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Sample records for afforded substantial protection

  1. 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

  2. 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:

  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. (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. 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:

  5. Assessment of Thermal Protection Afforded by Hot Water Diving Suits

    DTIC Science & Technology

    1980-07-03

    Assessment of Thermal Protect! " Afforded by Hot Water Diving Suits A AA L. A. Kuehn Diver thermal comfort in cold water is presently only...with proper control oj inlet suit water flow% and temperature, as well as heating of inspired gas, this suit technology suffices for thermal comfort for...technology provides in part to the convective heat loss that it prpsents, sustained long-term thermal comfort in cold water, Webb (W) has defined a

  6. 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.

  7. 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

    ... 45 CFR Parts 155 and 156 RIN 0938-AR76 Patient Protection and Affordable Care Act; Establishment of... 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) related to the Small Business...

  8. 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

    ... HUMAN SERVICES 45 CFR Part 155 RIN 0938-AR75 Patient Protection and Affordable Care Act; Exchange... state or Exchange must not prevent the application of the provisions of title I of the Affordable Care.... Introduction The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23,...

  9. The Patient Protection and Affordable Care Act and the regulation of the health insurance industry.

    PubMed

    Jha, Saurabh; Baker, Tom

    2012-12-01

    The Patient Protection and Affordable Care Act is a comprehensive and multipronged reform of the US health care system. The legislation makes incremental changes to Medicare, Medicaid, and the market for employer-sponsored health insurance. However, it makes substantial changes to the market for individual and small-group health insurance. The purpose of this article is to introduce the key regulatory reforms in the market for individual and small-group health insurance and explain how these reforms tackle adverse selection and risk classification and improve access to health care for the hitherto uninsured or underinsured population.

  10. 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

    2014-07-05

    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.

  11. 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

    ...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......

  12. 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

    ...This proposed rule would implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for......

  13. 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

    ... Protection and Affordable Care Act AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... Care Act (Pub. L. 111-148) was enacted on March 23, 2010; the Health Care and Education Reconciliation... collectively as the Affordable Care Act. The Affordable Care Act reorganizes, amends, and adds to...

  14. 78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    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......

  15. Child protection decisions to substantiate hospital child protection teams' reports of suspected maltreatment.

    PubMed

    Jedwab, Merav; Benbenishty, Rami; Chen, Wendy; Glasser, Saralee; Siegal, Gil; Lerner-Geva, Liat

    2015-02-01

    The present study focuses on the way child protection officers (CPOs) in Israel assess suspected abuse and neglect (SCAN) reports made by hospital child protection teams (CPTs), to determine whether the alleged maltreatment is substantiated. The study was conducted in six medical centers and included 358 reports investigated by CPOs for SCAN. A structured questionnaire was completed by hospital CPTs to capture all relevant information on each child referred to the CPTs. Structured phone interviews were conducted with each of the CPOs who received a CPT report. Bivariate associations and multivariate logistic regressions were conducted to estimate the substantiation rate of cases reported by CPTs and the types of maltreatment substantiated, as well as to identify case characteristics of the child and the family that were associated with the CPOs' substantiation decision. CPO follow-up investigations revealed a substantiation rate of 53.5%. The maltreatment type most commonly substantiated was neglect. The case characteristics associated with substantiation included socio-demographic background, parents' health and functioning, previous contact with social services, characteristics of the hospital referral, medical findings and an assessment of the parents' behaviors. The findings of the study highlighted the importance of cooperation between the health and welfare services and the policy makers. This cooperation is essential for identifying early signs of maltreatment. Enhanced cooperation and effective information transfer between various professionals would help prevent or at least reduce the recurrence of maltreatment and would ensure that the children and their families are treated appropriately.

  16. 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

    ... HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards... ] entitled, ``Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive...

  17. 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

    ..., risk management programs, internal monitoring and controls, capital and liquidity standards, customer... Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants and...'') published in the Federal Register a notice of proposed rulemaking (the ``Customer Protection Proposal'')...

  18. Measuring the skin dose protection afforded by protective apparel with a beta spectrometer

    SciTech Connect

    Martz, D.E.; Rich, B.L.; Johnson, L.O. )

    1986-10-01

    This paper reports that the protective apparel worn by radiation workers to avoid skin contamination also provides measurable protection against external beta sources. The beta contribution to the skin dose rate depends on the residual energy spectrum of the beta particles after they have penetrated the protective apparel. The shift in the beta energy spectra and consequent reduction in the shallow dose rates afforded by various items of protective apparel were investigated for a few laboratory beta sources using a beta spectrometer that is capable of dose calculations. The results presented here indicate that significant dose rates to the skin can occur despite the presence of protective apparel if high energy beta emitting isotopes are present.

  19. 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

    ...This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of 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. The final rule......

  20. How Child Protective Services Investigators Decide to Substantiate Mothers for Failure-to-Protect in Sexual Abuse Cases

    ERIC Educational Resources Information Center

    Coohey, Carol

    2006-01-01

    The purpose of this study was to determine how Child Protective Services (CPS) investigators decide to substantiate mothers for failure-to-protect from sexual abuse. A case-comparison study was used to compare 31 mothers who were and 62 mothers who were not substantiated for failure-to-protect by CPS. The multivariate analysis showed that mothers…

  1. 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...

  2. What Criteria Do Child Protective Services Investigators Use to Substantiate Exposure to Domestic Violence?

    ERIC Educational Resources Information Center

    Coohey, Carol

    2007-01-01

    The primary purpose of this study is to determine whether child protective services investigators apply a recognizable set of criteria to substantiate batterers and victims of battering for exposing their children to domestic violence. Although domestic violence occurred in 35% of the 1,248 substantiated incidents of child maltreatment, only 31…

  3. What criteria do child protective services investigators use to substantiate exposure to domestic violence?

    PubMed

    Coohey, Carol

    2007-01-01

    The primary purpose of this study is to determine whether child protective services investigators apply a recognizable set of criteria to substantiate batterers and victims of battering for exposing their children to domestic violence. Although domestic violence occurred in 35% of the 1,248 substantiated incidents of child maltreatment, only 31 (7.1%) couples were investigated for exposing a child to domestic violence or failing to protect a child from domestic violence. All of the batterers investigated and in the caregiver role when their children were exposed to domestic violence were substantiated. The unsubstantiated victims of battering tended to use more protective behaviors (M=3.82) than the substantiated victims (M=2.00); yet, at the case level, using more than one protective behavior did not seem to be a criterion used to substantiate the victims. Instead, it appears that investigators were discriminating between those protective behaviors by the victims that ended contact between the batterers and the children--for a substantial amount of time--and those that did not in both the substantiation and removal decision. Key issues related to applying criteria in incidents involving domestic violence are discussed along with recommendations to further refine and document them.

  4. 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…

  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

    ... From the Federal Register Online via the Government Publishing Office ] Vol. 76 Wednesday, No. 159 August 17, 2011 Part III Department of Health and Human Services 45 CFR Parts 155 and 157 Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market: Eligibility...

  6. Comments on "How Child Protective Services Investigators Decide to Substantiate Mothers for Failure-to-Protect in Sexual Abuse Cases"

    ERIC Educational Resources Information Center

    Shadoin, Amy L.; Carnes, Connie N.

    2006-01-01

    This commentary discusses the decisions of child protective service (CPS) investigators to substantiate mothers for failure-to-protect (FTP) in child sexual abuse cases. Four areas are identified in which the scientific literature remains inadequate to fully inform child maltreatment researchers, CPS practitioners and child welfare policymakers on…

  7. 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

    ...This document announces the effective date of a regulatory provision published in the Federal Register by OPM on March 11, 2013 (78 FR 15559), entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance...

  8. Public health law: the constitutionality of the Patient Protection and Affordable Care Act.

    PubMed

    De Ville, Kenneth

    2011-01-01

    Congress of the Patient Protection and Affordable Care Act (PPACA) was immediately challenged by lawsuits attacking the constitutionality of the legislation. The lawsuits, joined by over 2 dozen state's attorney generals, contend that PPACA is an unconstitutional exercise of federal power. Specifically, the suits argue that the individual insurance mandate portion of the law is justified by neither the "Commerce Power" nor Congress' authority to "tax" and provide for "the general welfare." This essay outlines and analyzes the constitutional arguments for, and against, PPACA forecasting the likely resolution of the debate if the suits reach the US Supreme Court.

  9. 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.

  10. 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).

  11. Candida albicans infection affords protection against reinfection via functional reprogramming of monocytes.

    PubMed

    Quintin, Jessica; Saeed, Sadia; Martens, Joost H A; Giamarellos-Bourboulis, Evangelos J; Ifrim, Daniela C; Logie, Colin; Jacobs, Liesbeth; Jansen, Trees; Kullberg, Bart-Jan; Wijmenga, Cisca; Joosten, Leo A B; Xavier, Ramnik J; van der Meer, Jos W M; Stunnenberg, Hendrik G; Netea, Mihai G

    2012-08-16

    Immunological memory in vertebrates is often exclusively attributed to T and B cell function. Recently it was proposed that the enhanced and sustained innate immune responses following initial infectious exposure may also afford protection against reinfection. Testing this concept of "trained immunity," we show that mice lacking functional T and B lymphocytes are protected against reinfection with Candida albicans in a monocyte-dependent manner. C. albicans and fungal cell wall β-glucans induced functional reprogramming of monocytes, leading to enhanced cytokine production in vivo and in vitro. The training required the β-glucan receptor dectin-1 and the noncanonical Raf-1 pathway. Monocyte training by β-glucans was associated with stable changes in histone trimethylation at H3K4, which suggests the involvement of epigenetic mechanisms in this phenomenon. The functional reprogramming of monocytes, reminiscent of similar NK cell properties, supports the concept of "trained immunity" and may be employed for the design of improved vaccination strategies.

  12. Contribution of epithelial innate immunity to systemic protection afforded by prolyl hydroxylase inhibition in murine colitis

    PubMed Central

    Keely, Simon; Campbell, Eric L.; Baird, Alan W.; Hansbro, Philip M.; Shalwitz, Robert A.; Kotsakis, Anna; McNamee, Eoin N.; Eltzschig, Holger K.; Kominsky, Douglas J.; Colgan, Sean P.

    2013-01-01

    Pharmacological stabilization of hypoxia-inducible factor (HIF) through prolyl hydroxylase (PHD) inhibition limits mucosal damage associated with models of murine colitis. However, little is known about how PHD inhibitors (PHDi) influence systemic immune function during mucosal inflammation or the relative importance of immunological changes to mucosal protection. We hypothesized that PHDi enhances systemic innate immune responses to colitis-associated bacteremia. Mice with colitis induced by TNBS were treated with AKB-4924, a new HIF-1 isoform-predominant PHDi and clinical, immunological and biochemical endpoints were assessed. Administration of AKB-4924 led to significantly reduced weight loss and disease activity compared to vehicle controls. Treated groups were pyrexic, but did not become subsequently hypothermic. PHDi treatment augmented epithelial barrier function and led to an approximately 50-fold reduction in serum endotoxin during colitis. AKB-4924 also decreased cytokines involved in pyrogenesis and hypothermia, significantly reducing serum levels of IL-1β, IL-6 and TNF-α, while increasing IL-10. Treatment offered no protection against colitis in epithelial-specific HIF-1α deficient mice, strongly implicating epithelial HIF-1α as the tissue target for AKB-4924-mediated protection. Taken together, these results indicate that inhibition of prolyl hydroxylase with AKB-4924 enhances innate immunity and identifies the epithelium is a central site of inflammatory protection afforded by PHDi in murine colitis. PMID:23695513

  13. 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.

  14. 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.

  15. Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; Small Business Health Options Program. Final rule.

    PubMed

    2013-06-04

    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) related to the Small Business Health Options Program (SHOP). Specifically, this final rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.

  16. 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

    ...The U.S. Office of Personnel Management (OPM) is issuing a proposed rule to implement the Multi-State Plan Program (MSPP). OPM is establishing the 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......

  17. Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

    PubMed Central

    Corman, Juliane; Levin, David

    2016-01-01

    Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309

  18. Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation

    PubMed Central

    Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau

    2015-01-01

    Context The Patient Protection and Affordable Care Act’s (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers’ role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers’ unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity

  19. A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.

    PubMed

    Williams, John C

    2015-01-01

    The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.

  20. The Patient Protection and Affordable Care Act: impact on mental health services demand and provider availability.

    PubMed

    Pearlman, Shoshannah A

    2013-01-01

    The Patient Protection and Affordable Care Act (ACA) will greatly increase the demand for mental health (MH) services, as 62.5 million Americans from relatively high-need populations will be newly eligible for MH benefits. Consequently, the supply of MH care provider services is expected to proportionately decrease by 18% to 21% in 2014. ACA funding does not demonstrate the ability to increase turnout of psychiatrists sufficiently to meet the need. Available data indicate that the numbers of advanced practice psychiatric nurses (APPNs) continue to increase at a much greater rate, but information from either a clinical perspective or a market perspective is complicated by the weak distinctions that are made between nurse practitioners (NPs) and other nonphysician care professionals. The following recommendations are made: (a) some of the ACA funding for research into efficient and effective care delivery systems should be allocated to acquiring data on APPNs in leadership roles or clinical settings in which they are ultimately responsible for management of MH care, as differentiated from settings in which they provide support for psychiatrists; and (b) since the available data indicate nurse practitioners achieve good outcomes and are more economically viable than psychiatrists, placement of psychiatric-mental health nurse practitioners in community settings should be recognized as a realistic solution to the shortfall of MH services.

  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.

  2. The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.

    PubMed

    Beaussier, Anne-Laure

    2012-10-01

    The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.

  3. 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

  4. Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule.

    PubMed

    2013-02-25

    This final rule sets forth standards for health insurance issuers consistent with title I of 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. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.

  5. 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

  6. Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization

    PubMed Central

    Hofer, Adam N; Abraham, Jean Marie; Moscovice, Ira

    2011-01-01

    Context: Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) expand Medicaid to all individuals in families earning less than 133 percent of the federal poverty level (FPL) and make available subsidies to uninsured lower-income Americans (133 to 400 percent of FPL) without access to employer-based coverage to purchase insurance in new exchanges. Since primary care physicians typically serve as the point of entry into the health care delivery system, an adequate supply of them is critical to meeting the anticipated increase in demand for medical care resulting from the expansion of coverage. This article provides state-level estimates of the anticipated increases in primary care utilization given the PPACA's provisions for expanded coverage. Methods: Using the Medical Expenditure Panel Survey, this article estimates a multivariate regression model of annual primary care utilization. Using the model estimates and state-level information regarding the number of uninsured, it predicts, by state, the change in primary care visits expected from the expanded coverage. Finally, the article predicts the number of primary care physicians needed to accommodate this change in utilization. Findings: This expanded coverage is predicted to increase by 2019 the number of annual primary care visits between 15.07 million and 24.26 million. Assuming stable levels of physicians’ productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase. Conclusions: The PPACA's health insurance expansion parameters are expected to significantly increase the use of primary care. Two strategies that policymakers may consider are creating stronger financial incentives to attract medical school students to primary care and changing the delivery of care in ways that lead to operational improvements, higher throughput, and better quality of care. PMID:21418313

  7. Chemokine Adjuvanted Electroporated-DNA Vaccine Induces Substantial Protection from Simian Immunodeficiency Virus Vaginal Challenge

    PubMed Central

    Hutnick, N A; Moldoveanu, Z; Hunter, M; Reuter, M; Yuan, S; Yan, J; Ginsberg, A; Sylvester, A; Pahar, B; Carnathan, D; Kathuria, N; Khan, A S; Montefiori, D; Sardesai, N Y; Betts, M R; Mestecky, J; Marx, P; Weiner, D B

    2015-01-01

    There have been encouraging results for the development of an effective HIV vaccine. However, many questions remain regarding the quality of immune responses and the role of mucosal antibodies. We addressed some of these issues by using a simian immunodeficiency virus (SIV) DNA vaccine adjuvanted with plasmid-expressed mucosal chemokines combined with an intravaginal SIV challenge in rhesus macaque (RhM) model. We previously reported on the ability of CCR9 and CCR10 ligand (L) adjuvants to enhance mucosal and systemic IgA and IgG in small animals. In this study, RhMs were intramuscularly immunized five times with either DNA or DNA plus chemokine adjuvant delivered by electroporation followed by challenge with SIVsmE660. Sixty-eight percent of all vaccinated animals (P=0.0016) remained either uninfected or had aborted infection compared to only 14% in the vaccine naïve group. The highest protection was observed in the CCR10L chemokines group, where 6 of 9 animals had aborted infection and two remained uninfected, leading to 89% protection (P=0.0003). The induction of mucosal SIV-specific antibodies and neutralization titers correlated with trends in protection. These results indicate the need to further investigate the contribution of chemokine adjuvants to modulate immune responses and the role of mucosal antibodies in SIV/HIV protection. PMID:25943275

  8. Chemokine-adjuvanted electroporated DNA vaccine induces substantial protection from simian immunodeficiency virus vaginal challenge.

    PubMed

    Kutzler, M A; Wise, M C; Hutnick, N A; Moldoveanu, Z; Hunter, M; Reuter, M A; Yuan, S; Yan, J; Ginsberg, A A; Sylvester, A; Pahar, B; Carnathan, D G; Kathuria, N; Khan, A S; Montefiori, D; Sardesai, N Y; Betts, M R; Mestecky, J; Marx, P A; Weiner, D B

    2016-01-01

    There have been encouraging results for the development of an effective HIV vaccine. However, many questions remain regarding the quality of immune responses and the role of mucosal antibodies. We addressed some of these issues by using a simian immunodeficiency virus (SIV) DNA vaccine adjuvanted with plasmid-expressed mucosal chemokines combined with an intravaginal SIV challenge in rhesus macaque (RhM) model. We previously reported on the ability of CCR9 and CCR10 ligand (L) adjuvants to enhance mucosal and systemic IgA and IgG responses in small animals. In this study, RhMs were intramuscularly immunized five times with either DNA or DNA plus chemokine adjuvant delivered by electroporation followed by challenge with SIVsmE660. Sixty-eight percent of all vaccinated animals (P<0.01) remained either uninfected or had aborted infection compared with only 14% in the vaccine naïve group. The highest protection was observed in the CCR10L chemokines group, where six of nine animals had aborted infection and two remained uninfected, leading to 89% protection (P<0.001). The induction of mucosal SIV-specific antibodies and neutralization titers correlated with trends in protection. These results indicate the need to further investigate the contribution of chemokine adjuvants to modulate immune responses and the role of mucosal antibodies in SIV/HIV protection.

  9. Bordetella pertussis Infection or Vaccination Substantially Protects Mice against B. bronchiseptica Infection

    PubMed Central

    Goebel, Elizabeth M.; Zhang, Xuqing; Harvill, Eric T.

    2009-01-01

    Although B. bronchiseptica efficiently infects a wide range of mammalian hosts and efficiently spreads among them, it is rarely observed in humans. In contrast to the many other hosts of B. bronchiseptica, humans are host to the apparently specialized pathogen B. pertussis, the great majority having immunity due to vaccination, infection or both. Here we explore whether immunity to B. pertussis protects against B. bronchiseptica infection. In a murine model, either infection or vaccination with B. pertussis induced antibodies that recognized antigens of B. bronchiseptica and protected the lower respiratory tract of mice against three phylogenetically disparate strains of B. bronchiseptica that efficiently infect naïve animals. Furthermore, vaccination with purified B. pertussis-derived pertactin, filamentous hemagglutinin or the human acellular vaccine, Adacel, conferred similar protection against B. bronchiseptica challenge. These data indicate that individual immunity to B. pertussis affects B. bronchiseptica infection, and suggest that the high levels of herd immunity against B. pertussis in humans could explain the lack of observed B. bronchiseptica transmission. This could also explain the apparent association of B. bronchiseptica infections with an immunocompromised state. PMID:19707559

  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

    ... requested translation of the requisite materials in non-English languages, and suggested that HHS refer to... applicable language in the Affordable Care Act. Upon publication of the Treasury final rule, we intend to... proposed to amend Sec. 155.200(a) to add a reference to indicate that, consistent with existing language...

  11. 78 FR 37031 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-19

    ...This proposed rule sets forth 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 proposes additional standards with respect to agents and brokers. These standards, which include......

  12. 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

    ... and other business cooperatives provide possible models for the successful development of CO-OPs... to promote integrated models of care and enhance competition in the Affordable Insurance Exchanges... met. Starting in 2014, individuals and small businesses will be able to purchase private...

  13. Commentary on "How Child Protective Service Investigators Decide to Substantiate Mothers for Failure-to-Protect in Sexual Abuse Cases"

    ERIC Educational Resources Information Center

    Vieth, Victor I.

    2006-01-01

    As this author traveled around the country, many university professors and domestic violence advocates told him that prosecuting or even intervening with social services is morally "wrong" in cases in which parents fail to protect their children. There are two problems with these arguments. First, these arguments assume that mothers should "never"…

  14. 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

  15. Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2011-08-03

    This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.

  16. Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs

    PubMed Central

    Buysse, Christina A.; Hubner, Lauren M.; Huffman, Lynne C.; Loe, Irene M.

    2015-01-01

    ABSTRACT: The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN. PMID:25793891

  17. Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.

    PubMed

    Feldman, Heidi M; Buysse, Christina A; Hubner, Lauren M; Huffman, Lynne C; Loe, Irene M

    2015-04-01

    The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.

  18. 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.

  19. 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.

  20. 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

  1. 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

    ...The Commodity Futures Trading Commission (``Commission'' or ``CFTC'') is adopting new regulations and amending existing regulations to require enhanced customer protections, risk management programs, internal monitoring and controls, capital and liquidity standards, customer disclosures, and auditing and examination programs for futures commission merchants (``FCMs''). The regulations also......

  2. 78 FR 79619 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-31

    ...] [Pages 79619-79620] [FR Doc No: 2013-31319] DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 155 [CMS.... Background In FR Doc. 2013-25326 of October 30, 2013 (78 FR 65046), final rule entitled ``Patient Protection... Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (78 FR 65046), there...

  3. Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.

    PubMed

    2012-07-20

    This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.

  4. Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

    PubMed

    Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

    2013-10-01

    The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment.

  5. Creatine affords protection against glutamate-induced nitrosative and oxidative stress.

    PubMed

    Cunha, Mauricio P; Lieberknecht, Vicente; Ramos-Hryb, Ana Belén; Olescowicz, Gislaine; Ludka, Fabiana K; Tasca, Carla I; Gabilan, Nelson H; Rodrigues, Ana Lúcia S

    2016-05-01

    Creatine has been reported to exert beneficial effects in several neurodegenerative diseases in which glutamatergic excitotoxicity and oxidative stress play an etiological role. The purpose of this study was to investigate the protective effects of creatine, as compared to the N-Methyl-d-Aspartate (NMDA) receptor antagonist dizocilpine (MK-801), against glutamate or hydrogen peroxide (H2O2)-induced injury in human neuroblastoma SH-SY5Y cells. Exposure of cells to glutamate (60-80 mM) or H2O2 (200-300 μM) for 24 h decreased cellular viability and increased dichlorofluorescein (DCF) fluorescence (indicative of increased reactive oxygen species, ROS) and nitric oxide (NO) production (assessed by mono-nitrogen oxides, NOx, levels). Creatine (1-10 mM) or MK-801 (0.1-10 μM) reduced glutamate- and H2O2-induced toxicity. The protective effect of creatine against glutamate-induced toxicity involves its antioxidant effect, since creatine, similar to MK-801, prevented the increase on DCF fluorescence induced by glutamate or H2O2. Furthermore, creatine or MK-801 blocked glutamate- and H2O2-induced increases in NOx levels. In another set of experiments, the repeated, but not acute, administration of creatine (300 mg/kg, po) in mice prevented the decreases on cellular viability and mitochondrial membrane potential (assessed by tetramethylrhodamine ethyl ester, TMRE, probe) of hippocampal slices incubated with glutamate (10 mM). Creatine concentration-dependent decreased the amount of nitrite formed in the reaction of oxygen with NO produced from sodium nitroprusside solution, suggesting that its protective effect against glutamate or H2O2-induced toxicity might be due to its scavenger activity. Overall, the results suggest that creatine may be useful as adjuvant therapy for neurodegenerative disease treatments.

  6. Blackberry subjected to in vitro gastrointestinal digestion affords protection against Ethyl Carbamate-induced cytotoxicity.

    PubMed

    Chen, Wei; Xu, Yang; Zhang, Lingxia; Su, Hongming; Zheng, Xiaodong

    2016-12-01

    Ethyl Carbamate (EC) was detected in many fermented foods. Previous studies indicated that frequent exposure to ethyl carbamate may increase the risk to suffer from cancers. Blackberry is rich in polyphenols and possesses potent antioxidant activity. This study aims to investigate the protective effect of blackberry homogenates produced before (BH) and after in vitro simulated gastrointestinal digestion (BD) on EC-induced toxicity in Caco-2 cells. Our results showed that blackberry homogenates after digestion (BD) was more effective than that before digestion (BH) in ameliorating EC-induced toxicity in Caco-2 cells. Further investigation revealed that BD remarkably attenuated EC-induced toxicity through restoring mitochondrial function, inhibiting glutathione depletion and decreasing overproduction of intracellular reactive oxygen species. Additionally, LC-MS result implied that the better protective capacity of BD may be related to the increased content of two anthocyanins (cyanidin-3-glucoside and cyanidin-3-dioxalyglucoside). Overall, the present study may give implication to prevent EC-induced health problem.

  7. UV protection afforded by gel-trapped TiO2 particles.

    PubMed

    Sojka, Milan F; Cummins, Phillip G; Declercq, Lieve A G; Fthenakis, Christina G; Ionita-Manzatu, Mirela C; Lee, Wilson A; Maes, Daniel H; McKeever-Alfieri, Mary Ann; Najdek, Linda J; Pernodet, Nadine; Sente, Ilse M E; Teta, Lawrence P; Van Rillaer, Katrin; Yarosh, Daniel B; Giacomoni, Paolo U

    2011-07-01

    We have developed a technology to incorporate micronized titanium dioxide (TiO(2)), together with antioxidants, in particles of a UV-visible transparent polymer gel. These particles are coated with silica to avoid clustering and the size of the micronized TiO(2) reduces the back scattering of white light. gel-trapped TiO(2) minimizes the oxidative stress exerted by UV radiation, increases the photo-stability of some accompanying ingredients, such as avobenzone. The size of the particles is in the micrometre range. This favors their permanence on the top of the stratum corneum. Gel-trapped TiO(2)-based sunscreens provide a larger SPF and two-fold larger UVA protection than equal-composition sunscreens that contain larger amounts of untrapped TiO(2).

  8. Hybrid cluster proteins and flavodiiron proteins afford protection to Desulfovibrio vulgaris upon macrophage infection.

    PubMed

    Figueiredo, Mafalda C O; Lobo, Susana A L; Sousa, Sara H; Pereira, Fábio P; Wall, Judy D; Nobre, Lígia S; Saraiva, Lígia M

    2013-06-01

    Desulfovibrio species are Gram-negative anaerobic sulfate-reducing bacteria that colonize the human gut. Recently, Desulfovibrio spp. have been implicated in gastrointestinal diseases and shown to stimulate the epithelial immune response, leading to increased production of inflammatory cytokines by macrophages. Activated macrophages are key cells of the immune system that impose nitrosative stress during phagocytosis. Hence, we have analyzed the in vitro and in vivo responses of Desulfovibrio vulgaris Hildenborough to nitric oxide (NO) and the role of the hybrid cluster proteins (HCP1 and HCP2) and rubredoxin oxygen oxidoreductases (ROO1 and ROO2) in NO protection. Among the four genes, hcp2 was the gene most highly induced by NO, and the hcp2 transposon mutant exhibited the lowest viability under conditions of NO stress. Studies in murine macrophages revealed that D. vulgaris survives incubation with these phagocytes and triggers NO production at levels similar to those stimulated by the cytokine gamma interferon (IFN-γ). Furthermore, D. vulgaris hcp and roo mutants exhibited reduced viability when incubated with macrophages, revealing that these gene products contribute to the survival of D. vulgaris during macrophage infection.

  9. Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act.

    PubMed

    McGeehan, Megan; DeMaria, Rebecca; Charney, Pamela; Batavia, Ashita S

    2017-03-04

    The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.

  10. 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.

  11. 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.

  12. Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.

    PubMed

    Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J

    2017-01-01

    This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.

  13. 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.

  14. Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

    PubMed Central

    Huntoon, Kristin M.; McCluney, Colin J.; Scannell, Christopher A.; Wiley, Elizabeth A.; Bruno, Richard; Andrews, Allen; Gorman, Paul

    2011-01-01

    Context Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. Objective To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. Design, Setting, and Participants An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October–December 2010, with 1232 students responding and a response rate of 18%. Main Outcome Measures Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. Results Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. Conclusion The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment. PMID:21931604

  15. Patient Protection and Affordable Care Act of 2010: Summary, Analysis, and Opportunities for Advocacy for the Academic Emergency Physician

    PubMed Central

    Kline, Jeffrey A.; Walthall, Jennifer D.H.

    2010-01-01

    The Patient Protection and Affordable Care Bill, commonly referred to as the “Health Care Bill” or the “Health Care Reform Bill,” became enacted in March, 2010. This article is a review and analysis of the sections of this Act that are relevant to researchers and teachers of emergency care. The purpose of this document is to serve as a citable reference for interested parties and a reference to quickly locate the sections of the Bill relevant to academic emergency physicians. When appropriate, text was copied verbatim from the bill. The source of the downloaded Act, and the page numbers of the text sections, are provided to help the reader to find the sections described. This review is presented in two parts. Part 1 presents 11 sections extirpated from the Act, with short interpretations of the significance of each section. Part II presents an analysis of the sections that the authors believe represent opportunities for emergency care researchers and teachers to make the most impact, through active involvement with the various departments and agencies of the federal government that will be charged with interpreting and implementing this Act. The Act contains sections that could lead to new funding opportunities for research in emergency care, especially for comparative clinical trials and clinical studies that focus on integration and efficiency of health care delivery. The Act will establish several new institutes, centers, and committees that will create policies highly relevant to emergency care. The authors conclude that this Act can be expected to have a profound influence on research and training in emergency care. PMID:20653573

  16. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Montana, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Montana will fall to 3 percent; without the law, it would remain at 18 percent. The model projects that total state government spending on health care will be 3 percent higher for the combined 2011-2020 period because of the ACA.

  17. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Illinois, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Illinois will fall to 3 percent; without the law, it would remain near 15 percent. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  18. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011-2020 period because of the ACA.

  19. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Texas, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Texas will fall to 6 percent; without the law, it would remain at 28 percent, the highest in the nation. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.

  20. Touch Affordances

    NASA Astrophysics Data System (ADS)

    Slegers, Karin; de Roeck, Dries; Arnall, Timo

    The workshop “Touch Affordances” addresses a concept relevant to human computer interactions based on touch. The main topic is the challenge of applying the notion of affordances to domains related to touch interactions (e.g. (multi)touch screens, RFID & NFC, ubiquitous interfaces). The goals of this workshop are to launch a community of researchers, designers, etc. interested in this topic, to create a common understanding of the field of touch affordances and to generate ideas for new research areas for intuitive touch interactions. The workshop will be highly interactive and will have a creative, generative character.

  1. 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

  2. Lack of protection afforded by ribonucleic acid preparations from Mycobacterium tuberculosis against Mycobacterium leprae infections in mice.

    PubMed Central

    Shepard, C C; Youmans, A Y; Youmans, G P

    1977-01-01

    Mycobacterial ribonucleic acid preparations from H37Ra, an attenuated strain of Mycobacterium tuberculosis, provide their usual marked protection against M. tuberculosis challenge; however, they provided no protection against Mycobacterium leprae challenge. Suspensions of intact H37Ra were not effective against M. leprae. Suspensions of BCG gave their usual distinct protection against M. leprae challenge. PMID:404242

  3. Interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.

    PubMed

    2010-06-17

    This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.

  4. Decision making in child protection: An international comparative study on maltreatment substantiation, risk assessment and interventions recommendations, and the role of professionals' child welfare attitudes.

    PubMed

    Benbenishty, Rami; Davidson-Arad, Bilha; López, Mónica; Devaney, John; Spratt, Trevor; Koopmans, Carien; Knorth, Erik J; Witteman, Cilia L M; Del Valle, Jorge F; Hayes, David

    2015-11-01

    Child welfare professionals regularly make crucial decisions that have a significant impact on children and their families. The present study presents the Judgments and Decision Processes in Context model (JUDPIC) and uses it to examine the relationships between three independent domains: case characteristic (mother's wish with regard to removal), practitioner characteristic (child welfare attitudes), and protective system context (four countries: Israel, the Netherlands, Northern Ireland and Spain); and three dependent factors: substantiation of maltreatment, risk assessment, and intervention recommendation. The sample consisted of 828 practitioners from four countries. Participants were presented with a vignette of a case of alleged child maltreatment and were asked to determine whether maltreatment was substantiated, assess risk and recommend an intervention using structured instruments. Participants' child welfare attitudes were assessed. The case characteristic of mother's wish with regard to removal had no impact on judgments and decisions. In contrast, practitioners' child welfare attitudes were associated with substantiation, risk assessments and recommendations. There were significant country differences on most measures. The findings support most of the predictions derived from the JUDPIC model. The significant differences between practitioners from different countries underscore the importance of context in child protection decision making. Training should enhance practitioners' awareness of the impact that their attitudes and the context in which they are embedded have on their judgments and decisions.

  5. 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.

  6. 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 Enrollment Opportunity...

  7. Thermal protection afforded by two anti-exposure coveralls when worn in cold water. Final technical report, December 1987-July 1988

    SciTech Connect

    Pimental, N.A.; Avellini, B.A.

    1988-10-01

    The Navy Clothing and Textile Research Facility (NCTRF) was contracted by U.S. Coast Guard Headquarters to evaluate the thermal protection afforded by two prototype aircrew anti exposure coveralls when worn in cold water. The coveralls were developed by two different manufacturers to meet U.S. Coast Guard specification G-OAV-3-1401/A of 15 July 1986. The coveralls were evaluated on seven male subjects immersed in 10/sup 0/C water for 2 hours (with air temperature 13/sup 0/C, minimal wind). When either of the two anti-exposure coveralls was worn, all subjects were able to complete the 2-hour water immersion. There were no differences in the thermal protection afforded by the two coveralls, as measured by rectal temperature, skin temperature, heart rate, and oxygen uptake responses (P>0.05). The decrease in rectal temperature after 2 hours of cold water immersion averaged 1.0 C; mean weighted skin temperature averaged 2.3/sup 0/C. Final heart rate averaged 77 b/min. Oxygen consumption, used as a measure of shivering, was the same when either coverall was worn. Both coveralls met the Coast Guard requirement of preventing rectal temperature from dropping more than 1 C per hour.

  8. 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.

  9. Affordable Care?

    PubMed

    Goldstein, Adam O

    2015-01-01

    Once a year, Stuart, a long-haul truck driver, visited a physician to get a signature on the forms that allowed him to continue driving his 18-wheeler. Over 8 years, he had never seen the same physician twice, in large part because of a lack of health insurance. Upon seeing him for the first time, I assured him that we could make financial arrangements, and he subsequently became my continuity patient. Two years later, we both looked forward to his impending 65th birthday, allowing Medicare to ease his fiscal health care burdens. His unexpected death made me ponder how a lack of access to affordable health care profoundly affects patients and their clinicians.

  10. Immunogenicity and Cross Protection in Mice Afforded by Pandemic H1N1 Live Attenuated Influenza Vaccine Containing Wild-Type Nucleoprotein

    PubMed Central

    Isakova-Sivak, Irina; Petukhova, Galina; Korenkov, Daniil; Losev, Igor; Smolonogina, Tatiana; Tretiak, Tatiana; Donina, Svetlana; Shcherbik, Svetlana; Bousse, Tatiana; Rudenko, Larisa

    2017-01-01

    Since conserved viral proteins of influenza virus, such as nucleoprotein (NP) and matrix 1 protein, are the main targets for virus-specific CD8+ cytotoxic T-lymphocytes (CTLs), we hypothesized that introduction of the NP gene of wild-type virus into the genome of vaccine reassortants could lead to better immunogenicity and afford better protection. This paper describes in vitro and in vivo preclinical studies of two new reassortants of pandemic H1N1 live attenuated influenza vaccine (LAIV) candidates. One had the hemagglutinin (HA) and neuraminidase (NA) genes from A/South Africa/3626/2013 H1N1 wild-type virus on the A/Leningrad/134/17/57 master donor virus backbone (6 : 2 formulation) while the second had the HA, NA, and NP genes of the wild-type virus on the same backbone (5 : 3 formulation). Although both LAIVs induced similar antibody immune responses, the 5 : 3 LAIV provoked greater production of virus-specific CTLs than the 6 : 2 variant. Furthermore, the 5 : 3 LAIV-induced CTLs had higher in vivo cytotoxic activity, compared to 6 : 2 LAIV. Finally, the 5 : 3 LAIV candidate afforded greater protection against infection and severe illness than the 6 : 2 LAIV. Inclusion in LAIV of the NP gene from wild-type influenza virus is a new approach to inducing cross-reactive cell-mediated immune responses and cross protection against pandemic influenza. PMID:28210631

  11. How Much Protection Does a College Degree Afford? The Impact of the Recession on Recent College Graduates

    ERIC Educational Resources Information Center

    Economic Mobility Project, 2013

    2013-01-01

    This report examines whether a college degree protected recent graduates from a range of poor employment outcomes during the recession, including unemployment, low-skill jobs, and lesser wages. The report draws upon data from the 2003-2011 Current Population Survey (CPS) to examine the early labor market outcomes of 21- through 24-year-olds. The…

  12. Practical and affordable measures for the protection of health care workers from tuberculosis in low-income countries.

    PubMed Central

    Harries, A. D.; Maher, D.; Nunn, P.

    1997-01-01

    With the global upsurge in tuberculosis (TB), fueled by the human immunodeficiency virus (HIV) pandemic, and the increase in multidrug-resistant TB, the condition has become a serious occupational hazard for health care workers worldwide. Much of the current understanding about nosocomial TB transmission stems from the USA; however, little is known about the risk of such transmission in low-income countries. The focus of this review is on sub-Saharan Africa, since this is the region with the highest TB incidence, the highest HIV incidence, the worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Measures used in industralized countries to control nosocomial TB transmission (ventilation systems, isolation rooms, personal protective equipment) are beyond the resources of low-income countries. Protecting health care workers in these settings involves practical measures relating to diagnosis and treatment of infectious cases; appropriate environmental control; and relevant personal protection and surveillance of health care workers. Research needs to be carried out to examine the feasibility and cost-effectiveness of measures such as voluntary HIV-testing of health care workers (to enable known HIV-positive health care workers to avoid high-risk settings) and isoniazid preventive therapy for workers in high-risk settings. More resources are also needed to ensure full implementation of currently recommended measures to decrease the risk of nosocomial and laboratory-acquired TB. PMID:9447782

  13. 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

  14. 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.

  15. Carvedilol-Afforded Protection against Daunorubicin-Induced Cardiomyopathic Rats In Vivo: Effects on Cardiac Fibrosis and Hypertrophy

    PubMed Central

    Arozal, Wawaimuli; Sari, Flori R.; Watanabe, Kenichi; Arumugam, Somasundaram; Veeraveedu, Punniyakoti T.; Ma, Meilei; Thandavarayan, Rajarajan A.; Sukumaran, Vijayakumar; Lakshmanan, Arun Prasath; Kobayashi, Yoshiyasu; Mito, Sayaka; Soetikno, Vivian; Suzuki, Kenji

    2011-01-01

    Anthracyclines, most powerful anticancer agents, suffer from their cardiotoxic effects, which may be due to the induction of oxidative stress. Carvedilol, a third-generation, nonselective β-adrenoreceptor antagonist, possesses both reactive oxygen species (ROS) scavenging and ROS suppressive effects. It showed protective effects against daunorubicin- (DNR-) induced cardiac toxicity by reducing oxidative stress and apoptosis. This study therefore was designed to examine the effects of carvedilol on DNR-induced cardiomyopathic rats, focused on the changes of left ventricular function, cardiac fibrosis, and hypertrophy. Carvedilol increased survival rate, prevented systolic and diastolic dysfunction, and attenuated myocardial fibrosis and hypertrophy. DNR alone treated rats showed upregulated myocardial expression of ANP, PKC-α, OPN, and TGF-β1 and downregulation of GATA-4 in comparison with control, and treatment with carvedilol significantly reversed these changes. The results of the present study add the available evidences on the cardioprotection by carvedilol when associated with anthracyclines and explain the mechanisms underlying the benefits of their coadministration. PMID:22084713

  16. The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE.

    PubMed

    Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Connecticut, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011-2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).

  17. Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.

    PubMed

    2010-11-17

    This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.

  18. 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

  19. 78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-28

    ... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended,...

  20. Assessment of the protection afforded by triple baculovirus recombinant coexpressing H5, N3, M1 proteins against a homologous H5N3 low-pathogenicity avian influenza virus challenge in Muscovy ducks.

    PubMed

    Prel, Anne; Le Gall-Reculé, Ghislaine; Cherbonnel, Martine; Grasland, Béatrice; Amelot, Michel; Jestin, Véronique

    2007-03-01

    In Asia, domestic ducks have been shown to play a pivotal role in H5 high-pathogenicity avian influenza virus transmission. We have also observed that the same situation may exist for H5 low-pathogenicity avian influenza (LPAI) virus. No data are available regarding the protection afforded by commercial inactivated vaccines against H5 LPAI virus infection in ducks, and two preliminary experiments using commercial inactivated vaccines gave poor results. Virus-like particles (VLPs) have been shown to be immunogenic in different species. With regard to the influenza model, the matrix (M) protein has been shown to be necessary for the formation of VLPs. In order to attempt to develop a VLP influenza vaccine expressing hemagglutinin and neuraminidase (NA) of interest, we generated a triple recombinant baculovirus (rB) expressing three structural proteins: H5, N3, and M, derived from a recent French LPAI virus strain. Although the three proteins were successfully expressed in rB-infected cells and displayed the expected biological activity, no VLPs were observed. Despite this result, the protection afforded to ducks by rB-infected cell lysates was assessed and was compared with the protection afforded by an inactivated commercial H5N9 vaccine. For this purpose, specific-pathogen-free Muscovy ducks (15 per group) received rB-infected cell lysates (3 wk apart), while a second group received the H5N9 vaccine. Ten days after the boost, a homologous virus challenge was implemented. Both vaccines induced positive hemagglutination inhibition titers and M immune response, whereas lysates of rB-infected cells elicited NA immune response. Tracheal and cloacal sheddings were measured using M-based real-time-reverse transcription-polymerase chain reaction and were compared with the sheddings of vaccinated and unvaccinated infected controls. Lysates of rB-infected cells afforded a significant decrease of cloacal shedding and a delayed peak of tracheal shedding, whereas the

  1. Establishing Substantial Equivalence: Transcriptomics

    NASA Astrophysics Data System (ADS)

    Baudo, María Marcela; Powers, Stephen J.; Mitchell, Rowan A. C.; Shewry, Peter R.

    Regulatory authorities in Western Europe require transgenic crops to be substantially equivalent to conventionally bred forms if they are to be approved for commercial production. One way to establish substantial equivalence is to compare the transcript profiles of developing grain and other tissues of transgenic and conventionally bred lines, in order to identify any unintended effects of the transformation process. We present detailed protocols for transcriptomic comparisons of developing wheat grain and leaf material, and illustrate their use by reference to our own studies of lines transformed to express additional gluten protein genes controlled by their own endosperm-specific promoters. The results show that the transgenes present in these lines (which included those encoding marker genes) did not have any significant unpredicted effects on the expression of endogenous genes and that the transgenic plants were therefore substantially equivalent to the corresponding parental lines.

  2. Transient Loss of Protection Afforded by a Live Attenuated Non-typhoidal Salmonella Vaccine in Mice Co-infected with Malaria

    PubMed Central

    Lokken, Kristen L.; Nanton, Minelva R.; Nuccio, Sean-Paul; McSorley, Stephen J.; Tsolis, Renée M.

    2015-01-01

    In immunocompetent individuals, non-typhoidal Salmonella serovars (NTS) are associated with gastroenteritis, however, there is currently an epidemic of NTS bloodstream infections in sub-Saharan Africa. Plasmodium falciparum malaria is an important risk factor for invasive NTS bloodstream in African children. Here we investigated whether a live, attenuated Salmonella vaccine could be protective in mice, in the setting of concurrent malaria. Surprisingly, mice acutely infected with the nonlethal malaria parasite Plasmodium yoelii 17XNL exhibited a profound loss of protective immunity to NTS, but vaccine-mediated protection was restored after resolution of malaria. Absence of protective immunity during acute malaria correlated with maintenance of antibodies to NTS, but a marked reduction in effector capability of Salmonella-specific CD4 and CD8 T cells. Further, increased expression of the inhibitory molecule PD1 was identified on memory CD4 T cells induced by vaccination. Blockade of IL-10 restored protection against S. Typhimurium, without restoring CD4 T cell effector function. Simultaneous blockade of CTLA-4, LAG3, and PDL1 restored IFN-γ production by vaccine-induced memory CD4 T cells but was not sufficient to restore protection. Together, these data demonstrate that malaria parasite infection induces a temporary loss of an established adaptive immune response via multiple mechanisms, and suggest that in the setting of acute malaria, protection against NTS mediated by live vaccines may be interrupted. PMID:26366739

  3. Transient Loss of Protection Afforded by a Live Attenuated Non-typhoidal Salmonella Vaccine in Mice Co-infected with Malaria.

    PubMed

    Mooney, Jason P; Lee, Seung-Joo; Lokken, Kristen L; Nanton, Minelva R; Nuccio, Sean-Paul; McSorley, Stephen J; Tsolis, Renée M

    2015-01-01

    In immunocompetent individuals, non-typhoidal Salmonella serovars (NTS) are associated with gastroenteritis, however, there is currently an epidemic of NTS bloodstream infections in sub-Saharan Africa. Plasmodium falciparum malaria is an important risk factor for invasive NTS bloodstream in African children. Here we investigated whether a live, attenuated Salmonella vaccine could be protective in mice, in the setting of concurrent malaria. Surprisingly, mice acutely infected with the nonlethal malaria parasite Plasmodium yoelii 17XNL exhibited a profound loss of protective immunity to NTS, but vaccine-mediated protection was restored after resolution of malaria. Absence of protective immunity during acute malaria correlated with maintenance of antibodies to NTS, but a marked reduction in effector capability of Salmonella-specific CD4 and CD8 T cells. Further, increased expression of the inhibitory molecule PD1 was identified on memory CD4 T cells induced by vaccination. Blockade of IL-10 restored protection against S. Typhimurium, without restoring CD4 T cell effector function. Simultaneous blockade of CTLA-4, LAG3, and PDL1 restored IFN-γ production by vaccine-induced memory CD4 T cells but was not sufficient to restore protection. Together, these data demonstrate that malaria parasite infection induces a temporary loss of an established adaptive immune response via multiple mechanisms, and suggest that in the setting of acute malaria, protection against NTS mediated by live vaccines may be interrupted.

  4. Establishing Substantial Equivalence: Metabolomics

    NASA Astrophysics Data System (ADS)

    Beale, Michael H.; Ward, Jane L.; Baker, John M.

    Modern ‘metabolomic’ methods allow us to compare levels of many structurally diverse compounds in an automated fashion across a large number of samples. This technology is ideally suited to screening of populations of plants, including trials where the aim is the determination of unintended effects introduced by GM. A number of metabolomic methods have been devised for the determination of substantial equivalence. We have developed a methodology, using [1H]-NMR fingerprinting, for metabolomic screening of plants and have applied it to the study of substantial equivalence of field-grown GM wheat. We describe here the principles and detail of that protocol as applied to the analysis of flour generated from field plots of wheat. Particular emphasis is given to the downstream data processing and comparison of spectra by multivariate analysis, from which conclusions regarding metabolome changes due to the GM can be assessed against the background of natural variation due to environment.

  5. Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.

    PubMed

    Shindul-Rothschild, Judith; Gregas, Matt

    2013-01-01

    The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.

  6. 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

  7. 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.

  8. Protection afforded by quercetin against H2O2-induced apoptosis on PC12 cells via activating PI3K/Akt signal pathway.

    PubMed

    Chen, Liang; Sun, Lejin; Liu, Zhene; Wang, Hongxia; Xu, Cunli

    2016-01-01

    Cell damage and apoptosis induced by oxidative stress have been involved in various neurodegenerative diseases. This study aims to explore the neuro-protective effects of quercetin on PC12 cells apoptosis induced by hydrogen peroxide (H(2)O(2)) and the underlying mechanisms. The cell viability was detected, as well as the production of reactive oxygen species (ROS), lactate dehydrogenase (LDH) leakage, and the activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and malondialdehyde (MDA) of the cells in control, H(2)O(2) and quercetin groups. It finally turned out that quercetin might protect PC12 cells against the negative effect of H(2)O(2) by decreasing of LDH release, ROS concentration and MDA level and regaining the GSH-Px and SOD activities. To investigate the mechanism, LY294002 was introduced, the phosphatidylinositol-3-kinase (PI3K) inhibitor. Bax/Bcl-2 ratio and Akt phosphorylation (p-Akt) were examined by Western blot analysis. The data showed that LY294002 almost had the same effects with H(2)O(2), which was also significantly reversed by quercetin could enhance Bax/Bcl-2 ratio and adjust the p-Akt expression, which indicated quercetin might protect PC12 cells against the negative effect of H(2)O(2) via activating the PI3K/Akt signal pathway.

  9. Establishing Substantial Equivalence: Proteomics

    NASA Astrophysics Data System (ADS)

    Lovegrove, Alison; Salt, Louise; Shewry, Peter R.

    Wheat is a major crop in world agriculture and is consumed after processing into a range of food products. It is therefore of great importance to determine the consequences (intended and unintended) of transgenesis in wheat and whether genetically modified lines are substantially equivalent to those produced by conventional plant breeding. Proteomic analysis is one of several approaches which can be used to address these questions. Two-dimensional PAGE (2D PAGE) remains the most widely available method for proteomic analysis, but is notoriously difficult to reproduce between laboratories. We therefore describe methods which have been developed as standard operating procedures in our laboratory to ensure the reproducibility of proteomic analyses of wheat using 2D PAGE analysis of grain proteins.

  10. Affordances: Ten Years On

    ERIC Educational Resources Information Center

    Brown, Jill P.; Stillman, Gloria

    2014-01-01

    Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

  11. Enhanced protective efficacy against Mycobacterium tuberculosis afforded by BCG prime-DNA boost regimen in an early challenge mouse model is associated with increased splenic interleukin-2-producing CD4 T-cell frequency post-vaccination.

    PubMed

    Kang, Han; Yuan, Qin; Ma, Hui; Hu, Zhi-Dong; Han, De-Ping; Wu, Kang; Lowrie, Douglas B; Fan, Xiao-Yong

    2014-12-01

    The development of improved vaccines and vaccination strategies against Mycobacterium tuberculosis has been hindered by a limited understanding of the immune correlates of anti-tuberculosis protective immunity. Simple measurement of interferon-γ frequency or production per se does not provide adequate prediction of immune protection. In this study, we examined the relationship between T-cell immune responses and protective efficacy conferred by the heterologous vaccination strategy, bacillus Calmette-Guérin (BCG) prime-Ag85A DNA boost (B/D), in an early challenge mouse model of pulmonary tuberculosis. The results demonstrated that mice vaccinated with the B/D regimen had a significantly reduced bacillary load compared with BCG-vaccinated mice, and the reduction in colony-forming units was associated with decreased pathology and lower levels of inflammatory cytokines in the infected lungs. Further analysis of immunogenicity showed that the superior protection afforded by the B/D regimen was associated with significantly increased frequency of splenic interleukin-2 (IL-2) -producing CD4 T cells and increased IL-2 production when measured as integrated mean fluorescence intensity post-vaccination as well. These data suggest that measurement of elevated frequency of IL-2-producing CD4 T cells or IL-2 production in the spleens of vaccinated mice can predict vaccine efficacy, at least in the B/D strategy, and add to the accumulating body of evidence suggesting that BCG prime-boost strategies may be a useful approach to the control of M. tuberculosis infection.

  12. "Affordable" Private Schools in South Africa. Affordable for Whom?

    ERIC Educational Resources Information Center

    Languille, Sonia

    2016-01-01

    The paper sets out to challenge the notions of "affordable" private schools in the context of South Africa. It is guided by one main question: "affordable private schools for whom?" It argues that, contrary to claims by its public and private proponents, affordable private schools in South Africa do not cater for poor children.…

  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. 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.

  15. Prime-boost vaccination with recombinant H5-fowlpox and Newcastle disease virus vectors affords lasting protection in SPF Muscovy ducks against highly pathogenic H5N1 influenza virus.

    PubMed

    Niqueux, Eric; Guionie, Olivier; Amelot, Michel; Jestin, Véronique

    2013-08-28

    Vaccination protocols were evaluated in one-day old Muscovy ducklings, using an experimental Newcastle disease recombinant vaccine (vNDV-H5) encoding an optimized synthetic haemagglutinin gene from a clade 2.2.1 H5N1 highly pathogenic (HP) avian influenza virus (AIV), either as a single administration or as a boost following a prime inoculation with a fowlpox vectored vaccine (vFP89) encoding a different H5 HP haemagglutinin from an Irish H5N8 strain. These vaccination schemes did not induce detectable levels of serum antibodies in HI test using a clade 2.2.1 H5N1 antigen, and only induced H5 ELISA positive response in less than 10% of vaccinated ducks. However, following challenge against a clade 2.2.1 HPAIV, both protocols afforded full clinical protection at six weeks of age, and full protection against mortality at nine weeks. Only the prime-boost vaccination (vFP89+vNDV-H5) was still fully protecting Muscovy ducks against disease and mortality at 12 weeks of age. Reduction of oropharyngeal shedding levels was also constantly observed from the onset of the follow-up at 2.5 or three days post-infection in vaccinated ducks compared to unvaccinated controls, and was significantly more important for vFP89+vNDV-H5 vaccination than for vNDV-H5 alone. Although the latter vaccine is shown immunogenic in one-day old Muscovy ducks, the present work is original in demonstrating the high efficacy of the successive administration of two different vector vaccines encoding two different H5 in inducing lasting protection (at least similar to the one induced by an inactivated reassortant vaccine, Re-5). In addition, such a prime-boost schedule allows implementation of a DIVA strategy (to differentiate vaccinated from infected ducks) contrary to Re-5, involves easy practice on the field (with injection at the hatchery and mass vaccination later on), and should avoid eventual interference with NDV maternally derived antibodies. Last, the HA insert could be updated according to

  16. 40 CFR 350.27 - Substantiation form to accompany claims of trade secrecy, instructions to substantiation form.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Substantiation form to accompany claims of trade secrecy, instructions to substantiation form. 350.27 Section 350.27 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY...

  17. Affordability of Defense Acquisition Programs

    DTIC Science & Technology

    2015-02-01

    the Office of Director, Cost Assessment and Program Evaluation (CAPE). The DPP is a particularly useful tool for assessing the affordability of DOD...within the Service programming communities. • The Defense Program Projection is a valuable tool for DOD’s use in assessing affordability; however, in... tool for assessing the affordability of future acquisition in the spirit of the Better Buying Power initiative. A. Ground Rules, Assumptions, and

  18. Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA).

    PubMed

    Eibner, Christine; Girosi, Federico; Miller, Amalia; Cordova, Amado; McGlynn, Elizabeth A; Pace, Nicholas M; Price, Carter C; Vardavas, Raffaele; Gresenz, Carole Roan

    2011-01-01

    The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA) changes the regulatory environment within which health insurance policies on the small-group market are bought and sold. New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include "essential health benefits." While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations. As a result, some firms may have a stronger incentive to offer self-insured plans after the ACA takes full effect. In this article we identify factors that influence employers' decisions to self-insure and estimate how the ACA will influence self-insurance rates. We also consider the implications of higher self-insurance rates for adverse selection in the non-self-insured small-group market and whether enrollees in self-insured plans receive different benefits than enrollees in fully-insured plans. Results are based on data analysis, literature review, findings from discussions with stakeholders, and microsimulation analysis using the COMPARE model. Overall, we find little evidence that self-insured plans differ systematically from fully insured plans in terms of benefit generosity, price, or claims denial rates. Stakeholders expressed significant concern about adverse selection in the health insurance exchanges due to regulatory exemptions for self-insured plans. However, our microsimulation analysis predicts a sizable increase in self-insurance only if comprehensive stop-loss policies become widely available after the ACA takes full effect and the expected cost of self-insuring with stop-loss is comparable to the cost of being fully insured in a market without rating regulations.

  19. 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..._PRA_PUBLIC@dol.gov . SUPPLEMENTARY INFORMATION: The Patient Protection Notice is used by health...

  20. 77 FR 16501 - Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ...-AR42 Certain Preventive Services Under the Affordable Care Act AGENCIES: Internal Revenue Service... regarding certain preventive health services under provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). The proposed amendments would establish alternative ways to fulfill...

  1. 77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ...This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of......

  2. Alternatives to the ACA's Affordability Firewall

    PubMed Central

    Nowak, Sarah A.; Saltzman, Evan; Cordova, Amado

    2016-01-01

    Abstract The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual “affordability firewall,” which limits subsidies to individuals lacking access to alternative sources of coverage that are “affordable.” This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the “entire family” scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the “dependents only” scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally

  3. Alternatives to the ACA's Affordability Firewall.

    PubMed

    Nowak, Sarah A; Saltzman, Evan; Cordova, Amado

    2016-05-09

    The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the "entire family" scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the "dependents only" scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally estimated that federal

  4. 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.

  5. Production of substantially pure fructose

    DOEpatents

    Hatcher, Herbert J.; Gallian, John J.; Leeper, Stephen A.

    1990-01-01

    A process is disclosed for the production of substantially pure fructose from sucrose-containing substrates. The process comprises converting the sucrose to levan and glucose, purifying the levan by membrane technology, hydrolyzing the levan to form fructose monomers, and recovering the fructose.

  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.

  7. 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...

  8. Measuring Substantial Reductions in Activity

    PubMed Central

    Schafer, Charles; Evans, Meredyth; Jason, Leonard A.; So, Suzanna; Brown, Abigail

    2015-01-01

    The case definitions for Myalgic Encephalomyelitis/chronic fatigue syndrome (ME/CFS), Myalgic Encephalomyelitis (ME), and chronic fatigue syndrome (CFS) each include a disability criterion requiring substantial reductions in activity in order to meet diagnostic criteria. Difficulties have been encountered in defining and operationalizing the substantial reduction disability criterion within these various illness definitions. The present study sought to relate measures of past and current activities in several domains including the SF-36, an objective measure of activity (e.g. actigraphy), a self-reported quality of life scale, and measures of symptom severity. Results of the study revealed that current work activities had the highest number of significant associations with domains such as the SF-36 subscales, actigraphy, and symptom scores. As an example, higher self-reported levels of current work activity were associated with better health. This suggests that current work related activities may provide a useful domain for helping operationalize the construct of substantial reductions in activity. PMID:25584524

  9. What does the Affordable Care Act mean for nursing?

    PubMed

    Luther, Brenda; Hart, Sara

    2014-01-01

    Nurses are ethically bound to engage in efforts of improving health and healthcare delivery and, even more important, nurses recently have been called out as key leaders in the reform of healthcare delivery, including many components of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act, its history, and what healthcare will look like during and after implementation are addressed in this article. A discussion of the role and value of nurses in healthcare reform accompanies knowledge-building and action-oriented resources available to nurses and clients.

  10. Visual object affordances: object orientation.

    PubMed

    Symes, Ed; Ellis, Rob; Tucker, Mike

    2007-02-01

    Five experiments systematically investigated whether orientation is a visual object property that affords action. The primary aim was to establish the existence of a pure physical affordance (PPA) of object orientation, independent of any semantic object-action associations or visually salient areas towards which visual attention might be biased. Taken together, the data from these experiments suggest that firstly PPAs of object orientation do exist, and secondly, the behavioural effects that reveal them are larger and more robust when the object appears to be graspable, and is oriented in depth (rather than just frontally) such that its leading edge appears to point outwards in space towards a particular hand of the viewer.

  11. Emerging Affordances in Telecollaborative Multimodal Interactions

    ERIC Educational Resources Information Center

    Dey-Plissonneau, Aparajita; Blin, Françoise

    2016-01-01

    Drawing on Gibson's (1977) theory of affordances, Computer-Assisted Language Learning (CALL) affordances are a combination of technological, social, educational, and linguistic affordances (Blin, 2016). This paper reports on a preliminary study that sought to identify the emergence of affordances during an online video conferencing session between…

  12. 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…

  13. 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

  14. Synthesis of substantially monodispersed colloids

    NASA Technical Reports Server (NTRS)

    Klabunde, Kenneth J. (Inventor); Stoeva, Savka (Inventor); Sorensen, Christopher (Inventor)

    2003-01-01

    A method of forming ligated nanoparticles of the formula Y(Z).sub.x where Y is a nanoparticle selected from the group consisting of elemental metals having atomic numbers ranging from 21-34, 39-52, 57-83 and 89-102, all inclusive, the halides, oxides and sulfides of such metals, and the alkali metal and alkaline earth metal halides, and Z represents ligand moieties such as the alkyl thiols. In the method, a first colloidal dispersion is formed made up of nanoparticles solvated in a molar excess of a first solvent (preferably a ketone such as acetone), a second solvent different than the first solvent (preferably an organic aryl solvent such as toluene) and a quantity of ligand moieties; the first solvent is then removed under vacuum and the ligand moieties ligate to the nanoparticles to give a second colloidal dispersion of the ligated nanoparticles solvated in the second solvent. If substantially monodispersed nanoparticles are desired, the second dispersion is subjected to a digestive ripening process. Upon drying, the ligated nanoparticles may form a three-dimensional superlattice structure.

  15. 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.

  16. The Family Smoking Prevention and Tobacco Control Act and the First Amendment: why a substantial interest in protecting public health won't save some new restrictions on tobacco advertising.

    PubMed

    Stoll, Elaine

    2010-01-01

    Congress passed the Family Smoking Prevention and Tobacco Control Act in 2009 with the aim of reducing tobacco-related illnesses and deaths by curbing tobacco's appeal to and use by children and adolescents. Legislators considered provisions of the FSPTCA restricting tobacco advertising and labeling key to realizing the law's intended health benefits. But a lawsuit now before the U.S. Court of Appeals for the Sixth Circuit challenges the tobacco marketing restrictions as impermissible restraints on tobacco companies' commercial speech rights under the First Amendment. This article analyzes the constitutionality of each FSPTCA tobacco advertising and labeling restriction in light of U.S. Supreme Court decisions defining the extent of First Amendment protection for commercial speech, prior efforts to restrict tobacco marketing, and the outcomes of legal challenges to some of the prior marketing restrictions. Several of the FSPTCA tobacco advertising and labeling restrictions were drafted with insufficient accommodations for tobacco companies' First Amendment right to convey and consumers' First Amendment right to receive truthful information about lawful tobacco products and are therefore unconstitutional as currently written.

  17. Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist

    PubMed Central

    Wise, Paul H.; Halfon, Neal

    2014-01-01

    The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The “voltage drop” framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children’s health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140

  18. 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...

  19. 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...

  20. 29 CFR 1977.12 - Exercise of any right afforded by the Act.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 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...

  1. Consequences of BBPs Affordability Initiative

    DTIC Science & Technology

    2016-04-30

    extending programming from five years in the future to the full life of each acquisition program—typically in excess of 25 years—and discussing the full ...concepts that are fundamental to the affordability vision. The memo text begins with the example of a program that the Army decided to cancel (thus...reducing spending. This is a laudable goal, but it cannot be the DoD’s only one. BBP 3.0’s full title includes the words Achieving Dominant

  2. 78 FR 19917 - Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-02

    ...This final rule implements the provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) relating to the availability of increased Federal Medical Assistance Percentage (FMAP) rates for certain adult populations under states' Medicaid programs. This final rule......

  3. 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…

  4. Perceiving affordances in rugby union.

    PubMed

    Passos, Pedro; Cordovil, Rita; Fernandes, Orlando; Barreiros, João

    2012-01-01

    To succeed in competitive environments, players need to continuously adjust their decisions and actions to the behaviour of relevant others. Players' interactions demand ongoing decisions that are constrained by what is previously defined (e.g., coaches' prescriptions that establish 'what' to do) and by information that is available in the context and specifies not only 'what' the player should do, but also 'how', 'when' and 'where'. We describe what affordances emerge to the ball carrier as a consequence of changes in kinematic variables, such as interpersonal distances or distances to the nearest sideline. Changes in these variables determine whether and when different actions are possible. The ball carrier tended to perform a pass when the tackler was farthest from the sideline and the velocity of approach to the tackler did not seem to effect the ball carrier's decision. In the few episodes where the ball carrier moved forward instead of passing the ball, he was mainly influenced by contextual information, such as the variability of the players' distance to the nearest sideline. In sum, actors must be aware of the affordances of others that are specified by particular variables that become available just before decision-making.

  5. 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.

  6. Energy efficient affordable housing. Final report

    SciTech Connect

    1995-07-01

    In 1994, the Southface Energy Institute, working with support from US DOE, initiated a program to provide technical assistance to nonprofit organizations developing affordable housing in the Olympic target communities of Atlanta. The specific project goals were: Identify the barriers that nonprofit affordable housing providers face in increasing the energy and resource efficiency of affordable housing; Assist them in developing the resources to overcome these barriers; Develop specific technical materials and program models that will enable these affordable housing groups to continue to improve the energy efficiency of their programs; and, To transfer the program materials to other affordable housing providers. This report summarizes the progress made in each of these areas.

  7. 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.

  8. The impact of comparative effectiveness research on interventional pain management: evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute.

    PubMed

    Manchikanti, Laxmaiah; Falco, Frank J E; Benyamin, Ramsin M; Helm, Standiford; Parr, Allan T; Hirsch, Joshua A

    2011-01-01

    The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act of 2010 to promote comparative effectiveness research (CER) to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis. The development of PCORI is vested in the Medicare Modernization Act (MMA) and the American Recovery and Reinvestment Act (ARRA). The framework of CER and PCORI describes multiple elements which are vested in all 3 regulations including stakeholder involvement, public participation, and open transparent decision-making process. Overall, PCORI is much more elaborate with significant involvement of stakeholders, transparency, public participation, and open decision-making. However, there are multiple issues concerning the operation of such agencies in the United States including the predecessor of Agency for Healthcare Research and Quality (AHRQ), the Agency for Healthcare Policy and Research (AHCPR), AHRQ Effectiveness Health Care programs, and others. The CER in the United States may be described at cross-roads or at the beginnings of a scientific era of CER and evidence-based medicine (EBM). However the United States suffers as other countries, including the United Kingdom with its National Health Services (NHS) and National Institute for Health and Clinical Excellence (NICE), with major misunderstandings of methodology, an inordinate focus on methodological assessment, lack of understanding of the study design (placebo versus active control), lack of involvement of clinicians, and misinterpretation of the evidence which continues to be disseminated. Consequently, PCORI and CER have been described as government-driven solutions without following the

  9. 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.

  10. 77 FR 34785 - Substantial Business Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BK86 Substantial Business Activities AGENCY: Internal... regulations regarding whether a foreign corporation has substantial business activities in a foreign country... substantial business activities in a foreign country, the Internal Revenue Service (IRS) and the Department...

  11. 77 FR 34887 - Substantial Business Activities

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-12

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BK85 Substantial Business Activities AGENCY: Internal... substantial business activities in a foreign country. These regulations affect certain domestic corporations... whether a foreign corporation has substantial business activities in a foreign country for purposes...

  12. Dopamine, Affordance and Active Inference

    PubMed Central

    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. PMID:22241972

  13. 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

  14. A single immunization with modified vaccinia virus Ankara-based influenza virus H7 vaccine affords protection in the influenza A(H7N9) pneumonia ferret model.

    PubMed

    Kreijtz, Joost H C M; Wiersma, Lidewij C M; De Gruyter, Heidi L M; Vogelzang-van Trierum, Stella E; van Amerongen, Geert; Stittelaar, Koert J; Fouchier, Ron A M; Osterhaus, Albert D M E; Sutter, Gerd; Rimmelzwaan, Guus F

    2015-03-01

    Since the first reports in early 2013, >440 human cases of infection with avian influenza A(H7N9) have been reported including 122 fatalities. After the isolation of the first A(H7N9) viruses, the nucleotide sequences became publically available. Based on the coding sequence of the influenza virus A/Shanghai/2/2013 hemagglutinin gene, a codon-optimized gene was synthesized and cloned into a recombinant modified vaccinia virus Ankara (MVA). This MVA-H7-Sh2 viral vector was used to immunize ferrets and proved to be immunogenic, even after a single immunization. Subsequently, ferrets were challenged with influenza virus A/Anhui/1/2013 via the intratracheal route. Unprotected animals that were mock vaccinated or received empty vector developed interstitial pneumonia characterized by a marked alveolitis, accompanied by loss of appetite, weight loss, and heavy breathing. In contrast, animals vaccinated with MVA-H7-Sh2 were protected from severe disease.

  15. Evaluation of reproductive protection against bovine viral diarrhea virus and bovine herpesvirus-1 afforded by annual revaccination with modified-live viral or combination modified-live/killed viral vaccines after primary vaccination with modified-live viral vaccine.

    PubMed

    Walz, Paul H; Givens, M Daniel; Rodning, Soren P; Riddell, Kay P; Brodersen, Bruce W; Scruggs, Daniel; Short, Thomas; Grotelueschen, Dale

    2017-02-15

    The objective of this study was to compare reproductive protection in cattle against bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BoHV-1) provided by annual revaccination with multivalent modified-live viral (MLV) vaccine or multivalent combination viral (CV) vaccine containing temperature-sensitive modified-live BoHV-1 and killed BVDV when MLV vaccines were given pre-breeding to nulliparous heifers. Seventy-five beef heifers were allocated into treatment groups A (n=30; two MLV doses pre-breeding, annual revaccination with MLV vaccine), B (n=30; two MLV doses pre-breeding, annual revaccination with CV vaccine) and C (n=15; saline in lieu of vaccine). Heifers were administered treatments on days 0 (weaning), 183 (pre-breeding), 366 (first gestation), and 738 (second gestation). After first calving, primiparous cows were bred, with pregnancy assessment on day 715. At that time, 24 group A heifers (23 pregnancies), 23 group B heifers (22 pregnancies), and 15 group C heifers (15 pregnancies) were commingled with six persistently infected (PI) cattle for 16days. Ninety-nine days after PI removal, cows were intravenously inoculated with BoHV-1. All fetuses and live offspring were assessed for BVDV and BoHV-1. Abortions occurred in 3/23 group A cows, 1/22 group B cows, and 11/15 group C cows. Fetal infection with BVDV or BoHV-1 occurred in 4/23 group A offspring, 0/22 group B offspring, and 15/15 group C offspring. This research demonstrates efficacy of administering two pre-breeding doses of MLV vaccine with annual revaccination using CV vaccine to prevent fetal loss due to exposure to BVDV and BoHV-1.

  16. Managing Requirements for Acquisition Program Affordability

    DTIC Science & Technology

    2012-04-14

    to buy weapon systems at a lower cost and higher quality by leveraging commercial technology. He also directed program managers (PMs) and... Managing Requirements for Acquisition Program Affordability by Colonel James O. Winbush, Jr. United States Army...2011 to 11-04-2012 4. TITLE AND SUBTITLE Managing Requirements for Acquisition Program Affordability 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

  17. 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…

  18. Section 8: Affordable Housing for Exceptional Families

    ERIC Educational Resources Information Center

    Wright, Wesley E.

    2009-01-01

    Shelter is a basic human need. Unfortunately, affordable housing is a need that low income families who are caring for children and adults with disabilities can rarely afford without assistance. Because participating families generally pay rent of no more than 30 percent of their adjusted monthly income, the Section 8 program can provide…

  19. 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

  20. 21 CFR 514.4 - Substantial evidence.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... effectiveness of the new animal drug involved that the new animal drug will have the effect it purports or is... substantial evidence, as defined in this section, that the combination new animal drug will have the effect it... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Substantial evidence. 514.4 Section 514.4 Food...

  1. 21 CFR 514.4 - Substantial evidence.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... effectiveness of the new animal drug involved that the new animal drug will have the effect it purports or is... substantial evidence, as defined in this section, that the combination new animal drug will have the effect it... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Substantial evidence. 514.4 Section 514.4 Food...

  2. 21 CFR 514.4 - Substantial evidence.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... effectiveness of the new animal drug involved that the new animal drug will have the effect it purports or is... substantial evidence, as defined in this section, that the combination new animal drug will have the effect it... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Substantial evidence. 514.4 Section 514.4 Food...

  3. 21 CFR 514.4 - Substantial evidence.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... effectiveness of the new animal drug involved that the new animal drug will have the effect it purports or is... substantial evidence, as defined in this section, that the combination new animal drug will have the effect it... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Substantial evidence. 514.4 Section 514.4 Food...

  4. 77 FR 39452 - Substantial Business Activities; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-03

    ... Internal Revenue Service 26 CFR Part 1 RIN 1545-BK85 Substantial Business Activities; Correction AGENCY..., June 12, 2012 (77 FR 34887) regarding whether a foreign corporation has substantial business activities... Advocacy of the Small Business Administration for comment on their impact on small business.'' LaNita...

  5. 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 ...

  6. Clinton Foundation - Home Energy Affordability Loan (HEAL)

    EPA Pesticide Factsheets

    Home Energy Affordability Loan (HEAL) provides the infrastructure that allows employers to offer Energy Upgrades in a turnkey manner. This document will breakdown the different models of HEAL, financing, etc.

  7. Modulation of visual attention by object affordance

    PubMed Central

    Garrido-Vásquez, Patricia; Schubö, Anna

    2014-01-01

    Some objects in our environment are strongly tied to motor actions, a phenomenon called object affordance. A cup, for example, affords us to reach out to it and grasp it by its handle. Studies indicate that merely viewing an affording object triggers motor activations in the brain. The present study investigated whether object affordance would also result in an attention bias, that is, whether observers would rather attend to graspable objects within reach compared to non-graspable but reachable objects or to graspable objects out of reach. To this end, we conducted a combined reaction time and motion tracking study with a table in a virtual three-dimensional space. Two objects were positioned on the table, one near, the other one far from the observer. In each trial, two graspable objects, two non-graspable objects, or a combination of both was presented. Participants were instructed to detect a probe appearing on one of the objects as quickly as possible. Detection times served as indirect measure of attention allocation. The motor association with the graspable object was additionally enhanced by having participants grasp a real object in some of the trials. We hypothesized that visual attention would be preferentially allocated to the near graspable object, which should be reflected in reduced reaction times in this condition. Our results confirm this assumption: probe detection was fastest at the graspable object at the near position compared to the far position or to a non-graspable object. A follow-up experiment revealed that in addition to object affordance per se, immediate graspability of an affording object may also influence this near-space advantage. Our results suggest that visuospatial attention is preferentially allocated to affording objects which are immediately graspable, and thus establish a strong link between an object’ s motor affordance and visual attention. PMID:24567725

  8. Nurse practitioner workforce: a substantial supply of primary care providers.

    PubMed

    Poghosyan, Lusine; Lucero, Robert; Rauch, Lindsay; Berkowitz, Bobbie

    2012-01-01

    For about 5 decades, nurse practitioners (NPs) have been utilized to deliver primary care, traditionally in underserved areas or to vulnerable populations. However, over the years, this workforce has experienced a steady growth and has expanded its reach to provide primary care in diverse settings. An additional 32 million patients will have access to primary care with full implementation of the Patient Protection and Affordable Care Act. It is unlikely that the scarce supply of primary care physicians will be able to properly meet the demand and the health care needs of the nation. NPs face challenges but practice, policy, and research recommendations for better utilizing NPs in primary care can mediate the workforce shortages and meet the demand for care.

  9. 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:

  10. 40 CFR 725.94 - Substantiation requirements.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...? How substantial would the harmful effects of disclosure be? What is the causal relationship between... information? What is the causal connection between the disclosure and harm? (7) If EPA disclosed to the public... factors facilitate or impede product analysis? (3) For each additional type of information claimed...

  11. Toward More Substantial Theories of Language Acquisition

    ERIC Educational Resources Information Center

    Jenson, Cinnamon Ann

    2015-01-01

    Cognitive linguists argue that certain sets of knowledge of language are innate. However, critics have argued that the theoretical concept of "innateness" should be eliminated since it is ambiguous and insubstantial. In response, I aim to strengthen theories of language acquisition and identify ways to make them more substantial. I…

  12. Substantially oxygen-free contact tube

    NASA Technical Reports Server (NTRS)

    Pike, James F. (Inventor)

    1993-01-01

    A device for arc welding is provided in which a continuously-fed electrode wire is in electrical contact with a contact tube. The contact tube is improved by using a substantially oxygen-free conductive alloy in order to reduce the amount of electrical erosion.

  13. 21 CFR 514.4 - Substantial evidence.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS NEW ANIMAL DRUG APPLICATIONS General Provisions § 514.4 Substantial evidence... adequate and well-controlled studies, such as a study in a target species, study in laboratory...

  14. Substantially Oxygen-Free Contact Tube

    NASA Technical Reports Server (NTRS)

    Pike, James F. (Inventor)

    1991-01-01

    A device for arc welding is provided in which a continuously-fed electrode wire is in electrical contact with a contact tube. The contact tube is improved by using a substantially oxygen-free conductive alloy in order to reduce the amount of electrical erosion.

  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. 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.

  18. Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain.

    PubMed

    Shartzer, Adele; Long, Sharon K; Anderson, Nathaniel

    2016-01-01

    There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults.

  19. 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.

  20. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  1. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  2. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  3. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  4. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...

  5. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  6. 12 CFR 1807.401 - Affordable housing-rental housing.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...

  7. 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…

  8. Substantiation of International Nanomaterials Security Group Creation

    NASA Astrophysics Data System (ADS)

    Sosnov, A.; Sadovnikov, S.; Panfilov, S.; Magarshak, Yu.

    Nanotechnology has achieved the status as one of the critical R&D area. Scientists use the unique properties of atomic and molecular assemblages built at the nanometer scale. The ability to manipulate the physical, chemical, and biological properties of molecules and particles affords to design agents with set up properties. But the technology allows creating not only useful agents. Possible accidental or deliberate creation of new nanoparticles (NPs) with dangerous properties is highly probable minor product of progress in the new area. The article briefly describes some pathways in development and implementation of NPs for medicinal and the similar purposes. Some of NPs can effective facilitate and mask transport of various agents in various environments. Possible creation of new dangerous NPs (e.g. conjugates based on combination of extensively use NPs and chemical, biological and radioactive agents) as well as creation of brand new NPs and nanodevices with unique properties needs creation of international multidiscipline community for security evaluation of nanomaterials and technologies. The community will forecast possible dangerous unexpectedness in the field of nanoscale materials and devices and suggests rational pathways for prevention of the threats.

  9. 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.

  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. 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…

  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. Housing Affordability And Children's Cognitive Achievement.

    PubMed

    Newman, Sandra; Holupka, C Scott

    2016-11-01

    Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant.

  14. 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.

  15. 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…

  16. Does Pluto have a substantial atmosphere

    SciTech Connect

    Trafton, L.

    1980-01-01

    The presence of CH4 ice on Pluto implies that Pluto may have a substantial atmosphere consisting of heavy gases. Without such an atmosphere, sublimation of the CH4 ice would be so rapid on a cosmogonic time scale that either such an atmosphere would soon develop through the exposure of gases trapped in the CH4 ice or else the surface CH4 ice would soon be all sublimated away as other, more stable, ices became exposed. If such stable ices were present from the beginning, the existence of CH4 frosts would also imply that Pluto's present atmosphere contains a remnant of its primordial atmosphere.

  17. Pathways in Learning to Teach Elementary Science: Navigating Contexts, Roles, Affordances and Constraints

    NASA Astrophysics Data System (ADS)

    Smith, Deborah C.; Jang, Shinho

    2011-12-01

    This case study of a fifth-year elementary intern's pathway in learning to teach science focused on her science methods course, placement science teaching, and reflections as a first-year teacher. We studied the sociocultural contexts within which the intern learned, their affordances and constraints, and participants' perspectives on their roles and responsibilities, and her learning. Semi-structured interviews were conducted with all participants. Audiotapes of the science methods class, videotapes of her science teaching, and field notes were collected. Data were transcribed and searched for affordances or constraints within contexts, perspectives on roles and responsibilities, and how views of her progress changed. Findings show the intern's substantial progress, the ways in which affordances sometimes became constraints, and participants' sometimes contradictory perspectives.

  18. Substantiating powder metal life methodologies for engines

    NASA Astrophysics Data System (ADS)

    Domas, P. A.

    1993-04-01

    The application of powder metal (PM) superalloys in aircraft turbine engine rotating components is prompted by performance driven high strength and creep resistance requirements. Fine grain, precipitation strengthened nickel-base alloys such as IN100, Rene'95, and Rene'88DT meet these requirements up to operating temperatures in the 1200-1300F (649-704C) range. In addition to burst and deformation limits, design constraints include durability (fatigue) and damage tolerance (crack growth resistance) capability to insure reliability and safety. Fatigue life for these alloys can be influenced by inhomogeneities (inclusions) intrinsic to the microstructure as the result of processing, and by perturbations of the surface integrity during component manufacture and subsequent usage. Understanding of PM fatigue behavior and substantiation of life assessment methodology must appropriately recognize these potential influences. New testing, modeling, and analysis schemes are necessitated in engineering development programs addressing generation and validation of life prediction techniques for these materials. This paper outlines one approach to substantiating PM fatigue life prediction that attempts to recognize homogeneous fatigue initiation by incorporating probabilistic models and development testing methods that address material volume and component feature effects. Complications and limitations being addressed in ongoing work are discussed.

  19. 78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-06

    ...This document proposes amendments to rules regarding coverage for certain preventive services under section 2713 of the Public Health Service Act, as 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 Public Health Service Act requires coverage without......

  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

    ... Protection and Affordable Care Act (ACA), Public Law 111-148, section 1251 provides that certain plans and... ACA grandfathered plan provision, requires a grandfathered health plan to include a statement in any... ] grandfathered health plan within the meaning of ACA section1251. To maintain its status as a...

  1. 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

  2. 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

  3. 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.

  4. 29 CFR 1990.145 - Consideration of substantial new issues or substantial new evidence.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., as well as a petition to consider “substantial new evidence”. (2) Contents. Each petition for... or an Advance Notice of Proposed Rulemaking; (v) A detailed statement and analysis as to why...

  5. 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.

  6. Information Dominance: Can We Afford It

    DTIC Science & Technology

    1997-03-01

    dominate all campaign areas such as air and fire superiority. This paper focuses on information warfare (IW) and its subset, information dominance (ID...the U.S. need information dominance , especially offensively, against second and third world countries, or should it put resources into active defense...Does the U.S. need defensive and offensive modes of information dominance ; can we afford both? Are we headed for information ’overkill’ to gain

  7. Affordability of medicines in the European Union

    PubMed Central

    Zaprutko, Tomasz; Kopciuch, Dorota; Kus, Krzysztof; Merks, Piotr; Nowicka, Monika; Augustyniak, Izabela; Nowakowska, Elżbieta

    2017-01-01

    Background Medications and their prices are key issues for healthcare. Although access to medicines at affordable prices had been specified as a key objective of the European Health Policy, it seems that these goals have not been achieved. Therefore, we attempted an evaluation of affordability of selected medicines at full prices. Methods The analysis concerned 2012 and was conducted between 2013 and 2015 in all the European Union (EU) countries divided into 3 groups depending on the date of their accession to the EU. Finally, we considered 9 originators used in the treatment of schizophrenia and multiple sclerosis. Information on drug prices were collected from pharmacies. Participation in the study was voluntary and anonymous in order to avoid accusations of advertising. To evaluate affordability, several factors were used (e.g. minimum earnings and Gini coefficient). Due to unavailability in some countries, the exact number of analyzed medicines varies. Results Drug prices vary significantly between EU Member States. Almost eleven fold difference was observed between Germany (EUR 1451.17) and Croatia (EUR 132.77) in relation to Interferone beta-1a 22 μg. Generally, prices were the highest in Germany. The cheapest drugs were found in various countries but never in the poorest ones like Bulgaria or Romania. Discrepancies in wages were observed too (the smallest minimum wage was EUR 138.00 in Bulgaria and the highest EUR 1801.00 in Luxembourg). Full price of olanzapine 5mg, however, was higher in Bulgaria (EUR 64.53) than, for instance, in Belgium (EUR 37.26). Conclusions Analyzed medications are still unaffordable for many citizens of the EU. Besides, access to medicines is also impaired e.g. due to parallel trade. Unaffordability of medications may lead to the patients’ non-compliance and therefore to increased direct and indirect costs of treatment. Common European solutions are needed to achieve a real affordability and accessibility of medications. PMID

  8. 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:

  9. Substantial bulk photovoltaic effect enhancement via nanolayering

    PubMed Central

    Wang, Fenggong; Young, Steve M.; Zheng, Fan; Grinberg, Ilya; Rappe, Andrew M.

    2016-01-01

    Spontaneous polarization and inversion symmetry breaking in ferroelectric materials lead to their use as photovoltaic devices. However, further advancement of their applications are hindered by the paucity of ways of reducing bandgaps and enhancing photocurrent. By unravelling the correlation between ferroelectric materials' responses to solar irradiation and their local structure and electric polarization landscapes, here we show from first principles that substantial bulk photovoltaic effect enhancement can be achieved by nanolayering PbTiO3 with nickel ions and oxygen vacancies ((PbNiO2)x(PbTiO3)1−x). The enhancement of the total photocurrent for different spacings between the Ni-containing layers can be as high as 43 times due to a smaller bandgap and photocurrent direction alignment for all absorption energies. This is due to the electrostatic effect that arises from nanolayering. This opens up the possibility for control of the bulk photovoltaic effect in ferroelectric materials by nanoscale engineering of their structure and composition. PMID:26791545

  10. Early childhood investments substantially boost adult health.

    PubMed

    Campbell, Frances; Conti, Gabriella; Heckman, James J; Moon, Seong Hyeok; Pinto, Rodrigo; Pungello, Elizabeth; Pan, Yi

    2014-03-28

    High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.

  11. Substantial bulk photovoltaic effect enhancement via nanolayering

    DOE PAGES

    Wang, Fenggong; Young, Steve M.; Zheng, Fan; ...

    2016-01-21

    Spontaneous polarization and inversion symmetry breaking in ferroelectric materials lead to their use as photovoltaic devices. However, further advancement of their applications are hindered by the paucity of ways of reducing bandgaps and enhancing photocurrent. By unravelling the correlation between ferroelectric materials’ responses to solar irradiation and their local structure and electric polarization landscapes, here we show from first principles that substantial bulk photovoltaic effect enhancement can be achieved by nanolayering PbTiO3 with nickel ions and oxygen vacancies ((PbNiO2)x(PbTiO3)1–x). The enhancement of the total photocurrent for different spacings between the Ni-containing layers can be as high as 43 times duemore » to a smaller bandgap and photocurrent direction alignment for all absorption energies. This is due to the electrostatic effect that arises from nanolayering. Lastly, this opens up the possibility for control of the bulk photovoltaic effect in ferroelectric materials by nanoscale engineering of their structure and composition.« less

  12. Substantial nitrogen pollution embedded in international trade

    NASA Astrophysics Data System (ADS)

    Oita, Azusa; Malik, Arunima; Kanemoto, Keiichiro; Geschke, Arne; Nishijima, Shota; Lenzen, Manfred

    2016-02-01

    Anthropogenic emissions of reactive nitrogen to the atmosphere and water bodies can damage human health and ecosystems. As a measure of a nation’s contribution to this potential damage, a country’s nitrogen footprint has been defined as the quantity of reactive nitrogen emitted during the production, consumption and transportation of commodities consumed within that country, whether those commodities are produced domestically or internationally. Here we use global emissions databases, a global nitrogen cycle model, and a global input-output database of domestic and international trade to calculate the nitrogen footprints for 188 countries as the sum of emissions of ammonia, nitrogen oxides and nitrous oxide to the atmosphere, and of nitrogen potentially exportable to water bodies. Per-capita footprints range from under 7 kg N yr-1 in some developing countries to over 100 kg N yr-1 in some wealthy nations. Consumption in China, India, the United States and Brazil is responsible for 46% of global emissions. Roughly a quarter of the global nitrogen footprint is from commodities that were traded across country borders. The main net exporters have significant agricultural, food and textile exports, and are often developing countries, whereas important net importers are almost exclusively developed economies. We conclude that substantial local nitrogen pollution is driven by demand from consumers in other countries.

  13. Substantial global carbon uptake by cement carbonation

    NASA Astrophysics Data System (ADS)

    Xi, Fengming; Davis, Steven J.; Ciais, Philippe; Crawford-Brown, Douglas; Guan, Dabo; Pade, Claus; Shi, Tiemao; Syddall, Mark; Lv, Jie; Ji, Lanzhu; Bing, Longfei; Wang, Jiaoyue; Wei, Wei; Yang, Keun-Hyeok; Lagerblad, Björn; Galan, Isabel; Andrade, Carmen; Zhang, Ying; Liu, Zhu

    2016-12-01

    Calcination of carbonate rocks during the manufacture of cement produced 5% of global CO2 emissions from all industrial process and fossil-fuel combustion in 2013. Considerable attention has been paid to quantifying these industrial process emissions from cement production, but the natural reversal of the process--carbonation--has received little attention in carbon cycle studies. Here, we use new and existing data on cement materials during cement service life, demolition, and secondary use of concrete waste to estimate regional and global CO2 uptake between 1930 and 2013 using an analytical model describing carbonation chemistry. We find that carbonation of cement materials over their life cycle represents a large and growing net sink of CO2, increasing from 0.10 GtC yr-1 in 1998 to 0.25 GtC yr-1 in 2013. In total, we estimate that a cumulative amount of 4.5 GtC has been sequestered in carbonating cement materials from 1930 to 2013, offsetting 43% of the CO2 emissions from production of cement over the same period, not including emissions associated with fossil use during cement production. We conclude that carbonation of cement products represents a substantial carbon sink that is not currently considered in emissions inventories.

  14. Substantial bulk photovoltaic effect enhancement via nanolayering.

    PubMed

    Wang, Fenggong; Young, Steve M; Zheng, Fan; Grinberg, Ilya; Rappe, Andrew M

    2016-01-21

    Spontaneous polarization and inversion symmetry breaking in ferroelectric materials lead to their use as photovoltaic devices. However, further advancement of their applications are hindered by the paucity of ways of reducing bandgaps and enhancing photocurrent. By unravelling the correlation between ferroelectric materials' responses to solar irradiation and their local structure and electric polarization landscapes, here we show from first principles that substantial bulk photovoltaic effect enhancement can be achieved by nanolayering PbTiO3 with nickel ions and oxygen vacancies ((PbNiO2)x(PbTiO3)(1-x)). The enhancement of the total photocurrent for different spacings between the Ni-containing layers can be as high as 43 times due to a smaller bandgap and photocurrent direction alignment for all absorption energies. This is due to the electrostatic effect that arises from nanolayering. This opens up the possibility for control of the bulk photovoltaic effect in ferroelectric materials by nanoscale engineering of their structure and composition.

  15. Substantial bulk photovoltaic effect enhancement via nanolayering

    SciTech Connect

    Wang, Fenggong; Young, Steve M.; Zheng, Fan; Grinberg, Ilya; Rappe, Andrew M.

    2016-01-21

    Spontaneous polarization and inversion symmetry breaking in ferroelectric materials lead to their use as photovoltaic devices. However, further advancement of their applications are hindered by the paucity of ways of reducing bandgaps and enhancing photocurrent. By unravelling the correlation between ferroelectric materials’ responses to solar irradiation and their local structure and electric polarization landscapes, here we show from first principles that substantial bulk photovoltaic effect enhancement can be achieved by nanolayering PbTiO3 with nickel ions and oxygen vacancies ((PbNiO2)x(PbTiO3)1–x). The enhancement of the total photocurrent for different spacings between the Ni-containing layers can be as high as 43 times due to a smaller bandgap and photocurrent direction alignment for all absorption energies. This is due to the electrostatic effect that arises from nanolayering. Lastly, this opens up the possibility for control of the bulk photovoltaic effect in ferroelectric materials by nanoscale engineering of their structure and composition.

  16. Global cancer surgery: delivering safe, affordable, and timely cancer surgery.

    PubMed

    Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie

    2015-09-01

    Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.

  17. 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

  18. Technologies for affordable access to space

    NASA Technical Reports Server (NTRS)

    Colladay, R. S.; Sadin, S. R.

    1986-01-01

    NASA plans for advanced research and technology programs aimed at reducing operating costs and extending the capability of future space systems are described. The evolution of an almost entirely space-based mode is discussed, including the role of earth launch, servicing, fabrication and assembly and communications. The development of technology for affordable access to space is examined, taking into account progress in the areas of telerobotics, machine autonomy, human autonomy, space-based manufacturing and construction, electric power, and space-based propulsion.

  19. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  20. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...

  1. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...

  2. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  3. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...

  4. 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... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...

  5. 12 CFR 1291.12 - Affordable Housing Reserve Fund.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...

  6. 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...

  7. 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...

  8. Pharmaceutical pricing: a review of proposals to improve access and affordability of prescription drugs.

    PubMed

    Tironi, Paula

    2010-01-01

    This article discusses how pharmaceutical innovation achieves remarkable improvements in human health but a significant portion of the U.S. population cannot afford prescription drugs. The author examines ways that patent protection, generics, supply chain complexity, and the cost of innovation and promotion affect access and affordability. The author then looks at the influences of marketing strategies and industry trends such as the patent cliff and pipeline for new drugs, innovations in biotechnology and genomics, comparative effectiveness analysis, and payor and employer strategies on drug prices. An analysis of reform proposals in the context of industry trends suggests that promoting generic drug use and availability through education, prohibiting authorized generics, and restricting the practice of developing follow-on drugs and discontinuing the original formulations upon patent expiration could improve access and affordability most quickly and significantly.

  9. States in the Driver's Seat: Leveraging State Aid to Align Policies and Promote Access, Success, and Affordability

    ERIC Educational Resources Information Center

    Prescott, Brian T.; Longanecker, David A.

    2014-01-01

    With increasingly widespread calls to raise educational attainment levels without substantially growing public investment in higher education, policymakers and others have devoted growing attention to the role of financial aid programs in providing access to, promoting affordability for, and incentivizing success in college. Given relative levels…

  10. 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.

  11. Affordable access to care for the undocumented.

    PubMed

    Rosen, Dennis

    2014-09-01

    How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding. However, a recent analysis in California has found that the costs of expanding state-supported care to include undocumented immigrants would largely be offset by the increased state sales tax revenue paid by managed care organizations and by reduced spending at the county level on emergency-room and hospital care of the uninsured.

  12. 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.

  13. 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…

  14. 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

  15. Critical Care Implications of the Affordable Care Act

    PubMed Central

    Dogra, Anjali P.; Dorman, Todd

    2015-01-01

    Objectives To provide an overview of key elements of the Affordable Care Act (ACA). To evaluate ways in which the ACA will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the ACA. Data Sources and Synthesis Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office (CBO). As all of the ACA's provisions will not be fully implemented until 2019, we also drew upon cost, population and utilization projections as well as the experience of existing state-based healthcare reforms. Conclusion The ACA represents the furthest reaching regulatory changes in the US healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The ACA aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the ACA outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-ACA era. PMID:26565630

  16. 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

  17. 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.

  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.

  19. Affordable Hybrid Heat Pump Clothes Dryer

    SciTech Connect

    TeGrotenhuis, Ward E.; Butterfield, Andrew; Caldwell, Dustin D.; Crook, Alexander

    2016-06-30

    This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project’s efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. A New Measure of Medication Affordability

    PubMed Central

    BRIESACHER, BECKY; ROSS-DEGNAN, DENNIS; ADAMS, ALYCE; WAGNER, ANITA; GURWITZ, JERRY; SOUMERAI, STEPHAN

    2010-01-01

    This study developed a new measure of medication affordability that examines out-of-pocket drug expenses relative to available household resources. The authors assessed the spending patterns of ~2.1 million poor households (≤100% federal poverty level) of adults aged 51 and older by Medicaid status. The data were drawn from the 2000–2001 Health and Retirement Study. Household spending was categorized into three broad types: basic living, health care, and discretionary. Older (aged 51 or older) poor households without Medicaid allocated about 72% of their total resources ($17,421, SE $783) to basic living needs. In comparison, those with Medicaid had scarcer total resources ($12,498, SE $423) and allocated 85% to basic living needs. Medication costs consumed the largest proportion of health care expenses for both types of poor households (Medicaid: $463, SE $67; non-Medicaid: $970, SE $102). After paying for basic living needs and health care costs, these families had, on average, only $16 left each week. Poor families have very few resources available for anything beyond basic living needs, even when they have Medicaid coverage. There is no great reservoir of discretionary funds to pay for increases in cost-sharing under Medicaid and Medicare Part D. PMID:19821195

  6. 24 CFR 907.3 - Bases for substantial default.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Bases for substantial default. 907.3 Section 907.3 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT... DEVELOPMENT SUBSTANTIAL DEFAULT BY A PUBLIC HOUSING AGENCY § 907.3 Bases for substantial default....

  7. 24 CFR 907.3 - Bases for substantial default.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Bases for substantial default. 907.3 Section 907.3 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT... DEVELOPMENT SUBSTANTIAL DEFAULT BY A PUBLIC HOUSING AGENCY § 907.3 Bases for substantial default....

  8. 24 CFR 907.3 - Bases for substantial default.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Bases for substantial default. 907.3 Section 907.3 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT... DEVELOPMENT SUBSTANTIAL DEFAULT BY A PUBLIC HOUSING AGENCY § 907.3 Bases for substantial default....

  9. 24 CFR 907.3 - Bases for substantial default.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Bases for substantial default. 907.3 Section 907.3 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT... DEVELOPMENT SUBSTANTIAL DEFAULT BY A PUBLIC HOUSING AGENCY § 907.3 Bases for substantial default....

  10. 19 CFR 10.7 - Substantial containers or holders.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Substantial containers or holders. 10.7 Section 10... Exported and Returned § 10.7 Substantial containers or holders. (a) Substantial containers or holders... domestic products exported and returned. When such containers or holders are imported not containing...

  11. 29 CFR 825.218 - Substantial and grievous economic injury.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Substantial and grievous economic injury. 825.218 Section... Medical Leave Act § 825.218 Substantial and grievous economic injury. (a) In order to deny restoration to... cause “substantial and grievous economic injury” to the operations of the employer, not whether...

  12. 45 CFR 1355.34 - Criteria for determining substantial conformity.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Criteria for determining substantial conformity... GENERAL § 1355.34 Criteria for determining substantial conformity. (a) Criteria to be satisfied. ACF will determine a State's substantial conformity with title IV-B and title IV-E State plan requirements based...

  13. 29 CFR 825.218 - Substantial and grievous economic injury.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Substantial and grievous economic injury. 825.218 Section... Medical Leave Act § 825.218 Substantial and grievous economic injury. (a) In order to deny restoration to... cause substantial and grievous economic injury to the operations of the employer, not whether...

  14. 29 CFR 825.218 - Substantial and grievous economic injury.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Substantial and grievous economic injury. 825.218 Section... Medical Leave Act § 825.218 Substantial and grievous economic injury. (a) In order to deny restoration to... cause “substantial and grievous economic injury” to the operations of the employer, not whether...

  15. 29 CFR 825.218 - Substantial and grievous economic injury.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Substantial and grievous economic injury. 825.218 Section... Medical Leave Act § 825.218 Substantial and grievous economic injury. (a) In order to deny restoration to... cause “substantial and grievous economic injury” to the operations of the employer, not whether...

  16. To Copy-Protect or Not to Copy-Protect?

    ERIC Educational Resources Information Center

    Sacks, Jonathan

    1985-01-01

    Discusses the issues of software piracy, why people illegally copy software, protection afforded software developers by copyright laws, and current and future methods of disk-based protection built into software by developers and the problems these methods have created. (MBR)

  17. 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

  18. 76 FR 37636 - Substantial Product Hazard List: Hand-Supported Hair Dryers

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... COMMISSION 16 CFR Part 1120 Substantial Product Hazard List: Hand-Supported Hair Dryers AGENCY: U.S. Consumer... are issuing a final rule to determine that any hand-supported hair dryer without integral immersion... appliances, including hand-supported hair dryers. The current immersion protection provisions have been...

  19. 10 CFR 140.85 - Criterion II-Substantial damages to persons offsite or property offsite.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 2 2012-01-01 2012-01-01 false Criterion II-Substantial damages to persons offsite or property offsite. 140.85 Section 140.85 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FINANCIAL PROTECTION REQUIREMENTS AND INDEMNITY AGREEMENTS Extraordinary Nuclear Occurrences § 140.85 Criterion...

  20. 10 CFR 140.85 - Criterion II-Substantial damages to persons offsite or property offsite.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 2 2010-01-01 2010-01-01 false Criterion II-Substantial damages to persons offsite or property offsite. 140.85 Section 140.85 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) FINANCIAL... practical to restore to use, (4) Financial loss resulting from protective actions appropriate to reduce...

  1. 32 CFR 48.302 - Substantiating evidence regarding dependency and age of dependents.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 1 2013-07-01 2013-07-01 false Substantiating evidence regarding dependency and age of dependents. 48.302 Section 48.302 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION...

  2. 32 CFR 48.302 - Substantiating evidence regarding dependency and age of dependents.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 1 2012-07-01 2012-07-01 false Substantiating evidence regarding dependency and age of dependents. 48.302 Section 48.302 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION...

  3. 32 CFR 48.302 - Substantiating evidence regarding dependency and age of dependents.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 1 2014-07-01 2014-07-01 false Substantiating evidence regarding dependency and age of dependents. 48.302 Section 48.302 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION...

  4. 32 CFR 48.302 - Substantiating evidence regarding dependency and age of dependents.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 1 2011-07-01 2011-07-01 false Substantiating evidence regarding dependency and age of dependents. 48.302 Section 48.302 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION...

  5. 32 CFR 48.302 - Substantiating evidence regarding dependency and age of dependents.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 32 National Defense 1 2010-07-01 2010-07-01 false Substantiating evidence regarding dependency and age of dependents. 48.302 Section 48.302 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN RETIRED SERVICEMAN'S FAMILY PROTECTION...

  6. An Exploratory Study of Drug-Exposed Infants: Case Substantiation and Subsequent Child Maltreatment

    ERIC Educational Resources Information Center

    Sun, An-Pyng; Freese, Margaret P.; Fitzgerald, Mark

    2007-01-01

    This study explores factors related to drug-exposed infants' case substantiation and subsequent child maltreatment. Child protective services computerized administrative data (from January 1998 to October 2001) were obtained from an urban Nevada county. The data included 457 drug-exposed infant cases. Chi-square, t-test, one-way ANOVA, and…

  7. 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

  8. Affordable WDM components: the polymer solution

    NASA Astrophysics Data System (ADS)

    Eldada, Louay A.; Yin, Shing; Norwood, Robert A.; Yardley, James T.

    1998-02-01

    An advanced polymeric waveguide technology was developed for affordable WDM components that address the needs of both the Telecom and the Datacom industries. We engineered high- performance organic polymers that can be readily made into both multimode and single-mode optical waveguide structures of controlled numerical aperture and geometry. These materials are formed from highly-crosslinked acrylate monomers with specific linkages that determine properties such as flexibility, toughness, loss, and environmental stability. These monomers are intermiscible, providing for precise adjustment of the refractive index from 1.3 to 1.6. In polymer form, they exhibit state-of-the-art loss values, high thermal stability, high humidity resistance, low dispersion and low birefringence. Waveguides are formed photolithographically, with the liquid monomer mixture polymerizing upon illumination in the UV via either mask exposure or laser direct writing. A wide range of rigid and flexible substrates can be used, including glass, quartz, oxidized silicon, glass-filled epoxy printed circuit board substrate, and flexible polyimide film. Waveguiding structures measuring tens of inches in length can be produced on computer boards, and guides that are meters long can be printed on rolls of plastic. We describe the fabrication of both Bragg gratings and waveguide grating routes in our polymers for filtering and demultiplexing applications in Telecom WDM systems. In Datacom, we describe polymeric components that we produced for aerospace WDM sensor systems. The importance of CAD tools in designing WDM devices is emphasized in this work. We further discuss the low-cost manufacturing of WDM components in an industrial environment.

  9. 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.

  10. 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…

  11. 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…

  12. 12 CFR 1282.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Special Affordable Housing Goal. 1282.14 Section 1282.14 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.14 Special Affordable Housing Goal. (a) Purpose of the...

  13. 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…

  14. Affordability Tradeoffs Under Uncertainty Using Epoch-Era Analysis

    DTIC Science & Technology

    2013-09-30

    exploration and change-related “ilities.” Dr. Ross holds a dual A.B. in Physics and Astronomy and Astrophysics from Harvard University, S.M. in Aeronautics...1  Introduction of Affordability in Defense Acquisition................................................. 2  Recent Definitions of Affordability...20  Introduction and Background ............................................................................... 20  Application

  15. What Are the Affordances of Information and Communication Technologies?

    ERIC Educational Resources Information Center

    Conole, Grainne; Dyke, Martin

    2004-01-01

    The paper examines the notion that Information and Communication Technologies (ICT) have affordances that epitomize the features of our late modern age (Giddens, 1991) and explores whether these affordances (Salomon, 1993, p. 51) can be used to facilitate particular approaches to educational practice. It argues that a clear articulation of these…

  16. 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…

  17. Tumor necrosis factor plays a protective role in experimental murine cutaneous leishmaniasis

    PubMed Central

    1989-01-01

    The ability of mice to resist infection with L. major correlated directly with the capacity of their LNC to produce TNF in response to in vitro parasite challenge. Blocking TNF in vivo by passively administering anti-TNF antibodies exacerbated the course of L. major infection, resulting in substantially larger cutaneous lesions and elevated numbers of parasites within those lesions. In addition, treatment of infected mice with exogenous rHuTNF afforded host protection as evidenced by smaller lesion size and decreased parasite counts. Taken together, these results suggest a central role for TNF in resistance to L. major. PMID:2584936

  18. Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.

    PubMed

    Oberlander, Jonathan

    2016-08-01

    The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA.

  19. 10 CFR 840.4 - Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite. 840.4 Section 840.4 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.4 Criterion I—Substantial discharge of radioactive material...

  20. 10 CFR 840.4 - Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite. 840.4 Section 840.4 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.4 Criterion I—Substantial discharge of radioactive material...

  1. 10 CFR 840.4 - Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite. 840.4 Section 840.4 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.4 Criterion I—Substantial discharge of radioactive material...

  2. 10 CFR 840.4 - Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite. 840.4 Section 840.4 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.4 Criterion I—Substantial discharge of radioactive material...

  3. 10 CFR 840.4 - Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Criterion I-Substantial discharge of radioactive material or substantial radiation levels offsite. 840.4 Section 840.4 Energy DEPARTMENT OF ENERGY EXTRAORDINARY NUCLEAR OCCURRENCES § 840.4 Criterion I—Substantial discharge of radioactive material...

  4. Embodied Perception: A Proposal to Reconcile Affordance and Spatial Perception

    PubMed Central

    2015-01-01

    Proffitt's embodied approach to perception is deeply indebted to Gibson's ecological approach to visual perception, in particular the idea that the primary objects of perception are affordances or what the environment offers for action. Yet, rather than directly addressing affordance perception, most of the empirical work evaluating Proffitt's approach focuses on the perception of spatial properties of the environment. We propose that theoretical and empirical efforts should be directed toward an understanding of the relationship between affordance perception and spatial perception, keeping in mind that this relationship is nontrivial because affordance perception is dichotomous, whereas the perception of spatial properties is gradual. We argue that the perception of spatial properties of the environment is enslaved by affordance perception, most notably at the critical boundaries for action. To empirically scrutinize this proposition, and to solve issues raised regarding the validity of several empirical findings, we call for joint research efforts to further understanding of embodied perception.

  5. 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.

  6. On Medicaid and the Affordable Care Act in Connecticut

    PubMed Central

    Manthous, Constantine A.; Sofair, Andre N.

    2014-01-01

    Background: Medicaid is the federal program, administered by states, for health care for the poor. The Affordable Care Act (ACA) has added a large number of new recipients to this program. Hypothesis: Medicaid programs in some, if not many, states do not provide patients uniform access to subspecialty care guaranteed by the federal statutes. Insofar as the ACA does not address this pre-existing “sub-specialty gap” and more patients are now covered by Medicaid under the ACA, the gap is likely to increase and may contribute to disparities of health care access and outcomes. Methods: A brief description of previous studies demonstrating or suggesting a subspecialty gap in Medicaid services is accompanied by perspectives of the authors, using published literature — most notably the Denver, Colorado health care system — to propose various solutions that may be deployed to address gaps in subspecialty coverage. Results: All published studies describing the Medicaid subspecialty gap are qualitative, survey designs. There are no authoritative objective data regarding the exact prevalence of gaps for each subspecialty in each state. However, surveys of caregivers suggest that gaps were prevalent in the United States prior to initiation of the ACA. Even fewer papers have addressed solutions (in light of the paucity of data describing the magnitude of the problem), and proposed solutions remain speculative and not grounded in objective data. Conclusions: There is reason to believe that a substantial proportion of U.S. citizens — those who are guaranteed a full complement of health services through Medicaid — have difficult or no access to some subspecialty services, many of which other citizens take for granted. This problem deserves greater attention to verify its existence, quantify its magnitude, and develop solutions. PMID:25506291

  7. 40 CFR 300.322 - Response to substantial threats to public health or welfare of the United States.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... public health or welfare of the United States. 300.322 Section 300.322 Protection of Environment... Removal § 300.322 Response to substantial threats to public health or welfare of the United States. (a) As... in a substantial threat to public health or welfare of the United States (including, but not...

  8. 40 CFR 300.322 - Response to substantial threats to public health or welfare of the United States.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... public health or welfare of the United States. 300.322 Section 300.322 Protection of Environment... Removal § 300.322 Response to substantial threats to public health or welfare of the United States. (a) As... in a substantial threat to public health or welfare of the United States (including, but not...

  9. 40 CFR 300.322 - Response to substantial threats to public health or welfare of the United States.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... public health or welfare of the United States. 300.322 Section 300.322 Protection of Environment... Removal § 300.322 Response to substantial threats to public health or welfare of the United States. (a) As... in a substantial threat to public health or welfare of the United States (including, but not...

  10. 40 CFR 300.322 - Response to substantial threats to public health or welfare of the United States.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... public health or welfare of the United States. 300.322 Section 300.322 Protection of Environment... Removal § 300.322 Response to substantial threats to public health or welfare of the United States. (a) As... in a substantial threat to public health or welfare of the United States (including, but not...

  11. 40 CFR 300.322 - Response to substantial threats to public health or welfare of the United States.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... public health or welfare of the United States. 300.322 Section 300.322 Protection of Environment... Removal § 300.322 Response to substantial threats to public health or welfare of the United States. (a) As... in a substantial threat to public health or welfare of the United States (including, but not...

  12. 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.

  13. Affordable Earth Observatories for Developing Countries

    NASA Astrophysics Data System (ADS)

    Meurer, R. H.

    Traditionally high cost has been the principal impediment to developing nations desiring to pursue space programs. More particularly, the benefits derivable from a space system have been less than adequate to justify the investment required. Chief among the causes has been the inability of the system to produce results with sufficient direct economic value to the peoples of their countries. Over the past 15 years, however, "the Microspace Revolution" has resulted in dramatic reductions in the cost of space systems, while at the same time technology has improved to provide greater capabilities in the smallest micro- and nano-class1 satellites. Because of these advances, it behooves developing nations to reevaluate space as an option for their national development. This paper summarizes two new micro-satellite concepts - NanoObservatoryTM and MicroObservatoryTM that offer the prom- ise of a dedicated Earth remote sensing capability at costs comparable to or less than simply buying data from the best known large systems, Landsat and SPOT. Each system is defined both by its observation capabilities and technical parameters of the system's design. Moreover, the systems are characterized in terms of the other potential benefits to developing economies, i.e., education of a technical workforce or applications of Earth imagery in solving national needs. Comparisons are provided with more traditional Earth observing satellites. NanoObservatoryTM is principally intended to serve as a developmental system to build general technical expertise space technology and Earth observation. MicroObservatoryTM takes the next step by focusing on a more sophisticated optical imag- ing camera while keeping the spacecraft systems simple and affordable. For both programs, AeroAstro is working with non- profit institutions to develop a corresponding program of technical participation with the nations that elect to pursue such programs. Dependent upon current capabilities, this might include

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. How Has the Affordable Care Act Affected Health Insurers' Financial Performance?

    PubMed

    Hall, Mark A; McCue, Michael J

    2016-07-01

    Starting in 2014, the Affordable Care Act transformed the market for individual health insurance by changing how insurance is sold and by subsidizing coverage for millions of new purchasers. Insurers, who had no previous experience under these market conditions, competed actively but faced uncertainty in how to price their products. This issue brief uses newly available data to understand how health insurers fared financially during the ACA's first year of full reforms. Overall, health insurers' financial performance began to show some strain in 2014, but the ACA's reinsurance program substantially buffered the negative effects for most insurers. Although a quarter of insurers did substantially worse than others, experience under the new market rules could improve the accuracy of pricing decisions in subsequent years.

  19. The Constitution of the Human Embryo as Substantial Change

    PubMed Central

    Alvargonzález, David

    2016-01-01

    This paper analyzes the transformation from the human zygote to the implanted embryo under the prism of substantial change. After a brief introduction, it vindicates the Aristotelian ideas of substance and accident, and those of substantial and accidental change. It then claims that the transformation from the multicelled zygote to the implanted embryo amounts to a substantial change. Pushing further, it contends that this substantial change cannot be explained following patterns of genetic reductionism, emergence, and self-organization, and proposes Gustavo Bueno’s idea of anamorphosis as a means to encapsulate criticism against such positions. PMID:26850033

  20. 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.

  1. 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.

  2. 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.

  3. 20 CFR 416.910 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....910 Section 416.910 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determining Disability and Blindness Definition of Disability § 416.910 Meaning of substantial gainful activity. Substantial gainful activity means work that—...

  4. 20 CFR 655.183 - Less than substantial violations.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Less than substantial violations. 655.183... Employment in the United States (H-2A Workers) Integrity Measures § 655.183 Less than substantial violations. (a) Requirement of special procedures. If the OFLC Administrator determines that a less...

  5. 5 CFR 550.183 - Substantial hours requirement.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement....

  6. 5 CFR 550.183 - Substantial hours requirement.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement....

  7. 5 CFR 550.183 - Substantial hours requirement.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement....

  8. 5 CFR 550.183 - Substantial hours requirement.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement....

  9. 5 CFR 550.183 - Substantial hours requirement.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Substantial hours requirement. 550.183 Section 550.183 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION (GENERAL) Premium Pay Law Enforcement Availability Pay § 550.183 Substantial hours requirement....

  10. 26 CFR 1.528-4 - Substantiality test.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 7 2014-04-01 2013-04-01 true Substantiality test. 1.528-4 Section 1.528-4 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Homeowners Associations § 1.528-4 Substantiality test. (a) In general. In...

  11. 20 CFR 604.6 - Conformity and substantial compliance.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Conformity and substantial compliance. 604.6... FOR ELIGIBILITY FOR UNEMPLOYMENT COMPENSATION § 604.6 Conformity and substantial compliance. (a) In... for the administration of its UC program. (b) Resolving Issues of Conformity and...

  12. 29 CFR 825.218 - Substantial and grievous economic injury.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... cause substantial and grievous economic injury to the operations of the employer, not whether the absence of the employee will cause such substantial and grievous injury. (b) An employer may take into... words, the effect on the operations of the company of reinstating the employee in an equivalent...

  13. 20 CFR 604.6 - Conformity and substantial compliance.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Conformity and substantial compliance. 604.6... FOR ELIGIBILITY FOR UNEMPLOYMENT COMPENSATION § 604.6 Conformity and substantial compliance. (a) In... for the administration of its UC program. (b) Resolving Issues of Conformity and...

  14. 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

  15. Reducing costs in aircraft: The metals affordability initiative consortium

    NASA Astrophysics Data System (ADS)

    Martin, Rick; Evans, Daniel

    2000-03-01

    Emerging metallic materials, processing, and manufacturing technologies offer an important opportunity to meet current aircraft-airframe and jet-engine affordability goals, due to their inherent low material costs and excellent producibility characteristics. But to successfully meet systems goals within this new affordability-driven scenario, a consolidation ofindustry and military-agency development resources and technology-implementation activities is necessary to positively impact the military-aircraft production and sustainment infrastructure. To address this need, a consortium of aircraft and engine manufacturers and key material-and engine manufacturers and key material-and component-supplier companies has been formed to identify critical affordable metal technologies, develop a strategic roadmap for accelerated development and insertion of these technologies, and oversee execution of development activities by integrated industry teams. the goal of the Metals Affordability Initiative is to reduce the cost of metallic components by 50 percent while accelerating the implementation time.

  16. 47 CFR 73.9008 - Interim approval of authorized digital output protection technologies and authorized recording...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... information: (1) A general description of how the digital output protection technology or recording method... digital output protection technology or recording method affords content; (3) Information regarding... information to evaluate the appropriateness of the underlying digital output protection technology...

  17. 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.

  18. 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.

  19. Center pivot, showing substantial beams that support the trusses. Looking ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Center pivot, showing substantial beams that support the trusses. Looking north from civilian land. - Naval Supply Annex Stockton, Daggett Road Bridge, Daggett Road traversing Burns Cut Off, Stockton, San Joaquin County, CA

  20. Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries

    PubMed Central

    McLane, Hannah C.; Berkowitz, Aaron L.; Patenaude, Bryan N.; McKenzie, Erica D.; Wolper, Emma; Wahlster, Sarah; Fink, Günther

    2015-01-01

    Objective: To determine the availability, accessibility, and affordability of EEG, EMG, CSF analysis, head CT, and brain MRI for neurologic disorders across countries. Methods: An online, 60-question survey was distributed to neurology practitioners in 2014 to assess the presence, wait time, and cost of each test in private and public health sectors. Data were stratified by World Bank country income group. Affordability was calculated with reference to the World Health Organization's definition of catastrophic health expenditure as health-related out-of-pocket expenditure of >40% of disposable household income, and assessment of providers' perceptions of affordability to the patient. Results: Availability of EEG and EMG is correlated with higher World Bank income group (correlation coefficient 0.38, test for trend p = 0.046; 0.376, p = 0.043); CSF, CT, and MRI did not show statistically significant associations with income groups. Patients in public systems wait longer for neurodiagnostic tests, especially MRI, EEG, and urgent CT (p < 0.0001). The mean cost per test, across all tests, was lower in the public vs private sector (US $55.25 vs $214.62, p < 0.001). Each drop in World Bank income group is associated with a 29% decrease in the estimated share of the population who can afford a given test (95% confidence interval −33.4, 25.2; p < 0.001). In most low-income countries surveyed, only the top 10% or 20% of the population was able to afford tests below catastrophic levels. In surveyed lower-middle-income countries, >40% of the population, on average, could not afford neurodiagnostic tests. Conclusions: Neurodiagnostic tests are least affordable in the lowest income settings. Closing this “diagnostic gap” for countries with the lowest incomes is essential. PMID:26446063

  1. Object affordance and spatial-compatibility effects in Parkinson's disease.

    PubMed

    Galpin, Adam; Tipper, Steven P; Dick, Jeremy P R; Poliakoff, Ellen

    2011-03-01

    Movement in Parkinson's disease (PD) is strongly influenced by sensory stimuli. Here, we investigated two features of visual stimuli known to affect response times in healthy individuals; the spatial location of an object (the spatial effect) and its action-relevance (the 'affordance' effect). Poliakoff et al. (2007) found that while PD patients show normal spatial effects, they do not show an additional affordance effect. Here we investigated whether these effects are driven by facilitation or inhibition, and whether the affordance effect emerges over a longer time-course in PD. Participants (24 PD and 24 controls) viewed either a lateralised door handle (affordance condition), a lateralised abstract stimulus (spatial condition), or a centrally presented baseline stimulus (baseline condition), and responded to a colour change in the stimulus occurring after 0 msec, 500 msec or 1000 msec. The colour change indicated whether to respond with the left or right hand, which were either spatially compatible or incompatible with the lateralised stimulus orientation in the affordance and spatial conditions. The baseline condition allowed us to assess whether compatibility effects were driven by facilitation of the compatible response or inhibition of the incompatible response. The results indicate that stimulus orientation elicited faster responses from the nearest hand. For controls, the affordance effect was stronger and driven by facilitation, whilst the spatial condition was driven by inhibition. In contrast, the affordance and spatial-compatibility effects did not differ between conditions in the PD group and both were driven by facilitation. This suggests that the PD group responded as if all stimuli were action-relevant, and may have implications for understanding the cueing of movement in PD.

  2. 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.

  3. 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.

  4. 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.

  5. The ACA’s Cost-Sharing Reduction Plans: A Key to Affordable Health Coverage for Millions of U.S. Workers.

    PubMed

    Gabel, Jon; Whitmore, Heidi; Green, Matthew; Call, Adrienne; Stromberg, Sam; Oran, Rebecca

    2016-10-01

    Issue: Without the cost-sharing reductions (CSRs) made available by the Affordable Care Act, health plans sold in the marketplaces may be unaffordable for many low-income people. CSRs are available to households earning between 100 percent and 250 percent of the federal poverty level that choose a silver-level marketplace plan. In 2016, about 7 million people received cost-sharing reductions that substantially lowered their deductibles, copayments, coinsurance, and out-of-pocket limits. Goal: To examine variations in consumer cost-sharing reductions between silver-level plans with CSRs to traditional marketplace plans and to employer-based insurance. Methods: Data analysis of 1,209 CSR-eligible plans sold in individual marketplaces in all 50 states and Washington, D.C. Key findings and conclusions: Cost-sharing amounts in silver plans with CSRs are much less than those in non-CSR base silver plans; silver plans with CSRs generally offer far better financial protection than those without. General annual deductibles range from $246 for CSR silver plans with a platinum-level actuarial value (94%) to as much as $3,063 for non-CSR silver plans. Out-of-pocket limits vary from $6,223 in base silver plans to $1,102 in silver plans with CSRs and a platinum-level actuarial level.

  6. Assessment of the DARPA Affordable Polymer Matrix Composites Programs.

    DTIC Science & Technology

    1997-07-01

    and CATM Aft-aft center fuselage structure IATA PR500/IM7 plus CATB RTM bulkhead PR500/IM7 plus CATC 5ftx5ftx5ft wing section VARTM keelson Upper...Institute of Standards and Technology National Science Foundation OHC OPvNL OUSD(A&T) PMC R&D RaPat RAPTECH RTM S&T SAMPE SPF/DB TRP VARTM ...Affordability (IATA) ü-4 C. Cure-Form Processing ü-4 D. Rapid RTM Tooling Project (RaPat) II-6 E. Induction Hearing II-7 F. Affordable

  7. 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. !

  8. Rhythm as an affordance for the entrainment of movement.

    PubMed

    Cummins, Fred

    2009-01-01

    A general account of rhythm in human behaviour is provided, according to which rhythm inheres in the affordance that a signal provides for the entrainment of movement on the part of a perceiver. This generic account is supported by an explication of the central concepts of affordance and entrainment. When viewed in this light, rhythm appears as the correct explanandum to account for coordinated behaviour in a wide variety of situations, including such core senses as dance and the production of music. Speech may appear to be only marginally rhythmical under such an account, but several experimental studies reveal that speech, too, has the potential to entrain movement.

  9. Method of sealing an ultracapacitor substantially free of water

    DOEpatents

    Chapman-Irwin, Patricia; Feist, Thomas Paul

    2002-04-02

    A method of sealing an ultracapacitor substantially free of water is disclosed. The method includes providing a multilayer cell comprising two solid, non porous current collectors, separated by two porous electrodes with a separator between the two electrodes, sealing the cell with a reclosable hermetic closure. Water inside the closure is dissociated by an applied voltage to the cell and escapes in the form of hydrogen and oxygen when the closure is unmated, the closure is then mated to hermetically seal the cell which is substantially free of water.

  10. 40 CFR Appendix C to Part 112 - Substantial Harm Criteria

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL... Lakes. 1.1.4Rivers and Canals means a body of water confined within the inland area, including the... Operations Include Over-Water Transfers of Oil. A non-transportation-related facility with a total...

  11. 40 CFR Appendix C to Part 112 - Substantial Harm Criteria

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL... Lakes. 1.1.4Rivers and Canals means a body of water confined within the inland area, including the... Operations Include Over-Water Transfers of Oil. A non-transportation-related facility with a total...

  12. 40 CFR Appendix C to Part 112 - Substantial Harm Criteria

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL... Lakes. 1.1.4Rivers and Canals means a body of water confined within the inland area, including the... Operations Include Over-Water Transfers of Oil. A non-transportation-related facility with a total...

  13. 40 CFR Appendix C to Part 112 - Substantial Harm Criteria

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL... Lakes. 1.1.4Rivers and Canals means a body of water confined within the inland area, including the... Operations Include Over-Water Transfers of Oil. A non-transportation-related facility with a total...

  14. 40 CFR Appendix C to Part 112 - Substantial Harm Criteria

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... to Part 112 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS OIL... Lakes. 1.1.4Rivers and Canals means a body of water confined within the inland area, including the... Operations Include Over-Water Transfers of Oil. A non-transportation-related facility with a total...

  15. Boron-mediated sequential alkyne insertion and C-C coupling reactions affording extended π-conjugated molecules

    NASA Astrophysics Data System (ADS)

    Shoji, Yoshiaki; Tanaka, Naoki; Muranaka, Sho; Shigeno, Naoki; Sugiyama, Haruka; Takenouchi, Kumiko; Hajjaj, Fatin; Fukushima, Takanori

    2016-09-01

    C-C bond coupling reactions illustrate the wealth of organic transformations, which are usually mediated by organotransition metal complexes. Here, we show that a borafluorene with a B-Cl moiety can mediate sequential alkyne insertion (1,2-carboboration) and deborylation/Csp2-Csp2 coupling reactions, leading to aromatic molecules. The first step, which affords a borepin derivative, proceeds very efficiently between the borafluorene and various alkynes by simply mixing these two components. The second step is triggered by a one-electron oxidation of the borepin derivative, which results in the formation of a phenanthrene framework. When an excess amount of oxidant is used in the second step, the phenanthrene derivatives can be further transformed in situ to afford dibenzo[g,p]chrysene derivatives. The results presented herein will substantially expand the understanding of main group chemistry and provide a powerful synthetic tool for the construction of a wide variety of extended π-conjugated systems.

  16. 26 CFR 7.105-2 - Substantial gainful activity.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ..., institutional therapy or training, school attendance, clubs, social programs, and similar activities is not substantial gainful activity. However, the nature of the work performed may be evidence of ability to engage... the nature of the duties performed, may establish a taxpayer's ability to engage in...

  17. 20 CFR 404.1510 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Meaning of substantial gainful activity. 404.1510 Section 404.1510 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Definition of Disability §...

  18. 20 CFR 404.1510 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Meaning of substantial gainful activity. 404.1510 Section 404.1510 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Definition of Disability §...

  19. 20 CFR 404.1510 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Meaning of substantial gainful activity. 404.1510 Section 404.1510 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Definition of Disability §...

  20. 20 CFR 404.1510 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Meaning of substantial gainful activity. 404.1510 Section 404.1510 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Definition of Disability §...

  1. 20 CFR 404.1510 - Meaning of substantial gainful activity.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Meaning of substantial gainful activity. 404.1510 Section 404.1510 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determining Disability and Blindness Definition of Disability §...

  2. 19 CFR 134.35 - Articles substantially changed by manufacture.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... substantially changed by manufacture. (a) Articles other than goods of a NAFTA country. An article used in the...) Goods of a NAFTA country. A good of a NAFTA country which is to be processed in the United States in a manner that would result in the good becoming a good of the United States under the NAFTA Marking...

  3. 19 CFR 134.35 - Articles substantially changed by manufacture.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... substantially changed by manufacture. (a) Articles other than goods of a NAFTA country. An article used in the...) Goods of a NAFTA country. A good of a NAFTA country which is to be processed in the United States in a manner that would result in the good becoming a good of the United States under the NAFTA Marking...

  4. 19 CFR 134.35 - Articles substantially changed by manufacture.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... substantially changed by manufacture. (a) Articles other than goods of a NAFTA country. An article used in the...) Goods of a NAFTA country. A good of a NAFTA country which is to be processed in the United States in a manner that would result in the good becoming a good of the United States under the NAFTA Marking...

  5. 19 CFR 134.35 - Articles substantially changed by manufacture.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... substantially changed by manufacture. (a) Articles other than goods of a NAFTA country. An article used in the...) Goods of a NAFTA country. A good of a NAFTA country which is to be processed in the United States in a manner that would result in the good becoming a good of the United States under the NAFTA Marking...

  6. 19 CFR 134.35 - Articles substantially changed by manufacture.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... substantially changed by manufacture. (a) Articles other than goods of a NAFTA country. An article used in the...) Goods of a NAFTA country. A good of a NAFTA country which is to be processed in the United States in a manner that would result in the good becoming a good of the United States under the NAFTA Marking...

  7. 26 CFR 1.528-4 - Substantiality test.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... for an organization to be considered a condominium management association or a residential real estate... condominium management association and a residential real estate management association shall be considered... organization's taxable year. (b) Condominium management associations. Substantially all of the units of...

  8. 15 CFR 970.209 - Substantial compliance with application requirements.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.209 Substantial compliance with application requirements. (a... application requirements. 970.209 Section 970.209 Commerce and Foreign Trade Regulations Relating to...

  9. 15 CFR 970.209 - Substantial compliance with application requirements.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.209 Substantial compliance with application requirements. (a... application requirements. 970.209 Section 970.209 Commerce and Foreign Trade Regulations Relating to...

  10. 15 CFR 970.209 - Substantial compliance with application requirements.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.209 Substantial compliance with application requirements. (a... application requirements. 970.209 Section 970.209 Commerce and Foreign Trade Regulations Relating to...

  11. 15 CFR 970.209 - Substantial compliance with application requirements.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.209 Substantial compliance with application requirements. (a... application requirements. 970.209 Section 970.209 Commerce and Foreign Trade Regulations Relating to...

  12. 15 CFR 970.209 - Substantial compliance with application requirements.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... GENERAL REGULATIONS OF THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.209 Substantial compliance with application requirements. (a... application requirements. 970.209 Section 970.209 Commerce and Foreign Trade Regulations Relating to...

  13. 76 FR 737 - Tobacco Products, Exemptions From Substantial Equivalence Requirements

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-06

    ... adding or deleting a tobacco additive, or increasing or decreasing the quantity of an existing tobacco additive, from the requirement of demonstrating substantial equivalence if the Agency determines that: (1... implementing this provision by July 1, 2011. ``Additive'' is defined at section 900(1) of the FD&C Act,...

  14. 50 CFR 80.13 - Substantiality in character and design.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... objectives to be accomplished based on the stated need; (c) Utilizes accepted fish and wildlife conservation... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false Substantiality in character and design. 80.13 Section 80.13 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF...

  15. 29 CFR 4043.27 - Distribution to a substantial owner.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... the substantial owner's death; and (4) Immediately after the distribution, the plan has nonforfeitable...,000 for calendar year 1996). (2) Plan funding. Notice is waived if— (i) No variable rate premium. No variable rate premium is required to be paid for the plan for the event year; (ii) No unfunded...

  16. Mistreatment in Assisted Living Facilities: Complaints, Substantiations, and Risk Factors

    ERIC Educational Resources Information Center

    Phillips, Linda R.; Guo, Guifang

    2011-01-01

    Purpose of the Study: Use archived public data from Arizona to explore relationships among selected institutional and resident risk and situation-specific factors and complaints and substantiated allegations of various types of mistreatment in assisted living facilities (ALFs). Design and Methods: An exploratory/descriptive 2-group design was…

  17. 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...

  18. An affordance analysis of unconditioned lever pressing in rats and hamsters.

    PubMed

    Cabrera, Felipe; Sanabria, Federico; Jiménez, Ángel Andrés; Covarrubias, Pablo

    2013-01-01

    Two experiments were conducted to assess the effect of lever height on lever pressing that was not explicitly reinforced - i.e., operant-level responding. Two rodent species were used as subjects, rats (Experiment 1) and hamsters (Experiment 2), aiming to compare the behavioral support offered by one lever at various heights relative to the subjects' body size. Results showed that lever height had a substantial effect on response rate. The rate of lever pressing varied similarly for rats and hamsters as a function of lever height, when lever height was re-scaled relative to body size. The distribution of inter-response times showed that lever pressing was organized in bouts separated by pauses. This pattern of responding was accurately described in both experiments by a mixture of two exponential distributions. These findings support an analysis of affordances in non-human species.

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 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…

  5. 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…

  6. 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…

  7. 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...

  8. 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? 1000.101 Section 1000.101 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  9. 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... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14...

  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... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14...

  11. 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 DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...

  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. 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…

  14. 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…

  15. 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…

  16. 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...

  17. 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…

  18. 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…

  19. Ubiquitous Knowledge and Experiences to Foster EFL Learning Affordances

    ERIC Educational Resources Information Center

    García-Sánchez, Soraya; Luján-García, Carmen

    2016-01-01

    This article explores the implementation of experiential learning affordances to improve skills in English as a Foreign Language (EFL) in higher education. The administration of an online anonymous survey to 100 students of different undergraduate degrees presents current learning reflections from EFL students at the Universidad de Las Palmas de…

  20. 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.

  1. 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…

  2. 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.

  3. 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…

  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. 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.

  6. 24 CFR 81.14 - Special Affordable Housing Goal.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 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...

  7. Toward Affordability: Policy Recommendations for Virginia Higher Education

    ERIC Educational Resources Information Center

    State Council of Higher Education for Virginia, 2009

    2009-01-01

    In its 2007-13 strategic plan, Advancing Virginia: Access, Alignment, Investment, the State Council highlighted 12 strategic higher education initiatives that it believed were necessary to ensure Virginia's future. Key among these goals was improvement of the affordability of a college education in the Commonwealth. Recent events have reinforced…

  8. 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…

  9. 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…

  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. 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. PMID:27698991

  12. The present and future role of coastal wetland vegetation in protecting shorelines: Answering recent challenges to the paradigm

    USGS Publications Warehouse

    Gedan, Keryn B.; Kirwan, Matthew L.; Wolanski, Eric; Barbier, Edward B.; Silliman, Brian R.

    2011-01-01

    For more than a century, coastal wetlands have been recognized for their ability to stabilize shorelines and protect coastal communities. However, this paradigm has recently been called into question by small-scale experimental evidence. Here, we conduct a literature review and a small meta-analysis of wave attenuation data, and we find overwhelming evidence in support of established theory. Our review suggests that mangrove and salt marsh vegetation afford context-dependent protection from erosion, storm surge, and potentially small tsunami waves. In biophysical models, field tests, and natural experiments, the presence of wetlands reduces wave heights, property damage, and human deaths. Meta-analysis of wave attenuation by vegetated and unvegetated wetland sites highlights the critical role of vegetation in attenuating waves. Although we find coastal wetland vegetation to be an effective shoreline buffer, wetlands cannot protect shorelines in all locations or scenarios; indeed large-scale regional erosion, river meandering, and large tsunami waves and storm surges can overwhelm the attenuation effect of vegetation. However, due to a nonlinear relationship between wave attenuation and wetland size, even small wetlands afford substantial protection from waves. Combining man-made structures with wetlands in ways that mimic nature is likely to increase coastal protection. Oyster domes, for example, can be used in combination with natural wetlands to protect shorelines and restore critical fishery habitat. Finally, coastal wetland vegetation modifies shorelines in ways (e.g. peat accretion) that increase shoreline integrity over long timescales and thus provides a lasting coastal adaptation measure that can protect shorelines against accelerated sea level rise and more frequent storm inundation. We conclude that the shoreline protection paradigm still stands, but that gaps remain in our knowledge about the mechanistic and context-dependent aspects of shoreline

  13. Intergenerational transmission of child abuse and neglect: Do maltreatment type, perpetrator, and substantiation status matter?

    PubMed

    Bartlett, Jessica Dym; Kotake, Chie; Fauth, Rebecca; Easterbrooks, M Ann

    2017-01-01

    A maternal history of childhood maltreatment is thought to be a potent risk factor for child abuse and neglect, yet the extent of continuity across generations is unclear, with studies reporting vastly different rates of intergenerational transmission. Disparate findings may be due to lack of attention to the nature of maltreatment experiences in each generation. We sought to expand the current literature by examining the role of maltreatment type, perpetrator identity, and substantiation status of reports to child protective services (CPS) on intergenerational maltreatment among adolescent mothers (n=417) and their children. We found that when mothers had at least one report of childhood maltreatment (substantiated or not), the odds that they maltreated their children increased by 72% (OR=2.52), compared to mothers who are not maltreated, but the odds were considerably lower when we limited analysis to substantiated reports. Both a maternal history of substantiated neglect and multiple type maltreatment (neglect and physical or sexual abuse) were associated with increased risk of child maltreatment, yet the likelihood of children experiencing multiple maltreatment perpetrated with their mothers identified as perpetrators increased over 300% when mothers had a childhood history of multiple maltreatment.

  14. 24 CFR 5.2005 - VAWA protections.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...

  15. 24 CFR 5.2005 - VAWA protections.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...

  16. 24 CFR 5.2005 - VAWA protections.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...

  17. 24 CFR 5.2005 - VAWA protections.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...

  18. 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...

  19. Substantial Life Extension and the Fair Distribution of Healthspans.

    PubMed

    Wareham, Christopher S

    2016-10-01

    One of the strongest objections to the development and use of substantially life-extending interventions is that they would exacerbate existing unjust disparities of healthy lifespans between rich and poor members of society. In both popular opinion and ethical theory, this consequence is sometimes thought to justify a ban on life-prolonging technologies. However, the practical and ethical drawbacks of banning receive little attention, and the viability of alternative policies is seldom considered. Moreover, where ethicists do propose alternatives, there is scant effort to consider their merits in light of developing world priorities. In response to these shortcomings, I distinguish four policy options and, on the basis of a plausible intuition about fairness, evaluate their implications for a fair distribution of healthy lifespans. I claim that even in developing nations it would be fairest to favor policies that promote equal access to at least one promising category of substantially life-extending intervention: calorie restriction mimetics.

  20. Patients' substantialization of disease, the hybrid symptom and metaphysical care.

    PubMed

    Pârvan, Alexandra

    2015-06-01

    In the context of current scholarship concerned with facilitating integration between the biomedical and the patient-centred models of care, the article suggests that disease brings about an ontological disruption in patients, which is not directly addressed in either model, and may interfere with treatment and therapy outcomes if not met with a type of care termed here as 'metaphysical'. The receipt of diagnosis and medical care can give patients the sense that they are ontologically diminished, or less of a human, and along with physicians' approaches to and discourses about disease, may prompt them to seek ontological restoration or security in the same way as psychologically traumatized patients sometimes do: by treating the disease and/or the experience of harm associated with it as a thing that exists per se. I call this 'substantialization' of disease (or harm) and draw on Augustine's theory of non-substantial deficiencies (physiological and moral) and on Plato's and Plotinus's different takes on such defects in order to discuss what substantialization can do for patients. Based on literature that examines patients' ways of talking about and living with their disease, I speculate that substantialization can generate a 'hybrid symptom', consisting in patterns of exercising agency which may predispose to non-adherence. Ways in which physicians could provide metaphysical care are proposed, along with an understanding of chronic patients as hybrid ontological and agentic units, which draws on theories of enactive cognition. I opine that metaphysical care may facilitate integration between the depersonalized and personalized models of care.

  1. Tobacco products, exemptions from substantial equivalence requirements. Final rule.

    PubMed

    2011-07-05

    The Food and Drug Administration (FDA) is issuing this final rule to establish procedures for requesting an exemption from the substantial equivalence requirements of the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act). The final rule describes the process and statutory criteria for requesting an exemption and explains how FDA reviews requests for exemptions. This regulation satisfies the requirement in the Tobacco Control Act that FDA issue regulations implementing the exemption provision.

  2. The effectiveness of hearing protection among construction workers.

    PubMed

    Neitzel, Richard; Seixas, Noah

    2005-04-01

    Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control

  3. 25 CFR 63.22 - Can an employer certify an individual with a prior conviction or substantiated misconduct as...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 25 Indians 1 2011-04-01 2011-04-01 false Can an employer certify an individual with a prior conviction or substantiated misconduct as suitable for employment? 63.22 Section 63.22 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR TRIBAL GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY...

  4. 25 CFR 63.22 - Can an employer certify an individual with a prior conviction or substantiated misconduct as...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 25 Indians 1 2014-04-01 2014-04-01 false Can an employer certify an individual with a prior conviction or substantiated misconduct as suitable for employment? 63.22 Section 63.22 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR TRIBAL GOVERNMENT INDIAN CHILD PROTECTION AND FAMILY...

  5. Affordable ART in Kenya: The only hope for involuntary childlessness

    PubMed Central

    Ndegwa, SW

    2016-01-01

    Abstract The reported overall subfertility rate in Kenia is 26.1% with 50% attributed to tubal factors and 15% due to male factors. This is probably an underestimation taking into consideration that due to the stigma and myths of the disease, many couples are seeking alternative care from religious sects, witchdoctors, herbalists. Because the costs associated with IVF in private centres are only affordable for the happy few, the only true hope for most Kenyans struggling with unintended childlessness lies in the introduction of affordable ART services. The major challenge is to reduce the costs of ovarian stimulation medication and the equipment set-up cost of the ART laboratory. An important foreseeable barrier to low-cost ART is adequately trained personnel. PMID:27909571

  6. 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.

  7. The Affordable Care Act: A Prescription for Homeland Security Preparedness?

    DTIC Science & Technology

    2014-09-01

    purchase health insurance  Correct the inequity of Medicaid preventive coverage for new beneficiaries vs. existing beneficiaries  Design and...might incentivize choosing health insurance over penalties. D. ADDRESS MEDICAID PREVENTIVE COVERAGE INEQUITY As noted in Chapter V, § 1001 of the...Affordable Care Act (ACA), tens of millions of U.S. citizens were without health insurance coverage. Without health insurance, health care can be

  8. 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.

  9. Setting the price of essential drugs: necessity and affordability.

    PubMed

    Litvack, J I; Shepard, D S; Quick, J D

    1989-08-12

    A method has been developed for fine tuning the selection of drugs to improve cost recovery, to promote appropriate drug use, and to make more drugs more affordable. This scheme is based on a classification of drug necessity (vital, essential, non-essential) and on the relative cost of complete courses of treatment so that expensive drugs can be subsidised by marking up inexpensive ones.

  10. 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

  11. Affordability of emergency obstetric and neonatal care at public hospitals in Madagascar.

    PubMed

    Honda, Ayako; Randaoharison, Pierana Gabriel; Matsui, Mitsuaki

    2011-05-01

    Timely access to emergency obstetric care is necessary to save the lives of women experiencing complications at delivery, and for newborn babies. Out-of-pocket costs are one of the critical factors hindering access to such services in low- and middle-income countries. This study measured out-of-pocket costs for caesarean section and neonatal care at an urban tertiary public hospital in Madagascar, assessed affordability in relation to household expenditure and investigated where families found the money to cover these costs. Data were collected for 103 women and 73 newborns at the Centre Hospitalier Universitaire de Mahajanga in the Boeny region of Madagascar between September 2007 and January 2008. Out-of-pocket costs for caesarean section were catastrophic for middle and lower socio-economic households, and treatment for neonatal complications also created a big financial burden, with geographical and other financial barriers further limiting access to hospital care. This study identified 12 possible cases where the mother required an emergency caesarean section and her newborn required emergency care, placing a double burden on the household. In an effort to make emergency obstetric and neonatal care affordable and available to all, including those living in rural areas and those of medium and lower socio-economic status, well-designed financial risk protection mechanisms and a strong commitment by the government to mobilise resources to finance the country's health system are necessary.

  12. Coverage of certain preventive services under the Affordable Care Act. Final rules.

    PubMed

    2013-07-02

    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.

  13. 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.

  14. Correspondence effects with torches: grasping affordance or visual feature asymmetry?

    PubMed

    Song, Xiaolei; Chen, Jing; Proctor, Robert W

    2014-01-01

    Three experiments were conducted to determine whether an object-based correspondence effect for torch (flashlight) stimuli reported by Pellicano et al. [( 2010 ). Simon-like and functional affordance effects with tools: The effects of object perceptual discrimination and object action state. Quarterly Journal of Experimental Psychology, 63, 2190-2201] is due to a grasping affordance provided by the handle or asymmetry of feature markings on the torch. In Experiment 1 the stimuli were the same as those from Pellicano et al.'s Experiment 2, whereas in Experiments 2 and 3 the stimuli were modified versions with the graspable handle removed. Participants in all experiments performed upright/inverted orientation judgements on the torch stimuli. The results of Experiment 1 replicated those of Pellicano et al.: A small but significant object-based correspondence effect was evident, mainly when the torch was in an active state. With the handle of the torch removed in Experiment 2, making the barrel markings more asymmetric in the display, the correspondence effect was larger. Experiment 3 directly demonstrated an effect of barrel-marking asymmetry on the correspondence effect: When only the half of the markings nearest the light end of the torch was included, the correspondence effect reversed to favour the light end. The results are in agreement with a visual feature-asymmetry account and are difficult to reconcile with a grasping-affordance account.

  15. 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.

  16. The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations.

    PubMed

    Kominski, Gerald F; Nonzee, Narissa J; Sorensen, Andrea

    2017-03-20

    The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.

  17. Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act

    PubMed Central

    Collins, Lydia N.

    2015-01-01

    This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn’t know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA. PMID:25798077

  18. Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act.

    PubMed

    Collins, Lydia N

    This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn't know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA.

  19. The visual encoding of tool-object affordances.

    PubMed

    Natraj, N; Pella, Y M; Borghi, A M; Wheaton, L A

    2015-12-03

    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

  20. 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.

  1. The DDR at telomeres lacking intact shelterin does not require substantial chromatin decompaction.

    PubMed

    Timashev, Leonid A; Babcock, Hazen; Zhuang, Xiaowei; de Lange, Titia

    2017-03-15

    Telomeres are protected by shelterin, a six-subunit protein complex that represses the DNA damage response (DDR) at chromosome ends. Extensive data suggest that TRF2 in shelterin remodels telomeres into the t-loop structure, thereby hiding telomere ends from double-stranded break repair and ATM signaling, whereas POT1 represses ATR signaling by excluding RPA. An alternative protection mechanism was suggested recently by which shelterin subunits TRF1, TRF2, and TIN2 mediate telomeric chromatin compaction, which was proposed to minimize access of DDR factors. We performed superresolution imaging of telomeres in mouse cells after conditional deletion of TRF1, TRF2, or both, the latter of which results in the complete loss of shelterin. Upon removal of TRF1 or TRF2, we observed only minor changes in the telomere volume in most of our experiments. Upon codeletion of TRF1 and TRF2, the telomere volume increased by varying amounts, but even those samples exhibiting small changes in telomere volume showed DDR at nearly all telomeres. Upon shelterin removal, telomeres underwent 53BP1-dependent clustering, potentially explaining at least in part the apparent increase in telomere volume. Furthermore, chromatin accessibility, as determined by ATAC-seq (assay for transposase-accessible chromatin [ATAC] with high-throughput sequencing), was not substantially altered by shelterin removal. These results suggest that the DDR induced by shelterin removal does not require substantial telomere decompaction.

  2. Neighborhood-Level Social Processes and Substantiated Cases of Child Maltreatment

    PubMed Central

    Molnar, Beth E.; Goerge, Robert M.; Gilsanz, Paola; Hill, Andrea; Subramanian, SV; Holton, John K.; Duncan, Dustin T.; Beatriz, Elizabeth D.; Beardslee, William R.

    2015-01-01

    Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g. poverty, crime) can influence the proportion of a neighborhood’s children who are victims of maltreatment. A newer strategy is the identification of potentially modifiable social processes at the neighborhood level that can also influence maltreatment. Toward this end, this study examines neighborhood-level data (maltreatment cases substantiated by Illinois’ child protection agency, 1995–2005, social processes measured by the Project on Human Development in Chicago Neighborhoods, U.S. Census data, proportions of neighborhoods on public assistance, and crime data) that were linked across clusters of contiguous, relatively homogenous Chicago, IL census tracts with respect to racial/ethnic and socioeconomic composition. Our analysis—an ecological-level, repeated cross-sectional design utilizing random-intercept logit models— with a sensitivity analysis using spatial models to control for spatial autocorrelation – revealed consistent associations between neighborhood social processes and maltreatment. Neighborhoods higher in collective efficacy, intergenerational closure, and social networks, and lower in disorder had lower proportions of neglect, physical abuse, and sexual abuse substantiated cases, controlling for differences in structural factors. Higher collective efficacy and social network size also predicted a lower proportion of substance-exposed infants. This research indicates that strategies to mobilize neighborhood-level protective factors may decrease child maltreatment more effectively than individual and family-focused efforts alone. PMID:26684963

  3. Neighborhood-level social processes and substantiated cases of child maltreatment.

    PubMed

    Molnar, Beth E; Goerge, Robert M; Gilsanz, Paola; Hill, Andrea; Subramanian, S V; Holton, John K; Duncan, Dustin T; Beatriz, Elizabeth D; Beardslee, William R

    2016-01-01

    Child maltreatment is a preventable public health problem. Research has demonstrated that neighborhood structural factors (e.g. poverty, crime) can influence the proportion of a neighborhood's children who are victims of maltreatment. A newer strategy is the identification of potentially modifiable social processes at the neighborhood level that can also influence maltreatment. Toward this end, this study examines neighborhood-level data (maltreatment cases substantiated by Illinois' child protection agency, 1995-2005, social processes measured by the Project on Human Development in Chicago Neighborhoods, U.S. Census data, proportions of neighborhoods on public assistance, and crime data) that were linked across clusters of contiguous, relatively homogenous Chicago, IL census tracts with respect to racial/ethnic and socioeconomic composition. Our analysis-an ecological-level, repeated cross-sectional design utilizing random-intercept logit models-with a sensitivity analysis using spatial models to control for spatial autocorrelation-revealed consistent associations between neighborhood social processes and maltreatment. Neighborhoods higher in collective efficacy, intergenerational closure, and social networks, and lower in disorder had lower proportions of neglect, physical abuse, and sexual abuse substantiated cases, controlling for differences in structural factors. Higher collective efficacy and social network size also predicted a lower proportion of substance-exposed infants. This research indicates that strategies to mobilize neighborhood-level protective factors may decrease child maltreatment more effectively than individual and family-focused efforts alone.

  4. 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.

  5. 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.

  6. The Relevance of the Affordable Care Act for Improving Mental Health Care.

    PubMed

    Mechanic, David; Olfson, Mark

    2016-01-01

    Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.

  7. 49 CFR 179.300-12 - Protection of fittings.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Protection of fittings. 179.300-12 Section 179.300-12 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS... Protection of fittings. (a) Tanks shall be of such design as will afford maximum protection to any...

  8. Protection from extinction.

    PubMed

    Rescorla, Robert A

    2003-05-01

    The effect of the presence of a conditioned inhibitor on extinction of excitatory conditioning was studied in one magazine approach and three autoshaping experiments using rats and pigeons. In each case, the presence of an inhibitor reduced responding to an exciter during extinction but allowed substantial recovery of responding to that exciter when subsequently tested separately. Control stimuli with a history of being irrelevant to reinforcement or being nonreinforced had less of a protective effect. This constitutes a clear demonstration of protection from extinction, a phenomenon of substantial theoretical and applied importance.

  9. Method and apparatus for a substantially coaxial injector element

    NASA Technical Reports Server (NTRS)

    Horn, Mark D. (Inventor); Miyata, Shinjiro (Inventor); Farhangi, Shahram (Inventor)

    2006-01-01

    A system to provide a two piece robust fluid injector. According to various embodiments, the fluid injector is a fuel injector for a combustion engine. The injector includes two coaxially formed annuluses. One annulus is formed in a face plate and the second annulus or hole is defined by a tube extending through the face plate. The tube extends through the face plate in a portion of a through bore which also is used to define the second annulus. The second annulus is formed using a throughbore through which the tube extends. This allows the second annulus to always be formed inherently and precisely substantially coaxial with the first annulus. Moreover, the second annulus can be formed with a much greater tolerance than if other independent components needed to be added.

  10. Resonant infrared detector with substantially unit quantum efficiency

    NASA Technical Reports Server (NTRS)

    Farhoomand, Jam (Inventor); Mcmurray, Robert E., Jr. (Inventor)

    1994-01-01

    A resonant infrared detector includes an infrared-active layer which has first and second parallel faces and which absorbs radiation of a given wavelength. The detector also includes a first tuned reflective layer, disposed opposite the first face of the infrared-active layer, which reflects a specific portion of the radiation incident thereon and allows a specific portion of the incident radiation at the given wavelength to reach the infrared-active layer. A second reflective layer, disposed opposite the second face of the infrared-active layer, reflects back into the infrared-active layer substantially all of the radiation at the given wavelength which passes through the infrared-active layer. The reflective layers have the effect of increasing the quantum efficiency of the infrared detector relative to the quantum efficiency of the infrared-active layer alone.

  11. Substantial Genetic Overlap between Schizotypy and Neuroticism: A Twin Study

    PubMed Central

    Macare, Christine; Bates, Timothy C.; Heath, Andrew C.; Martin, Nicholas G.; Ettinger, Ulrich

    2013-01-01

    Schizotypy is phenotypically associated with neuroticism. To reveal the origin of this association, we assessed 3349 (1449 monozygotic (MZ), 1105 dizygotic (DZ) same-sex and 795 DZ opposite-sex) twins on a 12-item version of Chapman’s Psychosis-Proneness Scales and the short-form of the Eysenck Personality Questionnaire-Revised as measures of schizotypy and neuroticism. A substantial proportion (.51 with 95% CI from .38 to .64) of the phenotypic correlation of .37 between neuroticism and the perceptual and ideational components of schizotypy was accounted for by shared genetic influences on these two traits. Moreover, a Cholesky decomposition including anhedonia, hypomania and impulsivity fully accounted for the heritable variance in perceptual and ideational components of schizotypy. These findings suggest a shared genetic etiology between neuroticism and perceptual and ideational components of schizotypy and affect future investigations on the etiology of these phenotypically overlapping traits and affective and psychotic disorders. PMID:22955548

  12. RF Sputtering for preparing substantially pure amorphous silicon monohydride

    DOEpatents

    Jeffrey, Frank R.; Shanks, Howard R.

    1982-10-12

    A process for controlling the dihydride and monohydride bond densities in hydrogenated amorphous silicon produced by reactive rf sputtering of an amorphous silicon target. There is provided a chamber with an amorphous silicon target and a substrate therein with the substrate and the target positioned such that when rf power is applied to the target the substrate is in contact with the sputtering plasma produced thereby. Hydrogen and argon are fed to the chamber and the pressure is reduced in the chamber to a value sufficient to maintain a sputtering plasma therein, and then rf power is applied to the silicon target to provide a power density in the range of from about 7 watts per square inch to about 22 watts per square inch to sputter an amorphous silicon hydride onto the substrate, the dihydride bond density decreasing with an increase in the rf power density. Substantially pure monohydride films may be produced.

  13. A substantial and unexpected enhancement of motion perception in autism.

    PubMed

    Foss-Feig, Jennifer H; Tadin, Duje; Schauder, Kimberly B; Cascio, Carissa J

    2013-05-08

    Atypical perceptual processing in autism spectrum disorder (ASD) is well documented. In addition, growing evidence supports the hypothesis that an excitatory/inhibitory neurochemical imbalance might underlie ASD. Here we investigated putative behavioral consequences of the excitatory/inhibitory imbalance in the context of visual motion perception. As stimulus size increases, typical observers exhibit marked impairments in perceiving motion of high-contrast stimuli. This result, termed "spatial suppression," is believed to reflect inhibitory motion-processing mechanisms. Motion processing is also affected by gain control, an inhibitory mechanism that underlies saturation of neural responses at high contrast. Motivated by these behavioral correlates of inhibitory function, we investigated motion perception in human children with ASD (n = 20) and typical development (n = 26). At high contrast, both groups exhibited similar impairments in motion perception with increasing stimulus size, revealing no apparent differences in spatial suppression. However, there was a substantial enhancement of motion perception in ASD: children with ASD exhibited a consistent twofold improvement in perceiving motion. Hypothesizing that this enhancement might indicate abnormal weakening of response gain control, we repeated our measurements at low contrast, where the effects of gain control should be negligible. At low contrast, we indeed found no group differences in motion discrimination thresholds. These low-contrast results, however, revealed weaker spatial suppression in ASD, suggesting the possibility that gain control abnormalities in ASD might have masked spatial suppression differences at high contrast. Overall, we report a pattern of motion perception abnormalities in ASD that includes substantial enhancements at high contrast and is consistent with an underlying excitatory/inhibitory imbalance.

  14. 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

    ... financially liable for contributions to be made by group health plans for which they administer benefits... behalf of group health plans make contributions. We are including text in Sec. 153.400 that clarifies... of self-insured group health plans, must make contributions to support reinsurance payments to...

  15. 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

    ... Immunization Status 0038 X X Chlamydia Screening in Women (Ages 16-20). 0033 X Cholesterol Management for... Prescribed ADHD Medication: Initiation Phase. Cardiovascular Care... Cholesterol Management for Patients With Cardiovascular Conditions: LDL-C screening. Cholesterol Management for Patients With Cardiovascular...

  16. 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

    ... health insurance issuer. To ensure consumer control, the governance of the organization must be subject... generally advised the Department to develop flexible criteria that recognize the diversity of market...) Consumer operation, control, and focus must be the salient features of the CO-OP and must be sustained...

  17. 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

    ... used total Accident and Health earned premiums as a proxy for annual receipts. We estimated that there are 28 small entities with less than $7 million in accident and health earned premiums offering... premium assistance under Medicaid or the Children's Health Insurance Program (CHIP) or loses...

  18. 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

    ... incurred in 2012 and 2013 up to 0.3 percent of an issuer's earned premium in the relevant State market in... earned premium, account for less than 0.02 percent of issuer spending in each market (individual, small... cap set at up to 0.3 percent of an issuer's earned premium is an appropriate amount based on past...

  19. 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

    ... Medicare & Medicaid Services, Department of Health and Human Services, Room 445-G, Hubert H. Humphrey... building. A stamp- in clock is available for persons wishing to retain a proof of filing by stamping in...

  20. 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

    ...), generally apply to individual health insurance issuers for policy years beginning on or after September 23... individual health insurance issuers for policy years beginning on or after January 1, 2014, except that in... section 2704 apply for policy years beginning on or after September 23, 2010. ADDRESSES: Written...

  1. 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

    ... drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and... of data on treatment limitations, prescription drug coverage, and other descriptive information for... discriminatory, that prescription drug coverage is comparable to a typical employer plan and that benefit...

  2. A bill to repeal the Patient Protection and Affordable Care Act.

    THOMAS, 111th Congress

    Sen. DeMint, Jim [R-SC

    2010-03-23

    03/23/2010 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 332. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

  3. Evidence of Zinc in Affording Protection Against X-Ray-Induced Brain Injury in Rats.

    PubMed

    Sharma, Priyanka; Singla, Neha; Dhawan, D K

    2017-03-06

    In the present world, X-rays have been regarded as one of the most efficient tools in medicine, industry and research. On the contrary, extensive human exposure to these rays is responsible for causing detrimental effects on physiological system. The aim of the present study was to investigate the role of zinc (Zn), if any, in mitigating the adverse effects induced by fractionated X-irradiation on rat brain. Female Sprague-Dawley rats weighing 170-200 g were divided into four different groups viz.: (a) normal control, (b) X-irradiated (21Gy), (c) zinc treated (227 mg/L in drinking water) and (d) X-irradiated + zinc treated. The skulls of animals belonging to groups (b) and (d) were exposed to X-rays in 30 fractions. Each fraction delivered a radiation dose of 70 rads, and rats were exposed to two fractions every day for 15 days, consecutively. X-ray treatment resulted in significant alterations in the neurobehavior, neurotransmitter levels and neuro-histoarchitecture of rats, whereas zinc co-treatment with X-rays resulted in significant improvement in these parameters. X-ray exposure also caused a significant increase in the levels of lipid peroxidation as well as activities of catalase and superoxide dismutase, which however were decreased upon simultaneous Zn treatment. On the contrary, X-ray treatment down-regulated the glutathione system, which were found to be up-regulated by zinc co-treatment. Further, protein expressions of p53 and NF-ҚB were found to be significantly elevated after X-irradiation, which were reversed following Zn supplementation. Hence, Zn seems to be an effective agent in mitigating the detrimental effects caused by exposure to X-rays.

  4. 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

    ... states allow age rating (often unlimited). While 37 states explicitly allow gender rating, three states that prohibit gender rating do not require maternity coverage in all individual market policies... allow some form of gender rating in practice. In the small group market, 38 states allow health...

  5. 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

    ... CHIP Children's Health Insurance Program CMP Civil Money Penalty CMS Centers for Medicare & Medicaid... enforce the Exchange standards using civil money penalties (CMPs) on the same basis as detailed in...

  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

    ... To Support Standards Related to Essential Health Benefits; Recognition of Entities for the... Health and Human Services to define essential health benefits. This proposed rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health...

  7. 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

    ... Qualified Health Plan SHOP Small Business Health Options Program SSA Social Security Administration The Act Social Security Act The Code Internal Revenue Code of 1986 USP United States Pharmacopeia...

  8. Residential building codes, affordability, and health protection: a risk-tradeoff approach.

    PubMed

    Hammitt, J K; Belsky, E S; Levy, J I; Graham, J D

    1999-12-01

    Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.

  9. 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

    ... enrollees be provided information in plain language and in a manner that is accessible and timely for... be certified, to register and receive HHS-approved training, the content required for training,...

  10. Evaluation of the Fallout Protection Afforded by Brookhaven National Laboratory Medical Research Center

    DTIC Science & Technology

    1961-10-01

    EFFECTS TEST OPERATIONS U.S. ATOMIC ENERGY COMMISSION NOTICE This report is published in the interest of providing information which may prove of...value to the reader in his study of effects data derived principally from nuclear weapons tests and from experiments designed to duplicate various...Z. Burson, and J. Jacovitch Approved by: R. L. CORSBIE Director Civil Effects Test Operations Edgerton, Germeshausen & Grier, Inc. Santa Barbara

  11. 78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-01

    ... shared responsibility payment for not maintaining minimum essential coverage as described in section 5000A of the Internal Revenue Code. Additionally, this proposed rule implements the responsibility of... responsibility payment. Amanda Ledford, (410) 786-1565, for provisions related to minimum essential...

  12. S-nitrosoglutathione reductase affords protection against pathogens in Arabidopsis, both locally and systemically.

    PubMed

    Rustérucci, Christine; Espunya, M Carme; Díaz, Maykelis; Chabannes, Matthieu; Martínez, M Carmen

    2007-03-01

    Nitric oxide and S-nitrosothiols (SNOs) are widespread signaling molecules that regulate immunity in animals and plants. Levels of SNOs in vivo are controlled by nitric oxide synthesis (which in plants is achieved by different routes) and by S-nitrosoglutathione turnover, which is mainly performed by the S-nitrosoglutathione reductase (GSNOR). GSNOR is encoded by a single-copy gene in Arabidopsis (Arabidopsis thaliana; Martínez et al., 1996; Sakamoto et al., 2002). We report here that transgenic plants with decreased amounts of GSNOR (using antisense strategy) show enhanced basal resistance against Peronospora parasitica Noco2 (oomycete), which correlates with higher levels of intracellular SNOs and constitutive activation of the pathogenesis-related gene, PR-1. Moreover, systemic acquired resistance is impaired in plants overexpressing GSNOR and enhanced in the antisense plants, and this correlates with changes in the SNO content both in local and systemic leaves. We also show that GSNOR is localized in the phloem and, thus, could regulate systemic acquired resistance signal transport through the vascular system. Our data corroborate the data from other authors that GSNOR controls SNO in vivo levels, and shows that SNO content positively influences plant basal resistance and resistance-gene-mediated resistance as well. These data highlight GSNOR as an important and widely utilized component of resistance protein signaling networks conserved in animals and plants.

  13. 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

    ... proceedings. On October 31, 2011, MF Global, Inc. (``MFGI''), which was dually-registered as an FCM with the... significant transfers of funds out of the customer accounts that were used by MFGI for various purposes other... re MF Global Inc., No. 11-2790 (MG) SIPA (Bankr. S.D.N.Y. Jun. 4, 2012). In addition, the...

  14. 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

    ... From the Federal Register Online via the Government Publishing Office ] Vol. 77 Monday, No. 227 November 26, 2012 Part V Department of Health and Human Services 45 CFR Parts 147, 155, and 156 Patient... Federal Register online database through Federal Digital System (FDsys), a service of the U.S....

  15. 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

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... prescription drug coverage. When shopping for coverage on an Exchange, prospective enrollees may base QHP selection decisions on whether their provider is considered in-network using the issuer's online...

  16. Who has housing affordability problems? Disparities in Housing Cost burden by Race, Nativity and Legal Status in Los Angeles

    PubMed Central

    McConnell, Eileen Diaz

    2013-01-01

    Housing costs are a substantial component of U.S. household expenditures. Those who allocate a large proportion of their income to housing often have to make difficult financial decisions with significant short-term and long-term implications for adults and children. This study employs cross-sectional data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS) collected between 2000 and 2002 to examine the most common U.S. standard of housing affordability, the likelihood of spending thirty percent or more of income on shelter costs. Multivariate analyses of a low-income sample of U.S. born Latinos, Whites, African Americans, authorized Latino immigrants and unauthorized Latino immigrants focus on baseline and persistent differences in the likelihood of being cost burdened by race, nativity and legal status. Nearly half or more of each group of low-income respondents experience housing affordability problems. The results suggest that immigrants’ legal status is the primary source of disparities among those examined, with the multivariate analyses revealing large and persistent disparities for unauthorized Latino immigrants relative to most other groups. Moreover, the higher odds of housing cost burden observed for unauthorized immigrants compared with their authorized immigrant counterparts remains substantial, accounting for traditional indicators of immigrant assimilation. These results are consistent with emerging scholarship regarding the role of legal status in shaping immigrant outcomes in the United States. PMID:24077641

  17. Modelling the affordability and distributional implications of future health care financing options in South Africa.

    PubMed

    McIntyre, Di; Ataguba, John E

    2012-03-01

    South Africa is considering introducing a universal health care system. A key concern for policy-makers and the general public is whether or not this reform is affordable. Modelling the resource and revenue generation requirements of alternative reform options is critical to inform decision-making. This paper considers three reform scenarios: universal coverage funded by increased allocations to health from general tax and additional dedicated taxes; an alternative reform option of extending private health insurance coverage to all formal sector workers and their dependents with the remainder using tax-funded services; and maintaining the status quo. Each scenario was modelled over a 15-year period using a spreadsheet model. Statistical analyses were also undertaken to evaluate the impact of options on the distribution of health care financing burden and benefits from using health services across socio-economic groups. Universal coverage would result in total health care spending levels equivalent to 8.6% of gross domestic product (GDP), which is comparable to current spending levels. It is lower than the status quo option (9.5% of GDP) and far lower than the option of expanding private insurance cover (over 13% of GDP). However, public funding of health services would have to increase substantially. Despite this, universal coverage would result in the most progressive financing system if the additional public funding requirements are generated through a surcharge on taxable income (but not if VAT is increased). The extended private insurance scheme option would be the least progressive and would impose a very high payment burden; total health care payments on average would be 10.7% of household consumption expenditure compared with the universal coverage (6.7%) and status quo (7.5%) options. The least pro-rich distribution of service benefits would be achieved under universal coverage. Universal coverage is affordable and would promote health system equity, but

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. Teacher Perceptions of Learning Affordances of Multi-User Virtual Environments

    ERIC Educational Resources Information Center

    Gamage, Vimani; Tretiakov, Alexei; Crump, Barbara

    2011-01-01

    While the affordances of multi-user virtual environments (MUVEs) for teaching and learning are a subject of numerous experience reports, there is little research on educators' perceptions of various MUVE affordances claimed in the literature. We investigate the educators' perceptions of claimed MUVE affordances for learning by conducting in-depth…

  3. 24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... affordable housing and income targeting. 954.306 Section 954.306 Housing and Urban Development Regulations... Affordability § 954.306 Rental housing: qualification as affordable housing and income targeting. (a) Rent...: (1) Bears rents not greater than the lesser of— (i) The section 8 fair market rent for...

  4. Learning Outcomes Afforded by Self-Assessed, Segmented Video-Print Combinations

    ERIC Educational Resources Information Center

    Koumi, Jack

    2015-01-01

    Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video-print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational…

  5. 76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-27

    ... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...

  6. Article having an improved platinum-aluminum-hafnium protective coating

    NASA Technical Reports Server (NTRS)

    Nagaraj, Bangalore Aswatha (Inventor); Williams, Jeffrey Lawrence (Inventor)

    2005-01-01

    An article protected by a protective coating has a substrate and a protective coating having an outer layer deposited upon the substrate surface and a diffusion zone formed by interdiffusion of the outer layer and the substrate. The protective coating includes platinum, aluminum, no more than about 2 weight percent hafnium, and substantially no silicon. The outer layer is substantially a single phase.

  7. Substantial proportion of global streamflow less than three months old

    NASA Astrophysics Data System (ADS)

    Jasechko, Scott; Kirchner, James W.; Welker, Jeffrey M.; McDonnell, Jeffrey J.

    2016-02-01

    Biogeochemical cycles, contaminant transport and chemical weathering are regulated by the speed at which precipitation travels through landscapes and reaches streams. Streamflow is a mixture of young and old precipitation, but the global proportions of these young and old components are not known. Here we analyse seasonal cycles of oxygen isotope ratios in rain, snow and streamflow compiled from 254 watersheds around the world, and calculate the fraction of streamflow that is derived from precipitation that fell within the past two or three months. This young streamflow accounts for about a third of global river discharge, and comprises at least 5% of discharge in about 90% of the catchments we investigated. We conclude that, although typical catchments have mean transit times of years or even decades, they nonetheless can rapidly transmit substantial fractions of soluble contaminant inputs to streams. Young streamflow is less prevalent in steeper landscapes, which suggests they are characterized by deeper vertical infiltration. Because young streamflow is derived from less than 0.1% of global groundwater storage, we conclude that this thin veneer of aquifer storage will have a disproportionate influence on stream water quality.

  8. Substantial overnight reaeration by convective cooling discovered in pond ecosystems

    NASA Astrophysics Data System (ADS)

    Holgerson, Meredith A.; Zappa, Christopher J.; Raymond, Peter A.

    2016-08-01

    Trends in freshwater dissolved oxygen (DO) reflect whole-ecosystem properties and influence organismal survival and behavior. Here we show that small ponds have unique oxygen dynamics that differ from larger lakes. We discovered that ponds undersaturated in DO experienced substantial increases in oxygen concentration overnight. Nighttime increases in DO occurred on 45% of the nights sampled and resulted in DO saturation increasing 12-fold (22% saturation) on average. Oxygen spikes were likely to occur when ponds became at least 1.8°C warmer than the air and later in the season when oxygen levels were low (<31% saturation) and the air was warm (≥5.8°C). We demonstrate that overnight increases in surface water DO resulted from atmospheric oxygen invasion as opposed to internal production. Convective cooling enhanced turbulence and air-water gas exchange, leading to intense bursts of oxygen invasion during nighttime hours. This mechanism has not been demonstrated before and has important implications for the biogeochemistry of these systems, as well as understanding how organisms survive in hypoxic small ponds.

  9. Scientific substantiation of functional food health claims in China.

    PubMed

    Yang, Yuexin

    2008-06-01

    This article provides an overview of the procedures involved in scientific substantiation of functional food health claims in China. The definition of a functional food is discussed, in addition to the factors that led to its modification in 2005. The framework of administration includes the regulation of functional foods, steps involved in submission of dossiers, the safety control system for raw materials and products, and technical procedures for testing and evaluation. Scientific evidence required for a claim includes evidence from product tests in addition to evidence resulting from complete scientific literature searches relative to the food material or component in question. Currently, the 4 main rules for functional food assessment in China include 1) functional assessment procedures; 2) standard toxicological assessment; 3) regulations on nutrient supplements; and 4) standard analytical methods for functional components. The current situation for functional foods in China is analyzed, including a discussion of the distribution of the 27 currently allowed functional food health claims. The effectiveness of functional foods and health claims for improving health relies largely on the motivation and education of the public to be able to make good choices.

  10. Process for preparing superconducting film having substantially uniform phase development

    DOEpatents

    Bharacharya, R.; Parilla, P.A.; Blaugher, R.D.

    1995-12-19

    A process is disclosed for preparing a superconducting film, such as a thallium-barium-calcium-copper oxide superconducting film, having substantially uniform phase development. The process comprises providing an electrodeposition bath having one or more soluble salts of one or more respective potentially superconducting metals in respective amounts adequate to yield a superconducting film upon subsequent appropriate treatment. Should all of the metals required for producing a superconducting film not be made available in the bath, such metals can be a part of the ambient during a subsequent annealing process. A soluble silver salt in an amount between about 0.1% and about 4.0% by weight of the provided other salts is also provided to the bath, and the bath is electrically energized to thereby form a plated film. The film is annealed in ambient conditions suitable to cause formation of a superconductor film. Doping with silver reduces the temperature at which the liquid phase appears during the annealing step, initiates a liquid phase throughout the entire volume of deposited material, and influences the nucleation and growth of the deposited material. 3 figs.

  11. Process for preparing superconducting film having substantially uniform phase development

    DOEpatents

    Bharacharya, Raghuthan; Parilla, Philip A.; Blaugher, Richard D.

    1995-01-01

    A process for preparing a superconducting film, such as a thallium-barium-calcium-copper oxide superconducting film, having substantially uniform phase development. The process comprises providing an electrodeposition bath having one or more soluble salts of one or more respective potentially superconducting metals in respective amounts adequate to yield a superconducting film upon subsequent appropriate treatment. Should all of the metals required for producing a superconducting film not be made available in the bath, such metals can be a part of the ambient during a subsequent annealing process. A soluble silver salt in an amount between about 0.1% and about 4.0% by weight of the provided other salts is also provided to the bath, and the bath is electrically energized to thereby form a plated film. The film is annealed in ambient conditions suitable to cause formation of a superconductor film. Doping with silver reduces the temperature at which the liquid phase appears during the annealing step, initiates a liquid phase throughout the entire volume of deposited material, and influences the nucleation and growth of the deposited material.

  12. Interaction between affordance and handedness recognition: a chronometric study.

    PubMed

    Lameira, A P; Pereira, A; Conde, E; Gawryszewski, L G

    2015-04-01

    The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT) task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation.

  13. Reference Reactor Module for the Affordable Fission Surface Power System

    NASA Astrophysics Data System (ADS)

    Poston, David I.; Kapernick, Richard J.; Dixon, David D.; Amiri, Benjamin W.; Marcille, Thomas F.

    2008-01-01

    Surface fission power systems on the Moon and Mars may provide the first US application of fission reactor technology in space since 1965. The requirements of many surface power applications allow the consideration of systems with much less development risk than most other space reactor applications, because of modest power (10s of kWe) and no driving need for minimal mass (allowing temperatures <1000 K). The Affordable Fission Surface Power System (AFSPS) study was completed by NASA/DOE to determine the cost of a modest performance, low-technical risk surface power system. This paper describes the reference AFSPS reactor module concept, which is designed to provide a net power of 40 kWe for 8 years on the lunar surface; note, the system has been designed with technologies that are fully compatible with a Martian surface application. The reactor concept uses stainless-steel based, UO2-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The reactor shielding approach utilizes both in-situ and launched shielding to keep the dose to astronauts much lower than the natural background radiation on the lunar surface. One of the important ``affordability'' attributes is that the concept has been designed to minimize both the technical and programmatic safety risk.

  14. Spatial compatibility and affordance compatibility in patients with chronic schizophrenia.

    PubMed

    Kume, Yu; Sato, Fumiyasu; Hiraoka, Yuya; Suzuki, Shingo; Niyama, Yoshitsugu

    2016-12-01

    A deterioration in information-processing performance is commonly recognized in patients with chronic schizophrenia. Although the enhancement of cognitive skills in patients with schizophrenia is important, the types of external stimuli that influence performance have not received much attention. The aim of present study was to clarify the effects of spatial and affordance compatibility in patients with schizophrenia, compared with those in healthy people. The subjects (25 patients with schizophrenia and 25 healthy controls) participated in two experiment examining the effects of the spatial location of stimuli and the action-relevance of objects. The results showed that the effect of spatial compatibility was similar in both the patients and the controls, whereas the influence of action-relevant objects was not highlighted in either patients with chronic schizophrenia or healthy controls. These findings provide important evidence of a normal spatial compatibility effect in patients with chronic schizophrenia. However, further research examining the affordance compatibility effect is needed, taking into consideration the symptomatology and the severity of the social functioning level in patients with schizophrenia.

  15. Interaction between affordance and handedness recognition: a chronometric study

    PubMed Central

    Lameira, A.P.; Pereira, A.; Conde, E.; Gawryszewski, L.G.

    2015-01-01

    The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT) task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation. PMID:25714894

  16. Demonstrating the Viability and Affordability of Nuclear Surface Power Systems

    NASA Technical Reports Server (NTRS)

    Vandyke, Melissa K.

    2006-01-01

    A set of tasks have been identified to help demonstrate the viability, performance, and affordability of surface fission systems. Completion of these tasks will move surface fission systems closer to reality by demonstrating affordability and performance potential. Tasks include fabrication and test of a 19-pin section of a Surface Power Unit Demonstrator (SPUD); design, fabrication, and utilization of thermal simulators optimized for surface fission' applications; design, fabrication, and utilization of GPHS module thermal simulators; design, fabrication, and test of a fission surface power system shield; and work related to potential fission surface power fuel/clad systems. Work on the SPUD will feed directly into joint NASA MSFC/NASA GRC fabrication and test of a surface power plant Engineering Development Unit (EDU). The goal of the EDU will be to perform highly realistic thermal, structural, and electrical testing on an integrated fission surface power system. Fission thermal simulator work will help enable high fidelity non-nuclear testing of pumped NaK surface fission power systems. Radioisotope thermal simulator work will help enable design and development of higher power radioisotope systems (power ultimately limited by Pu-238 availability). Shield work is designed to assess the potential of using a water neutron shield on the surface of the moon. Fuels work is geared toward assessing the current potential of using fuels that have already flown in space.

  17. Reference Reactor Module for the Affordable Fission Surface Power System

    SciTech Connect

    Poston, David I.; Kapernick, Richard J.; Dixon, David D.; Amiri, Benjamin W.; Marcille, Thomas F.

    2008-01-21

    Surface fission power systems on the Moon and Mars may provide the first US application of fission reactor technology in space since 1965. The requirements of many surface power applications allow the consideration of systems with much less development risk than most other space reactor applications, because of modest power (10s of kWe) and no driving need for minimal mass (allowing temperatures <1000 K). The Affordable Fission Surface Power System (AFSPS) study was completed by NASA/DOE to determine the cost of a modest performance, low-technical risk surface power system. This paper describes the reference AFSPS reactor module concept, which is designed to provide a net power of 40 kWe for 8 years on the lunar surface; note, the system has been designed with technologies that are fully compatible with a Martian surface application. The reactor concept uses stainless-steel based, UO{sub 2}-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The reactor shielding approach utilizes both in-situ and launched shielding to keep the dose to astronauts much lower than the natural background radiation on the lunar surface. One of the important 'affordability' attributes is that the concept has been designed to minimize both the technical and programmatic safety risk.

  18. The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals

    PubMed Central

    Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh

    2016-01-01

    American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665

  19. Enhanced Protection against Ebola Virus Mediated by an Improved Adenovirus-Based Vaccine

    PubMed Central

    Tran, Kaylie N.; Croyle, Maria A.; Strong, James E.; Feldmann, Heinz; Kobinger, Gary P.

    2009-01-01

    Background The Ebola virus is transmitted by direct contact with bodily fluids of infected individuals, eliciting death rates as high as 90% among infected humans. Currently, replication defective adenovirus-based Ebola vaccine is being studied in a phase I clinical trial. Another Ebola vaccine, based on an attenuated vesicular stomatitis virus has shown efficacy in post-exposure treatment of nonhuman primates to Ebola infection. In this report, we modified the common recombinant adenovirus serotype 5-based Ebola vaccine expressing the wild-type ZEBOV glycoprotein sequence from a CMV promoter (Ad-CMVZGP). The immune response elicited by this improved expression cassette vector (Ad-CAGoptZGP) and its ability to afford protection against lethal ZEBOV challenge in mice was compared to the standard Ad-CMVZGP vector. Methodology/Principal Findings Ad-CMVZGP was previously shown to protect mice, guinea pigs and nonhuman primates from an otherwise lethal challenge of Zaire ebolavirus. The antigenic expression cassette of this vector was improved through codon optimization, inclusion of a consensus Kozak sequence and reconfiguration of a CAG promoter (Ad-CAGoptZGP). Expression of GP from Ad-CAGoptZGP was substantially higher than from Ad-CMVZGP. Ad-CAGoptZGP significantly improved T and B cell responses at doses 10 to 100-fold lower than that needed with Ad-CMVZGP. Additionally, Ad-CAGoptZGP afforded full protections in mice against lethal challenge at a dose 100 times lower than the dose required for Ad-CMVZGP. Finally, Ad-CAGoptZGP induced full protection to mice when given 30 minutes post-challenge. Conclusions/Significance We describe an improved adenovirus-based Ebola vaccine capable of affording post-exposure protection against lethal challenge in mice. The molecular modifications of the new improved vaccine also translated in the induction of significantly enhanced immune responses and complete protection at a dose 100 times lower than with the previous generation

  20. Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ

    PubMed Central

    Albright, Len; Derickson, Elizabeth S.; Massey, Douglas S.

    2016-01-01

    This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ – the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities. PMID:27390552

  1. Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.

    PubMed

    Albright, Len; Derickson, Elizabeth S; Massey, Douglas S

    2013-06-01

    This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.

  2. NASA Affordable Vehicle Avionics (AVA): Common Modular Avionics System for Nano-Launchers Offering Affordable Access to Space

    NASA Technical Reports Server (NTRS)

    Cockrell, James

    2015-01-01

    Small satellites are becoming ever more capable of performing valuable missions for both government and commercial customers. However, currently these satellites can only be launched affordably as secondary payloads. This makes it difficult for the small satellite mission to launch when needed, to the desired orbit, and with acceptable risk. NASA Ames Research Center has developed and tested a prototype low-cost avionics package for space launch vehicles that provides complete GNC functionality in a package smaller than a tissue box with a mass less than 0.84 kg. AVA takes advantage of commercially available, low-cost, mass-produced, miniaturized sensors, filtering their more noisy inertial data with realtime GPS data. The goal of the Advanced Vehicle Avionics project is to produce and flight-verify a common suite of avionics and software that deliver affordable, capable GNC and telemetry avionics with application to multiple nano-launch vehicles at 1 the cost of current state-of-the-art avionics.

  3. Investigators unable to substantiate suspected link between sponge, TSS.

    PubMed

    1983-12-01

    Federal investigators have failed to substantiate a suspected link between the contraceptive sponge and toxic shock syndrome (TSS). In September the US Food and Drug Administration (FDA) reported the case of a woman who inserted the contraceptive sponge last July 17 and removed itthe following day. About 6 hours later she noted the sudden onset of a fever of 104 degrees Farenheit, nausea, redness, shaking chills, and an inflamed vagina. Cultures from the sponge revealed S. aureus and S. epidemis. There was initial concern that the case may have represented early TSS. A toxin produced by certain strains of S. aureus is thought to cause TSS. The syndrome includes a fever greater than 102 degrees, rash, blood pressure less than 90mmHG, peelin g skin on the palms and soles 1-2 weeks after onset, and involvement of 3 or more of the following organ systems: gastrointestinal, muscular, mucous membrane, renal, hepatic, hematologic,or central nervous system. FDA medical Officers Dr. William J. McCann told "Contraceptive Technology Update" (CTU) that the reported case failed to fill the Centers for Disease Control criteriaof the diagnosis of TSS. Because the woman has been treated with antibiotics early in the course of her disease, McCann said he could not entirely exclude the possibility that she might have developed TSS if she had gone untreated. He added that the possibility was "remote". Dr. Gail Bolan, CDC epidemiologist, told CTU that "antibiotics do not seem to affect the outcome of the original episode" of TSS cases. She commented that milder forms of TSS might exist that may not meet CDC's strict case definition. Without a specific test, there is no way to separate milder TSS cases from viral or other diseases that may appear similar. According to Deborah Gaynor, the sponge's package insert states that clinical trials were not large enough to assess the risk of TSS. The sponge is not recommended for use during menstration. Gaynor cites a variety of reasons why the

  4. Role of dynamics in enzyme catalysis: substantial versus semantic controversies.

    PubMed

    Kohen, Amnon

    2015-02-17

    CONSPECTUS: The role of the enzyme's dynamic motions in catalysis is at the center of heated contemporary debates among both theoreticians and experimentalists. Resolving these apparent disputes is of both intellectual and practical importance: incorporation of enzyme dynamics could be critical for any calculation of enzymatic function and may have profound implications for structure-based drug design and the design of biomimetic catalysts. Analysis of the literature suggests that while part of the dispute may reflect substantial differences between theoretical approaches, much of the debate is semantic. For example, the term "protein dynamics" is often used by some researchers when addressing motions that are in thermal equilibrium with their environment, while other researchers only use this term for nonequilibrium events. The last cases are those in which thermal energy is "stored" in a specific protein mode and "used" for catalysis before it can dissipate to its environment (i.e., "nonstatistical dynamics"). This terminology issue aside, a debate has arisen among theoreticians around the roles of nonstatistical vs statistical dynamics in catalysis. However, the author knows of no experimental findings available today that examined this question in enzyme catalyzed reactions. Another source of perhaps nonsubstantial argument might stem from the varying time scales of enzymatic motions, which range from seconds to femtoseconds. Motions at different time scales play different roles in the many events along the catalytic cascade (reactant binding, reprotonation of reactants, structural rearrangement toward the transition state, product release, etc.). In several cases, when various experimental tools have been used to probe catalytic events at differing time scales, illusory contradictions seem to have emerged. In this Account, recent attempts to sort the merits of those questions are discussed along with possible future directions. A possible summary of current

  5. Invasive mammal eradication on islands results in substantial conservation gains.

    PubMed

    Jones, Holly P; Holmes, Nick D; Butchart, Stuart H M; Tershy, Bernie R; Kappes, Peter J; Corkery, Ilse; Aguirre-Muñoz, Alfonso; Armstrong, Doug P; Bonnaud, Elsa; Burbidge, Andrew A; Campbell, Karl; Courchamp, Franck; Cowan, Philip E; Cuthbert, Richard J; Ebbert, Steve; Genovesi, Piero; Howald, Gregg R; Keitt, Bradford S; Kress, Stephen W; Miskelly, Colin M; Oppel, Steffen; Poncet, Sally; Rauzon, Mark J; Rocamora, Gérard; Russell, James C; Samaniego-Herrera, Araceli; Seddon, Philip J; Spatz, Dena R; Towns, David R; Croll, Donald A

    2016-04-12

    More than US$21 billion is spent annually on biodiversity conservation. Despite their importance for preventing or slowing extinctions and preserving biodiversity, conservation interventions are rarely assessed systematically for their global impact. Islands house a disproportionately higher amount of biodiversity compared with mainlands, much of which is highly threatened with extinction. Indeed, island species make up nearly two-thirds of recent extinctions. Islands therefore are critical targets of conservation. We used an extensive literature and database review paired with expert interviews to estimate the global benefits of an increasingly used conservation action to stem biodiversity loss: eradication of invasive mammals on islands. We found 236 native terrestrial insular faunal species (596 populations) that benefitted through positive demographic and/or distributional responses from 251 eradications of invasive mammals on 181 islands. Seven native species (eight populations) were negatively impacted by invasive mammal eradication. Four threatened species had their International Union for the Conservation of Nature (IUCN) Red List extinction-risk categories reduced as a direct result of invasive mammal eradication, and no species moved to a higher extinction-risk category. We predict that 107 highly threatened birds, mammals, and reptiles on the IUCN Red List-6% of all these highly threatened species-likely have benefitted from invasive mammal eradications on islands. Because monitoring of eradication outcomes is sporadic and limited, the impacts of global eradications are likely greater than we report here. Our results highlight the importance of invasive mammal eradication on islands for protecting the world's most imperiled fauna.

  6. Invasive mammal eradication on islands results in substantial conservation gains

    PubMed Central

    Jones, Holly P.; Holmes, Nick D.; Butchart, Stuart H. M.; Tershy, Bernie R.; Kappes, Peter J.; Corkery, Ilse; Aguirre-Muñoz, Alfonso; Armstrong, Doug P.; Bonnaud, Elsa; Burbidge, Andrew A.; Campbell, Karl; Courchamp, Franck; Cowan, Philip E.; Cuthbert, Richard J.; Ebbert, Steve; Genovesi, Piero; Howald, Gregg R.; Keitt, Bradford S.; Kress, Stephen W.; Miskelly, Colin M.; Oppel, Steffen; Poncet, Sally; Rauzon, Mark J.; Rocamora, Gérard; Russell, James C.; Samaniego-Herrera, Araceli; Seddon, Philip J.; Spatz, Dena R.; Towns, David R.; Croll, Donald A.

    2016-01-01

    More than US$21 billion is spent annually on biodiversity conservation. Despite their importance for preventing or slowing extinctions and preserving biodiversity, conservation interventions are rarely assessed systematically for their global impact. Islands house a disproportionately higher amount of biodiversity compared with mainlands, much of which is highly threatened with extinction. Indeed, island species make up nearly two-thirds of recent extinctions. Islands therefore are critical targets of conservation. We used an extensive literature and database review paired with expert interviews to estimate the global benefits of an increasingly used conservation action to stem biodiversity loss: eradication of invasive mammals on islands. We found 236 native terrestrial insular faunal species (596 populations) that benefitted through positive demographic and/or distributional responses from 251 eradications of invasive mammals on 181 islands. Seven native species (eight populations) were negatively impacted by invasive mammal eradication. Four threatened species had their International Union for the Conservation of Nature (IUCN) Red List extinction-risk categories reduced as a direct result of invasive mammal eradication, and no species moved to a higher extinction-risk category. We predict that 107 highly threatened birds, mammals, and reptiles on the IUCN Red List—6% of all these highly threatened species—likely have benefitted from invasive mammal eradications on islands. Because monitoring of eradication outcomes is sporadic and limited, the impacts of global eradications are likely greater than we report here. Our results highlight the importance of invasive mammal eradication on islands for protecting the world's most imperiled fauna. PMID:27001852

  7. Developing Countries Vaccine Manufacturers Network: doing good by making high-quality vaccines affordable for all.

    PubMed

    Pagliusi, Sonia; Leite, Luciana C C; Datla, Mahima; Makhoana, Morena; Gao, Yongzhong; Suhardono, Mahendra; Jadhav, Suresh; Harshavardhan, Gutla V J A; Homma, Akira

    2013-04-18

    The Developing Countries Vaccine Manufacturers Network (DCVMN) is a unique model of a public and private international alliance. It assembles governmental and private organizations to work toward a common goal of manufacturing and supplying high-quality vaccines at affordable prices to protect people around the world from known and emerging infectious diseases. Together, this group of manufacturers has decades of experience in manufacturing vaccines, with technologies, know-how, and capacity to produce more than 40 vaccines types. These manufacturers have already contributed more than 30 vaccines in various presentations that have been prequalified by the World Health Organization for use by global immunization programmes. Furthermore, more than 45 vaccines are in the pipeline. Recent areas of focus include vaccines to protect against rotavirus, human papillomavirus (HPV), Japanese encephalitis, meningitis, hepatitis E, poliovirus, influenza, and pertussis, as well as combined pentavalent vaccines for children. The network has a growing number of manufacturers that produce a growing number of products to supply the growing demand for vaccines in developing countries.

  8. Radiation Protection

    MedlinePlus

    Jump to main content US EPA United States Environmental Protection Agency Search Search Radiation Protection Share Facebook Twitter Google+ Pinterest Contact Us Radiation Protection Document Library View ...

  9. Phased array ultrasonic processing for enhanced and affordable diagnosis

    NASA Astrophysics Data System (ADS)

    Dominguez, N.; Rougeron, G.; Leberre, S.; Pautel, R.

    2013-01-01

    Phased array ultrasonic reconstruction techniques are often presented as a prospect for better and enhanced diagnosis. However to date few applications of these techniques can be found in the industry, partly because of questions on sizing but also because they often require heavy acquisitions. A way forward is then to propose techniques requiring less intensive data acquisition to make them broadly affordable in practice. Several approaches ranging from full matrix capture to paintbrush acquisitions are presented in this paper in combination with associated reconstruction processing like the Total Focusing Method (TFM) and the Time Domain Topological Energy (TDTE) techniques. Emphasis is given to their relative relevancies and practical applicability on typical configurations of interest for industries. The paper also presents recent efforts made on the acceleration of processing computation times, in particular through the use of GPU architectures.

  10. Community-specific evaluation of tool affordances in wild chimpanzees.

    PubMed

    Gruber, Thibaud; Muller, Martin N; Reynolds, Vernon; Wrangham, Richard; Zuberbühler, Klaus

    2011-01-01

    The notion of animal culture, defined as socially transmitted community-specific behaviour patterns, remains controversial, notably because the definition relies on surface behaviours without addressing underlying cognitive processes. In contrast, human cultures are the product of socially acquired ideas that shape how individuals interact with their environment. We conducted field experiments with two culturally distinct chimpanzee communities in Uganda, which revealed significant differences in how individuals considered the affording parts of an experimentally provided tool to extract honey from a standardised cavity. Firstly, individuals of the two communities found different functional parts of the tool salient, suggesting that they experienced a cultural bias in their cognition. Secondly, when the alternative function was made more salient, chimpanzees were unable to learn it, suggesting that prior cultural background can interfere with new learning. Culture appears to shape how chimpanzees see the world, suggesting that a cognitive component underlies the observed behavioural patterns.

  11. Affordable, Robust Ceramic Joining Technology (ARCJoinT)

    NASA Technical Reports Server (NTRS)

    Singh, M.

    1998-01-01

    Joining is recognized as one of the enabling technologies for the application of silicon carbide-based ceramic and composite components in a number of demanding and high temperature applications in aerospace and ground-based systems. An affordable, robust ceramic joining technology (ARCJoinT) for joining of silicon carbide-based ceramics and fiber reinforced composites has been developed. This technique is capable of producing joints with tailorable thickness and composition. A wide variety of silicon carbide-based ceramics and composites, in different shapes and sizes, have been joined using this technique. These joints maintain their mechanical strength up to 1350 C in air. This technology is suitable for the joining of large and complex shaped ceramic and composite components and with certain modifications, can be applied to repair ceramic components damaged in service.

  12. Women and the Affordable Care Act of 2010.

    PubMed

    Collins, Sara R; Rustgi, Sheila D; Doty, Michelle M

    2010-07-01

    This issue brief analyzes how, over the next decade, the Affordable Care Act (ACA) is likely to stabilize and reverse women's growing exposure to health care costs. Up to 15 million women who now are uninsured could gain subsidized coverage under the law. In addition, 14.5 million insured women will benefit from provisions that improve coverage or reduce premiums. Women who have coverage through the individual insurance market and are charged higher premiums than men, who have been unable to secure coverage for the cost of pregnancy, or who have a preexisting health condition excluded from their benefits will ultimately find themselves on a level playing field with men, enjoying a full range of comprehensive benefits.

  13. The Future of the Affordable Care Act and Insurance Coverage.

    PubMed

    Glied, Sherry; Jackson, Adlan

    2017-04-01

    We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.

  14. Design, analysis and testing of small, affordable HAWT rotors

    NASA Astrophysics Data System (ADS)

    Pricop, Mihai V.; Niculescu, Mihai L.; Cojocaru, Marius G.; Barsan, Dorin

    2012-09-01

    The paper presents affordable technologies dedicated to design, CAD modelling and manufacturing of the small-medium HAWT rotors. Three numerical tools are developed: blade/rotor design, blade modelling for industry CATIA(CATScript) and blade modelling for small scale developers. Numerical analysis of the rotors is accomplished for both performance and noise level estimation using XFLOW (LES) and an in-house code (URANS). Results are presented for a 5KW rotor at the design point only, since computations are expensive. Developement examples are included as two rotors are designed, manufactured and tested for 1.5 and 5KW. A third one, rated for 20KW is under developement. Basic testing results are also included.

  15. Pico Reentry Probes: Affordable Options for Reentry Measurements and Testing

    NASA Technical Reports Server (NTRS)

    Ailor, William H.; Kapoor, Vinod B.; Allen, Gay A., Jr.; Venkatapathy, Ethiraj; Arnold, James O.; Rasky, Daniel J.

    2005-01-01

    It is generally very costly to perform in-space and atmospheric entry experiments. This paper presents a new platform - the Pico Reentry Probe (PREP) - that we believe will make targeted flight-tests and planetary atmospheric probe science missions considerably more affordable. Small, lightweight, self-contained, it is designed as a "launch and forget" system, suitable for experiments that require no ongoing communication with the ground. It contains a data recorder, battery, transmitter, and user-customized instrumentation. Data recorded during reentry or space operations is returned at end-of-mission via transmission to Iridium satellites (in the case of earth-based operations) or a similar orbiting communication system for planetary missions. This paper discusses possible applications of this concept for Earth and Martian atmospheric entry science. Two well-known heritage aerodynamic shapes are considered as candidates for PREP: the shape developed for the Planetary Atmospheric Experiment Test (PAET) and that for the Deep Space II Mars Probe.

  16. An Object Oriented Extensible Architecture for Affordable Aerospace Propulsion Systems

    NASA Technical Reports Server (NTRS)

    Follen, Gregory J.

    2003-01-01

    Driven by a need to explore and develop propulsion systems that exceeded current computing capabilities, NASA Glenn embarked on a novel strategy leading to the development of an architecture that enables propulsion simulations never thought possible before. Full engine 3 Dimensional Computational Fluid Dynamic propulsion system simulations were deemed impossible due to the impracticality of the hardware and software computing systems required. However, with a software paradigm shift and an embracing of parallel and distributed processing, an architecture was designed to meet the needs of future propulsion system modeling. The author suggests that the architecture designed at the NASA Glenn Research Center for propulsion system modeling has potential for impacting the direction of development of affordable weapons systems currently under consideration by the Applied Vehicle Technology Panel (AVT).

  17. International examples of undocumented immigration and the affordable care act.

    PubMed

    Stutz, Matthew; Baig, Arshiya

    2014-08-01

    As it stands there is no viable health care option for undocumented immigrants of low socioeconomic status. Even more worrisome is that Affordable Care Act simply does not address this issue with any direct plan. The US is in a very influential time period in terms of undocumented immigration and its relationship with health care. The purpose of this paper is to examine international examples of undocumented immigrant health care and their implications for the United States' undocumented immigrant health care. This study found that physicians in the US must work to prevent the initiation of policies which exclude undocumented immigrants from accessing health care. Exclusionary policies implemented in European nations have had disastrous effects on physicians and patients. This paper examines the implications which similar policies would have if implemented in the US.

  18. Gender performativity in physics: affordances or only constraints?

    NASA Astrophysics Data System (ADS)

    Danielsson, Anna T.; Lundin, Mattias

    2014-06-01

    In this forum we engage in a dialogue with Allison Gonsalves's paper `"Physics and the girly girl—there is a contradiction somewhere": Doctoral students' positioning around discourses of gender and competence in physics'. In her paper Gonsalves uses a sociocultural approach to examine women doctoral students' stories about becoming physicists. In doing so her paper focuses on how discourses of masculinity and femininity can create available and unavailable positions for the women students. In this dialogue we do a parallel reading of two of the student narratives presented by Gonsalves, using Judith Butler's (1990) concept of discursive agency as a means to more explicitly bring the affordances for women identity constitution offered by their localized physicist context to the fore, rather focusing on its, often more visible, constraints.

  19. Suggested Interactivity: Seeking Perceived Affordances for Information Visualization.

    PubMed

    Boy, Jeremy; Eveillard, Louis; Detienne, Françoise; Fekete, Jean-Daniel

    2016-01-01

    In this article, we investigate methods for suggesting the interactivity of online visualizations embedded with text. We first assess the need for such methods by conducting three initial experiments on Amazon's Mechanical Turk. We then present a design space for Suggested Interactivity (i. e., visual cues used as perceived affordances-SI), based on a survey of 382 HTML5 and visualization websites. Finally, we assess the effectiveness of three SI cues we designed for suggesting the interactivity of bar charts embedded with text. Our results show that only one cue (SI3) was successful in inciting participants to interact with the visualizations, and we hypothesize this is because this particular cue provided feedforward.

  20. Mobilizing slit lamp to the field: A new affordable solution.

    PubMed

    Farooqui, Javed Hussain; Jorgenson, Richard; Gomaa, Ahmed

    2015-11-01

    We are describing a simple and affordable design to pack and carry the slit lamp to the field. Orbis staff working on the Flying Eye Hospital (FEH) developed this design to facilitate mobilization of the slit lamp to the field during various FEH programs. The solution involves using a big toolbox, a central plywood apparatus, and foam. These supplies were cut to measure and used to support the slit lamp after being fitted snuggly in the box. This design allows easy and safe mobilization of the slit lamp to remote places. It was developed with the efficient use of space in mind and it can be easily reproduced in developing countries using same or similar supplies. Mobilizing slit lamp will be of great help for staff and institutes doing regular outreach clinical work.