committee filed by Mr. King (IA). Petition No: 111-11. (Discharge petition text with signatures.) (All Actions) Notes: On 6/16/2010, a motion was filed to discharge the Committees on Energy and Commerce, Ways and Means, Education and Labor, the Judiciary, Natural Resources, Rules, House Administration, and Appropriations from consideration of H.R.4972. A discharge petition requires 218 signatures for... Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  11. Affordability of the Health Expenditures of Insured Americans Before the Affordable Care Act.

    PubMed

    Nyman, John A; Trenz, Helen M

    2016-02-01

    Central to the Affordable Care Act is the notion of affordability and the role of health insurance in making otherwise unaffordable health care affordable. We used data from the 1996 to 2008 versions of the Medical Expenditure Panel Survey to estimate the portion of overall health care expenditures by insured respondents that would otherwise have been beyond their disposable incomes and assets. We found that about one third of insured expenditures would have been unaffordable, with a much higher percentage among publicly insured individuals. This result suggests that one of the main functions of insurance is to cover expenses that insured individuals would not otherwise be able to afford. PMID:26691116

  12. Affordability of the Health Expenditures of Insured Americans Before the Affordable Care Act.

    PubMed

    Nyman, John A; Trenz, Helen M

    2016-02-01

    Central to the Affordable Care Act is the notion of affordability and the role of health insurance in making otherwise unaffordable health care affordable. We used data from the 1996 to 2008 versions of the Medical Expenditure Panel Survey to estimate the portion of overall health care expenditures by insured respondents that would otherwise have been beyond their disposable incomes and assets. We found that about one third of insured expenditures would have been unaffordable, with a much higher percentage among publicly insured individuals. This result suggests that one of the main functions of insurance is to cover expenses that insured individuals would not otherwise be able to afford.

  13. Affordable housing: Reducing the energy cost burden

    SciTech Connect

    Lee, A.D.; Chin, R.I.; Marden, C.L.

    1995-01-01

    Residential energy expenditures are a key determinant of housing affordability, particularly for lower Income households. For years, federal, state and local governments and agencies have sought to defray energy expenses and Increase residential energy efficiency for low Income households through legislative and regulatory actions and programs. Nevertheless, household energy costs continue to place a major burden on lower Income families. This issue paper was written to help formulate national energy policy by providing the United States Department of Energy`s (DOE`s) Office of Energy Efficiency and Renewable Energy (EE) with Information to help define the affordable housing issue; Identify major drivers, key factors, and primary stakeholders shaping the affordable housing issue; and review how responding to this Issue may impact EE`s goals and objectives and Influence the strategic direction of the office. Typically, housing affordability is an Issue associated with lower income households. This issue paper adopts this perspective, but it is important to note that reducing energy utility costs can make {open_quotes}better{close_quote} housing affordable to any household regardless of income. As energy efficiency is improved throughout all sectors of the economy, special consideration must be given to low income households. Of all households, low income households are burdened the most by residential energy costs; their residences often are the least energy-efficient and have the greatest potential for efficiency improvements, but the occupants have the fewest resources to dedicate to conservation measures. This paper begins with a definition of {open_quotes}affordability{close_quotes} as it pertains to total housing costs and summarizes several key statistics related to housing affordability and energy use by lower income households.

  14. Discovering affordances that determine the spatial structure of reach-to-grasp movements.

    PubMed

    Mon-Williams, Mark; Bingham, Geoffrey P

    2011-05-01

    Extensive research has identified the affordances used to guide actions, as originally conceived by Gibson (Perceiving, acting, and knowing: towards an ecological psychology. Erlbaum, Hillsdale, 1977; The ecological approach to visual perception. Erlbaum, Hillsdale, 1979/1986). We sought to discover the object affordance properties that determine the spatial structure of reach-to-grasp movements--movements that entail both collision avoidance and targeting. First, we constructed objects that presented a significant collision hazard and varied properties relevant to targeting, namely, object width and size of contact surface. Participants reached-to-grasp objects at three speeds (slow, normal, and fast). In Experiment 1, we explored a "stop" task where participants grasped the objects without moving them. In Experiment 2, we studied "fly-through" movements where the objects were lifted. We discovered the object affordance properties that produced covariance in the spatial structure of reaches-to-grasp. Maximum grasp aperture (MGA) reflected affordances determined by collision avoidance. Terminal grasp aperture (TGA)--when the hand stops moving but prior to finger contact--reflected affordances relevant to targeting accuracy. A model with a single free parameter predicted the prehensile spatial structure and provided a functional affordance-based account of that structure. In Experiment 3, we investigated a "slam" task where participants reached-to-grasp flat rectangular objects on a tabletop. The affordance structure of this task was found to eliminate the collision risk and thus reduced safety margins in MGA and TGA to zero for larger objects. The results emphasize the role of affordances in determining the structure and scaling of reach-to-grasp actions. Finally, we report evidence supporting the opposition vector as an appropriate unit of analysis in the study of grasping and a unit of action that maps directly to affordance properties.

  15. Achieving Sustainable Construction in Affordable Housing

    SciTech Connect

    Barcik, M.K.; Creech, D.B.; Ternes, M.P.

    1998-12-07

    An energy-efficient design and construction checklist and information sheets on energy-efficient design and construction are two products being developed. These products will help affordable housing providers take the first steps toward a whole-house approach to the design and implementation of energy-efficient construction practices. The checklist presents simple and clear guidance on energy improvements that can be readily addressed now by most affordable housing providers. The information sheets complement the checklist by providing installation instructions and material specifications that are accompanied by detailed graphics. The information sheets also identify benefits of recommended energy-efficiency measures and procedures including cost savings and impacts on health and comfort. This paper presents details on the checklist and information sheets and discusses their use in two affordable housing projects.

  16. The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System

    ERIC Educational Resources Information Center

    Chiappini, Giampaolo

    2012-01-01

    Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…

  17. Limb apraxia and the "affordance competition hypothesis".

    PubMed

    Rounis, Elisabeth; Humphreys, Glyn

    2015-01-01

    Limb apraxia, a disorder of higher order motor control, has long been a challenge for clinical assessment and understanding (Leiguarda and Marsden, 2000). The deficits originally described in limb apraxia (Liepmann, 1920) have been classified by the nature of the errors made by the patients leading to, namely, ideational and ideomotor apraxia. The dual stream hypothesis (Goodale and Milner, 1992) has been used to explain these categories: ideational apraxia is thought to relate to a deficit in the concept of a movement (coded in the ventral stream). Patients have difficulty using objects, sequencing actions to interact with them or pantomiming their use. Ideomotor apraxia, on the other hand, is thought to arise from problems in the accurate implementation of movements within the dorsal stream. One of the limitations on understanding apraxia is the failure by the clinical literature to draw on knowledge of the factors determining actions in the environment. Here we emphasize the role of affordance. There is much recent work indicating that our responses to stimuli are strongly influenced by the actions that the objects "afford", based on their physical properties and the intentions of the actor (e.g., Tucker and Ellis, 1998). The concept of affordance, originally suggested by Gibson (1979) has been incorporated in a recent model of interactive behavior that draws from findings in non-human primates, namely the "affordance competition hypothesis" (Cisek, 2007). This postulates that interactive behavior arises by a process of competition between possible actions elicited by the environment. In this paper we argue that "affordance competition" may play a role in apraxia. We review evidence that at least some aspects of apraxia may reflect an abnormal sensitivity to competition when multiple affordances are present (Riddoch et al., 1998) and/or a poor ability to exert cognitive control over this competition when it occurs. This framework suggests a new way of

  18. Affordance Templates for Shared Robot Control

    NASA Technical Reports Server (NTRS)

    Hart, Stephen; Dinh, Paul; Hambuchen, Kim

    2014-01-01

    This paper introduces the Affordance Template framework used to supervise task behaviors on the NASA-JSC Valkyrie robot at the 2013 DARPA Robotics Challenge (DRC) Trials. This framework provides graphical interfaces to human supervisors that are adjustable based on the run-time environmental context (e.g., size, location, and shape of objects that the robot must interact with, etc.). Additional improvements, described below, inject degrees of autonomy into instantiations of affordance templates at run-time in order to enable efficient human supervision of the robot for accomplishing tasks.

  19. Learning to grasp and extract affordances: the Integrated Learning of Grasps and Affordances (ILGA) model.

    PubMed

    Bonaiuto, James; Arbib, Michael A

    2015-12-01

    The activity of certain parietal neurons has been interpreted as encoding affordances (directly perceivable opportunities) for grasping. Separate computational models have been developed for infant grasp learning and affordance learning, but no single model has yet combined these processes in a neurobiologically plausible way. We present the Integrated Learning of Grasps and Affordances (ILGA) model that simultaneously learns grasp affordances from visual object features and motor parameters for planning grasps using trial-and-error reinforcement learning. As in the Infant Learning to Grasp Model, we model a stage of infant development prior to the onset of sophisticated visual processing of hand-object relations, but we assume that certain premotor neurons activate neural populations in primary motor cortex that synergistically control different combinations of fingers. The ILGA model is able to extract affordance representations from visual object features, learn motor parameters for generating stable grasps, and generalize its learned representations to novel objects.

  20. The Affordable Care Act, remedy, and litigation reform.

    PubMed

    Maher, Brendan S

    2014-01-01

    The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate.

  1. Maximum thrust mode evaluation

    NASA Technical Reports Server (NTRS)

    Orme, John S.; Nobbs, Steven G.

    1995-01-01

    Measured reductions in acceleration times which resulted from the application of the F-15 performance seeking control (PSC) maximum thrust mode during the dual-engine test phase is presented as a function of power setting and flight condition. Data were collected at altitudes of 30,000 and 45,000 feet at military and maximum afterburning power settings. The time savings for the supersonic acceleration is less than at subsonic Mach numbers because of the increased modeling and control complexity. In addition, the propulsion system was designed to be optimized at the mid supersonic Mach number range. Recall that even though the engine is at maximum afterburner, PSC does not trim the afterburner for the maximum thrust mode. Subsonically at military power, time to accelerate from Mach 0.6 to 0.95 was cut by between 6 and 8 percent with a single engine application of PSC, and over 14 percent when both engines were optimized. At maximum afterburner, the level of thrust increases were similar in magnitude to the military power results, but because of higher thrust levels at maximum afterburner and higher aircraft drag at supersonic Mach numbers the percentage thrust increase and time to accelerate was less than for the supersonic accelerations. Savings in time to accelerate supersonically at maximum afterburner ranged from 4 to 7 percent. In general, the maximum thrust mode has performed well, demonstrating significant thrust increases at military and maximum afterburner power. Increases of up to 15 percent at typical combat-type flight conditions were identified. Thrust increases of this magnitude could be useful in a combat situation.

  2. No Role for Motor Affordances in Visual Working Memory

    ERIC Educational Resources Information Center

    Pecher, Diane

    2013-01-01

    Motor affordances have been shown to play a role in visual object identification and categorization. The present study explored whether working memory is likewise supported by motor affordances. Use of motor affordances should be disrupted by motor interference, and this effect should be larger for objects that have motor affordances than for…

  3. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false What is affordable housing? 1000... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.101 What is affordable housing? Eligible affordable housing is defined in section 4(2) of NAHASDA and is described...

  4. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false What is affordable housing? 1000... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.101 What is affordable housing? Eligible affordable housing is defined in section 4(2) of NAHASDA and is described...

  5. Options for Affordable Fission Surface Power Systems

    NASA Technical Reports Server (NTRS)

    Houts, Mike; Gaddis, Steve; Porter, Ron; VanDyke, Melissa; Martin Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise

    2006-01-01

    Fission surface power systems could provide abundant power anywhere on free surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized; however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems.

  6. Are Selective Private and Public Colleges Affordable?

    ERIC Educational Resources Information Center

    Karikari, John A.; Dezhbakhsh, Hashem

    2013-01-01

    We examine college affordability under the existing pricing and financial aid system that awards both non need-based and need-based aid. Using data of freshmen attending a large number of selective private and public colleges in the USA, we find that the prices students actually pay for college have increased over time. Need-based grant aid has…

  7. Diabetes and the Affordable Care Act.

    PubMed

    Burge, Mark R; Schade, David S

    2014-07-01

    The Affordable Care Act--"Obamacare"--is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different "metallic" insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care.

  8. 24 CFR 572.120 - Affordability standards.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the additional monthly costs of utilities and other monthly housing costs, such as condominium and... at reasonable terms, energy conservation, and improvements that will entail low-cost maintenance. ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Affordability standards....

  9. Affordances of Instrumentation in General Chemistry Laboratories

    ERIC Educational Resources Information Center

    Sherman, Kristin Mary Daniels

    2010-01-01

    The purpose of this study is to find out what students in the first chemistry course at the undergraduate level (general chemistry for science majors) know about the affordances of instrumentation used in the general chemistry laboratory and how their knowledge develops over time. Overall, students see the PASCO(TM) system as a useful and accurate…

  10. 9 Tips for Affordable Student Trips

    ERIC Educational Resources Information Center

    Adams, Jonathan

    2013-01-01

    The trick to having a successful and affordable trip is planning ahead and planning thoroughly. Keep the spirits high and the costs low by following a well-traveled ensemble director's suggestions as presented in this article. These tips include finding local attractions that are unique to the city that the group will be visiting, looking at…

  11. Can the US afford a lunar base

    SciTech Connect

    Keaton, P.W.

    1986-01-01

    Establishing a lunar base will require steady funding for a decade or two. The question addressed here is whether such a large space project is affordable at this time. The relevant facts and methodology are presented so that the reader may formulate independent answers. It is shown that a permanent lunar base can be financed without increasing NASA's historical budgetary trends.

  12. Diabetes and the Affordable Care Act

    PubMed Central

    Schade, David S.

    2014-01-01

    Abstract The Affordable Care Act—“Obamacare”—is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different “metallic” insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care. PMID:24927108

  13. Options for Affordable Fission Surface Power Systems

    SciTech Connect

    Houts, Mike; Gaddis, Steve; Porter, Ron; Van Dyke, Melissa; Martin, Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise

    2006-07-01

    Fission surface power systems could provide abundant power anywhere on the surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized, however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems. (authors)

  14. Actions and Affordances in Syntactic Ambiguity Resolution

    ERIC Educational Resources Information Center

    Chambers, Craig G.; Tanenhaus, Michael K.; Magnuson, James S.

    2004-01-01

    In 2 experiments, eye movements were monitored as participants followed instructions containing temporary syntactic ambiguities (e.g., "Pour the egg in the bowl over the flour"). The authors varied the affordances of task-relevant objects with respect to the action required by the instruction (e.g., whether 1 or both eggs in the visual workspace…

  15. Effects of broken affordance on visual extinction.

    PubMed

    Wulff, Melanie; Humphreys, Glyn W

    2015-01-01

    Previous studies have shown that visual extinction can be reduced if two objects are positioned to "afford" an action. Here we tested if this affordance effect was disrupted by "breaking" the affordance, i.e., if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006), extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool) and unrelated tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool.

  16. Maximum outreach. . . minimum budget

    NASA Astrophysics Data System (ADS)

    Laychak, Mary Beth

    2011-06-01

    Many astronomical institutions have budgetary constraints that prevent them from spending large amounts on public outreach. This is especially true for smaller organizations, such as the Canada-France-Hawaii Telescope (CFHT), where manpower and funding are at a premium. To maximize our impact, we employ unconventional and affordable outreach techniques that underscore our commitment to astronomy education and our local community. We participate in many unique community interactions, ranging from rodeo calf-dressing tournaments to art gallery exhibitions of CFHT images. Further, we have developed many creative methods to communicate complex astronomical concepts to both children and adults, including the use of a modified webcam to teach infrared astronomy and the production of online newsletter for parents, children, and educators. This presentation will discuss the outreach methods CFHT has found most effective in our local schools and our rural community.

  17. Balancing adoption and affordability of medical devices in Europe.

    PubMed

    Schreyögg, Jonas; Bäumler, Michael; Busse, Reinhard

    2009-10-01

    Dramatic increases in health expenditures have led to a substantial number of regulatory interventions in the markets for devices over the last years. However, little attention has been paid thus far to the regulation of medical devices and its effects. This article explores the policies pursued by European countries to find the right balance between improving access to new medical devices and restricting market forces to contain costs and ensure affordability. We outline the medical device policies of the four European countries with the largest expenditures on devices: Germany, France, Italy, and the UK. Subsequently, we discuss how these policies attempt to balance technological adoption and affordability by illustrating two case studies from Italy and Germany. We find that reference prices, if defined as maximum reimbursement levels, can help to achieve balance, because they are supposed to contain costs effectively, but do not necessarily act as a hurdle for the adoption of innovations. We also find that policy tools that encourage technological adoption should be used carefully since the benefits of a new technology are often difficult to predict. Finally, we draw a number of policy implications based on our observations.

  18. 77 FR 9882 - Arsenic Small Systems Compliance and Alternative Affordability Criteria Working Group; public...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-21

    ... AGENCY 40 CFR Parts 141 and 142 Arsenic Small Systems Compliance and Alternative Affordability Criteria... meeting. SUMMARY: EPA is holding an initial meeting of the Arsenic Small Systems Working Group to provide... Appropriations Act of 2012 directs the Environmental Protection Agency to convene an Arsenic Small...

  19. Affordances and the musically extended mind

    PubMed Central

    Krueger, Joel

    2014-01-01

    I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. PMID:24432008

  20. An Affordable Open-Source Turbidimeter

    PubMed Central

    Kelley, Christopher D.; Krolick, Alexander; Brunner, Logan; Burklund, Alison; Kahn, Daniel; Ball, William P.; Weber-Shirk, Monroe

    2014-01-01

    Turbidity is an internationally recognized criterion for assessing drinking water quality, because the colloidal particles in turbid water may harbor pathogens, chemically reduce oxidizing disinfectants, and hinder attempts to disinfect water with ultraviolet radiation. A turbidimeter is an electronic/optical instrument that assesses turbidity by measuring the scattering of light passing through a water sample containing such colloidal particles. Commercial turbidimeters cost hundreds or thousands of dollars, putting them beyond the reach of low-resource communities around the world. An affordable open-source turbidimeter based on a single light-to-frequency sensor was designed and constructed, and evaluated against a portable commercial turbidimeter. The final product, which builds on extensive published research, is intended to catalyze further developments in affordable water and sanitation monitoring. PMID:24759114

  1. System Concepts for Affordable Fission Surface Power

    NASA Technical Reports Server (NTRS)

    Mason, Lee; Poston, David; Qualls, Louis

    2008-01-01

    This paper presents an overview of an affordable Fission Surface Power (FSP) system that could be used for NASA applications on the Moon and Mars. The proposed FSP system uses a low temperature, uranium dioxide-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The concept was determined by a 12 month NASA/DOE study that examined design options and development strategies based on affordability and risk. The system is considered a low development risk based on the use of terrestrial-derived reactor technology, high efficiency power conversion, and conventional materials. The low-risk approach was selected over other options that could offer higher performance and/or lower mass.

  2. America's Affordable Health Choices Act of 2009

    THOMAS, 111th Congress

    Rep. Dingell, John D. [D-MI-15

    2009-07-14

    10/14/2009 Placed on the Union Calendar, Calendar No. 168. (All Actions) Notes: For further action, see H.R.3590, which became Public Law 111-148 on 3/23/2010. H.R.3590, often referred to as the Affordable Care Act, is the bill that became the health care reform law. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. Affordable Heavy Lift Capability: 2000-2004

    NASA Technical Reports Server (NTRS)

    2004-01-01

    This custom bibliography from the NASA Scientific and Technical Information Program lists a sampling of records found in the NASA Aeronautics and Space Database. The scope of this topic includes technologies to allow robust, affordable access of cargo, particularly to low-Earth orbit. This area of focus is one of the enabling technologies as defined by NASA s Report of the President s Commission on Implementation of United States Space Exploration Policy, published in June 2004.

  4. Effects of broken affordance on visual extinction

    PubMed Central

    Wulff, Melanie; Humphreys, Glyn W.

    2015-01-01

    Previous studies have shown that visual extinction can be reduced if two objects are positioned to “afford” an action. Here we tested if this affordance effect was disrupted by “breaking” the affordance, i.e., if one of the objects actively used in the action had a broken handle. We assessed the effects of broken affordance on recovery from extinction in eight patients with right hemisphere lesions and left-sided extinction. Patients viewed object pairs that were or were not commonly used together and that were positioned for left- or right-hand actions. In the unrelated pair conditions, either two tools or two objects were presented. In line with previous research (e.g., Riddoch et al., 2006), extinction was reduced when action-related object pairs and when unrelated tool pairs were presented compared to unrelated object pairs. There was no significant difference in recovery rate between action-related (object-tool) and unrelated tool pairs. In addition, performance with action-related objects decreased when the tool appeared on the ipsilesional side compared to when it was on the contralesional side, but only when the tool handle was intact. There were minimal effects of breaking the handle of an object rather than a tool, and there was no effect of breaking the handle on either tools or objects on single item trials. The data suggest that breaking the handle of a tool lessens the degree to which it captures attention, with this attentional capture being strongest when the tool appears on the ipsilesional side. The capture of attention by the ipsilesional item then reduces the chance of detecting the contralesional stimulus. This attentional capture effect is mediated by the affordance to the intact tool. PMID:26441612

  5. The Affordable Care Act and emergency care.

    PubMed

    McClelland, Mark; Asplin, Brent; Epstein, Stephen K; Kocher, Keith Eric; Pilgrim, Randy; Pines, Jesse; Rabin, Elaine Judith; Rathlev, Niels Kumar

    2014-10-01

    The Affordable Care Act (ACA) will have far-reaching effects on the way health care is designed and delivered. Several elements of the ACA will directly affect both demand for ED care and expectations for its role in providing coordinated care. Hospitals will need to employ strategies to reduce ED crowding as the ACA expands insurance coverage. Discussions between EDs and primary care physicians about their respective roles providing acute unscheduled care would promote the goals of the ACA.

  6. Affordable health benefits for workers without employer coverage.

    PubMed

    Etheredge, L; Jones, S B

    1998-02-01

    With 42 million individuals lacking health insurance in 1996, an increase of 1.1 million uninsured from the previous year, new initiatives to deal with health insurance problems merit a high priority among domestic policy initiatives. This paper examines the opportunities for assisting full-time workers (and their families) who do not receive employer-paid health insurance-a group that now includes 49 million individuals-by using three policy tools that Congress and President Clinton have already agreed to use in recent healthcare legislation: (a) equitable tax assistance; (b) market reforms; and (c) competition among health plans that offer economical benefits. Estimates for a model plan illustrate that such strategies could make decent private health insurance more affordable and more accessible for workers and their families who want to purchase it; family insurance protection, with guaranteed issue of insurance and large-group-rated premiums, could be offered at potential savings of 42% (or more). Premiums for worker's coverage, after tax assistance, would be below $1,200 per year, i.e., less than 60 cents per hour. These market-oriented reforms can be accomplished with a limited government role, and, after start-up costs, ongoing federal expenses would be modest, predictable, and controllable. When combined with the new $24 billion child health initiative to assist low-income families, the proposed plan would provide considerable progress toward universal access to affordable insurance coverage.

  7. Affordances of instrumentation in general chemistry laboratories

    NASA Astrophysics Data System (ADS)

    Sherman, Kristin Mary Daniels

    The purpose of this study is to find out what students in the first chemistry course at the undergraduate level (general chemistry for science majors) know about the affordances of instrumentation used in the general chemistry laboratory and how their knowledge develops over time. Overall, students see the PASCO(TM) system as a useful and accurate measuring tool for general chemistry labs. They see the probeware as easy to use, portable, and able to interact with computers. Students find that the PASCO(TM) probeware system is useful in their general chemistry labs, more advanced chemistry labs, and in other science classes, and can be used in a variety of labs done in general chemistry. Students learn the affordances of the probeware through the lab manual, the laboratory teaching assistant, by trial and error, and from each other. The use of probeware systems provides lab instructors the opportunity to focus on the concepts illustrated by experiments and the opportunity to spend time discussing the results. In order to teach effectively, the instructor must know the correct name of the components involved, how to assemble and disassemble it correctly, how to troubleshoot the software, and must be able to replace broken or missing components quickly. The use of podcasts or Web-based videos should increase student understanding of affordances of the probeware.

  8. Perceiving Affordances for Different Motor Skills

    PubMed Central

    Cole, Whitney G.; Chan, Gladys L. Y.; Vereijken, Beatrix; Adolph, Karen E.

    2013-01-01

    We examined several factors that affect people’s ability to perceive possibilities for action. In Experiment 1, 24 participants crossed expanses of various sizes in three conditions: leaping, a familiar, launching action system; arm-swinging on monkey bars, an unpracticed skill that uses the arms rather than the legs; and crawling on hands and knees, a disused skill that involves all four limbs. Before and after performing each action, participants gave verbal judgments about the largest gap they could cross. Participants scaled initial judgments to their actual abilities in all three conditions. But they considerably underestimated their abilities for leaping, a launching action, and for arm-swinging when it was performed as a launching action; judgments about crawling, a non-launching action, and arm-swinging when it was performed as a non-launching action were more accurate. Thus, launching actions appear to produce a deficit in perceiving affordances that is not ameliorated by familiarity with the action. However, after performing the actions, participants partially corrected for the deficiency and more accurately judged their abilities for launching actions—suggesting that even brief action experience facilitates the perception of affordances. In Experiment 2, we confirmed that the deficit was due to the launching nature of the leaping and arm-swinging actions in Experiment 1. We asked an additional 12 participants to cross expanses using two non-launching actions using the legs (stepping across an expanse) and the arms (reaching across an expanse). Participants were highly accurate when judging affordances for these actions, supporting launching as the cause of the underestimation reported in Experiment 1. PMID:23411672

  9. Electric propulsion -- Fleet readiness at affordable costs

    SciTech Connect

    Orndorff, C.M.; Egan, C.J.

    1996-11-01

    The successful development and demonstration of the Al-AgO primary battery system dramatically demonstrated the viability of electric power plants for torpedo propulsion. Present efforts are focused on the development and demonstration of very low cost, quiet, high performance, safe, environmentally compatible, rechargeable batteries for heavyweight and lightweight torpedoes and tactical-sized UUVs. Electric power plants consisting of a rechargeable battery and a high reliability motor must be affordable to own and operate and enable turn around without teardown for today`s Fleet assets.

  10. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  11. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  12. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  13. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  14. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  15. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  16. 12 CFR 1807.400 - Affordable housing-general.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...

  17. 12 CFR 1807.402 - Affordable housing-homeownership.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...

  18. Lightning Protection

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Kit-built airplanes are more affordable because they are assembled by the owner and do not require Federal Aviation Administration (FAA) certification. The Glasair III, is an advanced technology homebuilt, constructed of a fiberglass and graphite fiber composite material, and equipped with digital instruments. Both technologies make the airplane more susceptible to lightning effects. When Glasair manufacturer, Stoddard-Hamilton, decided that lightning protection would enable more extensive instrument flight and make the plane more marketable, they proposed a joint development program to NASA Langley Research Center (LAR). Under a Small Business Innovation Research (SBIR) contract, Langley contractors designed and tested a lightning protection system, and the Glasair III-LP became the first kit-built composite aircraft to be lightning tested and protection-verified under FAA guidelines for general aviation aircraft.

  19. Proposed regulations could limit access to affordable health coverage for workers' children and family members.

    PubMed

    Jacobs, Ken; Graham-Squire, Dave; Roby, Dylan H; Kominski, Gerald F; Kinane, Christina M; Needleman, Jack; Watson, Greg; Gans, Daphna

    2011-12-01

    Key Findings. The Patient Protection and Affordable Care Act (ACA) is designed to offer premium subsidies to help eligible individuals and their families purchase insurance coverage when affordable job-based coverage is not available. However, the law is unclear on how this affordability protection is applied in those instances where self-only coverage offered by an employer is affordable but family coverage is not. Regulations recently proposed by the Department of the Treasury would make family members ineligible for subsidized coverage in the exchange if an employee is offered affordable self-only coverage by an employer, even if family coverage is unaffordable. This could have significant financial consequences for low- and moderate-income families that fall in this gap. Using an alternative interpretation of the law could allow the entire family to enter the exchange when family coverage is unaffordable, which would broaden access to coverage. However, this option has been cited as cost prohibitive. In this brief we consider a middle ground alternative that would base eligibility for the individual worker on the cost of self-only coverage, but would use the additional cost to the employee for family coverage as the basis for determining affordability and eligibility for subsidies for the remaining family members. We find that: Under the middle ground alternative scenario an additional 144,000 Californians would qualify for and use premium subsidies in the California Health Benefit Exchange, half of whom are children. Less than 1 percent of those with employer-based coverage would move to subsidized coverage in the California Health Benefit Exchange as a result of having unaffordable coverage on the job. PMID:23599987

  20. 40 CFR 141.13 - Maximum contaminant levels for turbidity.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... turbidity. 141.13 Section 141.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Maximum Contaminant Levels § 141.13... part. The maximum contaminant levels for turbidity in drinking water, measured at a...

  1. 40 CFR 141.13 - Maximum contaminant levels for turbidity.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... turbidity. 141.13 Section 141.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Maximum Contaminant Levels § 141.13... part. The maximum contaminant levels for turbidity in drinking water, measured at a...

  2. Affordable proteomics: the two-hybrid systems.

    PubMed

    Gillespie, Marc

    2003-06-01

    Numerous proteomic methodologies exist, but most require a heavy investment in expertise and technology. This puts these approaches out of reach for many laboratories and small companies, rarely allowing proteomics to be used as a pilot approach for biomarker or target identification. Two proteomic approaches, 2D gel electrophoresis and the two-hybrid systems, are currently available to most researchers. The two-hybrid systems, though accommodating to large-scale experiments, were originally designed as practical screens, that by comparison to current proteomics tools were small-scale, affordable and technically feasible. The screens rapidly generated data, identifying protein interactions that were previously uncharacterized. The foundation for a two-hybrid proteomic investigation can be purchased as separate kits from a number of companies. The true power of the technique lies not in its affordability, but rather in its portability. The two-hybrid system puts proteomics back into laboratories where the output of the screens can be evaluated by researchers with experience in the particular fields of basic research, cancer biology, toxicology or drug development.

  3. The last glacial maximum

    USGS Publications Warehouse

    Clark, P.U.; Dyke, A.S.; Shakun, J.D.; Carlson, A.E.; Clark, J.; Wohlfarth, B.; Mitrovica, J.X.; Hostetler, S.W.; McCabe, A.M.

    2009-01-01

    We used 5704 14C, 10Be, and 3He ages that span the interval from 10,000 to 50,000 years ago (10 to 50 ka) to constrain the timing of the Last Glacial Maximum (LGM) in terms of global ice-sheet and mountain-glacier extent. Growth of the ice sheets to their maximum positions occurred between 33.0 and 26.5 ka in response to climate forcing from decreases in northern summer insolation, tropical Pacific sea surface temperatures, and atmospheric CO2. Nearly all ice sheets were at their LGM positions from 26.5 ka to 19 to 20 ka, corresponding to minima in these forcings. The onset of Northern Hemisphere deglaciation 19 to 20 ka was induced by an increase in northern summer insolation, providing the source for an abrupt rise in sea level. The onset of deglaciation of the West Antarctic Ice Sheet occurred between 14 and 15 ka, consistent with evidence that this was the primary source for an abrupt rise in sea level ???14.5 ka.

  4. The Last Glacial Maximum.

    PubMed

    Clark, Peter U; Dyke, Arthur S; Shakun, Jeremy D; Carlson, Anders E; Clark, Jorie; Wohlfarth, Barbara; Mitrovica, Jerry X; Hostetler, Steven W; McCabe, A Marshall

    2009-08-01

    We used 5704 14C, 10Be, and 3He ages that span the interval from 10,000 to 50,000 years ago (10 to 50 ka) to constrain the timing of the Last Glacial Maximum (LGM) in terms of global ice-sheet and mountain-glacier extent. Growth of the ice sheets to their maximum positions occurred between 33.0 and 26.5 ka in response to climate forcing from decreases in northern summer insolation, tropical Pacific sea surface temperatures, and atmospheric CO2. Nearly all ice sheets were at their LGM positions from 26.5 ka to 19 to 20 ka, corresponding to minima in these forcings. The onset of Northern Hemisphere deglaciation 19 to 20 ka was induced by an increase in northern summer insolation, providing the source for an abrupt rise in sea level. The onset of deglaciation of the West Antarctic Ice Sheet occurred between 14 and 15 ka, consistent with evidence that this was the primary source for an abrupt rise in sea level approximately 14.5 ka.

  5. Maximum Entropy Fundamentals

    NASA Astrophysics Data System (ADS)

    Harremoeës, P.; Topsøe, F.

    2001-09-01

    In its modern formulation, the Maximum Entropy Principle was promoted by E.T. Jaynes, starting in the mid-fifties. The principle dictates that one should look for a distribution, consistent with available information, which maximizes the entropy. However, this principle focuses only on distributions and it appears advantageous to bring information theoretical thinking more prominently into play by also focusing on the "observer" and on coding. This view was brought forward by the second named author in the late seventies and is the view we will follow-up on here. It leads to the consideration of a certain game, the Code Length Game and, via standard game theoretical thinking, to a principle of Game Theoretical Equilibrium. This principle is more basic than the Maximum Entropy Principle in the sense that the search for one type of optimal strategies in the Code Length Game translates directly into the search for distributions with maximum entropy. In the present paper we offer a self-contained and comprehensive treatment of fundamentals of both principles mentioned, based on a study of the Code Length Game. Though new concepts and results are presented, the reading should be instructional and accessible to a rather wide audience, at least if certain mathematical details are left aside at a rst reading. The most frequently studied instance of entropy maximization pertains to the Mean Energy Model which involves a moment constraint related to a given function, here taken to represent "energy". This type of application is very well known from the literature with hundreds of applications pertaining to several different elds and will also here serve as important illustration of the theory. But our approach reaches further, especially regarding the study of continuity properties of the entropy function, and this leads to new results which allow a discussion of models with so-called entropy loss. These results have tempted us to speculate over the development of natural

  6. 40 CFR 94.107 - Determination of maximum test speed.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... specified in 40 CFR 1065.510. These data points form the lug curve. It is not necessary to generate the... 40 Protection of Environment 21 2012-07-01 2012-07-01 false Determination of maximum test speed... Determination of maximum test speed. (a) Overview. This section specifies how to determine maximum test...

  7. 40 CFR 94.107 - Determination of maximum test speed.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... specified in 40 CFR 1065.510. These data points form the lug curve. It is not necessary to generate the... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Determination of maximum test speed. 94... Determination of maximum test speed. (a) Overview. This section specifies how to determine maximum test...

  8. 40 CFR 94.107 - Determination of maximum test speed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... specified in 40 CFR 1065.510. These data points form the lug curve. It is not necessary to generate the... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Determination of maximum test speed... Determination of maximum test speed. (a) Overview. This section specifies how to determine maximum test...

  9. 40 CFR 94.107 - Determination of maximum test speed.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... specified in 40 CFR 1065.510. These data points form the lug curve. It is not necessary to generate the... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Determination of maximum test speed... Determination of maximum test speed. (a) Overview. This section specifies how to determine maximum test...

  10. 40 CFR 94.107 - Determination of maximum test speed.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... specified in 40 CFR 1065.510. These data points form the lug curve. It is not necessary to generate the... 40 Protection of Environment 21 2013-07-01 2013-07-01 false Determination of maximum test speed... Determination of maximum test speed. (a) Overview. This section specifies how to determine maximum test...

  11. Hierarchical nesting of affordances in a tool use task.

    PubMed

    Wagman, Jeffrey B; Caputo, Sarah E; Stoffregen, Thomas A

    2016-10-01

    In studying the perception of affordances, researchers have typically identified a single affordance and designed experiments to evaluate the perception of that affordance. Yet in daily life, multiple affordances always exist. One consequence of this is that there may be higher order, means-ends relations between different affordances. In 4 experiments, we created situations in which lower order, subordinate affordances could affect the realization of higher order, superordinate affordances, and we asked whether participants were sensitive to these hierarchical, nested relations. Participants wielded tools that varied in length, mass, and mass distribution. In Experiments 1 and 2, we asked them to evaluate these tools in terms of their suitability for executing specific interactions with target objects (striking vs. poking) that were positioned at different distances. In Experiments 3 and 4, we asked participants to select rods and masses and then to assemble them into tools that could be used to execute specific interactions with target objects at different distances. The results were compatible with the hypothesis that participants were simultaneously sensitive to affordances for tool assembly and affordances for tool use. We argue that the nesting of affordances is characteristic of many situations in daily life and that, consequently, sensitivity to hierarchical, means-ends relations among affordances may be an essential characteristic of perceptually guided action. (PsycINFO Database Record PMID:27668424

  12. Hierarchical nesting of affordances in a tool use task.

    PubMed

    Wagman, Jeffrey B; Caputo, Sarah E; Stoffregen, Thomas A

    2016-10-01

    In studying the perception of affordances, researchers have typically identified a single affordance and designed experiments to evaluate the perception of that affordance. Yet in daily life, multiple affordances always exist. One consequence of this is that there may be higher order, means-ends relations between different affordances. In 4 experiments, we created situations in which lower order, subordinate affordances could affect the realization of higher order, superordinate affordances, and we asked whether participants were sensitive to these hierarchical, nested relations. Participants wielded tools that varied in length, mass, and mass distribution. In Experiments 1 and 2, we asked them to evaluate these tools in terms of their suitability for executing specific interactions with target objects (striking vs. poking) that were positioned at different distances. In Experiments 3 and 4, we asked participants to select rods and masses and then to assemble them into tools that could be used to execute specific interactions with target objects at different distances. The results were compatible with the hypothesis that participants were simultaneously sensitive to affordances for tool assembly and affordances for tool use. We argue that the nesting of affordances is characteristic of many situations in daily life and that, consequently, sensitivity to hierarchical, means-ends relations among affordances may be an essential characteristic of perceptually guided action. (PsycINFO Database Record

  13. Social affordances and the possibility of ecological linguistics.

    PubMed

    Kono, Tetsuya

    2009-12-01

    This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.

  14. Piecing Together the College Affordability Puzzle: Student Characteristics and Patterns of (Un)Affordability

    ERIC Educational Resources Information Center

    Welbeck, Rashida; Diamond, John; Mayer, Alexander; Richburg-Hayes, Lashawn

    2014-01-01

    The cost of attending college has risen sharply over the last 40 years. Although more credit and grant aid have been made available to students, there are still major gaps between aid and the cost of attendance for many students in the United States, all of whom are left to figure out whether they can afford the remaining costs associated with…

  15. The Solar Maximum observatory

    NASA Technical Reports Server (NTRS)

    Rust, D. M.

    1984-01-01

    The successful retrieval and repair of the Solar Maximum Mission (SMM) satellite by Shuttle astronauts in April 1984 permitted continuance of solar flare observations that began in 1980. The SMM carries a soft X ray polychromator, gamma ray, UV and hard X ray imaging spectrometers, a coronagraph/polarimeter and particle counters. The data gathered thus far indicated that electrical potentials of 25 MeV develop in flares within 2 sec of onset. X ray data show that flares are composed of compressed magnetic loops that have come too close together. Other data have been taken on mass ejection, impacts of electron beams and conduction fronts with the chromosphere and changes in the solar radiant flux due to sunspots.

  16. NASA's Space Launch System: Affordability for Sustainability

    NASA Technical Reports Server (NTRS)

    May, Todd A.; Creech, Stephen D.

    2012-01-01

    The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and

  17. Affordable Laser Communication in the Classroom

    NASA Astrophysics Data System (ADS)

    Walker, Constance E.; Sparks, R.; Pompea, S.

    2006-12-01

    Several companies sell systems that illustrate laser communication such as Arbor Scientific1. These systems can be too expensive for classroom use. We will demonstrate a technique to modulate a standard diode laser using a microphone or other sound source that is capable of transmitting voice and music. This affordable system can transmit over 350 feet using simple, inexpensive parts readily available at your local electronics store. We will provide a list of parts necessary for assembly, detailed assembly instructions, as well as some suggested investigations using the laser communication system. This system can be used in the classroom either as a demonstration or hands-on activity to explore the physics and technology involved, citing more sophisticated laser communication systems on board spacecraft such as the Mercury Messenger Mission and the Mars Telecommunications Orbiter. 1http://www.arborsci.com

  18. Why epidemiologists cannot afford to ignore poverty.

    PubMed

    Krieger, Nancy

    2007-11-01

    Epidemiologists cannot afford to ignore poverty. To do so would, first, wrongly obscure the devastating impact of poverty on population health, and, second, undercut our commitment to scientific rigor. At issue is doing correct science, not "politically correct" science. Blot poverty and inequity from view, and not only will we contribute to making suffering invisible but our understanding of disease etiology and distribution will be marred. To make this case, I address current debates about the causal relationships between poverty and health, and provide examples of how failing to consider the impact of socioeconomic position has biased epidemiologic knowledge and harmed the public's health. By definition, the people we study are simultaneously social beings and biologic organisms-and we cannot study the latter without taking into account the former. It is the responsibility of all epidemiologists, and not only social epidemiologists, to keep in mind the connections between poverty and health. PMID:18049180

  19. Why epidemiologists cannot afford to ignore poverty.

    PubMed

    Krieger, Nancy

    2007-11-01

    Epidemiologists cannot afford to ignore poverty. To do so would, first, wrongly obscure the devastating impact of poverty on population health, and, second, undercut our commitment to scientific rigor. At issue is doing correct science, not "politically correct" science. Blot poverty and inequity from view, and not only will we contribute to making suffering invisible but our understanding of disease etiology and distribution will be marred. To make this case, I address current debates about the causal relationships between poverty and health, and provide examples of how failing to consider the impact of socioeconomic position has biased epidemiologic knowledge and harmed the public's health. By definition, the people we study are simultaneously social beings and biologic organisms-and we cannot study the latter without taking into account the former. It is the responsibility of all epidemiologists, and not only social epidemiologists, to keep in mind the connections between poverty and health.

  20. Affordable Care Act and Diabetes Mellitus.

    PubMed

    Shi, Qian; Nellans, Frank P; Shi, Lizheng

    2015-12-01

    The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.

  1. Employer Reactions to the Affordable Care Act.

    PubMed

    Muller, Leslie A; Isely, Paul; Levin, Adelin

    2015-01-01

    Although the implementation of parts of the Affordable Care Act (ACA) was delayed until 2015, many firms had already made changes to their health insurance plans and their business practices. This article reports results from a survey administered to western Michigan firms in October 2013 requesting information on any changes they made in response to ACA. The authors found that although 89% of employers planned to offer health insurance in 2014, that number dropped to 66% in 2015. The main ways organizations were controlling health costs were by changing prescription coverage, passing on the costs to employees through higher copays and premiums and offering more high-deductible health plans with health savings accounts. Employers also were altering business practices by decreasing future hiring and decreasing the hours of part-time workers. The authors find that many of these changes were due to the uncertainty firms were facing during the ACA implementation process. PMID:26540944

  2. Generalized Maximum Entropy

    NASA Technical Reports Server (NTRS)

    Cheeseman, Peter; Stutz, John

    2005-01-01

    A long standing mystery in using Maximum Entropy (MaxEnt) is how to deal with constraints whose values are uncertain. This situation arises when constraint values are estimated from data, because of finite sample sizes. One approach to this problem, advocated by E.T. Jaynes [1], is to ignore this uncertainty, and treat the empirically observed values as exact. We refer to this as the classic MaxEnt approach. Classic MaxEnt gives point probabilities (subject to the given constraints), rather than probability densities. We develop an alternative approach that assumes that the uncertain constraint values are represented by a probability density {e.g: a Gaussian), and this uncertainty yields a MaxEnt posterior probability density. That is, the classic MaxEnt point probabilities are regarded as a multidimensional function of the given constraint values, and uncertainty on these values is transmitted through the MaxEnt function to give uncertainty over the MaXEnt probabilities. We illustrate this approach by explicitly calculating the generalized MaxEnt density for a simple but common case, then show how this can be extended numerically to the general case. This paper expands the generalized MaxEnt concept introduced in a previous paper [3].

  3. Maximum bow force revisited.

    PubMed

    Mores, Robert

    2016-08-01

    Schelleng [J. Acoust. Soc. Am. 53, 26-41 (1973)], Askenfelt [J. Acoust. Soc. Am. 86, 503-516 (1989)], Schumacher [J. Acoust. Soc. Am. 96, 1985-1998 (1994)], and Schoonderwaldt, Guettler, and Askenfelt [Acta Acust. Acust. 94, 604-622 (2008)] formulated-in different ways-how the maximum bow force relates to bow velocity, bow-bridge distance, string impedance, and friction coefficients. Issues of uncertainty are how to account for friction or for the rotational admittance of the strings. Related measurements at the respective transitions between regimes of Helmholtz motion and non-Helmholtz motion employ a variety of bowing machines and stringed instruments. The related findings include all necessary parameters except the friction coefficients, leaving the underlying models unconfirmed. Here, a bowing pendulum has been constructed which allows precise measurement of relevant bowing parameters, including the friction coefficients. Two cellos are measured across all strings for three different bow-bridge distances. The empirical data suggest that-taking the diverse elements of existing models as options-Schelleng's model combined with Schumacher's velocity term yields the best fit. Furthermore, the pendulum employs a bow driving mechanism with adaptive impedance which discloses that mentioned regimes are stable and transitions between them sometimes require a hysteresis on related parameters. PMID:27586745

  4. 40 CFR 35.265 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.265 Section 35.265 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Nonpoint Source-Management (section 319(h)) §...

  5. 40 CFR 35.215 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.215 Section 35.215 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Hazardous Waste Management (section...

  6. 40 CFR 35.2205 - Maximum allowable project cost.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... adjustments for differing site conditions will be exempt, provided the requirements of 40 CFR part 35, subpart... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum allowable project cost. 35.2205 Section 35.2205 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER...

  7. 40 CFR 35.2205 - Maximum allowable project cost.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... adjustments for differing site conditions will be exempt, provided the requirements of 40 CFR part 35, subpart... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Maximum allowable project cost. 35.2205 Section 35.2205 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER...

  8. 40 CFR 35.2205 - Maximum allowable project cost.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... adjustments for differing site conditions will be exempt, provided the requirements of 40 CFR part 35, subpart... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Maximum allowable project cost. 35.2205 Section 35.2205 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER...

  9. 40 CFR 35.2205 - Maximum allowable project cost.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... adjustments for differing site conditions will be exempt, provided the requirements of 40 CFR part 35, subpart... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Maximum allowable project cost. 35.2205 Section 35.2205 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER...

  10. 40 CFR 35.235 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.235 Section 35.235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Pesticide Cooperative Enforcement (section...

  11. 40 CFR 35.235 - Maximum federal share.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Maximum federal share. 35.235 Section 35.235 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Pesticide Cooperative Enforcement (section...

  12. 40 CFR 141.13 - Maximum contaminant levels for turbidity.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum contaminant levels for turbidity. 141.13 Section 141.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER...) Interfere with disinfection; (2) Prevent maintenance of an effective disinfectant agent throughout...

  13. 40 CFR 35.364 - Maximum federal share.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Maximum federal share. 35.364 Section 35.364 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Cooperative Agreements...

  14. 40 CFR 35.364 - Maximum federal share.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Maximum federal share. 35.364 Section 35.364 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Cooperative Agreements...

  15. 40 CFR 35.415 - Maximum federal share.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Maximum federal share. 35.415 Section 35.415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning...

  16. 40 CFR 35.604 - Maximum federal share.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Maximum federal share. 35.604 Section 35.604 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Water Quality Cooperative...

  17. 40 CFR 35.604 - Maximum federal share.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Maximum federal share. 35.604 Section 35.604 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Water Quality Cooperative...

  18. 40 CFR 35.604 - Maximum federal share.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Maximum federal share. 35.604 Section 35.604 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Water Quality Cooperative...

  19. 40 CFR 35.604 - Maximum federal share.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Maximum federal share. 35.604 Section 35.604 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Water Quality Cooperative...

  20. 40 CFR 35.364 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.364 Section 35.364 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Cooperative Agreements...

  1. 40 CFR 35.415 - Maximum federal share.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Maximum federal share. 35.415 Section 35.415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning...

  2. 40 CFR 35.415 - Maximum federal share.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Maximum federal share. 35.415 Section 35.415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning...

  3. 40 CFR 35.604 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.604 Section 35.604 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants for Tribes Water Quality Cooperative...

  4. 40 CFR 35.364 - Maximum federal share.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Maximum federal share. 35.364 Section 35.364 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Cooperative Agreements...

  5. 40 CFR 35.364 - Maximum federal share.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Maximum federal share. 35.364 Section 35.364 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Cooperative Agreements...

  6. 40 CFR 35.415 - Maximum federal share.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Maximum federal share. 35.415 Section 35.415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning...

  7. 40 CFR 35.415 - Maximum federal share.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Maximum federal share. 35.415 Section 35.415 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Environmental Program Grants Water Quality Management Planning...

  8. 40 CFR 141.53 - Maximum contaminant level goals for disinfection byproducts.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Maximum contaminant level goals for disinfection byproducts. 141.53 Section 141.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.53 Maximum contaminant level goals...

  9. 40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.54 Maximum residual disinfectant level...

  10. 40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.54 Maximum residual disinfectant level...

  11. 40 CFR 141.52 - Maximum contaminant level goals for microbiological contaminants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum contaminant level goals for microbiological contaminants. 141.52 Section 141.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.52 Maximum contaminant level goals...

  12. 40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.54 Maximum residual disinfectant level...

  13. 40 CFR 141.52 - Maximum contaminant level goals for microbiological contaminants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Maximum contaminant level goals for microbiological contaminants. 141.52 Section 141.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.52 Maximum contaminant level goals...

  14. 40 CFR 141.53 - Maximum contaminant level goals for disinfection byproducts.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum contaminant level goals for disinfection byproducts. 141.53 Section 141.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.53 Maximum contaminant level goals...

  15. 40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.54 Maximum residual disinfectant level...

  16. 40 CFR 141.53 - Maximum contaminant level goals for disinfection byproducts.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum contaminant level goals for disinfection byproducts. 141.53 Section 141.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.53 Maximum contaminant level goals...

  17. 40 CFR 141.52 - Maximum contaminant level goals for microbiological contaminants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum contaminant level goals for microbiological contaminants. 141.52 Section 141.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.52 Maximum contaminant level goals...

  18. 40 CFR 141.52 - Maximum contaminant level goals for microbiological contaminants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Maximum contaminant level goals for microbiological contaminants. 141.52 Section 141.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.52 Maximum contaminant level goals...

  19. 40 CFR 141.53 - Maximum contaminant level goals for disinfection byproducts.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Maximum contaminant level goals for disinfection byproducts. 141.53 Section 141.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.53 Maximum contaminant level goals...

  20. 40 CFR 141.52 - Maximum contaminant level goals for microbiological contaminants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum contaminant level goals for microbiological contaminants. 141.52 Section 141.52 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.52 Maximum contaminant level goals...

  1. 40 CFR 141.54 - Maximum residual disinfectant level goals for disinfectants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum residual disinfectant level goals for disinfectants. 141.54 Section 141.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.54 Maximum residual disinfectant level...

  2. 40 CFR 141.53 - Maximum contaminant level goals for disinfection byproducts.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum contaminant level goals for disinfection byproducts. 141.53 Section 141.53 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.53 Maximum contaminant level goals...

  3. 40 CFR 141.50 - Maximum contaminant level goals for organic contaminants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum contaminant level goals for organic contaminants. 141.50 Section 141.50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.50 Maximum contaminant level goals for...

  4. 40 CFR 141.50 - Maximum contaminant level goals for organic contaminants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum contaminant level goals for organic contaminants. 141.50 Section 141.50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.50 Maximum contaminant level goals for...

  5. 40 CFR 141.50 - Maximum contaminant level goals for organic contaminants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Maximum contaminant level goals for organic contaminants. 141.50 Section 141.50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.50 Maximum contaminant level goals for...

  6. 40 CFR 141.50 - Maximum contaminant level goals for organic contaminants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Maximum contaminant level goals for organic contaminants. 141.50 Section 141.50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.50 Maximum contaminant level goals for...

  7. 40 CFR 141.50 - Maximum contaminant level goals for organic contaminants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum contaminant level goals for organic contaminants. 141.50 Section 141.50 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Goals and Maximum Residual Disinfectant Level Goals § 141.50 Maximum contaminant level goals for...

  8. Changes in context and perception of maximum reaching height.

    PubMed

    Wagman, Jeffrey B; Day, Brian M

    2014-01-01

    Successfully performing a given behavior requires flexibility in both perception and behavior. In particular, doing so requires perceiving whether that behavior is possible across the variety of contexts in which it might be performed. Three experiments investigated how (changes in) context (ie point of observation and intended reaching task) influenced perception of maximum reaching height. The results of experiment 1 showed that perceived maximum reaching height more closely reflected actual reaching ability when perceivers occupied a point of observation that was compatible with that required for the reaching task. The results of experiments 2 and 3 showed that practice perceiving maximum reaching height from a given point of observation improved perception of maximum reaching height from a different point of observation, regardless of whether such practice occurred at a compatible or incompatible point of observation. In general, such findings show bounded flexibility in perception of affordances and are thus consistent with a description of perceptual systems as smart perceptual devices.

  9. Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update.

    PubMed

    Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M Roy

    2015-12-01

    Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA. PMID:26668787

  10. Racial and Ethnic Health Disparities and the Affordable Care Act: a Status Update.

    PubMed

    Sealy-Jefferson, Shawnita; Vickers, Jasmine; Elam, Angela; Wilson, M Roy

    2015-12-01

    Persistent racial and ethnic health disparities exist in the USA, despite decades of research and public health initiatives. Several factors contribute to health disparities, including (but not limited to) implicit provider bias, access to health care, social determinants, and biological factors. Disparities in health by race/ethnicity are unacceptable and correctable. The Patient Protection and Affordable Care Act is a comprehensive legislation that is focused on improving health care access, quality, and cost control. This health care reform includes specific provisions which focus on preventive care, the standardized collection of data on race, ethnicity, primary language and disability status, and health information technology. Although some provisions of the Patient Protection and Affordable Care Act have not been implemented, such as funding for the U.S. Public Health Sciences track, which would have addressed the shortage of medical professionals in the USA who are trained to use patient-centered, interdisciplinary, and care coordination approaches, this legislation is still poised to make great strides toward eliminating health disparities. The purpose of this manuscript is to highlight the unprecedented opportunities that exist for the Patient Protection and Affordable Care Act to reduce racial and ethnic disparities in health in the USA.

  11. A general protocol to afford enantioenriched linear homoprenylic amines.

    PubMed

    Bosque, Irene; Foubelo, Francisco; Gonzalez-Gomez, Jose C

    2013-11-21

    The reaction of a readily obtained chiral branched homoprenylamonium salt with a range of aldehydes, including aliphatic substrates, affords the corresponding linear isomers in good yields and enantioselectivities.

  12. 47 CFR 27.1221 - Interference protection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 2 2011-10-01 2011-10-01 false Interference protection. 27.1221 Section 27... Technical Standards § 27.1221 Interference protection. (a) Interference protection will be afforded to BRS... height benchmark (hbm). (c) Protection for receiving antennas not exceeding the height benchmark....

  13. Income Dynamics and the Affordable Care Act

    PubMed Central

    Shore-Sheppard, Lara D

    2014-01-01

    Objective To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Data Source Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Study Design Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138–250 percent FPL, 250–400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Data Collection/Extraction Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22–64 years. Principal Findings Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Conclusions Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. PMID:25327987

  14. Affordable, Robust Ceramic Joining Technology (ARCJoint) Developed

    NASA Technical Reports Server (NTRS)

    Steele, Gynelle C.

    2001-01-01

    Affordable, Robust Ceramic Joining Technology (ARCJoint) is a method for joining high temperature- resistant ceramic pieces together, establishing joints that are strong, and allowing joining to be done in the field. This new way of joining allows complex shapes to be formed by joining together geometrically simple shapes. The joining technology at NASA is one of the enabling technologies for the application of silicon-carbide-based ceramic and composite components in demanding and high-temperature applications. The technology is being developed and tested for high-temperature propulsion parts for aerospace use. Commercially, it can be used for joining ceramic pieces used for high temperature applications in the power-generating and chemical industries, as well as in the microelectronics industry. This innovation could yield big payoffs for not only the power-generating industry but also the Silicon Valley chipmakers. This technology, which was developed at the NASA Glenn Research Center by Dr. Mrityunjay Singh, is a two-step process involving first using a paste to join together ceramic pieces and bonding them by heating the joint to 110 to 120 C for between 10 and 20 min. This makes the joint strong enough to be handled for the final joining. Then, a silicon-based substance is applied to the joint and heated to 1400 C for 10 to 15 min. The resulting joint is as strong as the original ceramic material and can withstand the same high temperatures.

  15. Robust, affordable, semi-direct Mars mission

    NASA Astrophysics Data System (ADS)

    Salotti, Jean-Marc

    2016-10-01

    A new architecture is proposed for the first manned Mars mission, based on current NASA developments (SLS and Orion), chemical propulsion for interplanetary transit, aerocapture for all vehicles, a split strategy, and a long stay on the surface. Two important choices make this architecture affordable and appropriate for the first mission. The first is splitting the Earth return vehicle into two parts that are launched separately and dock in Mars orbit. This is necessary to make aerocapture feasible and efficient, which considerably reduces mass. The second is reducing the crew to 3 astronauts. This simplifies the mission and reduces the SLS payload mass under the 45-metric ton limit for a direct TMI (trans-Mars injection) burn without LEO assembly. Only 4 SLS launches are required. The first takes the Mars ascent vehicle and in situ resource utilization systems to the planet's surface. The second takes the first part of the Earth return vehicle, the habitat, into Mars orbit. Two years later, two further SLS launches take a dual-use habitat (outbound trip and surface), Orion, and an enhanced service module to LEO, and then into Mars orbit, followed by the landing of the habitat on the surface. Transit time is demonstrated to be easily reduced to less than 6 months, with relatively low impact on propellant mass and none at all on the architecture.

  16. Broken affordances, broken objects: a TMS study.

    PubMed

    Buccino, Giovanni; Sato, Marc; Cattaneo, Luigi; Rodà, Francesca; Riggio, Lucia

    2009-12-01

    It is well known that specific components of motor programs are automatically activated when they are afforded by object related pragmatic features. Among these features the handle appears to be particularly salient for interacting with an object. The aim of this study was to test the modulation of the motor system when object features, particularly relevant for the action, like the object's handle, are violated. In order to address this issue a TMS paradigm was used in which familiar objects with a whole or broken handle, positioned to the right or to the left, were centrally presented. A control condition was also included in which a symbol ('#' character) was shown in the right or in the left visual field. Participants had to watch stimuli carefully. The left hemisphere hand motor area was magnetically stimulated 200 ms after stimulus presentation. Results showed that MEP areas were larger when the handle was located to the right side consistent with the visuomotor role of this feature, but only when the handle was complete. The present data (1) suggest a more active role of the dorsal stream in building up object knowledge and (2) allow one to rule out the role of any asymmetrical aspect of an object in motor coding. PMID:19615389

  17. Partnerships for affordable and equitable disaster insurance

    NASA Astrophysics Data System (ADS)

    Mysiak, J.; Pérez-Blanco, C. D.

    2015-08-01

    Extreme events are becoming more frequent and intense, inflating the economic damages and social hardship set-off by natural catastrophes. Amidst budgetary cuts, there is a growing concern on societies' ability to design solvent disaster recovery strategies, while addressing equity and affordability concerns. The participation of private sector along with public one through Public-Private Partnerships (PPPs) has gained on importance as a means to address these seemingly conflicting objectives through the provision of (catastrophic) natural hazard insurance. This is the case of many OECD countries, notably some EU Member States such as the United Kingdom and Spain. The EU legislator has adapted to this new scenario and recently produced major reforms in the legislation and regulation that govern the framework in which PPPs for (catastrophic) natural hazard insurance develop. This paper has a dual objective: (1) review the complex legal background that rules the provision of insurance against natural catastrophes in the EU after these major reforms, (2) assess the implications of the reforms and offer concise Policy Guiding Principles.

  18. Empathy and the responsiveness to social affordances.

    PubMed

    Kiverstein, Julian

    2015-11-01

    The direct perception theory of empathy claims that we can immediately experience a person's state of mind. I can see for instance that my neighbour is angry with me in his bodily countenance. I develop a version of the direct perception theory of empathy which takes this perceptual capacity to depend upon recognising in what way the other person is responsive to the affordances the environment provides. By recognising which possibilities for action are relevant to a person, I can thereby understand something about the meaning they give to the world. I come to share something of their perspective on the world, and this allows me to grasp based on my perception of them something about their current state of mind. I argue that shared affect plays a central role in this perceptual capacity. Shared affect allows me to orient my attention to possibilities for action that matter to the other person. I end by briefly discuss the implications of this view of empathy for the disturbances in so-called "cognitive empathy" that are found in people diagnosed with autism spectrum disorder.

  19. The U.S. health insurance marketplace: are premiums truly affordable?

    PubMed

    Graetz, Ilana; Kaplan, Cameron M; Kaplan, Erin K; Bailey, James E; Waters, Teresa M

    2014-10-21

    The Patient Protection and Affordable Care Act requires that individuals have health insurance or pay a penalty. Individuals are exempt from paying this penalty if the after-subsidy cost of the least-expensive plan available to them is greater than 8% of their income. For this study, premium data for all health plans offered on the state and federal health insurance marketplaces were collected; the after-subsidy cost of premiums for the least-expensive bronze plan for every county in the United States was calculated; and variations in premium affordability by age, income, and geographic area were assessed. Results indicated that-although marketplace subsidies ensure affordable health insurance for most persons in the United States-many individuals with incomes just above the subsidy threshold will lack affordable coverage and will be exempt from the mandate. Furthermore, young individuals with low incomes often pay as much as or more than older individuals for bronze plans. If substantial numbers of younger, healthier adults choose to remain uninsured because of cost, health insurance premiums across all ages may increase over time. PMID:25199512

  20. Ground Processing Affordability for Space Vehicles

    NASA Technical Reports Server (NTRS)

    Ingalls, John; Scott, Russell

    2011-01-01

    Launch vehicles and most of their payloads spend the majority of their time on the ground. The cost of ground operations is very high. So, why so often is so little attention given to ground processing during development? The current global space industry and economic environment are driving more need for efficiencies to save time and money. Affordability and sustainability are more important now than ever. We can not continue to treat space vehicles as mere science projects. More RLV's (Reusable Launch Vehicles) are being developed for the gains of reusability which are not available for ELV's (Expendable Launch Vehicles). More human-rated vehicles are being developed, with the retirement of the Space Shuttles, and for a new global space race, yet these cost more than the many unmanned vehicles of today. We can learn many lessons on affordability from RLV's. DFO (Design for Operations) considers ground operations during design, development, and manufacturing-before the first flight. This is often minimized for space vehicles, but is very important. Vehicles are designed for launch and mission operations. You will not be able to do it again if it is too slow or costly to get there. Many times, technology changes faster than space products such that what is launched includes outdated features, thus reducing competitiveness. Ground operations must be considered for the full product Lifecycle, from concept to retirement. Once manufactured, launch vehicles along with their payloads and launch systems require a long path of processing before launch. Initial assembly and testing always discover problems to address. A solid integration program is essential to minimize these impacts, as was seen in the Constellation Ares I-X test rocket. For RLV's, landing/recovery and post-flight turnaround activities are performed. Multi-use vehicles require reconfiguration. MRO (Maintenance, Repair, and Overhaul) must be well-planned--- even for the unplanned problems. Defect limits and

  1. Commercial Platforms Allow Affordable Space Research

    NASA Technical Reports Server (NTRS)

    2013-01-01

    At an altitude of about 240 miles, its orbital path carries it over 90 percent of the Earth s population. It circles the Earth in continuous free fall; its crew of six and one Robonaut pass the days, experiencing 16 sunrises and 16 sunsets every 24 hours, in microgravity, an environment in which everything from bodily functions to the physical behavior of materials changes drastically from what is common on the ground. Outside its shielded confines, temperatures cycle from one extreme to the other, radiation is rampant, and atomic oxygen corrodes everything it touches. A unique feat of engineering, the International Space Station (ISS) also represents the most remarkable platform for scientific research ever devised. In 2005, anticipating the space station s potential for NASA and non-NASA scientists alike, the NASA Authorization Act designated the US segment of the ISS as a national laboratory, instructing the Agency to "increase the utilization of the ISS by other Federal entities and the private sector." With the ISS set to maintain operations through at least 2020, the station offers an unprecedented long-term access to space conditions, enabling research not previously possible. "There will be new drug discoveries, new pharmaceuticals, a better understanding of how we affect the planet and how we can maintain it," says Marybeth Edeen, the ISS National Laboratory manager, based at Johnson Space Center. The ISS, she says, represents a major example of the government s role in making such advancements possible. "The government is key in that researchers cannot afford to build the kind of infrastructure that the government can provide. But we then have to make that infrastructure available at a reasonable cost." Enter Jeff Manber, who saw in the ISS National Lab an extraordinary opportunity to advance science, education, and business in ways never before seen.

  2. Affordable Space Tourism: SpaceStationSim

    NASA Technical Reports Server (NTRS)

    2006-01-01

    For over 5 years, people have been living and working in space on the International Space Station (ISS), a state-of-the-art laboratory complex orbiting high above the Earth. Offering a large, sustained microgravity environment that cannot be duplicated on Earth, the ISS furthers humankind s knowledge of science and how the body functions for extended periods of time in space all of which will prove vital on long-duration missions to Mars. On-orbit construction of the station began in November 1998, with the launch of the Russian Zarya Control Module, which provided battery power and fuel storage. This module was followed by additional components and supplies over the course of several months. In November 2000, the first ISS Expedition crew moved in. Since then, the ISS has continued to change and evolve. The space station is currently 240 feet wide, measured across the solar arrays, and 171 feet long, from the NASA Destiny Laboratory to the Russian Zvezda Habitation Module. It is 90 feet tall, and it weighs approximately 404,000 pounds. Crews inhabit a living space of about 15,000 cubic feet. To date, 90 scientific investigations have been conducted on the space station. New results from space station research, from basic science to exploration research, are being published each month, and more breakthroughs are likely to come. It is not all work on the space station, though. The orbiting home affords many of the comforts one finds on Earth. There is a weightless "weight room" and even a musical keyboard alongside research facilities. Holidays are observed, and with them, traditional foods such as turkey and cobbler are eaten, with lemonade to wash them down

  3. Affordance Analysis--Matching Learning Tasks with Learning Technologies

    ERIC Educational Resources Information Center

    Bower, Matt

    2008-01-01

    This article presents a design methodology for matching learning tasks with learning technologies. First a working definition of "affordances" is provided based on the need to describe the action potentials of the technologies (utility). Categories of affordances are then proposed to provide a framework for analysis. Following this, a methodology…

  4. One Hand, Two Objects: Emergence of Affordance in Contexts

    ERIC Educational Resources Information Center

    Borghi, Anna M.; Flumini, Andrea; Natraj, Nikhilesh; Wheaton, Lewis A.

    2012-01-01

    Studies on affordances typically focus on single objects. We investigated whether affordances are modulated by the context, defined by the relation between two objects and a hand. Participants were presented with pictures displaying two manipulable objects linked by a functional (knife-butter), a spatial (knife-coffee mug), or by no relation. They…

  5. The Influence of Affordability in Strategic Enrollment Management

    ERIC Educational Resources Information Center

    Pugh, Susan L.; Thompson, Roger J.

    2008-01-01

    In state houses around the country, one of the common higher education themes is affordability. As tuition costs have increased at rates exceeding that of inflation, students and families have pressed their legislative representatives to examine these increases. Affordability is a term used by various constituent groups, and its definition varies…

  6. Nurturing Opportunities for Educational Leadership: How Affordance and Leadership Interconnect

    ERIC Educational Resources Information Center

    Margolin, Ilana

    2013-01-01

    This qualitative ethnographic study focused on the affordances that facilitated the emergence of leadership, capturing a range of perspectives on leadership and leadership development of four groups: district superintendents; teacher-educators; mentor-teachers and graduates. The term "affordances" implies a reciprocal relationship…

  7. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.101 What...

  8. 24 CFR 1000.101 - What is affordable housing?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development Regulations Relating to Housing and Urban... URBAN DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Affordable Housing Activities § 1000.101 What...

  9. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Grants for affordable...

  10. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Grants for affordable...

  11. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Grants for affordable...

  12. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM General § 1006.20 Grants for affordable housing activities. (a) Annual grant. Each fiscal year, HUD will make a grant (to the extent that amounts... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Grants for affordable...

  13. An Affordability Comparison Tool (ACT) for Space Transportation

    NASA Technical Reports Server (NTRS)

    McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.

    2012-01-01

    NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.

  14. The Affording Mars Workshop: Background and Recommendations

    NASA Technical Reports Server (NTRS)

    Thronson, Harley A.; Carberry, Christopher

    2014-01-01

    . The workshop was organized around three topical breakout sessions: 1. The ISS and the path to Mars: The critical coming decade 2. Affordability and sustainability: what does it mean and what are its implications within guidelines established at the start of the workshop? 3. Notional sequence(s) of cost-achievable missions for the 2020s to 2030s, including capability objectives at each stage and opportunities for coordinated robotic partnerships.

  15. Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act.

    PubMed

    Haeder, Simon F

    2014-12-01

    The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings.

  16. Are Americans finding affordable coverage in the health insurance marketplaces? Results from the Commonwealth Fund Affordable Care Act Tracking Survey.

    PubMed

    Rasmussen, Petra W; Collins, Sara R; Doty, Michelle M; Beutel, Sophie

    2014-09-01

    By the end of the first open enrollment period for coverage offered through the Affordable Care Act's marketplaces, increasing numbers of people said they found it easy to find a plan they could afford, according to The Commonwealth Fund's Affordable Care Act Tracking Survey, April-June 2014. Adults with low or moderate incomes were more likely to say it was easy to find an affordable plan than were adults with higher incomes. Adults with low or moderate incomes who purchased a plan through the marketplaces this year have similar premium costs and deductibles as adults in the same income ranges with employer-provided coverage. A majority of adults with marketplace coverage gave high ratings to their insurance and were confident in their ability to afford the care they need when sick. PMID:25265646

  17. The Affordable Care Act: the ethical call to transform the organizational culture.

    PubMed

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.

  18. What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.

    PubMed

    Joseph, Tiffany D

    2016-02-01

    The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide.

  19. The Affordable Care Act: the ethical call to transform the organizational culture.

    PubMed

    Piper, Llewellyn E

    2014-01-01

    The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture. PMID:25068882

  20. The Affordable Care Act: the ethical call for value-based leadership to transform quality.

    PubMed

    Piper, Llewellyn E

    2013-01-01

    Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care. PMID:23903938

  1. Ninety-day waiting period limitation and technical amendments to certain health coverage requirements under the Affordable Care Act. Final rule.

    PubMed

    2014-02-24

    These final regulations implement the 90-day waiting period limitation under section 2708 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act), as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. These regulations also finalize amendments to existing regulations to conform to Affordable Care Act provisions. Specifically, these rules amend regulations implementing existing provisions such as some of the portability provisions added by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) because those provisions of the HIPAA regulations have become superseded or require amendment as a result of the market reform protections added by the Affordable Care Act.

  2. The Value of Full Correction: Achieving Excellent and Affordable Results.

    PubMed

    Kaplan, Julie Bass

    2016-01-01

    Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction.

  3. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... as specified in 40 CFR 1065.610. This is the maximum in-use engine speed used for calculating the NOX... procedures of 40 CFR part 1065, based on the manufacturer's design and production specifications for the..., power density, and maximum in-use engine speed. 1042.140 Section 1042.140 Protection of...

  4. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... as specified in 40 CFR 1065.610. This is the maximum in-use engine speed used for calculating the NOX... procedures of 40 CFR part 1065, based on the manufacturer's design and production specifications for the..., power density, and maximum in-use engine speed. 1042.140 Section 1042.140 Protection of...

  5. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... as specified in 40 CFR 1065.610. This is the maximum in-use engine speed used for calculating the NOX... procedures of 40 CFR part 1065, based on the manufacturer's design and production specifications for the..., power density, and maximum in-use engine speed. 1042.140 Section 1042.140 Protection of...

  6. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... as specified in 40 CFR 1065.610. This is the maximum in-use engine speed used for calculating the NOX... procedures of 40 CFR part 1065, based on the manufacturer's design and production specifications for the..., power density, and maximum in-use engine speed. 1042.140 Section 1042.140 Protection of...

  7. 40 CFR 1042.140 - Maximum engine power, displacement, power density, and maximum in-use engine speed.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... as specified in 40 CFR 1065.610. This is the maximum in-use engine speed used for calculating the NOX... procedures of 40 CFR part 1065, based on the manufacturer's design and production specifications for the..., power density, and maximum in-use engine speed. 1042.140 Section 1042.140 Protection of...

  8. Procedures for the Handling of Retaliation Complaints Under Section 1558 of the Affordable Care Act. Final rule.

    PubMed

    2016-10-13

    This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions). An interim final rule (IFR) governing these provisions and request for comments was published in the Federal Register on February 27, 2013. Thirteen comments were received; eleven were responsive to the IFR. This rule responds to those comments and establishes the final procedures and time frames for the handling of retaliation complaints under section 18C, including procedures and time frames for employee complaints to the Occupational Safety and Health Administration (OSHA), investigations by OSHA, appeals of OSHA determinations to an administrative law judge (ALJ) for a hearing de novo, hearings by ALJs, review of ALJ decisions by the Administrative Review Board (ARB) (acting on behalf of the Secretary of Labor), and judicial review of the Secretary of Labor's (Secretary's) final decision. It also sets forth the Secretary's interpretations of the Affordable Care Act whistleblower provision on certain matters.

  9. Minimizing the probable maximum flood

    SciTech Connect

    Woodbury, M.S.; Pansic, N. ); Eberlein, D.T. )

    1994-06-01

    This article examines Wisconsin Electric Power Company's efforts to determine an economical way to comply with Federal Energy Regulatory Commission requirements at two hydroelectric developments on the Michigamme River. Their efforts included refinement of the area's probable maximum flood model based, in part, on a newly developed probable maximum precipitation estimate.

  10. 40 CFR 141.13 - Maximum contaminant levels for turbidity.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... turbidity. 141.13 Section 141.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Maximum Contaminant Levels § 141.13... both community water systems and non-community water systems using surface water sources in whole or...

  11. 40 CFR 141.13 - Maximum contaminant levels for turbidity.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... turbidity. 141.13 Section 141.13 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Maximum Contaminant Levels § 141.13... both community water systems and non-community water systems using surface water sources in whole or...

  12. 40 CFR 143.3 - Secondary maximum contaminant levels.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... 143.3 Section 143.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL SECONDARY DRINKING WATER REGULATIONS § 143.3 Secondary maximum contaminant.... Zinc 5 mg/l. These levels represent reasonable goals for drinking water quality. The States...

  13. 40 CFR 143.3 - Secondary maximum contaminant levels.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    .... 143.3 Section 143.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL SECONDARY DRINKING WATER REGULATIONS § 143.3 Secondary maximum contaminant.... Zinc 5 mg/l. These levels represent reasonable goals for drinking water quality. The States...

  14. 40 CFR 143.3 - Secondary maximum contaminant levels.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    .... 143.3 Section 143.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL SECONDARY DRINKING WATER REGULATIONS § 143.3 Secondary maximum contaminant.... Zinc 5 mg/l. These levels represent reasonable goals for drinking water quality. The States...

  15. 40 CFR 143.3 - Secondary maximum contaminant levels.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    .... 143.3 Section 143.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL SECONDARY DRINKING WATER REGULATIONS § 143.3 Secondary maximum contaminant.... Zinc 5 mg/l. These levels represent reasonable goals for drinking water quality. The States...

  16. 40 CFR 143.3 - Secondary maximum contaminant levels.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... 143.3 Section 143.3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL SECONDARY DRINKING WATER REGULATIONS § 143.3 Secondary maximum contaminant.... Zinc 5 mg/l. These levels represent reasonable goals for drinking water quality. The States...

  17. Memory protection

    NASA Technical Reports Server (NTRS)

    Denning, Peter J.

    1988-01-01

    Accidental overwriting of files or of memory regions belonging to other programs, browsing of personal files by superusers, Trojan horses, and viruses are examples of breakdowns in workstations and personal computers that would be significantly reduced by memory protection. Memory protection is the capability of an operating system and supporting hardware to delimit segments of memory, to control whether segments can be read from or written into, and to confine accesses of a program to its segments alone. The absence of memory protection in many operating systems today is the result of a bias toward a narrow definition of performance as maximum instruction-execution rate. A broader definition, including the time to get the job done, makes clear that cost of recovery from memory interference errors reduces expected performance. The mechanisms of memory protection are well understood, powerful, efficient, and elegant. They add to performance in the broad sense without reducing instruction execution rate.

  18. Making Safe Surgery Affordable: Design of a Surgical Drill Cover System for Scale.

    PubMed

    Buchan, Lawrence L; Black, Marianne S; Cancilla, Michael A; Huisman, Elise S; Kooyman, Jeremy J R; Nelson, Scott C; OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

    2015-10-01

    Many surgeons in low-resource settings do not have access to safe, affordable, or reliable surgical drilling tools. Surgeons often resort to nonsterile hardware drills because they are affordable, robust, and efficient, but they are impossible to sterilize using steam. A promising alternative is to use a Drill Cover system (a sterilizable fabric bag plus surgical chuck adapter) so that a nonsterile hardware drill can be used safely for surgical bone drilling. Our objective was to design a safe, effective, affordable Drill Cover system for scale in low-resource settings. We designed our device based on feedback from users at Mulago Hospital (Kampala, Uganda) and focused on 3 main aspects. First, the design included a sealed barrier between the surgical field and hardware drill that withstands pressurized fluid. Second, the selected hardware drill had a maximum speed of 1050 rpm to match common surgical drills and reduce risk of necrosis. Third, the fabric cover was optimized for ease of assembly while maintaining a sterile technique. Furthermore, with the Drill Cover approach, multiple Drill Covers can be provided with a single battery-powered drill in a "kit," so that the drill can be used in back-to-back surgeries without requiring immediate sterilization. The Drill Cover design presented here provides a proof-of-concept for a product that can be commercialized, produced at scale, and used in low-resource settings globally to improve access to safe surgery.

  19. Making Safe Surgery Affordable: Design of a Surgical Drill Cover System for Scale.

    PubMed

    Buchan, Lawrence L; Black, Marianne S; Cancilla, Michael A; Huisman, Elise S; Kooyman, Jeremy J R; Nelson, Scott C; OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

    2015-10-01

    Many surgeons in low-resource settings do not have access to safe, affordable, or reliable surgical drilling tools. Surgeons often resort to nonsterile hardware drills because they are affordable, robust, and efficient, but they are impossible to sterilize using steam. A promising alternative is to use a Drill Cover system (a sterilizable fabric bag plus surgical chuck adapter) so that a nonsterile hardware drill can be used safely for surgical bone drilling. Our objective was to design a safe, effective, affordable Drill Cover system for scale in low-resource settings. We designed our device based on feedback from users at Mulago Hospital (Kampala, Uganda) and focused on 3 main aspects. First, the design included a sealed barrier between the surgical field and hardware drill that withstands pressurized fluid. Second, the selected hardware drill had a maximum speed of 1050 rpm to match common surgical drills and reduce risk of necrosis. Third, the fabric cover was optimized for ease of assembly while maintaining a sterile technique. Furthermore, with the Drill Cover approach, multiple Drill Covers can be provided with a single battery-powered drill in a "kit," so that the drill can be used in back-to-back surgeries without requiring immediate sterilization. The Drill Cover design presented here provides a proof-of-concept for a product that can be commercialized, produced at scale, and used in low-resource settings globally to improve access to safe surgery. PMID:26356212

  20. Object Affordances Potentiate Responses but Do Not Guide Attentional Prioritization

    PubMed Central

    Yamani, Yusuke; Ariga, Atsunori; Yamada, Yuki

    2016-01-01

    Handled objects automatically activate afforded responses. The current experiment examined whether objects that afford a response are also prioritized for attentional processing in visual search. Targets were pictures of coffee cups with handles oriented either to the right or the left. Subjects searched for a target, a right-handled vs. left-handled coffee cup, among a varying number of distractor cups oriented in the opposite direction. Responses were faster when the direction of target handle and the key press were spatially matched than mismatched (stimulus-response compatibility (SRC) effect), but object affordance did not moderate slopes of the search functions, indicating the absence of attentional prioritization effect. These findings imply that handled objects prime afforded responses without influencing attentional prioritization. PMID:26793077

  1. Stable and variable affordances are both automatic and flexible

    PubMed Central

    Borghi, Anna M.; Riggio, Lucia

    2015-01-01

    The mere observation of pictures or words referring to manipulable objects is sufficient to evoke their affordances since objects and their nouns elicit components of appropriate motor programs associated with object interaction. While nobody doubts that objects actually evoke motor information, the degree of automaticity of this activation has been recently disputed. Recent evidence has indeed revealed that affordances activation is flexibly modulated by the task and by the physical and social context. It is therefore crucial to understand whether these results challenge previous evidence showing that motor information is activated independently from the task. The context and the task can indeed act as an early or late filter. We will review recent data consistent with the notion that objects automatically elicit multiple affordances and that top-down processes select among them probably inhibiting motor information that is not consistent with behavior goals. We will therefore argue that automaticity and flexibility of affordances are not in conflict. We will also discuss how language can incorporate affordances showing similarities, but also differences, between the motor information elicited by vision and language. Finally we will show how the distinction between stable and variable affordances can accommodate all these effects. PMID:26150778

  2. Affordability of alcohol and alcohol-related mortality in Belarus.

    PubMed

    Razvodovsky, Yury E

    2013-01-01

    Alcohol abuse has numerous adverse health and social consequences. The consumer response to changes in alcohol affordability is an important issue on alcohol policy debates. Studies from many countries have shown an inverse relationship between alcohol prices and alcohol consumption in the population. There are, however, suggestions that increasing the price of alcohol by rising taxes may have limited effect on alcohol-related problems, associated with long-term heavy drinking. The aim of the present study was to evaluate the relationship between alcohol affordability and alcohol-related mortality rates in post-Soviet Belarus. For this purpose trends in alcohol-related mortality rates (mortality from liver cirrhosis, pancreatitis, alcoholism and alcohol psychoses) and affordability of vodka between 1990 and 2010 were compared. The time series analysis revealed that 1% increase in vodka affordability is associated with an increase in liver cirrhosis mortality of 0,77%, an increase in pancreatitis mortality of 0.53%, an increase in mortality from alcoholism and alcohol psychoses of 0,70%. The major conclusion emerging from this study is that affordability of alcohol is one of the most important predictor of alcohol-related problems in a population. These findings provide additional evidence that decreasing in affordability of alcohol is an effective strategy for reducing alcohol consumption and alcohol-related harm.

  3. Affordable Exploration of Mars: Recommendations from a Community Workshop

    NASA Technical Reports Server (NTRS)

    Thronson, Harley A.; Carberry, Chris; Cassady, R. Joseph; Cooke, Doug; Kirkpatrick, Jim; Perino, Maria Antonietta; Raftery, Michael; Westenberg, Artemis; Zucker, Richard

    2014-01-01

    There is a growing opinion that within two decades initial human missions to Mars are affordable under plausible budget scenarios, with sustained international participation, and --- especially --- without requiring those first missions to achieve a burdensome number of goals. In response to this view, a group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December 2013. Participants reviewed scenarios for proposed affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station as the essential early step toward humans to Mars, possible "bridge" or "transition" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and usable definitions of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop. In the context of affordable early missions to Mars, we also discuss the recent report of the National Research Council on human space flight and a pair of recent scenarios that appear to promise reduced costs.

  4. Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion

    NASA Technical Reports Server (NTRS)

    Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.

    2013-01-01

    Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability

  5. Arctic Sea Ice Maximum 2011

    NASA Video Gallery

    AMSR-E Arctic Sea Ice: September 2010 to March 2011: Scientists tracking the annual maximum extent of Arctic sea ice said that 2011 was among the lowest ice extents measured since satellites began ...

  6. Elected Officials Travel in Parallel Universes Regarding the Affordable Care Act.

    PubMed

    Elwood, Thomas W

    2015-01-01

    This authoritative appraisal of the much debated U.S. Patient Protection and Affordable Care Act, often referred to as Obamacare, describes the controversy, support, and opposition from federal and state governments during the first 5.5 years since the law was passed. Its history, the impact on individual and community health status, the limitations of health reform, its accomplishments and deficiencies, and the impact of societal determinants on program implementation are presented in a refreshing, candid, objective, and knowledgeable manner. PMID:26543040

  7. Nondestructive Evaluation (NDE) Results on Sikorsky Aircraft Survivable Affordable Reparable Airframe Program (SARAP) Samples

    NASA Technical Reports Server (NTRS)

    Zalameda, Joseph N.; Anastasi, Robert F.; Madaras, Eric I.

    2004-01-01

    The Survivable, Affordable, Reparable Airframe Program (SARAP) will develop/produce new structural design concepts with lower structural weight, reduced manufacturing complexity and development time, increased readiness, and improved threat protection. These new structural concepts will require advanced field capable inspection technologies to help meet the SARAP structural objectives. In the area of repair, damage assessment using nondestructive inspection (NDI) is critical to identify repair location and size. The purpose of this work is to conduct an assessment of new and emerging NDI methods that can potentially satisfy the SARAP program goals.

  8. Principles of maximum entropy and maximum caliber in statistical physics

    NASA Astrophysics Data System (ADS)

    Pressé, Steve; Ghosh, Kingshuk; Lee, Julian; Dill, Ken A.

    2013-07-01

    The variational principles called maximum entropy (MaxEnt) and maximum caliber (MaxCal) are reviewed. MaxEnt originated in the statistical physics of Boltzmann and Gibbs, as a theoretical tool for predicting the equilibrium states of thermal systems. Later, entropy maximization was also applied to matters of information, signal transmission, and image reconstruction. Recently, since the work of Shore and Johnson, MaxEnt has been regarded as a principle that is broader than either physics or information alone. MaxEnt is a procedure that ensures that inferences drawn from stochastic data satisfy basic self-consistency requirements. The different historical justifications for the entropy S=-∑ipilog⁡pi and its corresponding variational principles are reviewed. As an illustration of the broadening purview of maximum entropy principles, maximum caliber, which is path entropy maximization applied to the trajectories of dynamical systems, is also reviewed. Examples are given in which maximum caliber is used to interpret dynamical fluctuations in biology and on the nanoscale, in single-molecule and few-particle systems such as molecular motors, chemical reactions, biological feedback circuits, and diffusion in microfluidics devices.

  9. 76 FR 4377 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-25

    ...; Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent Coverage ACTION: Notice... Administration (EBSA) sponsored information collection request (ICR) titled, ``Affordable Care Act Enrollment... Collection: Affordable Care Act Enrollment Opportunity Notice Relating to Extension of Dependent......

  10. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability. PMID:25217142

  11. The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.

    PubMed

    Ung, Brian L; Mullins, C Daniel

    2015-01-01

    The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability.

  12. Probably maximum flood of the Sava River

    NASA Astrophysics Data System (ADS)

    Brilly, Mitja; Vidmar, Andrej; Raj, Mojca Å.

    2010-05-01

    The Nuclear Power Plant Krško (NEK) situated on the left bank of the Save River close to the border of Croatia. Probably Maximum Flood, on the location of the NEK could result in combination of probably maximum precipitation, sequential storm before PMP or snowmelt on the Sava River watershed. Mediterranean climate characterises very high precipitation and temporary high snow pack. The HBV-96 model as Integrated Hydrological Modelling System (IHMS) used for modelling. Model was calibrated and verification for daily time step at first for time period 1190-2006. Calibration and verification for hourly time step was done for period 1998-1999. The stream routing parameters were calibrated for flood event in years 1998 and 2007 and than verification for flood event in 1990. Discharge routing data analysis shown that possible inundation of Ljubljana and Savinja valley was not properly estimated. The flood areas are protected with levees and water does not spread over flooded areas in events used for calibration. Inundated areas in Ljubljana valley and Savinja valley are protected by levees and model could not simulate properly inundation of PMF. We recalibrate parameters controlled inundation on those areas for the worst scenario. Calculated PMF values drop down tramendosly after recalibration.

  13. The Affordance Template ROS Package for Robot Task Programming

    NASA Technical Reports Server (NTRS)

    Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly

    2015-01-01

    This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.

  14. Affordability Engineering: Bridging the Gap Between Design and Cost

    NASA Technical Reports Server (NTRS)

    Reeves, J. D.; DePasquale, Dominic; Lim, Evan

    2010-01-01

    Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.

  15. Convex accelerated maximum entropy reconstruction

    NASA Astrophysics Data System (ADS)

    Worley, Bradley

    2016-04-01

    Maximum entropy (MaxEnt) spectral reconstruction methods provide a powerful framework for spectral estimation of nonuniformly sampled datasets. Many methods exist within this framework, usually defined based on the magnitude of a Lagrange multiplier in the MaxEnt objective function. An algorithm is presented here that utilizes accelerated first-order convex optimization techniques to rapidly and reliably reconstruct nonuniformly sampled NMR datasets using the principle of maximum entropy. This algorithm - called CAMERA for Convex Accelerated Maximum Entropy Reconstruction Algorithm - is a new approach to spectral reconstruction that exhibits fast, tunable convergence in both constant-aim and constant-lambda modes. A high-performance, open source NMR data processing tool is described that implements CAMERA, and brief comparisons to existing reconstruction methods are made on several example spectra.

  16. Why do so many Americans oppose the Affordable Care Act?

    PubMed

    Dalen, James E; Waterbrook, Keith; Alpert, Joseph S

    2015-08-01

    The Patient Protection and Affordable Care Act (ACA) was passed by a Democratic Congress and signed into law by a Democratic president in 2010. Republican congressmen, governors, and Republican candidates have consistently opposed the ACA and have vowed to repeal it. Polls have consistently shown that it is supported by <50% of Americans. The most important goal of the ACA is to improve the health of Americans by increasing the number covered by health insurance. In the first year of its implementation, more than 10 million citizens gained health insurance. The percentage of Americans without health insurance decreased from 18% in July 2013 to 13.4% in June 2014. In addition, the ACA has eliminated many of the negative features of private insurance such as the denial of coverage for those with "prior conditions." The benefits of Medicare have been enhanced to decrease the cost of prescription drugs and to eliminate co-pays for preventive services. Despite these positive changes, a near majority of Americans still oppose the ACA, even though they approve of most of its features. They oppose the mandate that all Americans must have health insurance (the individual mandate), and they oppose a government role in health care. Yet Medicare, a mandatory insurance for seniors administered by the federal government since 1965, is overwhelmingly approved by the American public. The opposition to a government role in health care is based on the fact that that the vast majority of our citizens do not trust their government. Republicans are much less trusting of the federal government and much less supportive of a government role in health care than Democrats. The overwhelmingly negative TV ads against the ACA by the Republican candidates in the elections of 2012 and 2014 have had a major impact on Americans' views of the ACA. More than 60% of Americans have stated that most of what they know about the ACA came from watching TV. Opposition to a government role in health care

  17. The Value of Full Correction: Achieving Excellent and Affordable Results.

    PubMed

    Kaplan, Julie Bass

    2016-01-01

    Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction. PMID:27606585

  18. Conflict between object structural and functional affordances in peripersonal space.

    PubMed

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition.

  19. Conflict between object structural and functional affordances in peripersonal space.

    PubMed

    Kalénine, Solène; Wamain, Yannick; Decroix, Jérémy; Coello, Yann

    2016-10-01

    Recent studies indicate that competition between conflicting action representations slows down planning of object-directed actions. The present study aims to assess whether similar conflict effects exist during manipulable object perception. Twenty-six young adults performed reach-to-grasp and semantic judgements on conflictual objects (with competing structural and functional gestures) and non-conflictual objects (with similar structural and functional gestures) presented at difference distances in a 3D virtual environment. Results highlight a space-dependent conflict between structural and functional affordances. Perceptual judgments on conflictual objects were slower that perceptual judgments on non-conflictual objects, but only when objects were presented within reach. Findings demonstrate that competition between structural and functional affordances during object perception induces a processing cost, and further show that object position in space can bias affordance competition. PMID:27327864

  20. Predictors of Smoke-Free Policies in Affordable Multiunit Housing, North Carolina, 2013

    PubMed Central

    Suttie, Janet; Baker, Laura; Agans, Robert; Xue, Wei; Bowling, J. Michael

    2015-01-01

    Introduction Smoke-free policies can effectively protect nonsmokers from secondhand smoke (SHS) exposure in multiunit housing. We surveyed all affordable multiunit housing properties in North Carolina to determine the statewide prevalence of smoke-free policies and to identify predictors of smoke-free policies. Methods Representatives of affordable housing properties in North Carolina completed a mailed or online survey during June through October 2013. The primary outcome measure was presence of a smoke-free policy, defined as prohibiting smoking in all residential units. We used χ2 analysis and multivariate logistic regression to identify correlates of smoke-free policies. Results Of 1,865 eligible properties, responses were received for 1,063 (57%). A total of 16.5% of properties had policies that prohibited smoking in all residential units, while 69.6% prohibited smoking in indoor common areas. In multivariate analysis, an increase in the number of children per unit was associated with a decrease in the odds of having a smoke-free policy at most properties. Newer properties across all company sizes were more likely to have smoke-free policies. Accessing units from interior hallways predicted smoke-free policies among medium-sized companies. Conclusion More smoke-free policies in affordable multiunit housing are needed to protect vulnerable populations, particularly children, from SHS exposure. Public health professionals should continue to educate housing operators about SHS and the benefits of smoke-free policies at all properties, including older ones and ones where units are accessed from outside rather than from an interior hallway. PMID:25974143

  1. Can Low-Income Americans Afford a Healthy Diet?

    PubMed

    Drewnowski, Adam; Eichelsdoerfer, Petra

    2010-11-01

    Many nutritional professionals believe that all Americans, regardless of income, have access to a nutritious diet of whole grains, lean meats, and fresh vegetables and fruit. In reality, food prices pose a significant barrier for many consumers who are trying to balance good nutrition with affordability. The Thrifty Food Plan (TFP), commonly cited as a model of a healthy low-cost diet, achieves cost goals by relaxing some nutrition constraints and by disregarding the usual eating habits of the American population. Diet optimization techniques, when sensitive to cost and social norms, can help identify affordable, good tasting, nutrient-rich foods that are part of the mainstream American diet.

  2. Approach to an Affordable and Sustainable Space Transportation System

    NASA Technical Reports Server (NTRS)

    McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.

    2012-01-01

    This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !

  3. The Maximum Density of Water.

    ERIC Educational Resources Information Center

    Greenslade, Thomas B., Jr.

    1985-01-01

    Discusses a series of experiments performed by Thomas Hope in 1805 which show the temperature at which water has its maximum density. Early data cast into a modern form as well as guidelines and recent data collected from the author provide background for duplicating Hope's experiments in the classroom. (JN)

  4. Abolishing the maximum tension principle

    NASA Astrophysics Data System (ADS)

    Dąbrowski, Mariusz P.; Gohar, H.

    2015-09-01

    We find the series of example theories for which the relativistic limit of maximum tension Fmax =c4 / 4 G represented by the entropic force can be abolished. Among them the varying constants theories, some generalized entropy models applied both for cosmological and black hole horizons as well as some generalized uncertainty principle models.

  5. Maximum entropy beam diagnostic tomography

    SciTech Connect

    Mottershead, C.T.

    1985-01-01

    This paper reviews the formalism of maximum entropy beam diagnostic tomography as applied to the Fusion Materials Irradiation Test (FMIT) prototype accelerator. The same formalism has also been used with streak camera data to produce an ultrahigh speed movie of the beam profile of the Experimental Test Accelerator (ETA) at Livermore. 11 refs., 4 figs.

  6. Maximum cooling and maximum efficiency of thermoacoustic refrigerators

    NASA Astrophysics Data System (ADS)

    Tartibu, L. K.

    2016-01-01

    This work provides valid experimental evidence on the difference between design for maximum cooling and maximum efficiency for thermoacoustic refrigerators. In addition, the influence of the geometry of the honeycomb ceramic stack on the performance of thermoacoustic refrigerators is presented as it affects the cooling power. Sixteen cordierite honeycomb ceramic stacks with square cross sections having four different lengths of 26, 48, 70 and 100 mm are considered. Measurements are taken at six different locations of the stack hot ends from the pressure antinode, namely 100, 200, 300, 400, 500 and 600 mm respectively. Measurement of temperature difference across the stack ends at steady state for different stack geometries are used to compute the cooling load and the coefficient of performance. The results obtained with atmospheric air showed that there is a distinct optimum depending on the design goal.

  7. 76 FR 20354 - Notice of Intent To Award Supplemental Affordable Care Act Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support...: Notice. SUMMARY: This notice provides public announcement of CDC's intent to use Affordable Care Act (ACA....'' Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Title IV, Section...

  8. 40 CFR Appendix A1 to Subpart F of... - Generic Maximum Contaminant Levels

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 18 2013-07-01 2013-07-01 false Generic Maximum Contaminant Levels A1 Appendix A1 to Subpart F of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction Pt....

  9. 40 CFR Appendix A1 to Subpart F of... - Generic Maximum Contaminant Levels

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 17 2011-07-01 2011-07-01 false Generic Maximum Contaminant Levels A1 Appendix A1 to Subpart F of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction Pt....

  10. 40 CFR Appendix A1 to Subpart F of... - Generic Maximum Contaminant Levels

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 18 2014-07-01 2014-07-01 false Generic Maximum Contaminant Levels A1 Appendix A1 to Subpart F of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction Pt....

  11. 40 CFR Appendix A1 to Subpart F of... - Generic Maximum Contaminant Levels

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Generic Maximum Contaminant Levels A1 Appendix A1 to Subpart F of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction Pt....

  12. 40 CFR Appendix A1 to Subpart F of... - Generic Maximum Contaminant Levels

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 18 2012-07-01 2012-07-01 false Generic Maximum Contaminant Levels A1 Appendix A1 to Subpart F of Part 82 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) PROTECTION OF STRATOSPHERIC OZONE Recycling and Emissions Reduction Pt....

  13. Inside the Virtual Classroom: Student Perspectives on Affordances and Limitations

    ERIC Educational Resources Information Center

    Falloon, Garry

    2012-01-01

    Research indicates learners studying at a distance can experience perceptions of isolation and lack of "belonging" and support, which can adversely affect their learning experience and performance. Recently, the advent of affordable, accessible and reliable high-speed broadband has meant that a whole new array of digital tools to support…

  14. Learning to Identify and Actualize Affordances in a New Tool

    ERIC Educational Resources Information Center

    Haines, Karen J.

    2015-01-01

    Keeping abreast of new technologies and the opportunities they offer is a challenge for inservice teachers (Blake, 2008; Egbert, Akasha, Huff, & Lee, 2011; Hanson-Smith, 2006; Hubbard, 2007; Robb, 2006). An important aspect of teacher learning about the use of technology is the ability to identify the affordances of new tools and how they can…

  15. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Affordable Housing Reserve Fund. (b) Use or commitment of funds. Approval of applications for AHP subsidies... year-end are deemed to be used or committed if, in combination with AHP subsidies that have been... highest scoring AHP application in the Bank's final funding period of the year for its...

  16. Monitoring the price and affordability of foods and diets globally.

    PubMed

    Lee, A; Mhurchu, C N; Sacks, G; Swinburn, B; Snowdon, W; Vandevijvere, S; Hawkes, C; L'abbé, M; Rayner, M; Sanders, D; Barquera, S; Friel, S; Kelly, B; Kumanyika, S; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Walker, C

    2013-10-01

    Food prices and food affordability are important determinants of food choices, obesity and non-communicable diseases. As governments around the world consider policies to promote the consumption of healthier foods, data on the relative price and affordability of foods, with a particular focus on the difference between 'less healthy' and 'healthy' foods and diets, are urgently needed. This paper briefly reviews past and current approaches to monitoring food prices, and identifies key issues affecting the development of practical tools and methods for food price data collection, analysis and reporting. A step-wise monitoring framework, including measurement indicators, is proposed. 'Minimal' data collection will assess the differential price of 'healthy' and 'less healthy' foods; 'expanded' monitoring will assess the differential price of 'healthy' and 'less healthy' diets; and the 'optimal' approach will also monitor food affordability, by taking into account household income. The monitoring of the price and affordability of 'healthy' and 'less healthy' foods and diets globally will provide robust data and benchmarks to inform economic and fiscal policy responses. Given the range of methodological, cultural and logistical challenges in this area, it is imperative that all aspects of the proposed monitoring framework are tested rigorously before implementation. PMID:24074213

  17. Can Canadian Seniors on Public Pensions Afford a Nutritious Diet?

    ERIC Educational Resources Information Center

    Green, Rebecca J.; Williams, Patricia L.; Johnson, C. Shanthi; Blum, Ilya

    2008-01-01

    This study examined whether Canada's public pensions (Old Age Security and Canada Pension Plan) provided adequate income for seniors living in Nova Scotia in 2005 to afford a basic nutritious diet. Monthly incomes were compared to essential monthly expenses for four household scenarios: (a) married couple, 80 years and 78 years, in urban Nova…

  18. The ICCE Framework: Framing Learning Experiences Afforded by Games

    ERIC Educational Resources Information Center

    Foster, Aroutis; Shah, Mamta

    2015-01-01

    There is a need for game-based learning frameworks that provide a lens for understanding learning experiences afforded in digital games. These frameworks should aim to facilitate game analyses, identification of learning opportunities, and support for learner experiences. This article uses the inquiry, communication, construction, and expression…

  19. Teaching Text Structure: Examining the Affordances of Children's Informational Texts

    ERIC Educational Resources Information Center

    Jones, Cindy D.; Clark, Sarah K.; Reutzel, D. Ray

    2016-01-01

    This study investigated the affordances of informational texts to serve as model texts for teaching text structure to elementary school children. Content analysis of a random sampling of children's informational texts from top publishers was conducted on text structure organization and on the inclusion of text features as signals of text…

  20. Disengaged Students and Dialogic Learning: The Role of CSCL Affordances

    ERIC Educational Resources Information Center

    Slakmon, Benzi; Schwarz, Baruch B.

    2014-01-01

    Only a few studies have dealt with the challenge of bridging the linguistic gap between the dialogic realm and the talk of disengaged students. Bridging this gap is particularly relevant to the CSCL community since one of its utmost aims is to promote the dialogic. This study aims to articulate how to harness the CSCL design and affordances to…

  1. The Weight of Time: Affordances for an Integrated Magnitude System

    ERIC Educational Resources Information Center

    Lu, Aitao; Mo, Lei; Hodges, Bert H.

    2011-01-01

    In five experiments we explored the effects of weight on time in different action contexts to test the hypothesis that an integrated magnitude system is tuned to affordances. Larger magnitudes generally seem longer; however, Lu and colleagues (2009) found that if numbers were presented as weights in a range heavy enough to affect lifting, the…

  2. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201...

  3. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development Regulations Relating to Housing and Urban... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201...

  4. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201...

  5. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special..., as a Special Affordable Housing Home Purchase Subgoal, 17 percent of the total number of home purchase mortgages in metropolitan areas financed by each GSE's mortgage purchases shall be home...

  6. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special..., as a Special Affordable Housing Home Purchase Subgoal, 17 percent of the total number of home purchase mortgages in metropolitan areas financed by each GSE's mortgage purchases shall be home...

  7. 12 CFR 1282.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Fannie Mae and $4.60 billion for Freddie Mac. In addition, as a Special Affordable Housing Home Purchase Subgoal, 14 percent of the total number of home purchase mortgages in metropolitan areas financed by that Enterprise's mortgage purchases shall be home purchase mortgages in metropolitan areas which count toward...

  8. 24 CFR 954.307 - Homeownership: qualification as affordable housing.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... whose family qualifies as a low-income family at the time HOME funds are committed to the housing. ... HOUSING AND URBAN DEVELOPMENT INDIAN HOME PROGRAM Eligible Activities and Affordability § 954.307... (1- to 4-family residence, condominium unit, cooperative unit, combination manufactured home and...

  9. Lean, Mean and Green: An Affordable Net Zero School

    ERIC Educational Resources Information Center

    Stanfield, Kenneth

    2010-01-01

    From its conception, Richardsville Elementary was designed to be an affordable net zero facility. The design team explored numerous energy saving strategies to dramatically reduce energy consumption. By reducing energy use to 19.31 kBtus annually, the net zero goal could be realized through the implementation of a solar array capable of producing…

  10. Affordance, Learning Opportunities, and the Lesson Plan Pro Forma

    ERIC Educational Resources Information Center

    Anderson, Jason

    2015-01-01

    This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…

  11. Reinventing Financial Aid: Charting a New Course to College Affordability

    ERIC Educational Resources Information Center

    Kelly, Andrew P., Ed.; Goldrick-Rab, Sara, Ed.

    2014-01-01

    In this provocative volume, two experts with very different points of view address the growing concern that student loan programs are not a sustainable solution to the problem of mounting college costs. They argue that the time has come to reform the financial aid system so that it is more effective in promoting college affordability, access, and…

  12. Pedagogical Affordances of Multiple External Representations in Scientific Processes

    NASA Astrophysics Data System (ADS)

    Wu, Hsin-Kai; Puntambekar, Sadhana

    2012-12-01

    Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs could be introduced and used to support students' engagement in scientific processes and develop competent scientific practices (e.g., asking questions, planning investigations, and analyzing data). Additionally, little is understood about complex interactions among scientific processes and affordances of MERs. Therefore, this article focuses on pedagogical affordances of MERs in learning environments that engage students in various scientific processes. By reviewing literature in science education and cognitive psychology and integrating multiple perspectives, this article aims at exploring (1) how MERs can be integrated with science processes due to their different affordances, and (2) how student learning with MERs can be scaffolded, especially in a classroom situation. We argue that pairing representations and scientific processes in a principled way based on the affordances of the representations and the goals of the activities is a powerful way to use MERs in science education. Finally, we outline types of scaffolding that could help effective use of MERs including dynamic linking, model progression, support in instructional materials, teacher support, and active engagement.

  13. Learning Affordances of Language and Communication National Curricula

    ERIC Educational Resources Information Center

    Scott, David

    2016-01-01

    This article focuses on the learning affordances of different language and communication curricula in the world. For reasons of space, only two national education systems (Finland and Singapore) and their language and communication curricula are referred to. The accounts of national education systems consist of the identification of mechanisms…

  14. Conceptual and Physical Object Qualities Contribute Differently to Motor Affordances

    ERIC Educational Resources Information Center

    Vingerhoets, G.; Vandamme, K.; Vercammen, A.

    2009-01-01

    Priming studies have demonstrated that an object's intrinsic and extrinsic qualities (size, orientation) influence subsequent motor behavior thus suggesting that these object qualities "afford" actions that are congruent with the prime. We present four experiments that aim to evaluate the relative effect of conceptual and physical object qualities…

  15. Can the United States afford a lunar base

    NASA Technical Reports Server (NTRS)

    Keaton, Paul W.

    1988-01-01

    Establishing a lunar base will require steady funding for a decade or two. The question addressed is whether such a large space project is affordable at this time. The relevant facts and methodology are presented so that the reader may formulate independent answers. It is shown that a permanent lunar base can be financed without increasing NASA's historical budgetary trend.

  16. Affordances of Learning Technologies in Higher Education Multicultural Environments

    ERIC Educational Resources Information Center

    Arenas, Edilson

    2015-01-01

    A cluster of research has been conducted in higher education to investigate the affordances (action possibilities) and the influence information and communication technologies (ICT) may have on students' learning experiences and outcomes. Such studies have given rise to the implementation of a wide range of educational frameworks with a great deal…

  17. Affordances for Second Language Learning in "World of Warcraft"

    ERIC Educational Resources Information Center

    Rama, Paul S.; Black, Rebecca W.; van Es, Elizabeth; Warschauer, Mark

    2012-01-01

    What are the affordances of online gaming environments for second language learning and socialization? To answer this question, this qualitative study examines two college-age Spanish learners' experiences participating in the Spanish language version of the massively multi-player online game "World of Warcraft." Using data culled from participant…

  18. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... URBAN DEVELOPMENT NATIVE HAWAIIAN HOUSING BLOCK GRANT PROGRAM Eligible Activities § 1006.201 Eligible... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND...

  19. 24 CFR 1006.201 - Eligible affordable housing activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE...

  20. 24 CFR 1006.20 - Grants for affordable housing activities.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Grants for affordable housing activities. 1006.20 Section 1006.20 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT NATIVE...

  1. Can the United States afford a lunar base

    NASA Astrophysics Data System (ADS)

    Keaton, Paul W.

    1988-03-01

    Establishing a lunar base will require steady funding for a decade or two. The question addressed is whether such a large space project is affordable at this time. The relevant facts and methodology are presented so that the reader may formulate independent answers. It is shown that a permanent lunar base can be financed without increasing NASA's historical budgetary trend.

  2. Voters and the Affordable Care Act in the 2014 election.

    PubMed

    Blendon, Robert J; Benson, John M

    2014-11-13

    In this analysis of data from 27 public opinion polls, the authors examine the role of the Affordable Care Act in the 2014 congressional elections. The outcome of the elections is likely to influence implementation of the ACA and future U.S. health care policy. PMID:25353968

  3. Access and Affordability: Strategic Financial Perspectives for Independent Schools.

    ERIC Educational Resources Information Center

    Aitken, H. Peter

    The challenge to independent schools is maintaining excellent facilities and instruction while providing access to students from the widest range of financial backgrounds possible. This is difficult when many independent schools struggle to balance their budgets. There is growing evidence that independent schools are becoming less affordable and…

  4. A Few Reflections on Accountability, Affordability, and Access Worldwide

    ERIC Educational Resources Information Center

    Toma, J. Douglas

    2008-01-01

    Considering accountability, affordability, and access through the experiences in Chile, East Asia, Australia, Croatia, and the United States offers a clear reminder that trends and issues in higher education are often more similar across national contexts than they are distinct. Across higher education, institutions and systems are responding to…

  5. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 15 2010-01-01 2010-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...

  6. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 15 2012-01-01 2012-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...

  7. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 15 2011-01-01 2011-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...

  8. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...

  9. 7 CFR 3565.352 - Preservation of affordable housing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...

  10. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  11. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  12. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...

  13. Abduction and Affordance: A Semiotic View of Cognition.

    ERIC Educational Resources Information Center

    Cunningham, Donald J.

    The shortcomings of the dominant information processing models of cognition are outlined, and two alterative models derived from semiotics are presented. In addition, the possibility of incorporating J. J. Gibson's ecological theory of affordance within the semiotic models is explored as a means of addressing some criticism of the latter models.…

  14. Affordable comfort 95 - investing in our energy future

    SciTech Connect

    1995-12-31

    This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.

  15. The Affordability Challenge in California Higher Education: Options for Change

    ERIC Educational Resources Information Center

    California Postsecondary Education Commission, 2007

    2007-01-01

    California's Master Plan for Higher Education represented a promise, of an affordable college education, to every person who could benefit. For decades, California's lawmakers honored that promise. Rapidly increasing college fees, coupled with higher costs for room and board, books, transportation, and healthcare are pricing students out of higher…

  16. Learning at Work: Organisational Affordances and Individual Engagement

    ERIC Educational Resources Information Center

    Bryson, Jane; Pajo, Karl; Ward, Robyn; Mallon, Mary

    2006-01-01

    Purpose: The purpose of this research is to explore the interaction between organisational affordances for the development of individuals' capability, and the engagement of workers at various levels with those opportunities. Design/methodology/approach: A case study of a large New Zealand wine company, using in-depth interviews. Interviews were…

  17. Material Affordances: The Potential of Scrapbooks in the Composition Classroom

    ERIC Educational Resources Information Center

    Alexander, Kara Poe

    2013-01-01

    A multiliteracies pedagogy has renewed our interest in materiality, or how the physical text interacts with the author's choices and the context to contribute to the message, yet little attention has been paid to materiality in analog texts, such as the scrapbook, even though this medium contains affordances (capabilities and limitations) that…

  18. Early Visual Perception Potentiated by Object Affordances: Evidence From a Temporal Order Judgment Task

    PubMed Central

    Yamada, Yuki; Yamani, Yusuke

    2016-01-01

    Perceived objects automatically potentiate afforded action. Object affordances also facilitate perception of such objects, and this occurrence is known as the affordance effect. This study examined whether object affordances facilitate the initial visual processing stage, or perceptual entry processes, using the temporal order judgment task. The onset of the graspable (right-handled) coffee cup was perceived earlier than that of the less graspable (left-handled) cup for right-handed participants. The affordance effect was eliminated when the coffee cups were inverted, which presumably conveyed less affordance information. These results suggest that objects preattentively potentiate the perceptual entry processes in response to their affordances.

  19. The Testability of Maximum Magnitude

    NASA Astrophysics Data System (ADS)

    Clements, R.; Schorlemmer, D.; Gonzalez, A.; Zoeller, G.; Schneider, M.

    2012-12-01

    Recent disasters caused by earthquakes of unexpectedly large magnitude (such as Tohoku) illustrate the need for reliable assessments of the seismic hazard. Estimates of the maximum possible magnitude M at a given fault or in a particular zone are essential parameters in probabilistic seismic hazard assessment (PSHA), but their accuracy remains untested. In this study, we discuss the testability of long-term and short-term M estimates and the limitations that arise from testing such rare events. Of considerable importance is whether or not those limitations imply a lack of testability of a useful maximum magnitude estimate, and whether this should have any influence on current PSHA methodology. We use a simple extreme value theory approach to derive a probability distribution for the expected maximum magnitude in a future time interval, and we perform a sensitivity analysis on this distribution to determine if there is a reasonable avenue available for testing M estimates as they are commonly reported today: devoid of an appropriate probability distribution of their own and estimated only for infinite time (or relatively large untestable periods). Our results imply that any attempt at testing such estimates is futile, and that the distribution is highly sensitive to M estimates only under certain optimal conditions that are rarely observed in practice. In the future we suggest that PSHA modelers be brutally honest about the uncertainty of M estimates, or must find a way to decrease its influence on the estimated hazard.

  20. DIVA defense: Broad protection for salmonella suppression

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A live, attenuated Salmonella enterica serovar Typhimurium vaccine was developed to confer broad protection against multiple Salmonella serovars to prevent disease and reduce pathogen colonization and shedding. Two vaccine trials were performed in swine to determine the protection afforded by the va...

  1. University Tuition, Consumer Choice and College Affordability: Strategies for Addressing a Higher Education Affordability Challenge. A NASULGC Discussion Paper

    ERIC Educational Resources Information Center

    McPherson, Peter; Shulenburger, David

    2008-01-01

    With passage of the Higher Education Opportunity Act of 2008, the Higher Education Act (HEA) is now reauthorized. What effect will it have on U.S. higher education? Students receiving Pell grants will find that college is more affordable while those who feared that the government would exert control over learning outcomes have breathed a…

  2. Maximum life spur gear design

    NASA Technical Reports Server (NTRS)

    Savage, M.; Mackulin, B. J.; Coe, H. H.; Coy, J. J.

    1991-01-01

    Optimization procedures allow one to design a spur gear reduction for maximum life and other end use criteria. A modified feasible directions search algorithm permits a wide variety of inequality constraints and exact design requirements to be met with low sensitivity to initial guess values. The optimization algorithm is described, and the models for gear life and performance are presented. The algorithm is compact and has been programmed for execution on a desk top computer. Two examples are presented to illustrate the method and its application.

  3. Motivational Affordance and Risk-Taking Across Decision Domains.

    PubMed

    Zou, Xi; Scholer, Abigail A

    2016-03-01

    We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors. PMID:26802189

  4. 40 CFR 141.61 - Maximum contaminant levels for organic contaminants.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 23 2014-07-01 2014-07-01 false Maximum contaminant levels for organic... levels for organic contaminants. (a) The following maximum contaminant levels for organic contaminants... with the maximum contaminant level for organic contaminants identified in paragraphs (a) and (c)...

  5. 40 CFR 141.61 - Maximum contaminant levels for organic contaminants.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 24 2012-07-01 2012-07-01 false Maximum contaminant levels for organic... levels for organic contaminants. (a) The following maximum contaminant levels for organic contaminants... with the maximum contaminant level for organic contaminants identified in paragraphs (a) and (c)...

  6. 40 CFR 141.61 - Maximum contaminant levels for organic contaminants.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 23 2011-07-01 2011-07-01 false Maximum contaminant levels for organic... levels for organic contaminants. (a) The following maximum contaminant levels for organic contaminants... with the maximum contaminant level for organic contaminants identified in paragraphs (a) and (c)...

  7. 40 CFR 141.61 - Maximum contaminant levels for organic contaminants.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 24 2013-07-01 2013-07-01 false Maximum contaminant levels for organic... levels for organic contaminants. (a) The following maximum contaminant levels for organic contaminants... with the maximum contaminant level for organic contaminants identified in paragraphs (a) and (c)...

  8. 40 CFR 141.61 - Maximum contaminant levels for organic contaminants.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Maximum contaminant levels for organic... levels for organic contaminants. (a) The following maximum contaminant levels for organic contaminants... with the maximum contaminant level for organic contaminants identified in paragraphs (a) and (c)...

  9. The Affordable Care Act: Opportunities and Challenges for Physicians.

    PubMed

    Chen, Min

    2015-11-01

    The Affordable Care Act (ACA) will affect many aspects of health care across the nation, presenting both opportunities and challenges. Physicians who have a solid understanding of the recent industry trends and the role they will be playing in the post-ACA world will be able to better adapt to the new environment. This article analyzes the implications of the health care reform for physicians and offers recommendations on how to turn challenges into opportunities. PMID:26501969

  10. Options for Affordable Planetary Fission Surface Power Systems

    NASA Technical Reports Server (NTRS)

    Houts, Mike; Gaddis, Steve; Porter, Ron; VanDyke, Melissa; Martin, Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise

    2006-01-01

    Nuclear fission systems could serve as "workhorse" power plants for the Vision for Space Exploration. In this context, the "workhorse" power plant is defined as a system that could provide power anywhere on the surface of the moon or Mars, land on the moon using a Robotic Lunar Exploration Program (RLEP)-developed lander, and would be a viable, affordable option once power requirements exceed that which can be provided by existing energy systems.

  11. Promoting Prevention Through the Affordable Care Act: Workplace Wellness

    PubMed Central

    Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William

    2012-01-01

    Public health in the United States can be improved by building workplace “cultures of health” that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public’s health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness. PMID:23237245

  12. Monolithic QCL design approaches for improved reliability and affordability

    NASA Astrophysics Data System (ADS)

    Law, K. K.

    2013-12-01

    Many advances have been made recently in mid-wave infrared and long-wave infrared quantum cascade lasers (QCLs) technologies, and there is an increasing demand for these laser sources for ever expanding Naval, DoD and homeland security applications. We will discuss in this paper a portfolio of various Naval Air Warfare Weapons Division's current and future small business innovative research programs and efforts on significantly improving QCLs' performance, affordability, and reliability.

  13. The Affordable Care Act: Opportunities and Challenges for Physicians.

    PubMed

    Chen, Min

    2015-11-01

    The Affordable Care Act (ACA) will affect many aspects of health care across the nation, presenting both opportunities and challenges. Physicians who have a solid understanding of the recent industry trends and the role they will be playing in the post-ACA world will be able to better adapt to the new environment. This article analyzes the implications of the health care reform for physicians and offers recommendations on how to turn challenges into opportunities.

  14. The Affordable Care Act and the Medicare program: the engines of true health reform.

    PubMed

    Kinney, Eleanor D

    2013-01-01

    The Patient Protection and Affordable Care Act and its amendments by the Health Care and Education Reconciliation Act of 2010 constitute landmark legislation known as the Affordable Care Act (ACA). The ACA has made many changes in the Medicare program as part of comprehensive health reform for the U.S. health care sector. Title III of the ACA pertains to improving the efficiency and quality of health care. Title VI calls for greater program integrity for all federally funded health insurance programs. Collectively, the changes in Medicare in these two titles address the three major problems that the Medicare program has faced since its inception: cost and volume inflation, quality assurance, and fraud and abuse. These changes, if successfully implemented, will have a dramatic impact on the reform of the American health care sector. The policy-making process in the Medicare program is exemplary of the process of "muddling through," as described by the Yale economist Charles E. Lindblom. Nevertheless, these changes may also prepare the Medicare program to be transformed, through several incremental changes in upcoming years, into a single payer system.

  15. Coverage of certain preventive services under the Affordable Care Act. Final rules.

    PubMed

    2013-07-01

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. These final regulations simplify and clarify the religious employer exemption. These final regulations also establish accommodations with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), as well as student health insurance coverage arranged by eligible organizations that are institutions of higher education. These regulations also finalize related amendments to regulations concerning Affordable Insurance Exchanges.

  16. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making.

  17. The Politics of Native American Health Care and the Affordable Care Act.

    PubMed

    Skinner, Daniel

    2016-02-01

    This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making. PMID:26567380

  18. Radiation Shielding Options for the Affordable Fission Surface Power System

    SciTech Connect

    Craft, Aaron E.; King, Jeffrey C.

    2009-03-16

    The Affordable Fission Surface Power System (AFSPS) is a proposed power source for an outpost capable of housing six humans for up to six weeks on the lunar surface and emphasizes the design principles of low risk and affordability over high performance. The radiation shield is the most massive component of the reactor system and its effect on launch mass greatly affects the affordability of the AFSPS. Potential shielding materials include lithium hydride, enriched boron-10 carbide, water, borated water, beryllium, boron-doped beryllium and zirconium hydride. Zirconium hydride is the most effective neutron attenuator and also significantly attenuates gamma radiation, but at a significant mass penalty. The other neutron attenuating materials all require the addition of a tungsten layer to provide significant gamma attenuation. Based on neutron radiation alone, lithium hydride is the lightest of the potential attenuators, followed by water and borated water. When gamma radiation is also considered, the lithium hydride/tungsten shield is shown to be the lightest composite shield with a combined mass of 3246 kg, followed by the borated water/tungsten shield (3479 kg). The boron carbide/tungsten shield has a total mass of 4129 kg, but represents significantly less development risk.

  19. Approach to an Affordable and Productive Space Transportation System

    NASA Technical Reports Server (NTRS)

    McCleskey, Carey M.; Rhodes, Russel E.; Lepsch, Roger A.; Henderson, Edward M.; Robinson, John W.

    2012-01-01

    This paper describes an approach for creating space transportation architectures that are affordable, productive, and sustainable. The architectural scope includes both flight and ground system elements, and focuses on their compatibility to achieve a technical solution that is operationally productive, and also affordable throughout its life cycle. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on space flight system engineering methods, along with operationally efficient propulsion system concepts and technologies. This paper follows up previous work by using a structured process to derive examples of conceptual architectures that integrate a number of advanced concepts and technologies. The examples are not intended to provide a near-term alternative architecture to displace current near-term design and development activity. Rather, the examples demonstrate an approach that promotes early investments in advanced system concept studies and trades (flight and ground), as well as in advanced technologies with the goal of enabling highly affordable, productive flight and ground space transportation systems.

  20. Discrimination networks for maximum selection.

    PubMed

    Jain, Brijnesh J; Wysotzki, Fritz

    2004-01-01

    We construct a novel discrimination network using differentiating units for maximum selection. In contrast to traditional competitive architectures like MAXNET the discrimination network does not only signal the winning unit, but also provides information about its evidence. In particular, we show that a discrimination network converges to a stable state within finite time and derive three characteristics: intensity normalization (P1), contrast enhancement (P2), and evidential response (P3). In order to improve the accuracy of the evidential response we incorporate distributed redundancy into the network. This leads to a system which is not only robust against failure of single units and noisy data, but also enables us to sharpen the focus on the problem given in terms of a more accurate evidential response. The proposed discrimination network can be regarded as a connectionist model for competitive learning by evidence.

  1. The visual encoding of tool-object affordances.

    PubMed

    Natraj, N; Pella, Y M; Borghi, A M; Wheaton, L A

    2015-12-01

    The perception of tool-object pairs involves understanding their action-relationships (affordances). Here, we sought to evaluate how an observer visually encodes tool-object affordances. Eye-movements were recorded as right-handed participants freely viewed static, right-handed, egocentric tool-object images across three contexts: correct (e.g. hammer-nail), incorrect (e.g. hammer-paper), spatial/ambiguous (e.g. hammer-wood), and three grasp-types: no hand, functional grasp-posture (grasp hammer-handle), non-functional/manipulative grasp-posture (grasp hammer-head). There were three areas of interests (AOI): the object (nail), the operant tool-end (hammer-head), the graspable tool-end (hammer-handle). Participants passively evaluated whether tool-object pairs were functionally correct/incorrect. Clustering of gaze scanpaths and AOI weightings grouped conditions into three distinct grasp-specific clusters, especially across correct and spatial tool-object contexts and to a lesser extent within the incorrect tool-object context. The grasp-specific gaze scanpath clusters were reasonably robust to the temporal order of gaze scanpaths. Gaze was therefore automatically primed to grasp-affordances though the task required evaluating tool-object context. Participants also primarily focused on the object and the operant tool-end and sparsely attended to the graspable tool-end, even in images with functional grasp-postures. In fact, in the absence of a grasp, the object was foveally weighted the most, indicative of a possible object-oriented action priming effect wherein the observer may be evaluating how the tool engages on the object. Unlike the functional grasp-posture, the manipulative grasp-posture caused the greatest disruption in the object-oriented priming effect, ostensibly as it does not afford tool-object action due to its non-functional interaction with the operant tool-end that actually engages with the object (e.g., hammer-head to nail). The enhanced attention

  2. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    PubMed

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults.

  3. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    PubMed

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults. PMID:26445739

  4. Maximum Photovoltaic Penetration Levels on Typical Distribution Feeders: Preprint

    SciTech Connect

    Hoke, A.; Butler, R.; Hambrick, J.; Kroposki, B.

    2012-07-01

    This paper presents simulation results for a taxonomy of typical distribution feeders with various levels of photovoltaic (PV) penetration. For each of the 16 feeders simulated, the maximum PV penetration that did not result in steady-state voltage or current violation is presented for several PV location scenarios: clustered near the feeder source, clustered near the midpoint of the feeder, clustered near the end of the feeder, randomly located, and evenly distributed. In addition, the maximum level of PV is presented for single, large PV systems at each location. Maximum PV penetration was determined by requiring that feeder voltages stay within ANSI Range A and that feeder currents stay within the ranges determined by overcurrent protection devices. Simulations were run in GridLAB-D using hourly time steps over a year with randomized load profiles based on utility data and typical meteorological year weather data. For 86% of the cases simulated, maximum PV penetration was at least 30% of peak load.

  5. The Impact of the Affordable Care Act on Large Employers: A Retrospective.

    PubMed

    Abbott, Randall K

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) has created a new environment for employer health benefit plan management that is influencing costs, benefit design, delivery, administration, financing and compliance as well as the positioning of health care within the benefits portfolio and the broader total rewards strategy. This article will examine the key pragmatic effects of health reform for larger employers to date, quantifying its direct costs and discussing the new dimensions of management that reform has introduced. The discussion will focus on nongrandfathered self-funded plans and will address only major influences. It is not intended to be all-encompassing and is, of necessity, general in nature. Each employer will have somewhat differing experiences and results but should find the discussion to be helpful both in understanding what has evolved as well as what is to come. PMID:26540937

  6. Risk adjustment under the Affordable Care Act: a guide for federal and state regulators.

    PubMed

    Hall, Mark A

    2011-05-01

    To achieve the aims of the Affordable Care Act, state and federal regulators must construct an effective system of risk adjustment, one that protects health insurers that attract a disproportionate share of patients with poor health risks. This brief, which summarizes a Commonwealth Fund–supported conference of leading risk adjustment experts, explores the challenges regulators will face, considers the consequences of the law's risk adjustment provisions, and analyzes the merits of different risk adjustment strategies. Among other recommendations, the brief suggests that regulators use diagnostic rather than only demographic risk measures, that they allow states some but limited flexibility to tailor risk adjustment methods to local circumstances, and that they phase in the use of risk transfer payments to give insurers more time to predict and understand the full effects of risk adjustment.

  7. The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act.

    PubMed

    Konchak, Juleigh Nowinski; Moran, Margaret R; O'Brien, Matthew J; Kandula, Namratha R; Ackermann, Ronald T

    2016-06-01

    Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action. PMID:27145778

  8. Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.

    PubMed

    2015-07-14

    This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.

  9. Current and (Potential) Future Effects of the Affordable Care Act on HIV Prevention.

    PubMed

    Viall, Abigail H; McCray, Eugene; Mermin, Jonathan; Wortley, Pascale

    2016-04-01

    Recent advances in science, program, and policy could better position the nation to achieve its vision of the USA as a place where new HIV infections are rare. Among these developments, passage of the Patient Protection and Affordable Care Act (ACA) in 2010 may prove particularly important, as the health system transformations it has launched offer a supportive foundation for realizing the potential of other advances, both within and beyond the clinical arena. This article summarizes opportunities to expand access to high-impact HIV prevention interventions under the ACA, examines whether available evidence indicates that these opportunities are being realized, and considers potential challenges to further gains for HIV prevention in an era of health reform. This article also highlights the new roles that HIV prevention programs and providers may assume in a health system no longer defined by fragmentation among public health, medical care, and community service providers.

  10. The State of Diabetes Prevention Policy in the USA Following the Affordable Care Act.

    PubMed

    Konchak, Juleigh Nowinski; Moran, Margaret R; O'Brien, Matthew J; Kandula, Namratha R; Ackermann, Ronald T

    2016-06-01

    Type 2 diabetes is a major public health problem in the USA, affecting over 12 % of American adults and imposing considerable health and economic burden on individuals and society. There is a strong evidence base demonstrating that lifestyle behavioral changes and some medications can prevent or delay the onset of type 2 diabetes in high risk adults, and several policy and healthcare system changes motivated by the Patient Protection and Affordable Care Act (ACA) have the potential to accelerate diabetes prevention. In this narrative review, we (1) offer a conceptual framework for organizing how the ACA may influence diabetes prevention efforts at the level of individuals, healthcare providers, and health systems; (2) highlight ACA provisions at each of these levels that could accelerate type 2 diabetes prevention nationwide; and (3) explore possible policy gaps and opportunity areas for future research and action.

  11. Implications of the Affordable Care Act for occupational therapy practitioners providing services to Medicare recipients.

    PubMed

    Fisher, Gail; Friesema, Jennifer

    2013-01-01

    The passage of the Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111-148) represents the largest expansion in government funding of health care since Medicare and Medicaid were established in 1965 (Curfman, Abel, & Landers, 2012). Although the health insurance mandate and Medicaid expansion have received the most attention as a result of legal challenges and the July 2012 Supreme Court ruling on the legality of the ACA (Henry J. Kaiser Family Foundation, 2012), other ACA initiatives may have even greater implications for occupational therapy. The ACA includes sections on improving quality and health systems performance for Medicare recipients, with some sections also applying to Medicaid recipients. Insurance companies commonly follow Medicare rules; therefore, the Medicare reforms are likely to spread across all payers, health care settings, and care recipients. PMID:23968787

  12. Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.

    PubMed

    Zhang, Shuang Qin; Polite, Blase N

    2014-01-01

    The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform. PMID:24857142

  13. Analyzing the Affordable Care Act: Essential Health Benefits and Implications for Oncology

    PubMed Central

    Hutchins, Valerie A.; Samuels, Marc B.; Lively, Angela M.

    2013-01-01

    The Patient Protection and Affordable Care Act (ACA) will have lasting effects on oncology coverage and, perhaps, on oncology practice as well. The ACA ushers in a new class of insured individuals; approximately 25 million will purchase insurance through the exchanges, and Medicaid will expand by 12 million beneficiaries over the next 10 years. Essential health benefits (EHBs), which are required in all qualified health plans (QHPs) sold in the exchanges, will define the coverage available to the newly insured population and could lead to the development of new definitions and standards for medical necessity. This article will discuss effects of the ACA EHB requirements on oncology coverage, as well as the state and federal options and responsibilities as they relate to coverage of and access to oncology services within the QHPs in the exchanges. PMID:23814512

  14. THE AFFORDABLE CARE ACT AND MEDICAL LOSS RATIOS: NO IMPACT IN FIRST THREE YEARS.

    PubMed

    Day, Benjamin; Himmelstein, David U; Broder, Michael; Woolhandler, Steffie

    2015-01-01

    The Patient Protection and Affordable Care Act (ACA) set limits on insurers' overhead, mandating a medical loss ratio (MLR) of at least 80 percent in the individual and small-group markets and 85 percent in the large-group market starting in 2011. In implementing the law, the Obama administration introduced new rules that changed (and inflated) how insurers calculate MLRs, distorting time trends. We used insurers' filings with the U.S. Securities and Exchange Commission to calculate the largest insurers' MLRs before and after the ACA regulations took effect, using a constant definition of MLR. MLRs averaged 83.04 percent in the three years before reform and 83.05 percent in the three years after reform. We conclude that the ACA had no impact on insurance industry overhead spending. PMID:26460451

  15. Multiple Early Eocene Thermal Maximums

    NASA Astrophysics Data System (ADS)

    Roehl, U.; Zachos, J. C.; Thomas, E.; Kelly, D. C.; Donner, B.; Westerhold, T.

    2004-12-01

    Periodic dissolution horizons signifying abrupt shoaling of the lysocline and CCD are characteristic features of deep-sea sections and often attributed to Milankovitch forcing via their diagnostic frequencies. Prominent dissolution horizons also correspond to abrupt climate events, such as the Paleocene-Eocene thermal maximum (PETM), as a result of input of significant CH4 - CO2 into the ocean-atmosphere system. The question arises whether other significant dissolution horizons identified in sediments of late Paleocene and early Eocene age similar to the recently identified ELMO (Lourens et al., 2004) were formed as a result of greenhouse gas input, or whether they were related to cumulative effects of periodic changes in ocean chemistry and circulation. Here we report the discovery of a 3rd thermal maximum in early Eocene (about 52 Ma) sediments recovered from the South Atlantic during ODP Leg 208. The prominent clay layer was named the "X" event and was identified within planktonic foraminifer zone P7 and calcareous nannofossil zone CP10 at four Walvis Ridge Transect sites with a water depth range of 2000 m (Sites 1262 to 1267). Benthics assemblages are composed of small individuals, have low diversity and high dominance. Dominant taxa are Nuttallides truempyi and various abyssaminids, resembling the post PETM extinction assemblages. High-resolution bulk carbonate \\delta13C measurements of one of the more shallow Sites 1265 reveal a rapid about 0.6 per mill drop in \\delta13C and \\delta18O followed by an exponential recovery to pre-excursion \\delta13C values well known for the PETM and also observed for the ELMO. The planktonic foraminiferal \\delta13C records of Morozovella subbotina and Acaranina soldadoensis in the deepest Site 1262 show a 0.8 to 0.9 per mill drop, whereas the \\delta13C drop of benthic foraminifera Nuttallides truempyi is slightly larger (about 1 per mill). We are evaluating mechanisms for the widespread change in deep-water chemistry, its

  16. The maximum drag reduction asymptote

    NASA Astrophysics Data System (ADS)

    Choueiri, George H.; Hof, Bjorn

    2015-11-01

    Addition of long chain polymers is one of the most efficient ways to reduce the drag of turbulent flows. Already very low concentration of polymers can lead to a substantial drag and upon further increase of the concentration the drag reduces until it reaches an empirically found limit, the so called maximum drag reduction (MDR) asymptote, which is independent of the type of polymer used. We here carry out a detailed experimental study of the approach to this asymptote for pipe flow. Particular attention is paid to the recently observed state of elasto-inertial turbulence (EIT) which has been reported to occur in polymer solutions at sufficiently high shear. Our results show that upon the approach to MDR Newtonian turbulence becomes marginalized (hibernation) and eventually completely disappears and is replaced by EIT. In particular, spectra of high Reynolds number MDR flows are compared to flows at high shear rates in small diameter tubes where EIT is found at Re < 100. The research leading to these results has received funding from the People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme (FP7/2007-2013) under REA grant agreement n° [291734].

  17. Objects of Maximum Electromagnetic Chirality

    NASA Astrophysics Data System (ADS)

    Fernandez-Corbaton, Ivan; Fruhnert, Martin; Rockstuhl, Carsten

    2016-07-01

    We introduce a definition of the electromagnetic chirality of an object and show that it has an upper bound. Reciprocal objects attain the upper bound if and only if they are transparent for all the fields of one polarization handedness (helicity). Additionally, electromagnetic duality symmetry, i.e., helicity preservation upon interaction, turns out to be a necessary condition for reciprocal objects to attain the upper bound. We use these results to provide requirements for the design of such extremal objects. The requirements can be formulated as constraints on the polarizability tensors for dipolar objects or on the material constitutive relations for continuous media. We also outline two applications for objects of maximum electromagnetic chirality: a twofold resonantly enhanced and background-free circular dichroism measurement setup, and angle-independent helicity filtering glasses. Finally, we use the theoretically obtained requirements to guide the design of a specific structure, which we then analyze numerically and discuss its performance with respect to maximal electromagnetic chirality.

  18. Maximum entropy production in daisyworld

    NASA Astrophysics Data System (ADS)

    Maunu, Haley A.; Knuth, Kevin H.

    2012-05-01

    Daisyworld was first introduced in 1983 by Watson and Lovelock as a model that illustrates how life can influence a planet's climate. These models typically involve modeling a planetary surface on which black and white daisies can grow thus influencing the local surface albedo and therefore also the temperature distribution. Since then, variations of daisyworld have been applied to study problems ranging from ecological systems to global climate. Much of the interest in daisyworld models is due to the fact that they enable one to study self-regulating systems. These models are nonlinear, and as such they exhibit sensitive dependence on initial conditions, and depending on the specifics of the model they can also exhibit feedback loops, oscillations, and chaotic behavior. Many daisyworld models are thermodynamic in nature in that they rely on heat flux and temperature gradients. However, what is not well-known is whether, or even why, a daisyworld model might settle into a maximum entropy production (MEP) state. With the aim to better understand these systems, this paper will discuss what is known about the role of MEP in daisyworld models.

  19. 20 CFR 228.14 - Family maximum.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true Family maximum. 228.14 Section 228.14... SURVIVOR ANNUITIES The Tier I Annuity Component § 228.14 Family maximum. (a) Family maximum defined. Under... person's earnings record is limited. This limited amount is called the family maximum. The family...

  20. 20 CFR 228.14 - Family maximum.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false Family maximum. 228.14 Section 228.14... SURVIVOR ANNUITIES The Tier I Annuity Component § 228.14 Family maximum. (a) Family maximum defined. Under... person's earnings record is limited. This limited amount is called the family maximum. The family...

  1. 20 CFR 228.14 - Family maximum.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 1 2014-04-01 2012-04-01 true Family maximum. 228.14 Section 228.14... SURVIVOR ANNUITIES The Tier I Annuity Component § 228.14 Family maximum. (a) Family maximum defined. Under... person's earnings record is limited. This limited amount is called the family maximum. The family...

  2. 20 CFR 228.14 - Family maximum.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false Family maximum. 228.14 Section 228.14... SURVIVOR ANNUITIES The Tier I Annuity Component § 228.14 Family maximum. (a) Family maximum defined. Under... person's earnings record is limited. This limited amount is called the family maximum. The family...

  3. 78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-04

    ... Health Plans; Exchange Standards for Employers, 77 FR 18310 (March 27, 2012) (to be codified at 45 CFR... Payment Parameters for 2014, 78 FR 15410 (March 11, 2013) (to be codified at 45 CFR parts 153, 155, 156... Health Plans; Small Business Health Options Program, 77 FR 15553 (March 11, 2013) (to be codified at...

  4. 77 FR 70643 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... Printing Office. This database can be accessed via the internet at http://www.gpo.gov/fdsys/ . Table of....pdf.PDF . \\5\\ 77 FR 42658 (July 20, 2012). HHS also published a bulletin \\6\\ outlining an intended... FR 42658), which established the first phase of an intended two-phase approach to...

  5. 76 FR 51201 - Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-17

    ... same purchasing clout as big businesses. The Departments of Health and Human Services, Labor and the... on August 3, 2010 (75 FR 45584). Second, Initial Guidance to States on Exchanges was issued on... for State innovation was published in the Federal Register on March 14, 2011 (76 FR 13553)....

  6. 76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-13

    ... innovation was published in the Federal Register on March 14, 2011 (76 FR 13553). On July 15, 2011, two... FR 5774) seeking public comment on the rules that will govern the CO-OP program. The public comments... Federal Register on July 20, 2011 with a comment period that ended on September 16, 2011 (76 ] FR...

  7. 78 FR 76212 - Patient Protection and Affordable Care Act; Maximizing January 1, 2014 Coverage Opportunities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-17

    ... February 27, 2013 Federal Register (78 FR 13406), the coverage effective dates established in Sec. 155.410... System Codes,'' effective March 26, 2012, U.S. Small Business Administration, available at http://www.sba... effective coverage date of January 1, 2014. This rule generally allows consumers to select a QHP...

  8. 75 FR 37187 - Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and Annual...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-28

    ... 147.108) generally apply for plan years beginning on or after January 1, 2014, except that in the case... the case of enrollees who are under 19 years of age, these interim final regulations under PHS Act... name, address, or other contact information) or confidential business information that you do not...

  9. 78 FR 54069 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, and Eligibility...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-30

    ... define a new term, ``issuer customer service representative'' to mean an employee, contractor, or agent....415 below, we will use the term ``issuer application assisters'' in place of ``issuer customer service... ``issuer customer service representatives'' to more clearly articulate the role of such individuals and...

  10. 78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-01

    .... HHS Audit Authority (Sec. 156.606) III. Provisions of the Final Regulation IV. Collection of...; Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers'' (77 FR 18309). The... Exemptions; Miscellaneous Minimum Essential Coverage Provisions'' (78 FR 7348) that are, similarly...

  11. 76 FR 60788 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-30

    ... July 15, 2011 (76 FR 41866 and 76 FR 41930, respectively), is extended from 5 p.m. Eastern Standard... Register (76 FR 41866 through 41927 and 76 FR 41930 through 41956, respectively). The first rule would... (76 FR 51148, 76 FR 51202, and 76 FR 50931, respectively), about eligibility determinations by...

  12. 77 FR 70583 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-26

    ... the United States, 2007: Results of a National Study, The American Journal of Medicine, Vol. 122, No... standards for health insurance issuers and states regarding reporting, utilization, and collection of data under section 2794 of the Public Health Service Act (PHS Act). It also revises the timeline for...

  13. 76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-15

    ... Systems CHIP Children's Health Insurance Program CMS Centers for Medicare & Medicaid Services DOL U.S... relating to Exchanges, published in the Federal Register on August 3, 2010 (75 FR 45584). Second, ] Initial... March 14, 2011 (76 FR 13553). Fourth, two proposed regulations, including this one, are published...

  14. 78 FR 12833 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ..., Final Rule, 77 FR 42658-42672 (July 20, 2012) (to be codified at 45 CFR part 156). HHS also published a... CFR 156.275, as published on July 20, 2012 (77 FR 42658), which established the first phase of an... Assurance (NCQA) and URAC as published in the Federal Register notice on November 23, 2012 (77 FR...

  15. 77 FR 29235 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors, and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-17

    ... INFORMATION: I. Background In Federal Register Doc. 2012-6594 of March 23, 2012 (77 FR 17220- 17252), there... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive this... the finding and the reasons therefore in the notice. Section 553(d) of the APA ordinarily requires...

  16. 77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... Request for Comment (the RFC) on August 3, 2010 (75 FR 45584) inviting the public to provide input... preamble of the Exchange establishment proposed rule, at 76 FR 41870-41871, for a detailed discussion...

  17. 78 FR 79619 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ... INFORMATION: I. Background In FR Doc. 2013-25326 of October 30, 2013 (78 FR 65046), final rule entitled..., and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (78...

  18. 78 FR 4093 - Extension of Comment Period for the Rulemaking Enhancing Protections Afforded Customers and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-18

    ... Customer Funds Held by Futures Commission Merchants and Derivatives Clearing Organizations, 77 FR 67866... Piccoli, Deputy Director, 646-746-9834, kpiccoli@cftc.gov , 140 Broadway, 19th Floor, New York, NY...

  19. 76 FR 76573 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-07

    ... group markets. DATES: Effective date. This rule is effective on January 3, 2012. Comment date. We will... individual markets. A request for information relating to the medical loss ratio (MLR) provisions of PHS Act section 2718 was published in the Federal Register on April 14, 2010 (75 FR 19297). On December 1,...

  20. 77 FR 17219 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    .... Introduction II. Provisions of the Proposed Regulations and Analysis of and Responses to Public Comments A... Final Regulations IV. Collection of Information Requirements V. Summary of Regulatory Impact Analysis VI... individuals and small businesses the same purchasing power as big businesses. The Departments of Health...

  1. 78 FR 15553 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-11

    ... located in the main lobby of the building. A stamp- in clock is available for persons wishing to retain a... for Employers, 77 FR 18310 (Mar. 27, 2012) (to be codified at 45 CFR parts 155, 156, & 157). In the... Care Act; Establishment of Exchanges and Qualified Health Plans; Proposed Rule, 76 FR 41866 (July...

  2. Tonsillar application of AT-2 SIV affords partial protection against rectal challenge with SIVmac239

    PubMed Central

    Vagenas, Panagiotis; Williams, Vennansha G.; Piatak, Michael; Bess, Julian W.; Lifson, Jeffrey D.; Blanchard, James L.; Gettie, Agegnehu; Robbiani, Melissa

    2009-01-01

    While mucosal responses are important for preventing infections with HIV, the optimal strategies for inducing them remain unclear. To evaluate vaccine strategies targeting the oral mucosal lymphoid tissue inductive sites as an approach to provide immunity at distal sites, we vaccinated healthy macaques via the palatine/lingual tonsils with aldrithiol 2 (AT-2) inactivated SIVmac239, combined with CpG-C immunostimulatory oligonucleotide (CpG-C ISS-ODN , C274) as the adjuvant. Macaques received 5 doses of C274 or control ODN C661 and AT-2 SIV on the tonsillar tissues every 6 weeks before being challenged rectally with SIVmac239, 8 weeks after the last immunization. Although no T or B cell responses were detected in the blood prior to challenge, Ab responses were detected in the rectum . Immunization with AT-2 SIV significantly reduced the frequency of infection compared to non-immunized controls, irrespective of adjuvant. In the vaccinated animals that became infected, peak viremias were somewhat reduced. SIV-specific responses were detected in the blood once animals became infected with no detectable differences between the differently immunized groups and the controls. This work provides evidence that vaccine immunogens applied to the oral mucosal-associated lymphoid tissues can provide benefit against rectal challenge, a finding with important implications for mucosal vaccination strategies. PMID:19779309

  3. 77 FR 42658 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... that state's small group market. We proposed that enrollment data submitted to www.HealthCare.gov would... in 2014, all non-grandfathered health plans in the individual and small group market, and other plans... reporting standards for health plans that represent potential State-specific benchmark plans....

  4. 78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-27

    ... Care Act; Health Insurance Market Rules; Rate Review'' (77 FR 70584). These standards apply to health... health insurance coverage in the group or individual market in a state to accept every employer and... small group markets, and in the large group market if a state, beginning in 2017, allows...

  5. 76 FR 43237 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    ... businesses will be able to purchase private health insurance through State-based competitive marketplaces... State innovation was published in the Federal Register on March 14, 2011 (76 FR 13553). Fourth, on July..., Health Insurance Markets, and CO-OP Plans C. Anticipated Costs D. Anticipated Benefits E....

  6. 77 FR 33133 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-05

    ... insurance products in the State's small group market, (2) any of the largest three State employee health... reported to State regulators in an insurance filing. We propose that ``small group market'' has the meaning... small group market, Medicaid benchmark and benchmark- equivalent plans, and Basic Health Programs,...

  7. 78 FR 68505 - Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-14

    ... 2. New Cleared Swaps Segregation Schedules 3. Amendments to Form 1-FR-FCM 4. FCM Certified Annual.... Paperwork Reduction Act Appendix 1--Table of Comment Letters Appendix 2--CFTC Form 1-FR-FCM I. Background A... Contracts and Collateral; Conforming Amendments to the Commodity Broker Bankruptcy Provisions, 77 FR...

  8. 77 FR 67865 - Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-14

    ... Contracts and Collateral; Conforming Amendments to the Commodity Broker Bankruptcy Provisions, 77 FR 6336... conducting ongoing financial surveillance of an FCM under a joint audit agreement submitted to and approved... sometimes referred to as ``audits,'' but they are not full-scale audits as accountants commonly use...

  9. 78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... Plans; Exchange Standards for Employers, 77 FR 18310 (Mar. 27, 2012) (to be codified at 45 CFR parts 155... Quality for Exchanges: http://www.gpo.gov/fdsys/pkg/FR-2012-11-27/pdf/2012-28473.pdf . Importance: the... Rule 78 FR 12834 (Feb. 25, 2013) (to be codified at 45 CFR parts 147, 155 and 156). The draft...

  10. 76 FR 1504 - Pipeline Safety: Establishing Maximum Allowable Operating Pressure or Maximum Operating Pressure...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ...: Establishing Maximum Allowable Operating Pressure or Maximum Operating Pressure Using Record Evidence, and... system, especially when calculating Maximum Allowable Operating Pressure (MAOP) or Maximum Operating Pressure (MOP), and to utilize these risk analyses in the identification of appropriate assessment...

  11. 40 CFR 1039.140 - What is my engine's maximum engine power?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 32 2010-07-01 2010-07-01 false What is my engine's maximum engine power? 1039.140 Section 1039.140 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Emission Standards and Related Requirements...

  12. Maximum entropy principal for transportation

    SciTech Connect

    Bilich, F.; Da Silva, R.

    2008-11-06

    In this work we deal with modeling of the transportation phenomenon for use in the transportation planning process and policy-impact studies. The model developed is based on the dependence concept, i.e., the notion that the probability of a trip starting at origin i is dependent on the probability of a trip ending at destination j given that the factors (such as travel time, cost, etc.) which affect travel between origin i and destination j assume some specific values. The derivation of the solution of the model employs the maximum entropy principle combining a priori multinomial distribution with a trip utility concept. This model is utilized to forecast trip distributions under a variety of policy changes and scenarios. The dependence coefficients are obtained from a regression equation where the functional form is derived based on conditional probability and perception of factors from experimental psychology. The dependence coefficients encode all the information that was previously encoded in the form of constraints. In addition, the dependence coefficients encode information that cannot be expressed in the form of constraints for practical reasons, namely, computational tractability. The equivalence between the standard formulation (i.e., objective function with constraints) and the dependence formulation (i.e., without constraints) is demonstrated. The parameters of the dependence-based trip-distribution model are estimated, and the model is also validated using commercial air travel data in the U.S. In addition, policy impact analyses (such as allowance of supersonic flights inside the U.S. and user surcharge at noise-impacted airports) on air travel are performed.

  13. A Bootstrap Approach to an Affordable Exploration Program

    NASA Technical Reports Server (NTRS)

    Oeftering, Richard C.

    2011-01-01

    This paper examines the potential to build an affordable sustainable exploration program by adopting an approach that requires investing in technologies that can be used to build a space infrastructure from very modest initial capabilities. Human exploration has had a history of flight programs that have high development and operational costs. Since Apollo, human exploration has had very constrained budgets and they are expected be constrained in the future. Due to their high operations costs it becomes necessary to consider retiring established space facilities in order to move on to the next exploration challenge. This practice may save cost in the near term but it does so by sacrificing part of the program s future architecture. Human exploration also has a history of sacrificing fully functional flight hardware to achieve mission objectives. An affordable exploration program cannot be built when it involves billions of dollars of discarded space flight hardware, instead, the program must emphasize preserving its high value space assets and building a suitable permanent infrastructure. Further this infrastructure must reduce operational and logistics cost. The paper examines the importance of achieving a high level of logistics independence by minimizing resource consumption, minimizing the dependency on external logistics, and maximizing the utility of resources available. The approach involves the development and deployment of a core suite of technologies that have minimum initial needs yet are able expand upon initial capability in an incremental bootstrap fashion. The bootstrap approach incrementally creates an infrastructure that grows and becomes self sustaining and eventually begins producing the energy, products and consumable propellants that support human exploration. The bootstrap technologies involve new methods of delivering and manipulating energy and materials. These technologies will exploit the space environment, minimize dependencies, and

  14. Plastic modes of listening: affordance in constructed sound environments

    NASA Astrophysics Data System (ADS)

    Sjolin, Anders

    This thesis is concerned with how the ecological approach to perception with the inclusion of listening modes, informs the creation of sound art installation, or more specifically as referred to in this thesis as constructed sound environments. The basis for the thesis has been a practiced based research where the aim and purpose of the written part of this PhD project has been to critically investigate the area of sound art, in order to map various approaches towards participating in and listening to a constructed sound environment. The main areas has been the notion of affordance as coined by James J. Gibson (1986), listening modes as coined by Pierre Schaeffer (1966) and further developed by Michel Chion (1994), aural architects as coined by Blesser and Salter (2007) and the holistic approach towards understanding sound art developed by Brandon LaBelle (2006). The findings within the written part of the thesis, based on a qualitative analysis, have informed the practice that has resulted in artefacts in the form of seven constructed sound environments that also functions as case studies for further analysis. The aim of the practice has been to exemplify the methodology, strategy and progress behind the organisation and construction of sound environments The research concerns point towards the acknowledgment of affordance as the crucial factor in understanding a constructed sound environment. The affordance approach govern the idea that perceiving a sound environment is a top-down process where the autonomic quality of a constructed sound environment is based upon the perception of structures of the sound material and its relationship with speaker placement and surrounding space. This enables a researcher to side step the conflicting poles of musical/abstract and non-musical/realistic classification of sound elements and regard these poles as included, not separated elements in the analysis of a constructed sound environment.

  15. Delivering affordable cancer care in high-income countries.

    PubMed

    Sullivan, Richard; Peppercorn, Jeffrey; Sikora, Karol; Zalcberg, John; Meropol, Neal J; Amir, Eitan; Khayat, David; Boyle, Peter; Autier, Philippe; Tannock, Ian F; Fojo, Tito; Siderov, Jim; Williamson, Steve; Camporesi, Silvia; McVie, J Gordon; Purushotham, Arnie D; Naredi, Peter; Eggermont, Alexander; Brennan, Murray F; Steinberg, Michael L; De Ridder, Mark; McCloskey, Susan A; Verellen, Dirk; Roberts, Terence; Storme, Guy; Hicks, Rodney J; Ell, Peter J; Hirsch, Bradford R; Carbone, David P; Schulman, Kevin A; Catchpole, Paul; Taylor, David; Geissler, Jan; Brinker, Nancy G; Meltzer, David; Kerr, David; Aapro, Matti

    2011-09-01

    The burden of cancer is growing, and the disease is becoming a major economic expenditure for all developed countries. In 2008, the worldwide cost of cancer due to premature death and disability (not including direct medical costs) was estimated to be US$895 billion. This is not simply due to an increase in absolute numbers, but also the rate of increase of expenditure on cancer. What are the drivers and solutions to the so-called cancer-cost curve in developed countries? How are we going to afford to deliver high quality and equitable care? Here, expert opinion from health-care professionals, policy makers, and cancer survivors has been gathered to address the barriers and solutions to delivering affordable cancer care. Although many of the drivers and themes are specific to a particular field-eg, the huge development costs for cancer medicines-there is strong concordance running through each contribution. Several drivers of cost, such as over-use, rapid expansion, and shortening life cycles of cancer technologies (such as medicines and imaging modalities), and the lack of suitable clinical research and integrated health economic studies, have converged with more defensive medical practice, a less informed regulatory system, a lack of evidence-based sociopolitical debate, and a declining degree of fairness for all patients with cancer. Urgent solutions range from re-engineering of the macroeconomic basis of cancer costs (eg, value-based approaches to bend the cost curve and allow cost-saving technologies), greater education of policy makers, and an informed and transparent regulatory system. A radical shift in cancer policy is also required. Political toleration of unfairness in access to affordable cancer treatment is unacceptable. The cancer profession and industry should take responsibility and not accept a substandard evidence base and an ethos of very small benefit at whatever cost; rather, we need delivery of fair prices and real value from new technologies

  16. Three Words and the Future of the Affordable Care Act.

    PubMed

    Bagley, Nicholas

    2015-06-01

    As an essential part of its effort to achieve near universal coverage, the Affordable Care Act (ACA) extends sizable tax credits to most people who buy insurance on the newly established health care exchanges. Yet several lawsuits have been filed challenging the availability of those tax credits in the thirty-four states that refused to set up their own exchanges. The lawsuits are premised on a strained interpretation of the ACA that, if accepted, would make a hash of other provisions of the statute and undermine its effort to extend coverage to the uninsured. The courts should reject this latest effort to dismantle a critical feature of the ACA.

  17. Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation

    NASA Technical Reports Server (NTRS)

    Jones, Jonathan E.; Kibbey, Timothy P.; Cobb, C. Brent; Harris, Lawanna L.

    2014-01-01

    A launch vehicle at the scale and price point which allows developers to take reasonable risks with high payoff propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial technology "valley of death" that lies between demonstration in laboratory and flight environments. NASA's NanoLaunch effort will provide the framework to mature both earth-to-orbit and on-orbit propulsion and avionics technologies while also providing affordable, dedicated access to low earth orbit for cubesat class payloads.

  18. The Affordable Care Act versus Medicare for All.

    PubMed

    Seidman, Laurence

    2015-08-01

    Many problems facing the Affordable Care Act would disappear if the nation were instead implementing Medicare for All - the extension of Medicare to every age group. Every American would be automatically covered for life. Premiums would be replaced with a set of Medicare taxes. There would be no patient cost sharing. Individuals would have free choice of doctors. Medicare's single-payer bargaining power would slow price increases and reduce medical cost as a percentage of gross domestic product (GDP). Taxes as a percentage of GDP would rise from below average to average for economically advanced nations. Medicare for All would be phased in by age.

  19. Affordable Manufacturing Technologies Being Developed for Actively Cooled Ceramic Components

    NASA Technical Reports Server (NTRS)

    Bhatt, Ramakrishna T.

    1999-01-01

    Efforts to improve the performance of modern gas turbine engines have imposed increasing service temperature demands on structural materials. Through active cooling, the useful temperature range of nickel-base superalloys in current gas turbine engines has been extended, but the margin for further improvement appears modest. Because of their low density, high-temperature strength, and high thermal conductivity, in situ toughened silicon nitride ceramics have received a great deal of attention for cooled structures. However, high processing costs have proven to be a major obstacle to their widespread application. Advanced rapid prototyping technology, which is developing rapidly, offers the possibility of an affordable manufacturing approach.

  20. DOE-HUD Initiative: Making Housing Affordable Through Energy Efficiency

    SciTech Connect

    Not Available

    1991-10-01

    A new collaborative program of the U.S. Department of Energy (DOE) and the U.S. Department of Housing and Urban Development (HUD) is a significant step toward making HUD-aided housing more comfortable and affordable through greater energy efficiency. The initiative on Energy Efficiency in Housing combines DOE's technical capabilities and HUD's experience in housing assistance. Over the next decade, the energy savings potential of this initiative is estimated to be 150 trillion Btu (0.15 quad) per year, or nearly $1.5 billion in annual energy costs.