An Optimized Hidden Node Detection Paradigm for Improving the Coverage and Network Efficiency in Wireless Multimedia Sensor Networks

PubMed Central

Alanazi, Adwan; Elleithy, Khaled

2016-01-01

Successful transmission of online multimedia streams in wireless multimedia sensor networks (WMSNs) is a big challenge due to their limited bandwidth and power resources. The existing WSN protocols are not completely appropriate for multimedia communication. The effectiveness of WMSNs varies, and it depends on the correct location of its sensor nodes in the field. Thus, maximizing the multimedia coverage is the most important issue in the delivery of multimedia contents. The nodes in WMSNs are either static or mobile. Thus, the node connections change continuously due to the mobility in wireless multimedia communication that causes an additional energy consumption, and synchronization loss between neighboring nodes. In this paper, we introduce an Optimized Hidden Node Detection (OHND) paradigm. The OHND consists of three phases: hidden node detection, message exchange, and location detection. These three phases aim to maximize the multimedia node coverage, and improve energy efficiency, hidden node detection capacity, and packet delivery ratio. OHND helps multimedia sensor nodes to compute the directional coverage. Furthermore, an OHND is used to maintain a continuous node– continuous neighbor discovery process in order to handle the mobility of the nodes. We implement our proposed algorithms by using a network simulator (NS2). The simulation results demonstrate that nodes are capable of maintaining direct coverage and detecting hidden nodes in order to maximize coverage and multimedia node mobility. To evaluate the performance of our proposed algorithms, we compared our results with other known approaches. PMID:27618048

An Optimized Hidden Node Detection Paradigm for Improving the Coverage and Network Efficiency in Wireless Multimedia Sensor Networks.

PubMed

Alanazi, Adwan; Elleithy, Khaled

2016-09-07

Successful transmission of online multimedia streams in wireless multimedia sensor networks (WMSNs) is a big challenge due to their limited bandwidth and power resources. The existing WSN protocols are not completely appropriate for multimedia communication. The effectiveness of WMSNs varies, and it depends on the correct location of its sensor nodes in the field. Thus, maximizing the multimedia coverage is the most important issue in the delivery of multimedia contents. The nodes in WMSNs are either static or mobile. Thus, the node connections change continuously due to the mobility in wireless multimedia communication that causes an additional energy consumption, and synchronization loss between neighboring nodes. In this paper, we introduce an Optimized Hidden Node Detection (OHND) paradigm. The OHND consists of three phases: hidden node detection, message exchange, and location detection. These three phases aim to maximize the multimedia node coverage, and improve energy efficiency, hidden node detection capacity, and packet delivery ratio. OHND helps multimedia sensor nodes to compute the directional coverage. Furthermore, an OHND is used to maintain a continuous node- continuous neighbor discovery process in order to handle the mobility of the nodes. We implement our proposed algorithms by using a network simulator (NS2). The simulation results demonstrate that nodes are capable of maintaining direct coverage and detecting hidden nodes in order to maximize coverage and multimedia node mobility. To evaluate the performance of our proposed algorithms, we compared our results with other known approaches.

A Depth-Adjustment Deployment Algorithm Based on Two-Dimensional Convex Hull and Spanning Tree for Underwater Wireless Sensor Networks.

PubMed

Jiang, Peng; Liu, Shuai; Liu, Jun; Wu, Feng; Zhang, Le

2016-07-14

Most of the existing node depth-adjustment deployment algorithms for underwater wireless sensor networks (UWSNs) just consider how to optimize network coverage and connectivity rate. However, these literatures don't discuss full network connectivity, while optimization of network energy efficiency and network reliability are vital topics for UWSN deployment. Therefore, in this study, a depth-adjustment deployment algorithm based on two-dimensional (2D) convex hull and spanning tree (NDACS) for UWSNs is proposed. First, the proposed algorithm uses the geometric characteristics of a 2D convex hull and empty circle to find the optimal location of a sleep node and activate it, minimizes the network coverage overlaps of the 2D plane, and then increases the coverage rate until the first layer coverage threshold is reached. Second, the sink node acts as a root node of all active nodes on the 2D convex hull and then forms a small spanning tree gradually. Finally, the depth-adjustment strategy based on time marker is used to achieve the three-dimensional overall network deployment. Compared with existing depth-adjustment deployment algorithms, the simulation results show that the NDACS algorithm can maintain full network connectivity with high network coverage rate, as well as improved network average node degree, thus increasing network reliability.

A Depth-Adjustment Deployment Algorithm Based on Two-Dimensional Convex Hull and Spanning Tree for Underwater Wireless Sensor Networks

PubMed Central

Jiang, Peng; Liu, Shuai; Liu, Jun; Wu, Feng; Zhang, Le

2016-01-01

Most of the existing node depth-adjustment deployment algorithms for underwater wireless sensor networks (UWSNs) just consider how to optimize network coverage and connectivity rate. However, these literatures don’t discuss full network connectivity, while optimization of network energy efficiency and network reliability are vital topics for UWSN deployment. Therefore, in this study, a depth-adjustment deployment algorithm based on two-dimensional (2D) convex hull and spanning tree (NDACS) for UWSNs is proposed. First, the proposed algorithm uses the geometric characteristics of a 2D convex hull and empty circle to find the optimal location of a sleep node and activate it, minimizes the network coverage overlaps of the 2D plane, and then increases the coverage rate until the first layer coverage threshold is reached. Second, the sink node acts as a root node of all active nodes on the 2D convex hull and then forms a small spanning tree gradually. Finally, the depth-adjustment strategy based on time marker is used to achieve the three-dimensional overall network deployment. Compared with existing depth-adjustment deployment algorithms, the simulation results show that the NDACS algorithm can maintain full network connectivity with high network coverage rate, as well as improved network average node degree, thus increasing network reliability. PMID:27428970

24 CFR 203.16a - Mortgagor and mortgagee requirement for maintaining flood insurance coverage.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for maintaining flood insurance coverage. 203.16a Section 203.16a Housing and Urban Development... requirement for maintaining flood insurance coverage. (a) If the mortgage is to cover property improvements (dwelling and related structures/equipment essential to the value of the property and subject to flood...

Lessons From the Polio Endgame: Overcoming the Failure to Vaccinate and the Role of Subpopulations in Maintaining Transmission.

PubMed

Thompson, Kimberly M; Duintjer Tebbens, Radboud J

2017-07-01

Recent detections of circulating serotype 2 vaccine-derived poliovirus in northern Nigeria (Borno and Sokoto states) and Pakistan (Balochistan Province) and serotype 1 wild poliovirus in Pakistan, Afghanistan, and Nigeria (Borno) represent public health emergencies that require aggressive response. We demonstrate the importance of undervaccinated subpopulations, using an existing dynamic poliovirus transmission and oral poliovirus vaccine evolution model. We review the lessons learned during the polio endgame about the role of subpopulations in sustaining transmission, and we explore the implications of subpopulations for other vaccine-preventable disease eradication efforts. Relatively isolated subpopulations benefit little from high surrounding population immunity to transmission and will sustain transmission as long as they do not attain high vaccination coverage. Failing to reach such subpopulations with high coverage represents the root cause of polio eradication delays. Achieving and maintaining eradication requires addressing the weakest links, which includes immunizing populations in insecure areas and/or with disrupted or poor-performing health systems and managing the risks of individuals with primary immunodeficiencies who can excrete vaccine-derived poliovirus long-term. Eradication efforts for vaccine-preventable diseases need to create performance expectations for countries to immunize all people living within their borders and maintain high coverage with appropriate interventions.Keywords. Polio; eradication; transmission; heterogeneity. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

A Polygon Model for Wireless Sensor Network Deployment with Directional Sensing Areas

PubMed Central

Wu, Chun-Hsien; Chung, Yeh-Ching

2009-01-01

The modeling of the sensing area of a sensor node is essential for the deployment algorithm of wireless sensor networks (WSNs). In this paper, a polygon model is proposed for the sensor node with directional sensing area. In addition, a WSN deployment algorithm is presented with topology control and scoring mechanisms to maintain network connectivity and improve sensing coverage rate. To evaluate the proposed polygon model and WSN deployment algorithm, a simulation is conducted. The simulation results show that the proposed polygon model outperforms the existed disk model and circular sector model in terms of the maximum sensing coverage rate. PMID:22303159

Successful introduction of an underutilized elderly pneumococcal vaccine in a national immunization program by integrating the pre-existing public health infrastructure.

PubMed

Yang, Tae Un; Kim, Eunsung; Park, Young-Joon; Kim, Dongwook; Kwon, Yoon Hyung; Shin, Jae Kyong; Park, Ok

2016-03-18

Although pneumococcal vaccines had been recommended for the elderly population in South Korea for a considerable period of time, the coverage has been well below the optimal level. To increase the vaccination rate with integrating the pre-existing public health infrastructure and governmental funding, the Korean government introduced an elderly pneumococcal vaccination into the national immunization program with a 23-valent pneumococcal polysaccharide vaccine in May 2013. The aim of this study was to assess the performance of the program in increasing the vaccine coverage rate and maintaining stable vaccine supply and safe vaccination during the 20 months of the program. We qualitatively and quantitatively analyzed the process of introducing and the outcomes of the program in terms of the systematic organization, efficiency, and stability at the national level. A staggered introduction during the first year utilizing the public sector, with a target coverage of 60%, was implemented based on the public demand for an elderly pneumococcal vaccination, vaccine supply capacity, vaccine delivery capacity, safety, and sustainability. During the 20-month program period, the pneumococcal vaccine coverage rate among the population aged ≥65 years increased from 5.0% to 57.3% without a noticeable vaccine shortage or safety issues. A web-based integrated immunization information system, which includes the immunization registry, vaccine supply chain management, and surveillance of adverse events following immunization, reduced programmatic errors and harmonized the overall performance of the program. Introduction of an elderly pneumococcal vaccination in the national immunization program based on strong government commitment, meticulous preparation, financial support, and the pre-existing public health infrastructure resulted in an efficient, stable, and sustainable increase in vaccination coverage. Copyright © 2016. Published by Elsevier Ltd.

Longitudinal Patterns of Health Insurance Coverage Among a National Sample of Children in the Child Welfare System

PubMed Central

Raghavan, Ramesh; Aarons, Gregory A.; Roesch, Scott C.; Leslie, Laurel K.

2008-01-01

Objectives. We sought to describe health insurance coverage over time among a national sample of children who came into contact with child welfare or child protective services agencies. Methods. We used data from 4 waves of the National Survey of Child and Adolescent Well-Being to examine insurance coverage among 2501 youths. Longitudinal insurance trajectories were identified using latent class analyses, a technique used to classify individuals into groupings of observed variables, and survey-weighted logistic regression was used to identify variables associated with class membership. Results. We identified 2 latent insurance classes—1 contained children who gained health insurance, and the other contained children who stably maintained coverage over time. History of sexual abuse, and race/ethnicity other than White, Black, and Hispanic, were associated with membership in the “gainer” class. Foster care placement and poorer health status were associated with membership in the “maintainer” class. Caregiver characteristics were not associated with class membership. Conclusions. The majority of children in child welfare had stable health insurance coverage over time. Given this vulnerable population’s dependence upon Medicaid, protection of existing entitlements to Medicaid is essential to preserve their stable insurance coverage. PMID:18235059

Progress towards achieving and maintaining maternal and neonatal tetanus elimination in the African region.

PubMed

Ridpath, Alison Delano; Scobie, Heather Melissa; Shibeshi, Messeret Eshetu; Yakubu, Ahmadu; Zulu, Flint; Raza, Azhar Abid; Masresha, Balcha; Tohme, Rania

2017-01-01

Despite the availability of effective tetanus prevention strategies, as of 2016, Maternal and Neonatal Tetanus Elimination (MNTE) has not yet been achieved in 18 countries globally. In this paper, we review the status of MNTE in the World Health Organization African Region (AFR),and provide recommendations for achieving and maintaining MNTE in AFR. As of November 2016, 37 (79%) AFR countries have achieved MNTE, with 10 (21%) countries remaining. DTP3 coverage increased from 52% in 2000 to 76% in 2015. In 2015, coverage with at least 2 doses of tetanus containing vaccine (TT2+) and proportion of newborns protected at birth (PAB) were 69% and 77%, compared with 44% and 62% in 2000, respectively. Since 1999, over 79 million women of reproductive age (WRA) have been vaccinated with TT2+ through supplementary immunization activities (SIAs). Despite the progress, only 54% of births were attended by skilled birth attendants (SBAs), 5 (11%) countries provided the 3 WHO-recommended booster doses to both sexes, and about 5.5 million WRA still need to be reached with SIAs. Coverage disparities still exist between countries that have achieved MNTE and those that have not. In 2015, coverage with DTP3 and PAB were higher in MNTE countries compared with those yet to achieve MNTE: 84% vs. 68% and 86% vs. 69%, respectively. Challenges to achieving MNTE in the remaining AFR countries include weak health systems, competing priorities, insufficient funding, insecurity, and sub-optimal neonatal tetanus (NT) surveillance. To achieve and maintain MNTE in AFR, increasing SBAs and tetanus vaccination coverage, integrating tetanus vaccination with other opportunities (e.g., polio and measles campaigns, mother and child health days), and providing appropriately spaced booster doses are needed. Strengthening NT surveillance and conducting serosurveys would ensure appropriate targeting of MNTE activities and high-quality information for validating the achievement and maintenance of elimination.

Progress towards achieving and maintaining maternal and neonatal tetanus elimination in the African region

PubMed Central

Ridpath, Alison Delano; Scobie, Heather Melissa; Shibeshi, Messeret Eshetu; Yakubu, Ahmadu; Zulu, Flint; Raza, Azhar Abid; Masresha, Balcha; Tohme, Rania

2017-01-01

Despite the availability of effective tetanus prevention strategies, as of 2016, Maternal and Neonatal Tetanus Elimination (MNTE) has not yet been achieved in 18 countries globally. In this paper, we review the status of MNTE in the World Health Organization African Region (AFR),and provide recommendations for achieving and maintaining MNTE in AFR. As of November 2016, 37 (79%) AFR countries have achieved MNTE, with 10 (21%) countries remaining. DTP3 coverage increased from 52% in 2000 to 76% in 2015. In 2015, coverage with at least 2 doses of tetanus containing vaccine (TT2+) and proportion of newborns protected at birth (PAB) were 69% and 77%, compared with 44% and 62% in 2000, respectively. Since 1999, over 79 million women of reproductive age (WRA) have been vaccinated with TT2+ through supplementary immunization activities (SIAs). Despite the progress, only 54% of births were attended by skilled birth attendants (SBAs), 5 (11%) countries provided the 3 WHO-recommended booster doses to both sexes, and about 5.5 million WRA still need to be reached with SIAs. Coverage disparities still exist between countries that have achieved MNTE and those that have not. In 2015, coverage with DTP3 and PAB were higher in MNTE countries compared with those yet to achieve MNTE: 84% vs. 68% and 86% vs. 69%, respectively. Challenges to achieving MNTE in the remaining AFR countries include weak health systems, competing priorities, insufficient funding, insecurity, and sub-optimal neonatal tetanus (NT) surveillance. To achieve and maintain MNTE in AFR, increasing SBAs and tetanus vaccination coverage, integrating tetanus vaccination with other opportunities (e.g., polio and measles campaigns, mother and child health days), and providing appropriately spaced booster doses are needed. Strengthening NT surveillance and conducting serosurveys would ensure appropriate targeting of MNTE activities and high-quality information for validating the achievement and maintenance of elimination. PMID:29296159

42 CFR 457.440 - Existing comprehensive State-based coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Existing comprehensive State-based coverage. 457... STATES State Plan Requirements: Coverage and Benefits § 457.440 Existing comprehensive State-based coverage. (a) General requirements. Existing comprehensive State-based health benefits is coverage that— (1...

Expanding insurance coverage through tax credits, consumer choice, and market enhancements: the American Medical Association proposal for health insurance reform.

PubMed

Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D

2004-05-12

Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.

78 FR 78256 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage; Correction AGENCY: Internal... 5000A of the Internal Revenue Code for the shared responsibility payment for not maintaining minimum... language ``for shared responsibility payment for an'' is corrected to read ``for the shared responsibility...

Market-Based Approaches toward the Development of Urban Forest Carbon Projects in the United States

Treesearch

Neelam C. Poudyal; Jacek P. Siry; J. M. Bowker

2012-01-01

The United States has observed unprecedented urban growth over the last few decades. Nowak et al. (2005) noted that between 1990 and 2000, the share of urban land area in the nation increased from 2.5% to 3.1%. Existing urban areas in the U.S. maintain average tree coverage of 27% (Nowak et al. 2001), and consist of millions of trees along streets and in parks,...

Evaluating standard terminologies for encoding allergy information.

PubMed

Goss, Foster R; Zhou, Li; Plasek, Joseph M; Broverman, Carol; Robinson, George; Middleton, Blackford; Rocha, Roberto A

2013-01-01

Allergy documentation and exchange are vital to ensuring patient safety. This study aims to analyze and compare various existing standard terminologies for representing allergy information. Five terminologies were identified, including the Systemized Nomenclature of Medical Clinical Terms (SNOMED CT), National Drug File-Reference Terminology (NDF-RT), Medication Dictionary for Regulatory Activities (MedDRA), Unique Ingredient Identifier (UNII), and RxNorm. A qualitative analysis was conducted to compare desirable characteristics of each terminology, including content coverage, concept orientation, formal definitions, multiple granularities, vocabulary structure, subset capability, and maintainability. A quantitative analysis was also performed to compare the content coverage of each terminology for (1) common food, drug, and environmental allergens and (2) descriptive concepts for common drug allergies, adverse reactions (AR), and no known allergies. Our qualitative results show that SNOMED CT fulfilled the greatest number of desirable characteristics, followed by NDF-RT, RxNorm, UNII, and MedDRA. Our quantitative results demonstrate that RxNorm had the highest concept coverage for representing drug allergens, followed by UNII, SNOMED CT, NDF-RT, and MedDRA. For food and environmental allergens, UNII demonstrated the highest concept coverage, followed by SNOMED CT. For representing descriptive allergy concepts and adverse reactions, SNOMED CT and NDF-RT showed the highest coverage. Only SNOMED CT was capable of representing unique concepts for encoding no known allergies. The proper terminology for encoding a patient's allergy is complex, as multiple elements need to be captured to form a fully structured clinical finding. Our results suggest that while gaps still exist, a combination of SNOMED CT and RxNorm can satisfy most criteria for encoding common allergies and provide sufficient content coverage.

Evaluating standard terminologies for encoding allergy information

PubMed Central

Goss, Foster R; Zhou, Li; Plasek, Joseph M; Broverman, Carol; Robinson, George; Middleton, Blackford; Rocha, Roberto A

2013-01-01

Objective Allergy documentation and exchange are vital to ensuring patient safety. This study aims to analyze and compare various existing standard terminologies for representing allergy information. Methods Five terminologies were identified, including the Systemized Nomenclature of Medical Clinical Terms (SNOMED CT), National Drug File–Reference Terminology (NDF-RT), Medication Dictionary for Regulatory Activities (MedDRA), Unique Ingredient Identifier (UNII), and RxNorm. A qualitative analysis was conducted to compare desirable characteristics of each terminology, including content coverage, concept orientation, formal definitions, multiple granularities, vocabulary structure, subset capability, and maintainability. A quantitative analysis was also performed to compare the content coverage of each terminology for (1) common food, drug, and environmental allergens and (2) descriptive concepts for common drug allergies, adverse reactions (AR), and no known allergies. Results Our qualitative results show that SNOMED CT fulfilled the greatest number of desirable characteristics, followed by NDF-RT, RxNorm, UNII, and MedDRA. Our quantitative results demonstrate that RxNorm had the highest concept coverage for representing drug allergens, followed by UNII, SNOMED CT, NDF-RT, and MedDRA. For food and environmental allergens, UNII demonstrated the highest concept coverage, followed by SNOMED CT. For representing descriptive allergy concepts and adverse reactions, SNOMED CT and NDF-RT showed the highest coverage. Only SNOMED CT was capable of representing unique concepts for encoding no known allergies. Conclusions The proper terminology for encoding a patient's allergy is complex, as multiple elements need to be captured to form a fully structured clinical finding. Our results suggest that while gaps still exist, a combination of SNOMED CT and RxNorm can satisfy most criteria for encoding common allergies and provide sufficient content coverage. PMID:23396542

Specialist availability in emergencies: contributions of response times and the use of ad hoc coverage in New York State.

PubMed

Rabin, Elaine; Patrick, Lisa

2016-04-01

Nationwide, hospitals struggle to maintain specialist on-call coverage for emergencies. We seek to further understand the issue by examining reliability of scheduled coverage and the role of ad hoc coverage when none is scheduled. An anonymous electronic survey of all emergency department (ED) directors of a large state. Overall and for 10 specialties, respondents were asked to estimate on-call coverage extent and "reliability" (frequency of emergency response in a clinically useful time frame: 2 hours), and use and effect of ad hoc emergency coverage to fill gaps. Descriptive statistics were performed using Fisher exact and Wilcoxon sign rank tests for significance. Contact information was obtained for 125 of 167 ED directors. Sixty responded (48%), representing 36% of EDs. Forty-six percent reported full on-call coverage scheduled for all specialties. Forty-six percent reported consistent reliability. Coverage and reliability were strongly related (P<.01; 33% reported both), and larger ED volume correlated with both (P<.01). Ninety percent of hospitals that had gaps in either employed ad hoc coverage, significantly improving coverage for 8 of 10 specialties. For all but 1 specialty, more than 20% of hospitals reported that specialists are "Never", "Rarely" or "Sometimes" reliable (more than 50% for cardiovascular surgery, hand surgery and ophthalmology). Significant holes in scheduled on-call specialist coverage are compounded by frequent unreliability of on-call specialists, but partially ameliorated by ad hoc specialist coverage. Regionalization may help because a 2-tiered system may exist: larger hospitals have more complete, reliable coverage. Better understanding of specialists' willingness to treat emergencies ad hoc without taking formal call will suggest additional remedies. Copyright © 2015 Elsevier Inc. All rights reserved.

Assessing Mediational Models: Testing and Interval Estimation for Indirect Effects.

PubMed

Biesanz, Jeremy C; Falk, Carl F; Savalei, Victoria

2010-08-06

Theoretical models specifying indirect or mediated effects are common in the social sciences. An indirect effect exists when an independent variable's influence on the dependent variable is mediated through an intervening variable. Classic approaches to assessing such mediational hypotheses ( Baron & Kenny, 1986 ; Sobel, 1982 ) have in recent years been supplemented by computationally intensive methods such as bootstrapping, the distribution of the product methods, and hierarchical Bayesian Markov chain Monte Carlo (MCMC) methods. These different approaches for assessing mediation are illustrated using data from Dunn, Biesanz, Human, and Finn (2007). However, little is known about how these methods perform relative to each other, particularly in more challenging situations, such as with data that are incomplete and/or nonnormal. This article presents an extensive Monte Carlo simulation evaluating a host of approaches for assessing mediation. We examine Type I error rates, power, and coverage. We study normal and nonnormal data as well as complete and incomplete data. In addition, we adapt a method, recently proposed in statistical literature, that does not rely on confidence intervals (CIs) to test the null hypothesis of no indirect effect. The results suggest that the new inferential method-the partial posterior p value-slightly outperforms existing ones in terms of maintaining Type I error rates while maximizing power, especially with incomplete data. Among confidence interval approaches, the bias-corrected accelerated (BC a ) bootstrapping approach often has inflated Type I error rates and inconsistent coverage and is not recommended; In contrast, the bootstrapped percentile confidence interval and the hierarchical Bayesian MCMC method perform best overall, maintaining Type I error rates, exhibiting reasonable power, and producing stable and accurate coverage rates.

DoD Needs to Improve the Management and Oversight of Operations at the Defense Reutilization and Marketing Office-Camp Arifjan, Kuwait

DTIC Science & Technology

2011-01-12

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and...Contractor Sales Data 46 Recommendations, Management Comments, and Our Response 47 Appendices A. Scope and Methodology B. Prior Audit Coverage C. DRMO...the receiving offtcial verifies the item ’s condition and ensures the quantities of items received match the DTID data . If the DTID data is

Shared responsibility payment for not maintaining minimum essential coverage. Final regulations.

PubMed

2013-08-30

This document contains final regulations on the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the TRICARE Affirmation Act and Public Law 111-173. These final regulations provide guidance to individual taxpayers on the liability under section 5000A of the Internal Revenue Code for the shared responsibility payment for not maintaining minimum essential coverage and largely finalize the rules in the notice of proposed rulemaking published in the Federal Register on February 1, 2013.

14 CFR 205.5 - Minimum coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Minimum coverage. 205.5 Section 205.5... REGULATIONS AIRCRAFT ACCIDENT LIABILITY INSURANCE § 205.5 Minimum coverage. (a) Insurance contracts and self... maintain the following coverage: (1) Third-party aircraft accident liability coverage for bodily injury to...

Self-organisation of adsorbed nitrogen on (100) and (410) copper faces: a SPA-LEED study

NASA Astrophysics Data System (ADS)

Sotto, M.; Croset, B.

2000-08-01

The self-organisation of nitrogen nanostructures at different coverages on a (100) copper surface is studied by spot profile analysing low energy electron diffraction (SPA-LEED). The existence of two surface states with a domain of coverage leading to coexistence of the two states as already observed by scanning tunneling microscopy (STM) [Leibsle and Robinson, Phys. Rev. B 47 (1993) 15 865; Leibsle et al., Surf. Sci. 317 (1994) 309; Leibsle, Surf. Sci. 440 (1999) L835] and low energy electron diffraction (LEED) [Sotto et al., Surf. Sci. 371 (1997) 36] is confirmed. In the first state, the surface is organised in square shape islands separated by bare copper <100> rows. This work shows that the surface periodicity depends on the preparation of the nitrogen overlayer. When nitrogen coverage is obtained by adsorption with a sample temperature near 320°C, the periodicity does not vary with coverage and is found to be equal to 55±2 Å. At coverages below 0.75±0.05 and if the nitrogen is deposited at room temperature followed by an anneal at 320°C, during long periods of time, the periodicity evolves to large values (˜97±3 Å). During thermal desorption, the long range order with decreasing coverage is maintained but the surface periodicity also evolves continuously to large values (˜100 Å). However, a surface periodicity of 55±2 Å seems to be a characteristic length of this system. The second surface state corresponds to large c(2×2)N domains separated by <110> trenches [Leibsle and Robinson, Phys. Rev. B 47 (1993) 15 865; Leibsle et al., Surf. Sci. 317 (1994) 309; Leibsle, Surf. Sci. 440 (1999) L835]. Nitrogen adsorption on a (410) stepped face induces a reconstruction into a (810) face with double step height. The complex behaviour of this film growth is discussed in the light of existing theories about the driving force leading to nanostructuration.

24 CFR 320.11 - Insurance coverage.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Insurance coverage. 320.11 Section...-BACKED SECURITIES Pass-Through Type Securities § 320.11 Insurance coverage. The issuer shall maintain, for the benefit of the Association, insurance, errors and omissions, fidelity bond and other coverage...

78 FR 19155 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 1 [REG-148500-12] RIN 1545-BL36 Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage Correction In proposed rule document 2013-2141 appearing on pages 7314-7331 in the issue of Monday, February 1, 2013, make the...

Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act.

PubMed

Hatch, Brigit; Bailey, Steffani R; Cowburn, Stuart; Marino, Miguel; Angier, Heather; DeVoe, Jennifer E

2016-04-01

To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon's 2008 Medicaid expansion (the Oregon Experiment). We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n = 788) or lost (n = 944) insurance coverage. We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Individuals who maintained coverage through Oregon's Medicaid expansion increased long-term utilization of CHCs, whereas those with unstable coverage did not. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention.

Enhanced sequencing coverage with digital droplet multiple displacement amplification

PubMed Central

Sidore, Angus M.; Lan, Freeman; Lim, Shaun W.; Abate, Adam R.

2016-01-01

Sequencing small quantities of DNA is important for applications ranging from the assembly of uncultivable microbial genomes to the identification of cancer-associated mutations. To obtain sufficient quantities of DNA for sequencing, the small amount of starting material must be amplified significantly. However, existing methods often yield errors or non-uniform coverage, reducing sequencing data quality. Here, we describe digital droplet multiple displacement amplification, a method that enables massive amplification of low-input material while maintaining sequence accuracy and uniformity. The low-input material is compartmentalized as single molecules in millions of picoliter droplets. Because the molecules are isolated in compartments, they amplify to saturation without competing for resources; this yields uniform representation of all sequences in the final product and, in turn, enhances the quality of the sequence data. We demonstrate the ability to uniformly amplify the genomes of single Escherichia coli cells, comprising just 4.7 fg of starting DNA, and obtain sequencing coverage distributions that rival that of unamplified material. Digital droplet multiple displacement amplification provides a simple and effective method for amplifying minute amounts of DNA for accurate and uniform sequencing. PMID:26704978

Minimum essential coverage and other rules regarding the shared responsibility payment for individuals. Final regulations.

PubMed

2014-11-26

This document contains final regulations relating to the requirement to maintain minimum essential coverage enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the TRICARE Affirmation Act and Public Law 111-173 (collectively, the Affordable Care Act). These final regulations provide individual taxpayers with guidance under section 5000A of the Internal Revenue Code on the requirement to maintain minimum essential coverage and rules governing certain types of exemptions from that requirement.

Model-based semantic dictionaries for medical language understanding.

PubMed Central

Rassinoux, A. M.; Baud, R. H.; Ruch, P.; Trombert-Paviot, B.; Rodrigues, J. M.

1999-01-01

Semantic dictionaries are emerging as a major cornerstone towards achieving sound natural language understanding. Indeed, they constitute the main bridge between words and conceptual entities that reflect their meanings. Nowadays, more and more wide-coverage lexical dictionaries are electronically available in the public domain. However, associating a semantic content with lexical entries is not a straightforward task as it is subordinate to the existence of a fine-grained concept model of the treated domain. This paper presents the benefits and pitfalls in building and maintaining multilingual dictionaries, the semantics of which is directly established on an existing concept model. Concrete cases, handled through the GALEN-IN-USE project, illustrate the use of such semantic dictionaries for the analysis and generation of multilingual surgical procedures. PMID:10566333

Community Health Center Utilization Following the 2008 Medicaid Expansion in Oregon: Implications for the Affordable Care Act

PubMed Central

Bailey, Steffani R.; Cowburn, Stuart; Marino, Miguel; Angier, Heather; DeVoe, Jennifer E.

2016-01-01

Objectives. To assess longitudinal patterns of community health center (CHC) utilization and the effect of insurance discontinuity after Oregon’s 2008 Medicaid expansion (the Oregon Experiment). Methods. We conducted a retrospective cohort study with electronic health records and Medicaid data. We divided individuals who gained Medicaid in the Oregon Experiment into those who maintained (n = 788) or lost (n = 944) insurance coverage. We compared these groups with continuously insured (n = 921) and continuously uninsured (n = 5416) reference groups for community health center utilization rates over a 36-month period. Results. Both newly insured groups increased utilization in the first 6 months. After 6 months, use among those who maintained coverage stabilized at a level consistent with the continuously insured, whereas it returned to baseline for those who lost coverage. Conclusions. Individuals who maintained coverage through Oregon’s Medicaid expansion increased long-term utilization of CHCs, whereas those with unstable coverage did not. Policy implications. This study predicts long-term increase in CHC utilization following Affordable Care Act Medicaid expansion and emphasizes the need for policies that support insurance retention. PMID:26890164

Women's Preventive Services Guidelines Affordable Care Act Expands Prevention Coverage for Women's Health and Well-Being

MedlinePlus

... 2012. Type of Preventive Service HHS Guideline for Health Insurance Coverage Frequency Well-woman visits. Well-woman preventive ... established or maintained by an objecting organization, or health insurance coverage offered or arranged by an objecting organization, ...

32 CFR 2001.71 - Coverage.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Coverage. 2001.71 Section 2001.71 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL... Training § 2001.71 Coverage. (a) General. Each department or agency shall establish and maintain a formal...

32 CFR 2001.71 - Coverage.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Coverage. 2001.71 Section 2001.71 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL... Training § 2001.71 Coverage. (a) General. Each department or agency shall establish and maintain a formal...

32 CFR 2001.71 - Coverage.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Coverage. 2001.71 Section 2001.71 National Defense Other Regulations Relating to National Defense INFORMATION SECURITY OVERSIGHT OFFICE, NATIONAL... Training § 2001.71 Coverage. (a) General. Each department or agency shall establish and maintain a formal...

78 FR 39869 - Coverage of Certain Preventive Services Under the Affordable Care Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-02

... on Birth Outcomes: Findings from Recent U.S. Studies, International Journal of Gynecology... 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...

Impact of current and scaled-up levels of hepatitis C prevention and treatment interventions for people who inject drugs in three UK settings-what is required to achieve the WHO's HCV elimination targets?

PubMed

Ward, Zoe; Platt, Lucy; Sweeney, Sedona; Hope, Vivian D; Maher, Lisa; Hutchinson, Sharon; Palmateer, Norah; Smith, Josie; Craine, Noel; Taylor, Avril; Martin, Natasha; Ayres, Rachel; Dillon, John; Hickman, Matthew; Vickerman, Peter

2018-05-17

To estimate the impact of existing high-coverage needle and syringe provision (HCNSP, defined as obtaining more than one sterile needle and syringe per injection reported) and opioid substitution therapy (OST) on hepatitis C virus (HCV) transmission among people who inject drugs (PWID) in three UK settings and to determine required scale-up of interventions, including HCV treatment, needed to reach the World Health Organization (WHO) target of reducing HCV incidence by 90% by 2030. HCV transmission modelling using UK empirical estimates for effect of OST and/or HCNSP on individual risk of HCV acquisition. Three UK cities with varying chronic HCV prevalence (Bristol 45%, Dundee 26%, Walsall 19%), OST (72-81%) and HCNSP coverage (28-56%). Relative change in new HCV infections throughout 2016-30 if current interventions were stopped. Scale-up of HCNSP, OST and HCV treatment required to achieve the WHO elimination target. Removing HCNSP or OST would increase the number of new HCV infections throughout 2016 to 2030 by 23-64 and 92-483%, respectively. Conversely, scaling-up these interventions to 80% coverage could achieve a 29 or 49% reduction in Bristol and Walsall, respectively, whereas Dundee may achieve a 90% decrease in incidence with current levels of intervention because of existing high levels of HCV treatment (47-58 treatments per 1000 PWID). If OST and HCNSP are scaled-up, Walsall and Bristol can achieve the same impact by treating 14 or 40 per 1000 PWID annually, respectively (currently two and nine treatments per 1000 PWID), while 18 and 43 treatments per 1000 PWID would be required if OST and HCNSP are not scaled-up. Current opioid substitution therapy and high-coverage needle and syringe provision coverage is averting substantial hepatitis C transmission in the United Kingdom. Maintaining this coverage while getting current drug injectors onto treatment can reduce incidence by 90% by 2030. © 2018 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Maintaining and Enhancing Diversity of Sampled Protein Conformations in Robotics-Inspired Methods.

PubMed

Abella, Jayvee R; Moll, Mark; Kavraki, Lydia E

2018-01-01

The ability to efficiently sample structurally diverse protein conformations allows one to gain a high-level view of a protein's energy landscape. Algorithms from robot motion planning have been used for conformational sampling, and several of these algorithms promote diversity by keeping track of "coverage" in conformational space based on the local sampling density. However, large proteins present special challenges. In particular, larger systems require running many concurrent instances of these algorithms, but these algorithms can quickly become memory intensive because they typically keep previously sampled conformations in memory to maintain coverage estimates. In addition, robotics-inspired algorithms depend on defining useful perturbation strategies for exploring the conformational space, which is a difficult task for large proteins because such systems are typically more constrained and exhibit complex motions. In this article, we introduce two methodologies for maintaining and enhancing diversity in robotics-inspired conformational sampling. The first method addresses algorithms based on coverage estimates and leverages the use of a low-dimensional projection to define a global coverage grid that maintains coverage across concurrent runs of sampling. The second method is an automatic definition of a perturbation strategy through readily available flexibility information derived from B-factors, secondary structure, and rigidity analysis. Our results show a significant increase in the diversity of the conformations sampled for proteins consisting of up to 500 residues when applied to a specific robotics-inspired algorithm for conformational sampling. The methodologies presented in this article may be vital components for the scalability of robotics-inspired approaches.

42 CFR 486.110 - Condition for coverage: Inspection of equipment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Condition for coverage: Inspection of equipment... coverage: Inspection of equipment. Inspections of all X-ray equipment and shielding are made by qualified... supplier maintains records of current inspections which include the extent to which equipment and shielding...

Health Insurance Stability and Health Status: Do Family-Level Coverage Patterns Matter?

ERIC Educational Resources Information Center

Nielsen, Robert B.; Garasky, Steven

2008-01-01

Being uninsured affects one's ability to access medical services and maintain health. Using longitudinal data from the Survey of Income and Program Participation, the authors investigated how individual and family insurance coverage affects adult health. They found that health insurance coverage often varies across family members and changes…

No survival benefit to gaining private health insurance coverage for post-lung transplant care in adults with cystic fibrosis.

PubMed

Tumin, Dmitry; Foraker, Randi E; Tobias, Joseph D; Hayes, Don

2016-03-01

The use of public insurance is associated with diminished survival in patients with cystic fibrosis (CF) following lung transplantation. No data exist on benefits of gaining private health insurance for post-transplant care among such patients previously using public insurance. The United Network for Organ Sharing database was used to identify first-time lung transplant recipients participating in Medicare or Medicaid, diagnosed with CF, and transplanted between 2005 and 2015. Survival outcomes were compared between recipients gaining private insurance after transplantation and those maintaining public coverage throughout follow-up. Since implementation of the lung allocation score, 575 adults with CF received lung transplantation funded by Medicare or Medicaid and contributed data on insurance status post-transplant. There were 128 (22%) patients who gained private insurance. Multivariable analysis of time-varying insurance status found no survival benefit of gaining private insurance (HR = 0.822; 95% CI = 0.525, 1.286; p = 0.390). Further analysis demonstrated that resuming public insurance coverage was detrimental, relative to gaining and keeping private insurance (HR = 2.315; 95% CI = 1.020, 5.258; p = 0.045). Survival disadvantages of lung transplant recipients with CF who have public health insurance were not ameliorated by a switch to private coverage for post-transplant care. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Planning long lasting insecticide treated net campaigns: should households’ existing nets be taken into account?

PubMed Central

2013-01-01

Background Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. Methods A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net ‘decay’ parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Conclusions Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage. PMID:23763773

Planning long lasting insecticide treated net campaigns: should households' existing nets be taken into account?

PubMed

Yukich, Joshua; Bennett, Adam; Keating, Joseph; Yukich, Rudy K; Lynch, Matt; Eisele, Thomas P; Kolaczinski, Kate

2013-06-14

Mass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time. A stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net 'decay' parameters and other factors including the feasibility and accuracy of identifying existing nets in the field. Results indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered. Where pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage.

32 CFR 2001.71 - Coverage.

Code of Federal Regulations, 2011 CFR

2011-07-01

... ARCHIVES AND RECORDS ADMINISTRATION CLASSIFIED NATIONAL SECURITY INFORMATION Security Education and Training § 2001.71 Coverage. (a) General. Each department or agency shall establish and maintain a formal security education and training program which provides for initial training, refresher training...

Maintaining high rates of measles immunization in Africa.

PubMed

Lessler, J; Moss, W J; Lowther, S A; Cummings, D A T

2011-07-01

Supplementary immunization activities (SIAs) are important in achieving high levels of population immunity to measles virus. Using data from a 2006 survey of measles vaccination in Lusaka, Zambia, we developed a model to predict measles immunity following routine vaccination and SIAs, and absent natural infection. Projected population immunity was compared between the current programme and alternatives, including supplementing routine vaccination with a second dose, or SIAs at 1-, 2-, 3-, 4- and 5-year intervals. Current routine vaccination plus frequent SIAs could maintain high levels of population immunity in children aged <5 years, even if each frequent SIA has low coverage (e.g. ≥ 72% for bi-annual 60% coverage SIAs vs. ≥ 69% for quadrennial 95% coverage SIAs). A second dose at 12 months with current coverage could achieve 81% immunity. Circulating measles virus will only increase population immunity. Public health officials should consider frequent SIAs when resources for a two-dose strategy are unavailable.

Balancing Evidence and Uncertainty when Considering Rubella Vaccine Introduction

PubMed Central

Lessler, Justin; Metcalf, C. Jessica E.

2013-01-01

Background Despite a safe and effective vaccine, rubella vaccination programs with inadequate coverage can raise the average age of rubella infection; thereby increasing rubella cases among pregnant women and the resulting congenital rubella syndrome (CRS) in their newborns. The vaccination coverage necessary to reduce CRS depends on the birthrate in a country and the reproductive number, R0, a measure of how efficiently a disease transmits. While the birthrate within a country can be known with some accuracy, R0 varies between settings and can be difficult to measure. Here we aim to provide guidance on the safe introduction of rubella vaccine into countries in the face of substantial uncertainty in R0. Methods We estimated the distribution of R0 in African countries based on the age distribution of rubella infection using Bayesian hierarchical models. We developed an age specific model of rubella transmission to predict the level of R0 that would result in an increase in CRS burden for specific birth rates and coverage levels. Combining these results, we summarize the safety of introducing rubella vaccine across demographic and coverage contexts. Findings The median R0 of rubella in the African region is 5.2, with 90% of countries expected to have an R0 between 4.0 and 6.7. Overall, we predict that countries maintaining routine vaccination coverage of 80% or higher are can be confident in seeing a reduction in CRS over a 30 year time horizon. Conclusions Under realistic assumptions about human contact, our results suggest that even in low birth rate settings high vaccine coverage must be maintained to avoid an increase in CRS. These results lend further support to the WHO recommendation that countries reach 80% coverage for measles vaccine before introducing rubella vaccination, and highlight the importance of maintaining high levels of vaccination coverage once the vaccine is introduced. PMID:23861777

Balancing evidence and uncertainty when considering rubella vaccine introduction.

PubMed

Lessler, Justin; Metcalf, C Jessica E

2013-01-01

Despite a safe and effective vaccine, rubella vaccination programs with inadequate coverage can raise the average age of rubella infection; thereby increasing rubella cases among pregnant women and the resulting congenital rubella syndrome (CRS) in their newborns. The vaccination coverage necessary to reduce CRS depends on the birthrate in a country and the reproductive number, R0, a measure of how efficiently a disease transmits. While the birthrate within a country can be known with some accuracy, R0 varies between settings and can be difficult to measure. Here we aim to provide guidance on the safe introduction of rubella vaccine into countries in the face of substantial uncertainty in R0. We estimated the distribution of R0 in African countries based on the age distribution of rubella infection using Bayesian hierarchical models. We developed an age specific model of rubella transmission to predict the level of R0 that would result in an increase in CRS burden for specific birth rates and coverage levels. Combining these results, we summarize the safety of introducing rubella vaccine across demographic and coverage contexts. The median R0 of rubella in the African region is 5.2, with 90% of countries expected to have an R0 between 4.0 and 6.7. Overall, we predict that countries maintaining routine vaccination coverage of 80% or higher are can be confident in seeing a reduction in CRS over a 30 year time horizon. Under realistic assumptions about human contact, our results suggest that even in low birth rate settings high vaccine coverage must be maintained to avoid an increase in CRS. These results lend further support to the WHO recommendation that countries reach 80% coverage for measles vaccine before introducing rubella vaccination, and highlight the importance of maintaining high levels of vaccination coverage once the vaccine is introduced.

SU-E-T-639: Proton Dose Calculation for Irregular Motion Using a Sliding Interface

DOE Office of Scientific and Technical Information (OSTI.GOV)

Phillips, J; Gueorguiev, G; Grassberger, C

2015-06-15

Purpose: While many techniques exist to evaluate dose to regularly moving lung targets, there are few available to calculate dose at tumor positions not present in the 4DCT. We have previously developed a method that extrapolates an existing dose to a new tumor location. In this abstract, we present a novel technique that accounts for relative anatomical shifts at the chest wall interface. We also utilize this procedure to simulate breathing motion functions on a cohort of eleven patients. Amplitudes exceeding the original range of motion were used to evaluate coverage using several aperture and smearing beam settings. Methods: Themore » water-equivalent depth (WED) technique requires an initial dose and CT image at the corresponding tumor position. Each dose volume was converted from its Cartesian geometry into a beam-specific radiological depth space. The sliding chest wall interface was determined by converting the lung contour into this same space. Any dose proximal to the initial boundary of the warped lung contour was held fixed, while the remaining distal dose was moved in the direction of motion along the interface. Results: V95 coverage was computed for each patient using the updated algorithm. Incorporation of the sliding motion yielded large dose differences, with gamma pass rates as low as 69.7% (3mm, 3%) and V95 coverage differences up to 2.0%. Clinical coverage was maintained for most patients with 5 mm excess simulated breathing motion, and up to 10 mm of excess motion was tolerated for a subset of patients and beam settings. Conclusion: We have established a method to determine the maximum allowable excess breathing motion for a given plan on a patient-by-patient basis. By integrating a sliding chest wall interface into our dose calculation technique, we have analyzed the robustness of breathing patterns that differ during treatment from at the time of 4DCT acquisition.« less

South Africa's universal health coverage reforms in the post-apartheid period.

PubMed

van den Heever, Alexander Marius

2016-12-01

In 2011, the South African government published a Green Paper outlining proposals for a single-payer National Health Insurance arrangement as a means to achieve universal health coverage (UHC), followed by a White Paper in 2015. This follows over two decades of health reform proposals and reforms aimed at deepening UHC. The most recent reform departure aims to address pooling and purchasing weaknesses in the health system by internalising both functions within a single scheme. This contrasts with the post-apartheid period from 1994 to 2008 where pooling weaknesses were to be addressed using pooling schemes, in the form of government subsidies and risk-equalisation arrangements, external to the public and private purchasers. This article reviews both reform paths and attempts to reconcile what may appear to be very different approaches. The scale of the more recent set of proposals requires a very long reform path because in the mid-term (the next 25 years) no single scheme will be able to raise sufficient revenue to provide a universal package for the entire population. In the interim, reforms that maintain and improve existing forms of coverage are required. The earlier reform framework (1994-2008) largely addressed this concern while leaving open the final form of the system. Both reform approaches are therefore compatible: the earlier reforms addressed medium- to long-term coverage concerns, while the more recent define the long-term institutional goal. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Transforming Coverage of Primary Prevention in Abnormal Psychology Courses.

ERIC Educational Resources Information Center

Dalton, James H.; And Others

1994-01-01

Maintains that a comprehensive understanding of abnormal psychology requires coverage of recent advances in primary prevention. Describes a conceptual scheme and recommends resources and teaching methods for instructors. Asserts that clinical and community psychology are conceptually distinct but complementary fields. (CFR)

29 CFR 825.211 - Maintenance of benefits under multi-employer health plans.

Code of Federal Regulations, 2010 CFR

2010-07-01

... which is maintained pursuant to one or more collective bargaining agreements between employee..., unless the plan contains an explicit FMLA provision for maintaining coverage such as through pooled... by the group health plan, and benefits provided pursuant to the plan, must be maintained at the level...

Correlation between measles vaccine doses: implications for the maintenance of elimination.

PubMed

McKee, A; Ferrari, M J; Shea, K

2018-03-01

Measles eradication efforts have been successful at achieving elimination in many countries worldwide. Such countries actively work to maintain this elimination by continuing to improve coverage of two routine doses of measles vaccine following measles elimination. While improving measles vaccine coverage is always beneficial, we show, using a steady-state analysis of a dynamical model, that the correlation between populations receiving the first and second routine dose also has a significant impact on the population immunity achieved by a specified combination of first and second dose coverage. If the second dose is administered to people independently of whether they had the first dose, high second-dose coverage improves the proportion of the population receiving at least one dose, and will have a large effect on population immunity. If the second dose is administered only to people who have had the first dose, high second-dose coverage reduces the rate of primary vaccine failure, but does not reach people who missed the first dose; this will therefore have a relatively small effect on population immunity. When doses are administered dependently, and assuming the first dose has higher coverage, increasing the coverage of the first dose has a larger impact on population immunity than does increasing the coverage of the second. Correlation between vaccine doses has a significant impact on the level of population immunity maintained by current vaccination coverage, potentially outweighing the effects of age structure and, in some cases, recent improvements in vaccine coverage. It is therefore important to understand the correlation between vaccine doses as such correlation may have a large impact on the effectiveness of measles vaccination strategies.

Insuring Your Property. The CIRcular: Consumer Information Report 29.

ERIC Educational Resources Information Center

Bank of America NT & SA, San Francisco, CA.

This report presents guidelines to help homeowners, renters, and condominium owners purchase and maintain adequate insurance coverage for their residences and personal property. Types of property coverage discussed include the following: (1) standard policies and exclusions; (2) special programs (earthquake insurance, federal programs for…

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Condition for coverage-Environment. 416.44 Section... for coverage—Environment. The ASC must have a safe and sanitary environment, properly constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical environment...

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Condition for coverage-Environment. 416.44 Section... for coverage—Environment. The ASC must have a safe and sanitary environment, properly constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical environment...

Vaccination coverage among children in kindergarten - United States, 2012-13 school year.

PubMed

2013-08-02

State and local school vaccination requirements are implemented to maintain high vaccination coverage and minimize the risk from vaccine preventable diseases. To assess school vaccination coverage and exemptions, CDC annually analyzes school vaccination coverage data from federally funded immunization programs. These awardees include 50 states and the District of Columbia (DC), five cities, and eight U.S.-affiliated jurisdictions. This report summarizes vaccination coverage from 48 states and DC and exemption rates from 49 states and DC for children entering kindergarten for the 2012-13 school year. Forty-eight states and DC reported vaccination coverage, with medians of 94.5% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.1% for local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccination; and 93.8% for 2 doses of varicella vaccine among awardees with a 2-dose requirement. Forty-nine states and DC reported exemption rates, with the median total of 1.8%. Although school entry coverage for most awardees was at or near national Healthy People 2020 targets of maintaining 95% vaccination coverage levels for 2 doses of MMR vaccine, 4 doses of DTaP† vaccine, and 2 doses of varicella vaccine, low vaccination and high exemption levels can cluster within communities, increasing the risk for disease. Reports to CDC are aggregated at the state level; however, local reporting of school vaccination coverage might be accessible by awardees. These local-level data can be used to create evidence-based health communication strategies to help parents understand the risks for vaccine-preventable diseases and the benefits of vaccinations to the health of their children and other kindergarteners.

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Condition for coverage-Environment. 416.44 Section... constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical... Health Care Centers of the 2000 edition of the Life Safety Code of the National Fire Protection...

42 CFR 416.44 - Condition for coverage-Environment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Condition for coverage-Environment. 416.44 Section... constructed, equipped, and maintained to protect the health and safety of patients. (a) Standard: Physical... Health Care Centers of the 2000 edition of the Life Safety Code of the National Fire Protection...

78 FR 7314 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... accounting firm in accordance with generally accepted accounting principles the report of which is made... affordable coverage if the individual's required contribution (determined on an annual basis) for minimum... portion of the required contribution made through a salary reduction arrangement and excluded from gross...

Comprehensive smoke alarm coverage in lower economic status homes: alarm presence, functionality, and placement.

PubMed

Sidman, Elanor A; Grossman, David C; Mueller, Beth A

2011-08-01

The objectives of this study are to estimate smoke alarm coverage and adherence with national guidelines in low- to mid-value owner-occupied residences, and to identify resident demographic, behavioral, and building characteristics and other fire and burn safety practices associated with smoke alarm utilization. Baseline visits were conducted with 779 households in King County, Washington, for a randomized trial of smoke alarm functionality. Presence, functionality, features, and location of pre-existing smoke alarms were ascertained by staff observation and testing. Household and building descriptors were collected using questionnaires. Households were classified by presence of smoke alarms, functional alarms, and functional and properly mounted alarms placed in hallways and on each floor but not in recommended avoidance locations. Smoke alarms were present in 89%, and functional units in 78%, of households. Only 6-38% met all assessed functionality and placement recommendations. Homes frequently lacked alarms in any bedrooms or on each floor. Building age, but not renovation status, was associated with all dimensions of smoke alarm coverage; post-1980 constructions were 1.7 times more likely to comply with placement recommendations than were pre-1941 homes (95% CI: 1.1-2.6). Respondent education and race/ethnicity, children <5 years, residency duration, number of floors, wood stoves and fireplaces, number of smoke alarms, recency of smoke alarm testing, carbon monoxide monitors, and fire ladders displayed varying relationships with alarm presence, functionality, and placement. Strategies for maintaining smoke alarms in functional condition and improving compliance with placement recommendations are necessary to achieve universal coverage, and will benefit the majority of households.

Node Self-Deployment Algorithm Based on an Uneven Cluster with Radius Adjusting for Underwater Sensor Networks

PubMed Central

Jiang, Peng; Xu, Yiming; Wu, Feng

2016-01-01

Existing move-restricted node self-deployment algorithms are based on a fixed node communication radius, evaluate the performance based on network coverage or the connectivity rate and do not consider the number of nodes near the sink node and the energy consumption distribution of the network topology, thereby degrading network reliability and the energy consumption balance. Therefore, we propose a distributed underwater node self-deployment algorithm. First, each node begins the uneven clustering based on the distance on the water surface. Each cluster head node selects its next-hop node to synchronously construct a connected path to the sink node. Second, the cluster head node adjusts its depth while maintaining the layout formed by the uneven clustering and then adjusts the positions of in-cluster nodes. The algorithm originally considers the network reliability and energy consumption balance during node deployment and considers the coverage redundancy rate of all positions that a node may reach during the node position adjustment. Simulation results show, compared to the connected dominating set (CDS) based depth computation algorithm, that the proposed algorithm can increase the number of the nodes near the sink node and improve network reliability while guaranteeing the network connectivity rate. Moreover, it can balance energy consumption during network operation, further improve network coverage rate and reduce energy consumption. PMID:26784193

A review of adipocyte lineage cells and dermal papilla cells in hair follicle regeneration

PubMed Central

Zhang, Peipei; Kling, Russell E; Ravuri, Sudheer K; Kokai, Lauren E; Rubin, J Peter; Chai, Jia-ke

2014-01-01

Alopecia is an exceedingly prevalent problem effecting men and women of all ages. The standard of care for alopecia involves either transplanting existing hair follicles to bald areas or attempting to stimulate existing follicles with topical and/or oral medication. Yet, these treatment options are fraught with problems of cost, side effects, and, most importantly, inadequate long-term hair coverage. Innovative cell-based therapies have focused on the dermal papilla cell as a way to grow new hair in previously bald areas. However, despite this attention, many obstacles exist, including retention of dermal papilla inducing ability and maintenance of dermal papilla productivity after several passages of culture. The use of adipocyte lineage cells, including adipose-derived stem cells, has shown promise as a cell-based solution to regulate hair regeneration and may help in maintaining or increasing dermal papilla cells inducing hair ability. In this review, we highlight recent advances in the understanding of the cellular contribution and regulation of dermal papilla cells and summarize adipocyte lineage cells in hair regeneration. PMID:25383178

78 FR 17900 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-25

... program under title XIX of the Social Security Act, (3) the Children's Health Insurance Program (CHIP... program under title XIX of the Social Security Act; (3) the Children's Health Insurance Program (CHIP... qualified health plans in which the taxpayers or a member of the taxpayers family (coverage family) is...

A Novel Deployment Scheme Based on Three-Dimensional Coverage Model for Wireless Sensor Networks

PubMed Central

Xiao, Fu; Yang, Yang; Wang, Ruchuan; Sun, Lijuan

2014-01-01

Coverage pattern and deployment strategy are directly related to the optimum allocation of limited resources for wireless sensor networks, such as energy of nodes, communication bandwidth, and computing power, and quality improvement is largely determined by these for wireless sensor networks. A three-dimensional coverage pattern and deployment scheme are proposed in this paper. Firstly, by analyzing the regular polyhedron models in three-dimensional scene, a coverage pattern based on cuboids is proposed, and then relationship between coverage and sensor nodes' radius is deduced; also the minimum number of sensor nodes to maintain network area's full coverage is calculated. At last, sensor nodes are deployed according to the coverage pattern after the monitor area is subdivided into finite 3D grid. Experimental results show that, compared with traditional random method, sensor nodes number is reduced effectively while coverage rate of monitor area is ensured using our coverage pattern and deterministic deployment scheme. PMID:25045747

NSW annual immunisation coverage report, 2011.

PubMed

Hull, Brynley; Dey, Aditi; Campbell-Lloyd, Sue; Menzies, Robert I; McIntyre, Peter B

2012-12-01

This annual report, the third in the series, documents trends in immunisation coverage in NSW for children, adolescents and the elderly, to the end of 2011. Data from the Australian Childhood Immunisation Register, the NSW School Immunisation Program and the NSW Population Health Survey were used to calculate various measures of population coverage. During 2011, greater than 90% coverage was maintained for children at 12 and 24 months of age. For children at 5 years of age the improvement seen in 2010 was sustained, with coverage at or near 90%. For adolescents, there was improved coverage for all doses of human papillomavirus vaccine, both doses of hepatitis B vaccine, varicella vaccine and the dose of diphtheria, tetanus and acellular pertussis given to school attendees in Years 7 and 10. Pneumococcal vaccination coverage in the elderly has been steadily rising, although it has remained lower than the influenza coverage estimates. This report provides trends in immunisation coverage in NSW across the age spectrum. The inclusion of coverage estimates for the pneumococcal conjugate, varicella and meningococcal C vaccines in the official coverage assessments for 'fully immunised' in 2013 is a welcome initiative.

Novel color additive for chlorine disinfectants corrects deficiencies in spray surface coverage and wet-contact time and checks for correct chlorine concentration.

PubMed

Tyan, Kevin; Jin, Katherine; Kang, Jason; Kyle, Aaron M

2018-04-18

Bleach sprays suffer from poor surface coverage, dry out before reaching proper contact time, and can be inadvertently over-diluted to ineffective concentrations. Highlight ® , a novel color additive for bleach that fades to indicate elapsed contact time, maintained >99.9% surface coverage over full contact time and checked for correct chlorine concentration. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Medicare Part D formulary coverage since program inception: are beneficiaries choosing wisely?

PubMed

Jackson, E Anne; Axelsen, Kirsten J

2008-11-01

To evaluate how Medicare Part D formulary composition has changed since program inception, including comparison of plans eligible for full premium subsidy (ie, benchmark plans) with their counterparts. The study used publicly available data released by the Centers for Medicare & Medicaid Services to generate snapshots of formulary coverage and enrollment levels in each plan year. The analysis included all Part D plans and tracked formulary coverage of 152 of the most common brand name and generic drugs prescribed to seniors. Since 2006, the number of products available without restriction has increased and the number of drugs not on formulary has decreased. However, it appears that beneficiaries (subsidized beneficiaries in particular) may not be using their open-enrollment periods to reevaluate the available plan offerings. Beneficiaries need to reevaluate the Part D options available on an annual basis to maintain enrollment with the most appropriate plan available. Although all plans meet the proscribed formulary requirements, some plans offer richer drug coverage with more drugs available on an unrestricted basis. Benchmark plan status allows Part D plans to maintain or gain significant Medicare enrollment from year to year. Careful oversight should be provided to ensure that the level of formulary coverage offered at benchmark and other plans remains consistent.

Recent El Niño brought downpour of media coverage

NASA Astrophysics Data System (ADS)

Hare, Steven R.

Media coverage of the 1997-1998 tropical ocean warming event made the term “El Nino” a household word. So pervasive was coverage of El Nino that it became the fodder of late night talk show monologues and an oft-invoked gremlin responsible for many of society's ailments. As a fisheries biologist studying climate impacts on marine resources, I followed the event very closely and created an El Nino Web site (http://www. iphc.washington.edu/PAGES/IPHC/Staff/ hare/html/1997ENSO/ 1997ENSO.html) in the spring of 1997 when the magnitude of the event was becoming obvious.As part of my daily routine in updating the Web page, I began tracking El Nino media coverage over the Internet. Between June 1997 and July 1998,1 accumulated links to stories about El Nino. I attempted to maintain a constant level of effort so that the number of stories accurately reflected the level of coverage given the event as it progressed. In fisheries lingo, this is known as a Catch Per Unit Effort (CPUE) index. Because Internet content is often removed after a period of time, a retrospective accumulation of daily stories would not yield as accurate a count as the contemporary CPUE index I maintained.

Progress Toward Measles Elimination - Western Pacific Region, 2013-2017.

PubMed

Hagan, José E; Kriss, Jennifer L; Takashima, Yoshihiro; Mariano, Kayla Mae L; Pastore, Roberta; Grabovac, Varja; Dabbagh, Alya J; Goodson, James L

2018-05-04

In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR)* established a goal for measles elimination † by 2012 (1). To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination (2) and the Field Guidelines for Measles Elimination (3). The strategies include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. This report updates the previous report (4) and describes progress toward measles elimination in WPR during 2013-2017. During 2013-2016, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved ≥95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013-2017 reported achieving ≥95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013-2016 to a high of 68.9 in 2014, because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.

Earthquakes of the Central United States, 1795-2002

USGS Publications Warehouse

Wheeler, Russell L.

2003-01-01

This report describes construction of a list of Central U.S. earthquakes to be shown on a large-format map that is targeted for a non-technical audience. The map shows the locations and sizes of historical earthquakes of magnitude 3.0 or larger over the most seismically active part of the central U.S., including the New Madrid seismic zone. The map shows more than one-half million square kilometers and parts or all of ten States. No existing earthquake catalog had provided current, uniform coverage down to magnitude 3.0, so one had to be made. Consultation with State geological surveys insured compatibility with earthquake lists maintained by them, thereby allowing the surveys and the map to present consistent information to the public.

20 CFR 404.1251 - Final reports-for wages paid prior to 1987.

Code of Federal Regulations, 2010 CFR

2010-04-01

... entity. The report shall include each coverage group whose existence ceases with that of the entity. It... State shall submit a statement showing the title and business address of the State official responsible... records for each coverage group whose existence is ended. The State shall also identify, as prescribed by...

Conflict in the Colonies: The London Times Coverage of Watergate from the Break-in to the Pardon.

ERIC Educational Resources Information Center

Stovall, James Glen

1979-01-01

From the breakin through the pardon of President Nixon, the London "Times" maintained thorough coverage of the Watergate scandal--a difficult task, considering the complexities of the American judicial and political systems. A special Watergate section was added to the other sections of the "Times," and even the British…

24 CFR 200.17 - Mortgage coverage.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 2 2014-04-01 2014-04-01 false Mortgage coverage. 200.17 Section 200.17 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... Eligibility Requirements for Existing Projects Eligible Mortgage § 200.17 Mortgage coverage. The mortgage...

24 CFR 200.17 - Mortgage coverage.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 2 2013-04-01 2013-04-01 false Mortgage coverage. 200.17 Section 200.17 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued... Eligibility Requirements for Existing Projects Eligible Mortgage § 200.17 Mortgage coverage. The mortgage...

46 CFR 8.230 - Minimum standards for a recognized classification society.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and maintain class rules in the English language for the design, construction and certification of ships and their associated essential engineering systems; (8) Maintain written survey procedures in the... and geographical coverage to carry out all plan review and vessel survey activities associated with...

46 CFR 8.230 - Minimum standards for a recognized classification society.

Code of Federal Regulations, 2012 CFR

2012-10-01

... and maintain class rules in the English language for the design, construction and certification of ships and their associated essential engineering systems; (8) Maintain written survey procedures in the... and geographical coverage to carry out all plan review and vessel survey activities associated with...

4D Optimization of Scanned Ion Beam Tracking Therapy for Moving Tumors

PubMed Central

Eley, John Gordon; Newhauser, Wayne David; Lüchtenborg, Robert; Graeff, Christian; Bert, Christoph

2014-01-01

Motion mitigation strategies are needed to fully realize the theoretical advantages of scanned ion beam therapy for patients with moving tumors. The purpose of this study was to determine whether a new four-dimensional (4D) optimization approach for scanned-ion-beam tracking could reduce dose to avoidance volumes near a moving target while maintaining target dose coverage, compared to an existing 3D-optimized beam tracking approach. We tested these approaches computationally using a simple 4D geometrical phantom and a complex anatomic phantom, that is, a 4D computed tomogram of the thorax of a lung cancer patient. We also validated our findings using measurements of carbon-ion beams with a motorized film phantom. Relative to 3D-optimized beam tracking, 4D-optimized beam tracking reduced the maximum predicted dose to avoidance volumes by 53% in the simple phantom and by 13% in the thorax phantom. 4D-optimized beam tracking provided similar target dose homogeneity in the simple phantom (standard deviation of target dose was 0.4% versus 0.3%) and dramatically superior homogeneity in the thorax phantom (D5-D95 was 1.9% versus 38.7%). Measurements demonstrated that delivery of 4D-optimized beam tracking was technically feasible and confirmed a 42% decrease in maximum film exposure in the avoidance region compared with 3D-optimized beam tracking. In conclusion, we found that 4D-optimized beam tracking can reduce the maximum dose to avoidance volumes near a moving target while maintaining target dose coverage, compared with 3D-optimized beam tracking. PMID:24889215

4D optimization of scanned ion beam tracking therapy for moving tumors

NASA Astrophysics Data System (ADS)

Eley, John Gordon; Newhauser, Wayne David; Lüchtenborg, Robert; Graeff, Christian; Bert, Christoph

2014-07-01

Motion mitigation strategies are needed to fully realize the theoretical advantages of scanned ion beam therapy for patients with moving tumors. The purpose of this study was to determine whether a new four-dimensional (4D) optimization approach for scanned-ion-beam tracking could reduce dose to avoidance volumes near a moving target while maintaining target dose coverage, compared to an existing 3D-optimized beam tracking approach. We tested these approaches computationally using a simple 4D geometrical phantom and a complex anatomic phantom, that is, a 4D computed tomogram of the thorax of a lung cancer patient. We also validated our findings using measurements of carbon-ion beams with a motorized film phantom. Relative to 3D-optimized beam tracking, 4D-optimized beam tracking reduced the maximum predicted dose to avoidance volumes by 53% in the simple phantom and by 13% in the thorax phantom. 4D-optimized beam tracking provided similar target dose homogeneity in the simple phantom (standard deviation of target dose was 0.4% versus 0.3%) and dramatically superior homogeneity in the thorax phantom (D5-D95 was 1.9% versus 38.7%). Measurements demonstrated that delivery of 4D-optimized beam tracking was technically feasible and confirmed a 42% decrease in maximum film exposure in the avoidance region compared with 3D-optimized beam tracking. In conclusion, we found that 4D-optimized beam tracking can reduce the maximum dose to avoidance volumes near a moving target while maintaining target dose coverage, compared with 3D-optimized beam tracking.

Implementing Preventive Chemotherapy through an Integrated National Neglected Tropical Disease Control Program in Mali

PubMed Central

Dembélé, Massitan; Bamani, Sanoussi; Dembélé, Robert; Traoré, Mamadou O.; Goita, Seydou; Traoré, Mamadou Namory; Sidibe, Abdoul Karim; Sam, Letitia; Tuinsma, Marjon; Toubali, Emily; MacArthur, Chad; Baker, Shawn K.; Zhang, Yaobi

2012-01-01

Background Mali is endemic for all five targeted major neglected tropical diseases (NTDs). As one of the five ‘fast-track’ countries supported with the United States Agency for International Development (USAID) funds, Mali started to integrate the activities of existing disease-specific national control programs on these diseases in 2007. The ultimate objectives are to eliminate lymphatic filariasis, onchocerciasis and trachoma as public health problems and to reduce morbidity caused by schistosomiasis and soil-transmitted helminthiasis through regular treatment to eligible populations, and the specific objectives were to achieve 80% program coverage and 100% geographical coverage yearly. The paper reports on the implementation of the integrated mass drug administration and the lessons learned. Methodology/Principal Findings The integrated control program was led by the Ministry of Health and coordinated by the national NTD Control Program. The drug packages were designed according to the disease endemicity in each district and delivered through various platforms to eligible populations involving the primary health care system. Treatment data were recorded and reported by the community drug distributors. After a pilot implementation of integrated drug delivery in three regions in 2007, the treatment for all five targeted NTDs was steadily scaled up to 100% geographical coverage by 2009, and program coverage has since been maintained at a high level: over 85% for lymphatic filariasis, over 90% for onchocerciasis and soil-transmitted helminthiasis, around 90% in school-age children for schistosomiasis, and 76–97% for trachoma. Around 10 million people have received one or more drug packages each year since 2009. No severe cases of adverse effects were reported. Conclusions/Significance Mali has scaled up the drug treatment to national coverage through integrated drug delivery involving the primary health care system. The successes and lessons learned in Mali can be valuable assets to other countries starting up their own integrated national NTD control programs. PMID:22448294

A Cooperative Search and Coverage Algorithm with Controllable Revisit and Connectivity Maintenance for Multiple Unmanned Aerial Vehicles.

PubMed

Liu, Zhong; Gao, Xiaoguang; Fu, Xiaowei

2018-05-08

In this paper, we mainly study a cooperative search and coverage algorithm for a given bounded rectangle region, which contains several unknown stationary targets, by a team of unmanned aerial vehicles (UAVs) with non-ideal sensors and limited communication ranges. Our goal is to minimize the search time, while gathering more information about the environment and finding more targets. For this purpose, a novel cooperative search and coverage algorithm with controllable revisit mechanism is presented. Firstly, as the representation of the environment, the cognitive maps that included the target probability map (TPM), the uncertain map (UM), and the digital pheromone map (DPM) are constituted. We also design a distributed update and fusion scheme for the cognitive map. This update and fusion scheme can guarantee that each one of the cognitive maps converges to the same one, which reflects the targets’ true existence or absence in each cell of the search region. Secondly, we develop a controllable revisit mechanism based on the DPM. This mechanism can concentrate the UAVs to revisit sub-areas that have a large target probability or high uncertainty. Thirdly, in the frame of distributed receding horizon optimizing, a path planning algorithm for the multi-UAVs cooperative search and coverage is designed. In the path planning algorithm, the movement of the UAVs is restricted by the potential fields to meet the requirements of avoiding collision and maintaining connectivity constraints. Moreover, using the minimum spanning tree (MST) topology optimization strategy, we can obtain a tradeoff between the search coverage enhancement and the connectivity maintenance. The feasibility of the proposed algorithm is demonstrated by comparison simulations by way of analyzing the effects of the controllable revisit mechanism and the connectivity maintenance scheme. The Monte Carlo method is employed to validate the influence of the number of UAVs, the sensing radius, the detection and false alarm probabilities, and the communication range on the proposed algorithm.

12 CFR 745.0 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insured credit union member or otherwise eligible to maintain an insured account in a credit union. These rules do not extend insurance coverage to persons not entitled to maintain an insured account or to account relationships that have not been approved by the Board as an insured account. Where there are...

[Gaps in effective coverage by socioeconomic status and poverty condition].

PubMed

Gutiérrez, Juan Pablo

2013-01-01

To analyze, in the context of increased health protection in Mexico, the gaps by socioeconomic status and poverty condition on effective coverage of selected preventive interventions. Data from the National Health & Nutrition Survey 2012 and 2006, using previously defined indicators of effective coverage and stratifying them by socioeconomic (SE) status and multidimensional poverty condition. For vaccination interventions, immunological equity has been maintained in Mexico. For indicators related to preventive interventions provided at the clinical setting, effective coverage is lower among those in the lowest SE quintile and among people living in multidimensional poverty. Comparing 2006 and 2012, there is no evidence on gap reduction. While health protection has significantly increased in Mexico, thus reducing SE gaps, those gaps are still important in magnitude for effective coverage of preventive interventions.

Phosphonic Acids on an Atomically Defined Oxide Surface: The Binding Motif Changes with Surface Coverage.

PubMed

Schuschke, Christian; Schwarz, Matthias; Hohner, Chantal; Silva, Thais N; Fromm, Lukas; Döpper, Tibor; Görling, Andreas; Libuda, Jörg

2018-04-19

We have studied the anchoring mechanism of a phosphonic acid on an atomically defined oxide surface. Using time-resolved infrared reflection absorption spectroscopy, we investigated the reaction of deuterated phenylphosphonic acid (DPPA, C 6 H 5 PO 3 D 2 ) with an atomically defined Co 3 O 4 (111) surface in situ during film growth by physical vapor deposition. We show that the binding motif of the phosphonate anchor group changes as a function of coverage. At low coverage, DPPA binds in the form of a chelating tridentate phosphonate, while a transition to a chelating bidentate occurs close to monolayer saturation coverage. However, the coverage-dependent change in the binding motif is not associated with a major change of the molecular orientation, suggesting that the rigid phosphonate linker always maintains the DPPA in a strongly tilted orientation irrespective of the surface coverage.

20 CFR 10.739 - What kind of objective evidence of a potential Federal crime must exist for coverage to be extended?

Code of Federal Regulations, 2011 CFR

2011-04-01

...-Federal Law Enforcement Officers § 10.739 What kind of objective evidence of a potential Federal crime... potential Federal crime must exist for coverage to be extended? 10.739 Section 10.739 Employees' Benefits OFFICE OF WORKERS' COMPENSATION PROGRAMS, DEPARTMENT OF LABOR FEDERAL EMPLOYEES' COMPENSATION ACT CLAIMS...

Maintaining health insurance during a recession: likely COBRA eligibility: an updated analysis using the Commonwealth Fund 2007 Biennial Health Insurance Survey.

PubMed

Doty, Michelle; Rustgi, Sheila D; Schoen, Cathy; Collins, Sara R

2009-01-01

As the U.S. economic downturn continues and job losses mount, more working Americans are likely to lose access to affordable health benefits subsidized by their employers. Analysis of the 2007 Commonwealth Fund Biennial Health Insurance Survey finds that two of three working adults would be eligible to extend job-based coverage, under the 1985 Consolidated Omnibus Budget Reconciliation Act (COBRA) if they became unemployed. Under COBRA, however, unemployed workers would have to pay four to six times their current contribution at a time of sharply reduced income. In fact, the latest national figures indicate that, because of high premiums, only 9 percent of unemployed workers have COBRA coverage. Substantial financial assistance of 75 percent to 85 percent of premiums could help laid-off workers maintain coverage. In addition, expansion of Medicaid and the State Children's Health Insurance Program would benefit low-income, laid-off workers and their families who are ineligible for COBRA.

Implementation of the 64-meter-diameter Antennas at the Deep Space Stations in Australia and Spain

NASA Technical Reports Server (NTRS)

Bartos, K. P.; Bell, H. B.; Phillips, H. P.; Sweetser, B. M.; Rotach, O. A.

1975-01-01

The management and construction aspects of the Overseas 64-m Antenna Project in which two 64-m antennas were constructed at the Tidbinbilla Deep Space Communications Complex in Australia, and at the Madrid Deep Space Communications Complex in Spain are described. With the completion of these antennas the Deep Space Network is equipped with three 64-m antennas spaced around the world to maintain continuous coverage of spacecraft operations. These antennas provide approximately a 7-db gain over the capabilities of the existing 26-m antenna nets. The report outlines the project organization and management, resource utilization, fabrication, quality assurance, and construction methods by which the project was successfully completed. Major problems and their solutions are described as well as recommendations for future projects.

Nanoporous Gold as a Neural Interface Coating: Effects of Topography, Surface Chemistry, and Feature Size

DOE PAGES

Chapman, Christopher A. R.; Chen, Hao; Stamou, Marianna; ...

2015-02-23

We report that designing neural interfaces that maintain close physical coupling of neurons to an electrode surface remains a major challenge for both implantable and in vitro neural recording electrode arrays. Typically, low-impedance nanostructured electrode coatings rely on chemical cues from pharmaceuticals or surface-immobilized peptides to suppress glial scar tissue formation over the electrode surface (astrogliosis), which is an obstacle to reliable neuron–electrode coupling. Nanoporous gold (np-Au), produced by an alloy corrosion process, is a promising candidate to reduce astrogliosis solely through topography by taking advantage of its tunable length scale. In the present in vitro study on np-Au’s interactionmore » with cortical neuron–glia co-cultures, we demonstrate that the nanostructure of np-Au achieves close physical coupling of neurons by maintaining a high neuron-to-astrocyte surface coverage ratio. Atomic layer deposition-based surface modification was employed to decouple the effect of morphology from surface chemistry. Additionally, length scale effects were systematically studied by controlling the characteristic feature size of np-Au through variations in the dealloying conditions. In conclusion, our results show that np-Au nanotopography, not surface chemistry, reduces astrocyte surface coverage while maintaining high neuronal coverage and may enhance neuron–electrode coupling through nanostructure-mediated suppression of scar tissue formation.« less

The impact of new vaccine introduction on the coverage of existing vaccines: a cross-national, multivariable analysis.

PubMed

Shearer, Jessica C; Walker, Damian G; Risko, Nicholas; Levine, Orin S

2012-12-14

A surge of new and underutilized vaccine introductions into national immunization programmes has called into question the effect of new vaccine introduction on immunization and health systems. In particular, countries deciding whether to introduce a new or underutilized vaccine into their routine immunization programme may query possible effects on the delivery and coverage of existing vaccines. Using coverage of diphtheria-tetanus-pertussis (DTP) vaccine as a proxy for immunization system performance, this study aims to test whether new vaccine introduction into national immunization programs was associated with changes in coverage of three doses of DTP vaccine among infants. DTP3 vaccine coverage was analyzed in 187 countries during 1999-2009 using multivariable cross-national mixed-effect longitudinal models. Controlling for other possible determinants of DTP3 coverage at the national level these models found minimal association between the introduction of Hepatitis-, Haemophilus influenzae type b-, and rotavirus-containing vaccines and DTP3 coverage. Instead, frequent and sometimes large fluctuations in coverage are associated with other development and health systems variables, including the presence of armed conflict, coverage of antenatal care services, infant mortality, the percent of health expenditures that are private and total health expenditures per capita. Introductions of new vaccines did not affect national coverage of DTP3 vaccine in the countries studied. Introductions of other new vaccines and multiple vaccine introductions should be monitored for immunization and health systems impacts. Copyright © 2012 Elsevier Ltd. All rights reserved.

Maintaining the Gains: The Importance of Preserving Coverage in MEDICAID and SCHIP.

ERIC Educational Resources Information Center

O'Brien, Ellen; Mann, Cindy

As states face increasing fiscal pressures, many are considering proposals to cut eligibility levels, eliminate outreach, and retract simplified enrollment procedures for children and families eligible for Medicaid and the State Children's Health Insurance Program (SCHIP). This paper presents evidence on the importance of maintaining gains made in…

20 CFR 10.739 - What kind of objective evidence of a potential Federal crime must exist for coverage to be extended?

Code of Federal Regulations, 2010 CFR

2010-04-01

... potential Federal crime must exist for coverage to be extended? 10.739 Section 10.739 Employees' Benefits...-Federal Law Enforcement Officers § 10.739 What kind of objective evidence of a potential Federal crime... circumstances, to conclude that a Federal crime was in progress, or was about to occur. This awareness need not...

Implications of health reform for retiree health benefits.

PubMed

Fronstin, Paul

2010-01-01

This Issue Brief examines how current health reform legislation being debated in Congress will impact the future of retiree health benefits. In general, the proposals' provisions will have a mixed impact on retiree health benefits: In the short term, the reinsurance provisions would help shore up early retiree coverage and Medicare Part D coverage would become more valuable to retirees. In the longer term, insurance reform combined with new subsidies for individuals enrolling for coverage through insurance exchanges, the maintenance-of-effort provision affecting early retiree benefits, increases to the cost of providing drug benefits to retirees, and enhanced Medicare Part D coverage, would all create significant incentives for employers to drop coverage for early retirees and drug coverage for Medicare-eligible retirees. REINSURANCE PROGRAM FOR EARLY RETIREES: Proposed legislation includes a provision to create a temporary reinsurance program for employers providing health benefits to retirees over age 55 and not yet eligible for Medicare. Given the temporary nature of the program, it is intended to provide employers an incentive to maintain benefits until the health insurance exchange is fully operational. At that point, employers will have less incentive to provide health benefits to early retirees, and retirees will have less need for former employers to maintain a program. MEDICARE DRUG BENEFITS: The House-passed bill would initially reduce the coverage gap (the so-called "doughnut hole") for individuals in the Medicare Part D program by $500 and eliminate it altogether by 2019. The bill currently before the Senate would also reduce the coverage gap by $500, but does not call for eliminating it. Both would also provide a 50 percent discount to brand-name drug coverage in the coverage gap. These provisions increase the value of the Medicare Part D drug program to Medicare-eligible beneficiaries relative to drug benefits provided by employers. TAX TREATMENT OF EMPLOYER SUBSIDIES UNDER MMA: The Medicare Modernization Act provides subsidies to employers that continue to offer prescription drug coverage through a retiree health benefits program. This subsidy is currently not counted as taxable income to the employer receiving it. Both the House and Senate bills would effectively repeal this tax exclusion. This would have two effects: The real cost of providing retiree health benefits to Medicare-eligible retirees would increase, and an employer's FAS 106 liability would increase immediately. The increase in the cost of retiree drug benefits will cause employers to re-evaluate the subsidy, compared with other available options. Moving retirees to Medicare Part D may become even more attractive to employers if the coverage gap is reduced and/or eliminated. POSTRETIREMENT BENEFIT CHANGES: With some exceptions, the House-passed legislation would prohibit employers from changing the benefits offered to retirees and their beneficiaries once a person has retired. This provision could have a number of different effects: More employers may move toward capping their contributions; employers that want to maintain retiree health benefits may react by cutting the health benefits of active workers; employers may eliminate retiree health benefits altogether to avoid being locked into providing a permanent benefit; or they may drop benefits if they think there is no need to provide them.

Is the introduction of another variable to the strength-duration curve necessary in neurostimulation?

PubMed

Abejón, David; Rueda, Pablo; del Saz, Javier; Arango, Sara; Monzón, Eva; Gilsanz, Fernando

2015-04-01

Neurostimulation is the process and technology derived from the application of electricity with different parameters to activate or inhibit nerve pathways. Pulse width (Pw) is the duration of each electrical impulse and, along with amplitude (I), determines the total energy charge of the stimulation. The aim of the study was to test Pw values to find the most adequate pulse widths in rechargeable systems to obtain the largest coverage of the painful area, the most comfortable paresthesia, and the greatest patient satisfaction. A study of the parameters was performed, varying Pw while maintaining a fixed frequency at 50 Hz. Data on perception threshold (Tp ), discomfort threshold (Td ), and therapeutic threshold (Tt ) were recorded, applying 14 increasing Pw values ranging from 50 µsec to 1000 µsec. Lastly, the behavior of the therapeutic range (TR), the coverage of the painful area, the subjective patient perception of paresthesia, and the degree of patient satisfaction were assessed. The findings after analyzing the different thresholds were as follows: When varying the Pw, the differences obtained at each threshold (Tp , Tt , and Td ) were statistically significant (p < 0.05). The differences among the resulting Tp values and among the resulting Tt values were statistically significant when varying Pw from 50 up to 600 µsec (p < 0.05). For Pw levels 600 µsec and up, no differences were observed in these thresholds. In the case of Td , significant differences existed as Pw increased from 50 to 700 µsec (p ≤ 0.05). The coverage increased in a statistically significant way (p < 0.05) from Pw values of 50 µsec to 300 µsec. Good or very good subjective perception was shown at about Pw 300 µsec. The patient paresthesia coverage was introduced as an extra variable in the chronaxie-rheobase curve, allowing the adjustment of Pw values for optimal programming. The coverage of the patient against the current chronaxie-rheobase formula will be represented on three axes; an extra axis (z) will appear, multiplying each combination of Pw value and amplitude by the percentage of coverage corresponding to those values. Using this new comparison of chronaxie-rheobase curve vs. coverage, maximum Pw values will be obtained different from those obtained by classic methods. © 2014 International Neuromodulation Society.

Systematic review of the incremental costs of interventions that increase immunization coverage.

PubMed

Ozawa, Sachiko; Yemeke, Tatenda T; Thompson, Kimberly M

2018-05-10

Achieving and maintaining high vaccination coverage requires investments, but the costs and effectiveness of interventions to increase coverage remain poorly characterized. We conducted a systematic review of the literature to identify peer-reviewed studies published in English that reported interventions aimed at increasing immunization coverage and the associated costs and effectiveness of the interventions. We found limited information in the literature, with many studies reporting effectiveness estimates, but not providing cost information. Using the available data, we developed a cost function to support future programmatic decisions about investments in interventions to increase immunization coverage for relatively low and high-income countries. The cost function estimates the non-vaccine cost per dose of interventions to increase absolute immunization coverage by one percent, through either campaigns or routine immunization. The cost per dose per percent increase in absolute coverage increased with higher baseline coverage, demonstrating increasing incremental costs required to reach higher coverage levels. Future studies should evaluate the performance of the cost function and add to the database of available evidence to better characterize heterogeneity in costs and generalizability of the cost function. Copyright © 2018. Published by Elsevier Ltd.

Pre-Scheduled and Self Organized Sleep-Scheduling Algorithms for Efficient K-Coverage in Wireless Sensor Networks

PubMed Central

Hwang, I-Shyan

2017-01-01

The K-coverage configuration that guarantees coverage of each location by at least K sensors is highly popular and is extensively used to monitor diversified applications in wireless sensor networks. Long network lifetime and high detection quality are the essentials of such K-covered sleep-scheduling algorithms. However, the existing sleep-scheduling algorithms either cause high cost or cannot preserve the detection quality effectively. In this paper, the Pre-Scheduling-based K-coverage Group Scheduling (PSKGS) and Self-Organized K-coverage Scheduling (SKS) algorithms are proposed to settle the problems in the existing sleep-scheduling algorithms. Simulation results show that our pre-scheduled-based KGS approach enhances the detection quality and network lifetime, whereas the self-organized-based SKS algorithm minimizes the computation and communication cost of the nodes and thereby is energy efficient. Besides, SKS outperforms PSKGS in terms of network lifetime and detection quality as it is self-organized. PMID:29257078

An Analysis of Television's Coverage of the "Iran Crisis": 5 November 1979 to 15 January 1980.

ERIC Educational Resources Information Center

Miller, Christine

The three television networks, acting under severe restrictions imposed by the Iranian government, all provided comprehensive coverage of the hostage crisis. A study was conducted to examine what, if any, salient differences arose or existed in this coverage from November 5, 1979, until January 15, 1980. A research procedure combining qualitative…

7 CFR 1740.8 - Scoring criteria for the grant competition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... might be the case for some western states and for most translators, there may be only one county within... transmitter and translator must have a core coverage area consisting of one or more counties. (ii) In the case of translators, where a coverage contour area does not exist, the applicant shall define a coverage...

Policy statement—Professional liability insurance and medicolegal education for pediatric residents and fellows.

PubMed

Gonzalez, Jose Luis

2011-09-01

The American Academy of Pediatrics believes that pediatric residents and fellows should be fully informed of the scope and limitations of their professional liability insurance coverage while in training. The academy states that residents and fellows should be educated by their training institutions on matters relating to medical liability and the importance of maintaining adequate and continuous professional liability insurance coverage throughout their careers in medicine.

24 CFR 203.16a - Mortgagor and mortgagee requirement for maintaining flood insurance coverage.

Code of Federal Regulations, 2014 CFR

2014-04-01

... (NFIP) is available with respect to these property improvements, the mortgagor and mortgagee shall be obligated, by a special condition to be included in the mortgage commitment, to obtain and to maintain NFIP..., less estimated land costs, or the maximum amount of the NFIP insurance available with respect to the...

24 CFR 203.16a - Mortgagor and mortgagee requirement for maintaining flood insurance coverage.

Code of Federal Regulations, 2013 CFR

2013-04-01

... (NFIP) is available with respect to these property improvements, the mortgagor and mortgagee shall be obligated, by a special condition to be included in the mortgage commitment, to obtain and to maintain NFIP..., less estimated land costs, or the maximum amount of the NFIP insurance available with respect to the...

24 CFR 203.16a - Mortgagor and mortgagee requirement for maintaining flood insurance coverage.

Code of Federal Regulations, 2011 CFR

2011-04-01

... (NFIP) is available with respect to these property improvements, the mortgagor and mortgagee shall be obligated, by a special condition to be included in the mortgage commitment, to obtain and to maintain NFIP..., less estimated land costs, or the maximum amount of the NFIP insurance available with respect to the...

24 CFR 203.16a - Mortgagor and mortgagee requirement for maintaining flood insurance coverage.

Code of Federal Regulations, 2012 CFR

2012-04-01

... (NFIP) is available with respect to these property improvements, the mortgagor and mortgagee shall be obligated, by a special condition to be included in the mortgage commitment, to obtain and to maintain NFIP..., less estimated land costs, or the maximum amount of the NFIP insurance available with respect to the...

44 CFR 64.5 - Relationship of rates to zone designations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the entire community at chargeable rates (i.e., subsidized) for first layer coverage of existing... improvements. Upon the effective date of a FIRM, second layer coverage is available only at risk premium rates...

Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination

PubMed Central

Tohme, Rania A.; François, Jeannot; Wannemuehler, Kathleen; Magloire, Roc; Danovaro-Holliday, M. Carolina; Flannery, Brendan; Cavallaro, Kathleen F.; Fitter, David L.; Purcell, Nora; Dismer, Amber; Tappero, Jordan W.; Vertefeuille, John F.; Hyde, Terri B.

2015-01-01

Objectives We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1–9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA). Methods Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster. Results Among the 7000 visited households, 75.8% had at least one child aged 1–9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1–4 years had significantly lower MR SIA coverage than those aged 5–9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8–9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001). Conclusions The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1–4 years and in regions with lower coverage. PMID:25041586

Measles and rubella vaccination coverage in Haiti, 2012: progress towards verifying and challenges to maintaining measles and rubella elimination.

PubMed

Tohme, Rania A; François, Jeannot; Wannemuehler, Kathleen; Magloire, Roc; Danovaro-Holliday, M Carolina; Flannery, Brendan; Cavallaro, Kathleen F; Fitter, David L; Purcell, Nora; Dismer, Amber; Tappero, Jordan W; Vertefeuille, John F; Hyde, Terri B

2014-09-01

We conducted a nationwide survey to assess measles containing vaccine (MCV) coverage among children aged 1-9 years in Haiti and identify factors associated with vaccination before and during the 2012 nationwide supplementary immunisation activities (SIA). Haiti was stratified into five geographic regions (Metropolitan Port-au-Prince, North, Centre, South and West), 40 clusters were randomly selected in each region, and 35 households were selected per cluster. Among the 7000 visited households, 75.8% had at least one child aged 1-9 years; of these, 5279 (99.5%) households consented to participate in the survey. Of 9883 children enrolled, 91% received MCV before and/or during the SIA; 31% received MR for the first time during the SIA, and 50.7% received two doses of MCV (one before and one during the 2012 SIA). Among the 1685 unvaccinated children during the SIA, the primary reason of non-vaccination was caregivers not being aware of the SIA (31.0%). Children aged 1-4 years had significantly lower MR SIA coverage than those aged 5-9 years (79.5% vs. 84.8%) (P < 0.0001). A higher proportion of children living in the West (12.3%) and Centre (11.2%) regions had never been vaccinated than in other regions (4.8-9.1%). Awareness, educational level of the mother and region were significantly associated with MR vaccination during and before the SIA (P < 0.001). The 2012 SIA successfully increased MR coverage; however, to maintain measles and rubella elimination, coverage needs to be further increased among children aged 1-4 years and in regions with lower coverage. © 2014 John Wiley & Sons Ltd.

Premium growth and its effect on employer-sponsored insurance.

PubMed

Vistnes, Jessica; Selden, Thomas

2011-03-01

We use variation in premium inflation and general inflation across geographic areas to identify the effects of downward nominal wage rigidity on employers' health insurance decisions. Using employer level data from the 2000 to 2005 Medical Expenditure Panel Survey-Insurance Component, we examine the effect of premium growth on the likelihood that an employer offers insurance, eligibility rates among employees, continuous measures of employee premium contributions for both single and family coverage, and deductibles. We find that small, low-wage employers are less likely to offer health insurance in response to increased premium inflation, and if they do offer coverage they increase employee contributions and deductible levels. In contrast, larger, low-wage employers maintain their offers of coverage, but reduce eligibility for such coverage. They also increase employee contributions for single and family coverage, but not deductibles. Among high-wage employers, all but the largest increase deductibles in response to cost pressures.

29 CFR 4.155 - Employee coverage does not depend on form of employment contract.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 1 2013-07-01 2013-07-01 false Employee coverage does not depend on form of employment... Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain... contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons...

29 CFR 4.155 - Employee coverage does not depend on form of employment contract.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 1 2014-07-01 2013-07-01 true Employee coverage does not depend on form of employment... Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain... contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons...

29 CFR 4.155 - Employee coverage does not depend on form of employment contract.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 1 2011-07-01 2011-07-01 false Employee coverage does not depend on form of employment... Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain... contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons...

29 CFR 4.155 - Employee coverage does not depend on form of employment contract.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 1 2012-07-01 2012-07-01 false Employee coverage does not depend on form of employment... Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain... contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons...

29 CFR 4.155 - Employee coverage does not depend on form of employment contract.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Employee coverage does not depend on form of employment... Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain... contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons...

Complementary satellite sound broadcasting systems: A NASA assessment for the Voice of America

NASA Technical Reports Server (NTRS)

Stevens, Grady H.; Spence, Rodney L.

1988-01-01

Satellite concepts are examined which offer potentially significant sound broadcast coverage of audio as a complement to VOA's existing and planned terrestrial sound broadcasting system. HF bands are emphasized but additional discussion is included for systems using higher frequencies. Low altitude satellites, shuttle altitude (275 km) and sun synchronous (about 1600 to 1800 km), would not be practical for international broadcasting since many satellites would be required for reliable and widespread coverage. Two concepts are discussed which would offer significant and practical broadcast coverage at HF. One, an 8-hr posigrade equatorial orbit, would offer about 1 hr of widespread, twice daily, coverage to three areas of the globe. The time of coverage is even greater when confined to densely populated areas only (2 to 3 hrs). Another orbit, the Apogee at Constant Time/Equatorial (ACE), provides the same coverage, but only once daily to each area. The latter orbit is highly elliptical, allowing insertion of a greater payload (more broadcast channels) with the existing launch capability. The ACE and 8-hr orbit concepts led to systems of about equal costs, with the ACE being slightly better.

Competing Discourses about Youth Sexual Exploitation in Canadian News Media.

PubMed

Saewyc, Elizabeth M; Miller, Bonnie B; Rivers, Robert; Matthews, Jennifer; Hilario, Carla; Hirakata, Pam

2013-10-01

Media holds the power to create, maintain, or break down stigmatizing attitudes, which affect policies, funding, and services. To understand how Canadian news media depicts the commercial sexual exploitation of children and youth, we examined 835 Canadian newspaper articles from 1989-2008 using a mixed methods critical discourse analysis approach, comparing representations to existing research about sexually exploited youth. Despite research evidence that equal rates of boys and girls experience exploitation, Canadian news media depicted exploited youth predominantly as heterosexual girls, and described them alternately as victims or workers in a trade, often both in the same story. News media mentioned exploiters far less often than victims, and portrayed them almost exclusively as male, most often called 'customers' or 'consumers,' and occasionally 'predators'; in contrast, research has documented the majority of sexually exploited boys report female exploiters. Few news stories over the past two decades portrayed the diversity of victims, perpetrators, and venues of exploitation reported in research. The focus on victims but not exploiters helps perpetuate stereotypes of sexual exploitation as business or a 'victimless crime,' maintains the status quo, and blurs responsibility for protecting youth under the UN Convention on the Rights of the Child. Health care providers and researchers can be advocates for accuracy in media coverage about sexual exploitation; news reporters and editors should focus on exploiters more than victims, draw on existing research evidence to avoid perpetuating stereotypes, and use accurate terms, such as commercial sexual exploitation, rather than terms related to business or trade.

Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009-2013 National Immunization Survey-Teen.

PubMed

Perkins, Rebecca B; Lin, Mengyun; Wallington, Sherrie F; Hanchate, Amresh D

2016-06-02

To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Using data from the National Immunization Survey-Teen from 2009-2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13-17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, and WA) did not have higher HPV vaccine series initiation or completion than those living in states without mandates for any year (2009-2013). Similar results were seen when comparing girls ages 13-14 to those ages 15-17, and after adjustment for known covariates of vaccination. States and jurisdictions with school-entry and education mandates do not currently have higher HPV vaccination coverage than states without such legislation. Liberal opt-out language in existing school entry mandates may weaken their impact. Policy-makers contemplating legislation to improve vaccination coverage should be aware of the limitations of existing mandates.

Top 10 revenue cycle mistakes.

PubMed

Stuller, Elizabeth

2005-01-01

Hospitals looking to gain and maintain strong revenue cycle performance should avoid common mistakes, such as not verifying insurance coverage in advance and placing sole responsibility for correct documentation on physicians.

How does the use of multiple needles/syringes per injecting episode impact on the measurement of individual level needle and syringe program coverage?

PubMed

O'Keefe, Daniel; McCormack, Angus; Cogger, Shelley; Aitken, Campbell; Burns, Lucinda; Bruno, Raimondo; Stafford, Jenny; Butler, Kerryn; Breen, Courtney; Dietze, Paul

2017-08-01

Recent work by McCormack et al. (2016) showed that the inclusion of syringe stockpiling improves the measurement of individual-level syringe coverage. We explored whether including the use of a new parameter, multiple sterile syringes per injecting episode, further improves coverage measures. Data comes from 838 people who inject drugs, interviewed as part of the 2015 Illicit Drug Reporting System. Along with syringe coverage questions, the survey recorded the number of sterile syringes used on average per injecting episode. We constructed three measures of coverage: one adapted from Bluthenthal et al. (2007), the McCormack et al. measure, and a new coverage measure that included use of multiple syringes. Predictors of multiple syringe use and insufficient coverage (<100% of injecting episodes using a sterile syringe) using the new measure, were tested in logistic regression and the ability of the measures to discriminate key risk behaviours was compared using ROC curve analysis. 134 (16%) participants reported needing multiple syringes per injecting episode. Women showed significantly increased odds of multiple syringe use, as did those reporting injection related injuries/diseases and injecting of opioid substitution drugs or pharmaceutical opioids. Levels of insufficient coverage across the three measures were substantial (20%-28%). ROC curve analysis suggested that our new measure was no better at discriminating injecting risk behaviours than the existing measures. Based on our findings, there appears to be little need for adding a multiple syringe use parameter to existing coverage formulae. Hence, we recommend that multiple syringe use is not included in the measurement of individual-level syringe coverage. Copyright © 2017 Elsevier B.V. All rights reserved.

78 FR 2200 - Establishment of VOR Federal Airway V-629; Las Vegas, NV

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-10

... existing routes structure for aircraft navigating in an area of marginal radar coverage. This action... navigating in an area of marginal radar coverage. VOR Federal airways are published in paragraph 6010(a) of...

Sustainable industrial estate by managing the building coverage ratio in Cibitung Industrial Town, Indonesia

NASA Astrophysics Data System (ADS)

Budiyanto, T. M. T.; Prajitno, I. S.; Hasibuan, H. S.

2018-03-01

The problem faced in the management of the industrial estate is the development of industrial buildings which are not in accordance with the existing environmental regulations, especially the building coverage ratio (BCR). This violation is due to the limitation of industrial land owned, and the tenant’s desire to maximize building area. This research conducted at Cibitung Industrial Town, Indonesia, to assess the compliance of industrial building in complying with environmental regulations, and efforts by industrial estate manager together with industrial communities to meet building regulations. The compliance is shown from the conformity of the tenant’s BCR to the building provisions contained in the regulation within the industrial estate; which is maximum 60% from land owned. And whether the rest of green open space (GOS) area can still be maintained at a minimum 10%. This study found tenant’s building density (BCR) at 24.55% population was 84.77%, and the rest of green open space at 21.56% population was only 2.49%. Excessive building development and expansion by the industrial communities, led to a continued reduction in green open space as a rainwater absorption area. It is resulting the rainfall runoff directly into the environmental drainage system, and causing flooding in the region.

AccessMod 3.0: computing geographic coverage and accessibility to health care services using anisotropic movement of patients

PubMed Central

Ray, Nicolas; Ebener, Steeve

2008-01-01

Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage. Conclusion By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations. PMID:19087277

Comparisons of three anti-G suit configurations during long duration, low onset, +Gz

NASA Technical Reports Server (NTRS)

Stegmann, B. J.; Krutz, R. W.; Burton, R. R.; Sawin, C. F.

1992-01-01

Little physiologic data exist on the effects of long duration, low onset, hypergravity (+G). Space shuttle crewmembers are subjected to low +G forces (less than +3G) for upwards of 30 minutes during reentry. A similar reentry profile is predicted for the National Aerospace Plane (NASP). The physiologic effects of this acceleration stress are compounded by the loss of body water experienced during microgravity. Currently, a standard 5 bladder anti-G suit is being used during shuttle reentry. There have been complaints of discomfort using this suit, mainly due to the abdominal bladder. This study compared the effectiveness of three anti-G suit configurations in volume depleted subjects during a simulated space shuttle reentry profile. Methods: Seven male subjects were given intravenous Lasix in a dose from 20-40 mg to induce a total body weight loss of 3 plus or minus 1.5 percent. Approximately six hours after the injection, the subjects donned one of three anti-G suits - a standard 5 bladder anti-G suit, an extended coverage anti-G suit (the advanced technology anti-G suit or ATAGS), or an extended coverage anti-G suit without an abdominal bladder (the reentry anti-G suit or REAGS). All subjects were exposed to a simulated space shuttle reentry profile. Non-invasive eye-level blood pressure (ELBP) was monitored throughout the +G exposure. When systolic ELBP dropped below 70 mmHg, the anti-G suit was inflated in 0.5 psig increments to the pressure required to maintain 70 mmHg ELBP. Each subject rode with all three suits. Comparisons were made between the final pressure required in each suit to maintain ELBP and subjective reports of comfort. Results: The mean final suit pressure required to maintain ELBP was 1.1 psi, in both the ATAGS and REAGS versus 1.8 psi in the standard suit. In addition, the subjects rated the REAGS suit highest on the comfort scale, citing the absence of the abdominal bladder as the main reason. Conclusions: Overall, the REAGS suit was the superior anti-G suit during long duration, low onset +G. This is based on its ability to maintain ELBP and still remain comfortable when inflated for prolonged periods of time.

Toward a more reliable federal survey for tracking health insurance coverage and access.

PubMed

Kenney, Genevieve; Holahan, John; Nichols, Len

2006-06-01

Examination of the extent to which federal surveys provide the data needed to estimate the coverage/cost impacts of policy alternatives to address the problem of uninsurance. Assessment of the major federal household surveys that regularly provide information on health insurance and access to care based on an examination of each survey instrument and related survey documentation and the methodological literature. Identification of the data needed to address key policy questions on insurance coverage, assessment of how well existing surveys meet this need, definition of the critical elements of an ideal survey, and examination of the potential for building on existing surveys. Collection and critical assessment of pertinent survey documentation and methodological studies. While all the federal surveys examined provide valuable information, the information available to guide key policy decisions still has major gaps. Issues include measurement of insurance coverage and critical content gaps, inadequate sample sizes to support precise state and substate estimates, considerable delays between data collection and availability, and concerns about response rates and item nonresponse. Our assessment is that the Current Population Survey (CPS) and the National Health Interview Survey could be most readily modified to address these issues. The vast resources devoted to health care and the magnitude of the uninsurance problem make it critical that we have a reliable source for tracking health care and coverage at the national and state levels and for major local areas. It is plausible that this could be more cost effectively done by building on existing surveys than by designing and fielding a new one, but further research is needed to make a definitive judgment. At a minimum, the health insurance information collected on the CPS should be revised to address existing measurement problems.

The Current Status of Mapping in the World - Spotlight on Oceania

NASA Astrophysics Data System (ADS)

Trinder, John C.

2016-06-01

A summary is presented of the results of questionnaires sent to mapping agencies in Oceania, covering Australia, New Zealand and the Pacific Island countries, to investigate the status of mapping in those countries. After World War II, the Australian Federal Government funded the initial small scale mapping of the whole country leading to increased percentages of map coverage of Australia. Mapping at larger scales is undertaken by the states and territories in Australia, including cadastral mapping. In New Zealand mapping is maintained by Land Information New Zealand (LINZ) at 1:50,000 scale and smaller with regular updating. The results of the questionnaires also demonstrate the extent of map coverage in six Pacific Islands, but there is little information available on the actual percent coverage. Overall there are estimated to be an increases in the percentages of coverage of most map scales in Oceania. However, there appear to be insufficient professionals in most Pacific Island countries to maintain the mapping programs. Given that many Pacific Island countries will be impacted by rising sea level in the future, better mapping of these countries is essential. The availability of modern technology especially satellite images, digital aerial photography and airborne lidar data should enable the Pacific Island countries to provide better map products in future, but this would depend on foreign aid on many occasions.

CystiSim – An Agent-Based Model for Taenia solium Transmission and Control

PubMed Central

Gabriël, Sarah; Dorny, Pierre; Speybroeck, Niko; Magnussen, Pascal; Torgerson, Paul; Johansen, Maria Vang

2016-01-01

Taenia solium taeniosis/cysticercosis was declared eradicable by the International Task Force for Disease Eradication in 1993, but remains a neglected zoonosis. To assist in the attempt to regionally eliminate this parasite, we developed cystiSim, an agent-based model for T. solium transmission and control. The model was developed in R and available as an R package (http://cran.r-project.org/package=cystiSim). cystiSim was adapted to an observed setting using field data from Tanzania, but adaptable to other settings if necessary. The model description adheres to the Overview, Design concepts, and Details (ODD) protocol and consists of two entities—pigs and humans. Pigs acquire cysticercosis through the environment or by direct contact with a tapeworm carrier's faeces. Humans acquire taeniosis from slaughtered pigs proportional to their infection intensity. The model allows for evaluation of three interventions measures or combinations hereof: treatment of humans, treatment of pigs, and pig vaccination, and allows for customary coverage and efficacy settings. cystiSim is the first agent-based transmission model for T. solium and suggests that control using a strategy consisting of an intervention only targeting the porcine host is possible, but that coverage and efficacy must be high if elimination is the ultimate goal. Good coverage of the intervention is important, but can be compensated for by including an additional intervention targeting the human host. cystiSim shows that the scenarios combining interventions in both hosts, mass drug administration to humans, and vaccination and treatment of pigs, have a high probability of success if coverage of 75% can be maintained over at least a four year period. In comparison with an existing mathematical model for T. solium transmission, cystiSim also includes parasite maturation, host immunity, and environmental contamination. Adding these biological parameters to the model resulted in new insights in the potential effect of intervention measures. PMID:27984581

CystiSim - An Agent-Based Model for Taenia solium Transmission and Control.

PubMed

Braae, Uffe Christian; Devleesschauwer, Brecht; Gabriël, Sarah; Dorny, Pierre; Speybroeck, Niko; Magnussen, Pascal; Torgerson, Paul; Johansen, Maria Vang

2016-12-01

Taenia solium taeniosis/cysticercosis was declared eradicable by the International Task Force for Disease Eradication in 1993, but remains a neglected zoonosis. To assist in the attempt to regionally eliminate this parasite, we developed cystiSim, an agent-based model for T. solium transmission and control. The model was developed in R and available as an R package (http://cran.r-project.org/package=cystiSim). cystiSim was adapted to an observed setting using field data from Tanzania, but adaptable to other settings if necessary. The model description adheres to the Overview, Design concepts, and Details (ODD) protocol and consists of two entities-pigs and humans. Pigs acquire cysticercosis through the environment or by direct contact with a tapeworm carrier's faeces. Humans acquire taeniosis from slaughtered pigs proportional to their infection intensity. The model allows for evaluation of three interventions measures or combinations hereof: treatment of humans, treatment of pigs, and pig vaccination, and allows for customary coverage and efficacy settings. cystiSim is the first agent-based transmission model for T. solium and suggests that control using a strategy consisting of an intervention only targeting the porcine host is possible, but that coverage and efficacy must be high if elimination is the ultimate goal. Good coverage of the intervention is important, but can be compensated for by including an additional intervention targeting the human host. cystiSim shows that the scenarios combining interventions in both hosts, mass drug administration to humans, and vaccination and treatment of pigs, have a high probability of success if coverage of 75% can be maintained over at least a four year period. In comparison with an existing mathematical model for T. solium transmission, cystiSim also includes parasite maturation, host immunity, and environmental contamination. Adding these biological parameters to the model resulted in new insights in the potential effect of intervention measures.

State budget transfers to Health Insurance to expand coverage to people outside formal sector work in Latin America.

PubMed

Mathauer, Inke; Behrendt, Thorsten

2017-02-16

Contributory social health insurance for formal sector employees only has proven challenging for moving towards universal health coverage (UHC). This is because the informally employed and the poor usually remain excluded. One way to expand UHC is to fully or partially subsidize health insurance contributions for excluded population groups through government budget transfers. This paper analyses the institutional design features of such government subsidization arrangements in Latin America and assesses their performance with respect to UHC progress. The aim is to identify UHC conducive institutional design features of such arrangements. A literature search provided the information to analyse institutional design features, with a focus on the following aspects: eligibility/enrolment rules, financing and pooling arrangements, and purchasing and benefit package design. Based on secondary data analysis, UHC progress is assessed in terms of improved population coverage, financial protection and access to needed health care services. Such government subsidization arrangements currently exist in eight countries of Latin America (Bolivia, Chile, Colombia, Costa Rica, Dominican Republic, Mexico, Peru, Uruguay). Institutional design features and UHC related performance vary significantly. Notably, countries with a universalist approach or indirect targeting have higher population coverage rates. Separate pools for the subsidized maintain inequitable access. The relatively large scopes of the benefit packages had a positive impact on financial protection and access to care. In the long term, merging different schemes into one integrated health financing system without opt-out options for the better-off is desirable, while equally expanding eligibility to cover those so far excluded. In the short and medium term, the harmonization of benefit packages could be a priority. UHC progress also depends on substantial supply side investments to ensure the availability of quality services, particularly in rural areas. Future research should generate more evidence on the implementation process and impact of subsidization arrangements on UHC progress.

Deep Space Network and Lunar Network Communication Coverage of the Moon

NASA Technical Reports Server (NTRS)

Lee, Charles H.; Cheung, Kar-Ming

2006-01-01

In this article, we describe the communication coverage analysis for the lunar network and the Earth ground stations. The first part of this article focuses on the direct communication coverage of the Moon from the Earth's ground stations. In particular, we assess the coverage performance of the Moon based on the existing Deep Space Network (DSN) antennas and the complimentary coverage of other potential stations at Hartebeesthoek, South Africa and at Santiago, Chile. We also address the coverage sensitivity based on different DSN antenna scenarios and their capability to provide single and redundant coverage of the Moon. The second part of this article focuses on the framework of the constrained optimization scheme to seek a stable constellation six relay satellites in two planes that not only can provide continuous communication coverage to any users on the Moon surface, but can also deliver data throughput in a highly efficient manner.

Proposals to Subsidize Health Insurance for the Unemployed

DTIC Science & Technology

1998-01-01

firms with 20 or more employees to continue offering health coverage to workers who separate from the firm. However, firms may charge former employees ...employment-based health plans must make continuation coverage available to former employees and covered family members. Sepated workers may continue COBRA... workers in firms of 20 or more employees who participate in an existing employer-sponsored health plan are eligible to continue coverage under COBRA

The Challenges in Measuring Local Immunization Coverage: A Statewide Case Study

PubMed Central

Rowhani-Rahbar, Ali; Duchin, Jeffrey; DeHart, M. Patricia; Opel, Douglas

2016-01-01

There are many forms of existing immunization surveillance in the United States and Washington state, but all are limited in their ability to provide timely identification of clusters of unimmunized individuals and assess the risk of vaccine-preventable diseases. This article aims to: (1) describe challenges to measuring immunization coverage at a local level in the United States using Washington State as a case study; and (2) propose improvements to existing surveillance systems that address the challenges identified. PMID:27244807

Effect Of Water On Permeation By Hydrogen

NASA Technical Reports Server (NTRS)

Tomazic, William A.; Hulligan, David

1988-01-01

Water vapor in working fluid equilibrates with permeability-reducing oxides in metal parts. Report describes study of effects of water on permeation of heater-head tubes by hydrogen in Stirling engine. Experiments performed to determine minimum concentration of oxygen and/or oxygen-bearing gas maintaining oxide coverage adequate for low permeability. Tests showed 750 ppm or more of water effective in maintaining stable, low permeability.

A qualitative analysis of immunization programs with sustained high coverage, 2000-2005.

PubMed

Kennedy, Allison; Groom, Holly; Evans, Victoria; Fasano, Nancy

2010-01-01

Despite record-high immunization coverage nationally, there is considerable variation across state and local immunization programs, which are responsible for the implementation of vaccine recommendations in their jurisdictions. The objectives of this study were to describe activities of state and local immunization programs that sustained high coverage levels across several years and to identify common themes and practical examples for sustaining childhood vaccination coverage rates that could be applied elsewhere. We conducted 95 semi-structured key informant interviews with internal staff members and external partners at the 10 immunization programs with the highest sustained childhood immunization coverage from 2000 to 2005, as measured by the National Immunization Survey. Interview transcripts were analyzed qualitatively using a general inductive approach. Common themes across the 10 programs included maintaining a strong program infrastructure, using available data to drive planning and decision making, a commitment to building and sustaining relationships, and a focus on education and communication. Given the challenges of an increasingly complex immunization system, the lessons learned from these programs may help inform others who are working to improve childhood immunization delivery and coverage in their own programs.

The Mental and Physical Health Consequences of Changes in Private Insurance Before and After Early Retirement

PubMed Central

2016-01-01

Objectives. This study evaluated the impact of private insurance coverage on the symptoms of depression, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) in the years leading up to Medicare eligibility focusing on the transition from full-time work to early full retirement. Method. The Health and Retirement Study was used to (a) estimate 2-stage selection equations of (i) the transition to retirement and (ii) current insurance status, and (b) the impact of insurance coverage on health, net of endogeneity associated retirement and insurance coverage. Results. Employment-based insurance coverage was generally associated with better health. Moreover, being without employment-based insurance was particularly problematic during the transition to retirement. Non-group insurance only moderated the association between losing employment-based insurance and IADLs. Discussion. Results indicated that private insurance coverage is an important contextual factor for the health of early retirees. Those who maintain steady coverage tend to fare the best in retirement. This highlights the dynamic nature of changes in health in later life. PMID:25819976

Population Dynamics of Owned, Free-Roaming Dogs: Implications for Rabies Control

PubMed Central

Conan, Anne; Akerele, Oluyemisi; Simpson, Greg; Reininghaus, Bjorn; van Rooyen, Jacques; Knobel, Darryn

2015-01-01

Background Rabies is a serious yet neglected public health threat in resource-limited communities in Africa, where the virus is maintained in populations of owned, free-roaming domestic dogs. Rabies elimination can be achieved through the mass vaccination of dogs, but maintaining the critical threshold of vaccination coverage for herd immunity in these populations is hampered by their rapid turnover. Knowledge of the population dynamics of free-roaming dog populations can inform effective planning and implementation of mass dog vaccination campaigns to control rabies. Methodology/Principal Findings We implemented a health and demographic surveillance system in dogs that monitored the entire owned dog population within a defined geographic area in a community in Mpumalanga Province, South Africa. We quantified demographic rates over a 24-month period, from 1st January 2012 through 1st January 2014, and assessed their implications for rabies control by simulating the decline in vaccination coverage over time. During this period, the population declined by 10%. Annual population growth rates were +18.6% in 2012 and -24.5% in 2013. Crude annual birth rates (per 1,000 dog-years of observation) were 451 in 2012 and 313 in 2013. Crude annual death rates were 406 in 2012 and 568 in 2013. Females suffered a significantly higher mortality rate in 2013 than males (mortality rate ratio [MRR] = 1.54, 95% CI = 1.28–1.85). In the age class 0–3 months, the mortality rate of dogs vaccinated against rabies was significantly lower than that of unvaccinated dogs (2012: MRR = 0.11, 95% CI = 0.05–0.21; 2013: MRR = 0.31, 95% CI = 0.11–0.69). The results of the simulation showed that achieving a 70% vaccination coverage during annual campaigns would maintain coverage above the critical threshold for at least 12 months. Conclusions and Significance Our findings provide an evidence base for the World Health Organization’s empirically-derived target of 70% vaccination coverage during annual campaigns. Achieving this will be effective even in highly dynamic populations with extremely high growth rates and rapid turnover. This increases confidence in the feasibility of dog rabies elimination in Africa through mass vaccination. PMID:26545242

Barrier Coverage for 3D Camera Sensor Networks

PubMed Central

Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi; Ji, Peng; Chu, Hao

2017-01-01

Barrier coverage, an important research area with respect to camera sensor networks, consists of a number of camera sensors to detect intruders that pass through the barrier area. Existing works on barrier coverage such as local face-view barrier coverage and full-view barrier coverage typically assume that each intruder is considered as a point. However, the crucial feature (e.g., size) of the intruder should be taken into account in the real-world applications. In this paper, we propose a realistic resolution criterion based on a three-dimensional (3D) sensing model of a camera sensor for capturing the intruder’s face. Based on the new resolution criterion, we study the barrier coverage of a feasible deployment strategy in camera sensor networks. Performance results demonstrate that our barrier coverage with more practical considerations is capable of providing a desirable surveillance level. Moreover, compared with local face-view barrier coverage and full-view barrier coverage, our barrier coverage is more reasonable and closer to reality. To the best of our knowledge, our work is the first to propose barrier coverage for 3D camera sensor networks. PMID:28771167

Barrier Coverage for 3D Camera Sensor Networks.

PubMed

Si, Pengju; Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi; Ji, Peng; Chu, Hao

2017-08-03

Barrier coverage, an important research area with respect to camera sensor networks, consists of a number of camera sensors to detect intruders that pass through the barrier area. Existing works on barrier coverage such as local face-view barrier coverage and full-view barrier coverage typically assume that each intruder is considered as a point. However, the crucial feature (e.g., size) of the intruder should be taken into account in the real-world applications. In this paper, we propose a realistic resolution criterion based on a three-dimensional (3D) sensing model of a camera sensor for capturing the intruder's face. Based on the new resolution criterion, we study the barrier coverage of a feasible deployment strategy in camera sensor networks. Performance results demonstrate that our barrier coverage with more practical considerations is capable of providing a desirable surveillance level. Moreover, compared with local face-view barrier coverage and full-view barrier coverage, our barrier coverage is more reasonable and closer to reality. To the best of our knowledge, our work is the first to propose barrier coverage for 3D camera sensor networks.

Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada.

PubMed

Morgan, Steven G; Li, Winny; Yau, Brandon; Persaud, Nav

2017-02-27

Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada. We compared prices of these essential medicines in Canada with prices in the United States, Sweden and New Zealand. We estimated the cost of adding universal public drug coverage of these essential medicines based on anticipated effects on medication use and pricing. The 117 essential medicines on the model list accounted for 44% of all prescriptions and 30% of total prescription drug expenditures in 2015. Average prices of generic essential medicines were 47% lower in the US, 60% lower in Sweden and 84% lower in New Zealand; brand-name drugs were priced 43% lower in the US. Estimated savings from universal public coverage of these essential medicines was $4.27 billion per year (range $2.72 billion to $5.83 billion; 28% reduction) for patients and private drug plan sponsors, at an incremental government cost of $1.23 billion per year (range $373 million to $1.98 billion; 11% reduction). Our analysis showed that adding universal public coverage of essential medicines to the existing public drug plans in Canada could address most of Canadians' pharmaceutical needs and save billions of dollars annually. Doing so may be a pragmatic step forward while more comprehensive pharmacare reforms are planned. © 2017 Canadian Medical Association or its licensors.

Impact of school-entry and education mandates by states on HPV vaccination coverage: Analysis of the 2009–2013 National Immunization Survey-Teen

PubMed Central

Perkins, Rebecca B.; Lin, Mengyun; Wallington, Sherrie F.; Hanchate, Amresh D.

2016-01-01

ABSTRACT Objective: To determine the effectiveness of existing school entry and education mandates on HPV vaccination coverage, we compared coverage among girls residing in states and jurisdictions with and without education and school-entry mandates. Virginia and the District of Columbia enacted school entry mandates, though both laws included liberal opt-out provisions. Ten additional states had mandates requiring distribution of education to parents or provision of education within school curricula. Methods: Using data from the National Immunization Survey-Teen from 2009–2013, we estimated multilevel logistic regression models to compare coverage with HPV vaccines for girls ages 13–17 residing in states and jurisdictions with and without school entry and education mandates, adjusting for demographic factors, healthcare access, and provider recommendation. Results: Girls residing in states and jurisdictions with HPV vaccine school entry mandates (DC and VA) and education mandates (LA, MI, CO, IN, IA, IL, NJ, NC, TX, and WA) did not have higher HPV vaccine series initiation or completion than those living in states without mandates for any year (2009–2013). Similar results were seen when comparing girls ages 13–14 to those ages 15–17, and after adjustment for known covariates of vaccination. Conclusions: States and jurisdictions with school-entry and education mandates do not currently have higher HPV vaccination coverage than states without such legislation. Liberal opt-out language in existing school entry mandates may weaken their impact. Policy-makers contemplating legislation to improve vaccination coverage should be aware of the limitations of existing mandates. PMID:27152418

Population-genomic variation within RNA viruses of the Western honey bee, Apis mellifera, inferred from deep sequencing

PubMed Central

2013-01-01

Background Deep sequencing of viruses isolated from infected hosts is an efficient way to measure population-genetic variation and can reveal patterns of dispersal and natural selection. In this study, we mined existing Illumina sequence reads to investigate single-nucleotide polymorphisms (SNPs) within two RNA viruses of the Western honey bee (Apis mellifera), deformed wing virus (DWV) and Israel acute paralysis virus (IAPV). All viral RNA was extracted from North American samples of honey bees or, in one case, the ectoparasitic mite Varroa destructor. Results Coverage depth was generally lower for IAPV than DWV, and marked gaps in coverage occurred in several narrow regions (< 50 bp) of IAPV. These coverage gaps occurred across sequencing runs and were virtually unchanged when reads were re-mapped with greater permissiveness (up to 8% divergence), suggesting a recurrent sequencing artifact rather than strain divergence. Consensus sequences of DWV for each sample showed little phylogenetic divergence, low nucleotide diversity, and strongly negative values of Fu and Li’s D statistic, suggesting a recent population bottleneck and/or purifying selection. The Kakugo strain of DWV fell outside of all other DWV sequences at 100% bootstrap support. IAPV consensus sequences supported the existence of multiple clades as had been previously reported, and Fu and Li’s D was closer to neutral expectation overall, although a sliding-window analysis identified a significantly positive D within the protease region, suggesting selection maintains diversity in that region. Within-sample mean diversity was comparable between the two viruses on average, although for both viruses there was substantial variation among samples in mean diversity at third codon positions and in the number of high-diversity sites. FST values were bimodal for DWV, likely reflecting neutral divergence in two low-diversity populations, whereas IAPV had several sites that were strong outliers with very low FST. Conclusions This initial survey of genetic variation within honey bee RNA viruses suggests future directions for studies examining the underlying causes of population-genetic structure in these economically important pathogens. PMID:23497218

Population-genomic variation within RNA viruses of the Western honey bee, Apis mellifera, inferred from deep sequencing.

PubMed

Cornman, Robert Scott; Boncristiani, Humberto; Dainat, Benjamin; Chen, Yanping; vanEngelsdorp, Dennis; Weaver, Daniel; Evans, Jay D

2013-03-07

Deep sequencing of viruses isolated from infected hosts is an efficient way to measure population-genetic variation and can reveal patterns of dispersal and natural selection. In this study, we mined existing Illumina sequence reads to investigate single-nucleotide polymorphisms (SNPs) within two RNA viruses of the Western honey bee (Apis mellifera), deformed wing virus (DWV) and Israel acute paralysis virus (IAPV). All viral RNA was extracted from North American samples of honey bees or, in one case, the ectoparasitic mite Varroa destructor. Coverage depth was generally lower for IAPV than DWV, and marked gaps in coverage occurred in several narrow regions (< 50 bp) of IAPV. These coverage gaps occurred across sequencing runs and were virtually unchanged when reads were re-mapped with greater permissiveness (up to 8% divergence), suggesting a recurrent sequencing artifact rather than strain divergence. Consensus sequences of DWV for each sample showed little phylogenetic divergence, low nucleotide diversity, and strongly negative values of Fu and Li's D statistic, suggesting a recent population bottleneck and/or purifying selection. The Kakugo strain of DWV fell outside of all other DWV sequences at 100% bootstrap support. IAPV consensus sequences supported the existence of multiple clades as had been previously reported, and Fu and Li's D was closer to neutral expectation overall, although a sliding-window analysis identified a significantly positive D within the protease region, suggesting selection maintains diversity in that region. Within-sample mean diversity was comparable between the two viruses on average, although for both viruses there was substantial variation among samples in mean diversity at third codon positions and in the number of high-diversity sites. FST values were bimodal for DWV, likely reflecting neutral divergence in two low-diversity populations, whereas IAPV had several sites that were strong outliers with very low FST. This initial survey of genetic variation within honey bee RNA viruses suggests future directions for studies examining the underlying causes of population-genetic structure in these economically important pathogens.

Stable Satellite Orbits for Global Coverage of the Moon

NASA Technical Reports Server (NTRS)

Ely, Todd; Lieb, Erica

2006-01-01

A document proposes a constellation of spacecraft to be placed in orbit around the Moon to provide navigation and communication services with global coverage required for exploration of the Moon. There would be six spacecraft in inclined elliptical orbits: three in each of two orthogonal orbital planes, suggestive of a linked-chain configuration. The orbits have been chosen to (1) provide 99.999-percent global coverage for ten years and (2) to be stable under perturbation by Earth gravitation and solar-radiation pressure, so that no deterministic firing of thrusters would be needed to maintain the orbits. However, a minor amount of orbit control might be needed to correct for such unmodeled effects as outgassing of the spacecraft.

75 FR 38773 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... needed to maintain proper coverage of the business universe. Based on information collected on the SQ... business birth survey keeps the sample universe current. Affected Public: Business or other for-profit; Not...

Disparities in Health Care Coverage Among U.S. Born and Mexican/Central American Born Labor Workers in the U.S.

PubMed

Hammig, Bart; Henry, Jean; Davis, Donna

2018-01-31

We examined health insurance coverage among U.S. and Mexican/Central American (M/CA) born labor workers living in the U.S. Using data from the 2010-2015 National Health Interview Survey, we employed logistic regression models to examine health insurance coverage and covariates among U.S. and M/CA born labor workers. Prevalence ratios between U.S. and M/CA born workers were also obtained. U.S. born workers had double the prevalence of insurance coverage. Regarding private insurance coverage, U.S. born workers had a higher prevalence of coverage compared to their M/CA born counterparts. Among foreign born workers with U.S. citizenship, the odds of having insurance coverage was greater than that of noncitizens. Additionally, those who had lived in the U.S. for 10 or more years had higher odds of having health insurance coverage. Disparities in health care coverage exist between U.S. born and foreign born labor workers.

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

An Introduction to Multicultural Counseling.

ERIC Educational Resources Information Center

Lee, Wanda M. L.

When client and counselor are from different cultural backgrounds, they tend to view things from disparate perspectives. Though a background in multiculturalism is required for program accreditation, most existing texts limit coverage to ethnicity, without the emphasis of broad concepts such as discrimination and acculturation, or coverage of…

The cost of doing business: cost structure of electronic immunization registries.

PubMed

Fontanesi, John M; Flesher, Don S; De Guire, Michelle; Lieberthal, Allan; Holcomb, Kathy

2002-10-01

To predict the true cost of developing and maintaining an electronic immunization registry, and to set the framework for developing future cost-effective and cost-benefit analysis. Primary data collected at three immunization registries located in California, accounting for 90 percent of all immunization records in registries in the state during the study period. A parametric cost analysis compared registry development and maintenance expenditures to registry performance requirements. Data were collected at each registry through interviews, reviews of expenditure records, technical accomplishments development schedules, and immunization coverage rates. The cost of building immunization registries is predictable and independent of the hardware/software combination employed. The effort requires four man-years of technical effort or approximately $250,000 in 1998 dollars. Costs for maintaining a registry were approximately $5,100 per end user per three-year period. There is a predictable cost structure for both developing and maintaining immunization registries. The cost structure can be used as a framework for examining the cost-effectiveness and cost-benefits of registries. The greatest factor effecting improvement in coverage rates was ongoing, user-based administrative investment.

1993 Intercomparison of Photometric Units Maintained at NIST (USA) and PTB (Germany)

PubMed Central

Ohno, Yoshihiro; Sauter, Georg

1995-01-01

A bilateral intercomparison of photometric units between NIST, USA and PTB, Germany has been conducted to update the knowledge of the relationship between the photometric units disseminated in each country. The luminous intensity unit (cd) and the luminous flux unit (lm) maintained at both laboratories are compared by circulating transfer standard lamps. Also, the photometric responsivity sv is compared by circulating a V(λ)-corrected detector with a built-in current-to-voltage converter. The results show that the difference of luminous intensity unit between NIST and PTB, (PTB-NIST)/NIST, is 0.2 % with a relative expanded uncertainty (coverage factor k = 2) of 0.24 %. The difference is reduced significantly from that at the 1985 CCPR intercomparison (0.9 %). The difference in luminous flux unit, (PTB – NIST)/NIST, is found to be 1.5 % with a relative expanded uncertainty (coverage factor k =2) of 0.15 %. The difference remained nearly the same as that at the 1985 intercomparison (1.6 %). These results agree with what is predicted from the history of maintaining the units at each laboratory. PMID:29151737

Tax treatment of cafeteria plans. Internal Revenue Service (IRS), Treasury. Final regulations.

PubMed

2000-03-23

This document contains final regulations relating to section 125 cafeteria plans. The final regulations clarify the circumstances under which a section 125 cafeteria plan election may be changed. The final regulations permit an employer to allow a section 125 cafeteria plan participant to revoke an existing election and make a new election during a period of coverage for accident or health coverage or group-term life insurance coverage.

An Optimized Handover Scheme with Movement Trend Awareness for Body Sensor Networks

PubMed Central

Sun, Wen; Zhang, Zhiqiang; Ji, Lianying; Wong, Wai-Choong

2013-01-01

When a body sensor network (BSN) that is linked to the backbone via a wireless network interface moves from one coverage zone to another, a handover is required to maintain network connectivity. This paper presents an optimized handover scheme with movement trend awareness for BSNs. The proposed scheme predicts the future position of a BSN user using the movement trend extracted from the historical position, and adjusts the handover decision accordingly. Handover initiation time is optimized when the unnecessary handover rate is estimated to meet the requirement and the outage probability is minimized. The proposed handover scheme is simulated in a BSN deployment area in a hospital environment in UK. Simulation results show that the proposed scheme reduces the outage probability by 22% as compared with the existing hysteresis-based handover scheme under the constraint of acceptable handover rate. PMID:23736852

Prudent use guidelines: a review of existing veterinary guidelines.

PubMed

Teale, C J; Moulin, G

2012-04-01

The World Organisation for Animal Health (OIE) TerrestrialAnimal Health Code considers the prudent use of antimicrobial agents in veterinary medicine to comprise a series of practical measures and recommendations which confer benefits to animal and public health while preserving and maintaining the therapeutic efficacy of antimicrobials. This paper reviews some of the main veterinary prudent use guidelines which have been published in English and the responsibilities of those involved at all levels in the administration of antimicrobials to animals, including national regulatory authorities. The OIE guidelines are considered comprehensive and cover all of those levels, from regulatory authorities to veterinarians and food producers. Guidelines produced by national authorities, professional veterinary associations or farming associations and which are targeted at particular individuals, for example veterinarians or food animal producers, will, obviously, restrict their coverage to those aspects considered relevant for their target audience.

Safe use of cellular telephones in hospitals: fundamental principles and case studies.

PubMed

Cohen, Ted; Ellis, Willard S; Morrissey, Joseph J; Bakuzonis, Craig; David, Yadin; Paperman, W David

2005-01-01

Many industries and individuals have embraced cellular telephones. They provide mobile, synchronous communication, which could hypothetically increase the efficiency and safety of inpatient healthcare. However, reports of early analog cellular telephones interfering with critical life-support machines had led many hospitals to strictly prohibit cellular telephones. A literature search revealed that individual hospitals now are allowing cellular telephone use with various policies to prevent electromagnetic interference with medical devices. The fundamental principles underlying electromagnetic interference are immunity, frequency, modulation technology, distance, and power Electromagnetic interference risk mitigation methods based on these principles have been successfully implemented. In one case study, a minimum distance between cellular telephones and medical devices is maintained, with restrictions in critical areas. In another case study, cellular telephone coverage is augmented to automatically control the power of the cellular telephone. While no uniform safety standard yet exists, cellular telephones can be safely used in hospitals when their use is managed carefully.

Contingent workers: Workers' compensation data analysis strategies and limitations.

PubMed

Foley, Michael; Ruser, John; Shor, Glenn; Shuford, Harry; Sygnatur, Eric

2014-07-01

The growth of the contingent workforce presents many challenges in the occupational safety and health arena. State and federal laws impose obligations and rights on employees and employers, but contingent work raises issues regarding responsibilities to maintain a safe workplace and difficulties in collecting and reporting data on injuries and illnesses. Contingent work may involve uncertainty about the length of employment, control over the labor process, degree of regulatory, or statutory protections, and access to benefits under workers' compensation. The paper highlights differences in regulatory protections and benefits among various types of contingent workers and how these different arrangements affect safety incentives. It discusses challenges caused by contingent work for accurate data reporting in existing injury and illness surveillance and benefit programs, differences between categories of contingent work in their coverage in various data sources, and opportunities for overcoming obstacles to effectively using workers' compensation data. © 2014 Wiley Periodicals, Inc.

Eradication of poliomyelitis in Cuba: a historical perspective.

PubMed Central

Más Lago, P.

1999-01-01

The eradication of poliomyelitis in Cuba, for which effective vaccines had to be acquired, is reviewed in this article. The strategy for eradication was based on mass immunization campaigns for the annual delivery of two doses of trivalent Sabin oral poliovirus vaccine (OPV). Except during the first campaign in 1962, the ages of the children for immunization were determined through national serological surveys of the entire country, including rural and urban areas. The interruption of wild virus transmission had been suspected since 1967 in Cuba, and since 1970 no studies have detected any wild virus. The important role of political and social organizations in the success of the programme and in the execution of the mass immunization campaigns is underscored. Countries that have successfully interrupted poliovirus circulation should maintain high immunization coverage for as long as there are other countries in the world where poliovirus still exists. PMID:10516790

Domestic animals as carriers of Bordetella species in Senegal.

PubMed

Ngom, Abdoulaye; Boulanger, Denis; Ndiaye, Tofène; Mboup, Souleymane; Bada-Alambedji, Rianatou; Simondon, François; Ayih-Akakpo, Ayayi Justin

2006-01-01

Despite intense efforts to maintain a high level of vaccine coverage against human whooping cough, rural senegalese areas are still endemic for Bordetella pertussis. One explanation being the potential existence of animal reservoirs, the objective of this work was to precise the carriage by domestic animals of bacteria belonging to the genus Bordetella in Senegal. Bacteriological samples (swabs and aspirates) were obtained from various domestic animals living in different parts of the country. No B. pertussis nor B. parapertussis were isolated. However, for the first time to our knowledge, B. bronchiseptica was identified from small ruminants located in Africa. The positive animals were two goats and two sheep from Dakar slaughterhouse together with a goat living in a rural compound. The fact that it was identified in goats and sheep underlines the potential zoonotic of that bacterial species in countries where small ruminants are of economical and cultural relevance.

75 FR 45013 - Pre-Existing Condition Insurance Plan Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... provided (an important protection for a program designed to offer coverage to those with a pre-existing... Part II Department of Health and Human Services 45 CFR Part 152 Pre-Existing Condition Insurance... [OCIIO-9995-IFC] RIN 0991-AB71 Pre-Existing Condition Insurance Plan Program AGENCY: Office of Consumer...

EVATS: a proactive solution to improve surgical education and maintain flexibility in the new training era.

PubMed

Horvath, Karen D; Mann, Gary N; Pellegrini, Carlos

2006-01-01

To describe the development of the EVATS rotation. Descriptive document. University teaching hospital. Faculty and residents of the University of Washington. In July 2003 we identified the need for a new, independent, educational module within our residency training. Requirements for this rotation included dedicated time for technical skills training on simulators, independent competency learning modules, academic research project time, vacation time and coverage, and flexibility for unplanned leave (eg, interview travel, m/paternity leave). An EVATS rotation was created in July 2003 that is provided at each training level and lasts from 4 to 8 weeks depending on R-level. EVATS meets the following challenges: Emergency coverage (EVATS residents available for last-minute service coverage), vacation time/vacation coverage (2 weeks vacation + 1 week vacation coverage; this maintains vacations for all residents every 6 months), academic time (residents now must complete 1 academic project for graduation) and ACGME competency learning and assessment, and technical skills training (includes simulator work for open/lap skills). Initial implementation indices are high and include resident satisfaction, 80-hour work week compliance, academic productivity, and patient continuity of care. The 21st century brought new challenges for surgical training. Increased societal demands for skills training in a laboratory setting using simulators and the 6 ACGME competencies all require classroom-type training periods. Paradoxically, the 80-hour work week restricted the time available for these educational activities and made it more difficult for programs to accommodate resident vacations and emergencies. These challenges provided an opportunity to enhance the educational experience for our residency program. The product was the EVATS rotation. Early data after implementation are favorable.

Successful Control of Winter Pyrexias Caused by Equine Herpesvirus Type 1 in Japanese Training Centers by Achieving High Vaccination Coverage

PubMed Central

Mae, Naomi; Ode, Hirotaka; Nemoto, Manabu; Tsujimura, Koji; Yamanaka, Takashi; Kondo, Takashi; Matsumura, Tomio

2014-01-01

Equine herpesvirus type 1 (EHV-1) is a major cause of winter pyrexia in racehorses in two training centers (Ritto and Miho) in Japan. Until the epizootic period of 2008-2009, a vaccination program using a killed EHV-1 vaccine targeted only susceptible 3-year-old horses with low antibody levels to EHV-1 antigens. However, because the protective effect was not satisfactory, in 2009-2010 the vaccination program was altered to target all 3-year-old horses. To evaluate the vaccine's efficacy, we investigated the number of horses with pyrexia due to EHV-1 or equine herpesvirus type 4 (EHV-4) infection or both and examined the vaccination coverage in the 3-year-old population and in the whole population before and after changes in the program. The mean (± standard deviation [SD]) estimated numbers of horses infected with EHV-1 or EHV-4 or both, among pyretic horses from 1999-2000 to 2008-2009 were 105 ± 47 at Ritto and 66 ± 44 at Miho. Although the estimated number of infected horses did not change greatly in the first period of the current program, it decreased from the second period, with means (±SD) of 21 ± 12 at Ritto and 14 ± 15 at Miho from 2010-2011 to 2012-2013. Vaccination coverage in the 3-year-old population was 99.4% at Ritto and 99.8% at Miho in the first period, and similar values were maintained thereafter. Coverage in the whole population increased more gradually than that in the 3-year-old population. The results suggest that EHV-1 epizootics can be suppressed by maintaining high vaccination coverage, not only in the 3-year-old population but also in the whole population. PMID:24872513

42 CFR 423.2315 - Medicare Coverage Gap Discount Program Agreement.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) Maintain up-to-date NDC listings with the electronic database vendors for which the manufacturer provides... under this subpart must comply with the requirements imposed by CMS or the third party administrator (as...

42 CFR 423.2315 - Medicare Coverage Gap Discount Program Agreement.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Maintain up-to-date NDC listings with the electronic database vendors for which the manufacturer provides... under this subpart must comply with the requirements imposed by CMS or the third party administrator (as...

42 CFR 423.2315 - Medicare Coverage Gap Discount Program Agreement.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Maintain up-to-date NDC listings with the electronic database vendors for which the manufacturer provides... under this subpart must comply with the requirements imposed by CMS or the third party administrator (as...

Assessing the Potential Cost-Effectiveness of Microneedle Patches in Childhood Measles Vaccination Programs: The Case for Further Research and Development.

PubMed

Adhikari, Bishwa B; Goodson, James L; Chu, Susan Y; Rota, Paul A; Meltzer, Martin I

2016-12-01

Currently available measles vaccines are administered by subcutaneous injections and require reconstitution with a diluent and a cold chain, which is resource intensive and challenging to maintain. To overcome these challenges and potentially increase vaccination coverage, microneedle patches are being developed to deliver the measles vaccine. This study compares the cost-effectiveness of using microneedle patches with traditional vaccine delivery by syringe-and-needle (subcutaneous vaccination) in children's measles vaccination programs. We built a simple spreadsheet model to compute the vaccination costs for using microneedle patch and syringe-and-needle technologies. We assumed that microneedle vaccines will be, compared with current vaccines, more heat stable and require less expensive cool chains when used in the field. We used historical data on the incidence of measles among communities with low measles vaccination rates. The cost of microneedle vaccination was estimated at US$0.95 (range US$0.71-US$1.18) for the first dose, compared with US$1.65 (range US$1.24-US$2.06) for the first dose delivered by subcutaneous vaccination. At 95 % vaccination coverage, microneedle patch vaccination was estimated to cost US$1.66 per measles case averted (range US$1.24-US$2.07) compared with an estimated cost of US$2.64 per case averted (range US$1.98-US$3.30) using subcutaneous vaccination. Use of microneedle patches may reduce costs; however, the cost-effectiveness of patches would depend on the vaccine recipients' acceptability and vaccine effectiveness of the patches relative to the existing conventional vaccine-delivery method. This study emphasizes the need to continue research and development of this vaccine-delivery method that could boost measles elimination efforts through improved access to vaccines and increased vaccination coverage.

CoMet: a workflow using contig coverage and composition for binning a metagenomic sample with high precision.

PubMed

Herath, Damayanthi; Tang, Sen-Lin; Tandon, Kshitij; Ackland, David; Halgamuge, Saman Kumara

2017-12-28

In metagenomics, the separation of nucleotide sequences belonging to an individual or closely matched populations is termed binning. Binning helps the evaluation of underlying microbial population structure as well as the recovery of individual genomes from a sample of uncultivable microbial organisms. Both supervised and unsupervised learning methods have been employed in binning; however, characterizing a metagenomic sample containing multiple strains remains a significant challenge. In this study, we designed and implemented a new workflow, Coverage and composition based binning of Metagenomes (CoMet), for binning contigs in a single metagenomic sample. CoMet utilizes coverage values and the compositional features of metagenomic contigs. The binning strategy in CoMet includes the initial grouping of contigs in guanine-cytosine (GC) content-coverage space and refinement of bins in tetranucleotide frequencies space in a purely unsupervised manner. With CoMet, the clustering algorithm DBSCAN is employed for binning contigs. The performances of CoMet were compared against four existing approaches for binning a single metagenomic sample, including MaxBin, Metawatt, MyCC (default) and MyCC (coverage) using multiple datasets including a sample comprised of multiple strains. Binning methods based on both compositional features and coverages of contigs had higher performances than the method which is based only on compositional features of contigs. CoMet yielded higher or comparable precision in comparison to the existing binning methods on benchmark datasets of varying complexities. MyCC (coverage) had the highest ranking score in F1-score. However, the performances of CoMet were higher than MyCC (coverage) on the dataset containing multiple strains. Furthermore, CoMet recovered contigs of more species and was 18 - 39% higher in precision than the compared existing methods in discriminating species from the sample of multiple strains. CoMet resulted in higher precision than MyCC (default) and MyCC (coverage) on a real metagenome. The approach proposed with CoMet for binning contigs, improves the precision of binning while characterizing more species in a single metagenomic sample and in a sample containing multiple strains. The F1-scores obtained from different binning strategies vary with different datasets; however, CoMet yields the highest F1-score with a sample comprised of multiple strains.

Parallel Proximity Detection for Computer Simulation

NASA Technical Reports Server (NTRS)

Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

1997-01-01

The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are includes by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

Parallel Proximity Detection for Computer Simulations

NASA Technical Reports Server (NTRS)

Steinman, Jeffrey S. (Inventor); Wieland, Frederick P. (Inventor)

1998-01-01

The present invention discloses a system for performing proximity detection in computer simulations on parallel processing architectures utilizing a distribution list which includes movers and sensor coverages which check in and out of grids. Each mover maintains a list of sensors that detect the mover's motion as the mover and sensor coverages check in and out of the grids. Fuzzy grids are included by fuzzy resolution parameters to allow movers and sensor coverages to check in and out of grids without computing exact grid crossings. The movers check in and out of grids while moving sensors periodically inform the grids of their coverage. In addition, a lookahead function is also included for providing a generalized capability without making any limiting assumptions about the particular application to which it is applied. The lookahead function is initiated so that risk-free synchronization strategies never roll back grid events. The lookahead function adds fixed delays as events are scheduled for objects on other nodes.

Exposing Coverage Data to the Semantic Web within the MELODIES project: Challenges and Solutions

NASA Astrophysics Data System (ADS)

Riechert, Maik; Blower, Jon; Griffiths, Guy

2016-04-01

Coverage data, typically big in data volume, assigns values to a given set of spatiotemporal positions, together with metadata on how to interpret those values. Existing storage formats like netCDF, HDF and GeoTIFF all have various restrictions that prevent them from being preferred formats for use over the web, especially the semantic web. Factors that are relevant here are the processing complexity, the semantic richness of the metadata, and the ability to request partial information, such as a subset or just the appropriate metadata. Making coverage data available within web browsers opens the door to new ways for working with such data, including new types of visualization and on-the-fly processing. As part of the European project MELODIES (http://melodiesproject.eu) we look into the challenges of exposing such coverage data in an interoperable and web-friendly way, and propose solutions using a host of emerging technologies like JSON-LD, the DCAT and GeoDCAT-AP ontologies, the CoverageJSON format, and new approaches to REST APIs for coverage data. We developed the CoverageJSON format within the MELODIES project as an additional way to expose coverage data to the web, next to having simple rendered images available using standards like OGC's WMS. CoverageJSON partially incorporates JSON-LD but does not encode individual data values as semantic resources, making use of the technology in a practical manner. The development also focused on it being a potential output format for OGC WCS. We will demonstrate how existing netCDF data can be exposed as CoverageJSON resources on the web together with a REST API that allows users to explore the data and run operations such as spatiotemporal subsetting. We will show various use cases from the MELODIES project, including reclassification of a Land Cover dataset client-side within the browser with the ability for the user to influence the reclassification result by making use of the above technologies.

Competing Discourses about Youth Sexual Exploitation in Canadian News Media

PubMed Central

Saewyc, Elizabeth M.; Miller, Bonnie B.; Rivers, Robert; Matthews, Jennifer; Hilario, Carla; Hirakata, Pam

2015-01-01

Media holds the power to create, maintain, or break down stigmatizing attitudes, which affect policies, funding, and services. To understand how Canadian news media depicts the commercial sexual exploitation of children and youth, we examined 835 Canadian newspaper articles from 1989–2008 using a mixed methods critical discourse analysis approach, comparing representations to existing research about sexually exploited youth. Despite research evidence that equal rates of boys and girls experience exploitation, Canadian news media depicted exploited youth predominantly as heterosexual girls, and described them alternately as victims or workers in a trade, often both in the same story. News media mentioned exploiters far less often than victims, and portrayed them almost exclusively as male, most often called ‘customers’ or ‘consumers,’ and occasionally ‘predators’; in contrast, research has documented the majority of sexually exploited boys report female exploiters. Few news stories over the past two decades portrayed the diversity of victims, perpetrators, and venues of exploitation reported in research. The focus on victims but not exploiters helps perpetuate stereotypes of sexual exploitation as business or a ‘victimless crime,’ maintains the status quo, and blurs responsibility for protecting youth under the UN Convention on the Rights of the Child. Health care providers and researchers can be advocates for accuracy in media coverage about sexual exploitation; news reporters and editors should focus on exploiters more than victims, draw on existing research evidence to avoid perpetuating stereotypes, and use accurate terms, such as commercial sexual exploitation, rather than terms related to business or trade. PMID:26793015

Compound Event Barrier Coverage in Wireless Sensor Networks under Multi-Constraint Conditions.

PubMed

Zhuang, Yaoming; Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi

2016-12-24

It is important to monitor compound event by barrier coverage issues in wireless sensor networks (WSNs). Compound event barrier coverage (CEBC) is a novel coverage problem. Unlike traditional ones, the data of compound event barrier coverage comes from different types of sensors. It will be subject to multiple constraints under complex conditions in real-world applications. The main objective of this paper is to design an efficient algorithm for complex conditions that can combine the compound event confidence. Moreover, a multiplier method based on an active-set strategy (ASMP) is proposed to optimize the multiple constraints in compound event barrier coverage. The algorithm can calculate the coverage ratio efficiently and allocate the sensor resources reasonably in compound event barrier coverage. The proposed algorithm can simplify complex problems to reduce the computational load of the network and improve the network efficiency. The simulation results demonstrate that the proposed algorithm is more effective and efficient than existing methods, especially in the allocation of sensor resources.

Compound Event Barrier Coverage in Wireless Sensor Networks under Multi-Constraint Conditions

PubMed Central

Zhuang, Yaoming; Wu, Chengdong; Zhang, Yunzhou; Jia, Zixi

2016-01-01

It is important to monitor compound event by barrier coverage issues in wireless sensor networks (WSNs). Compound event barrier coverage (CEBC) is a novel coverage problem. Unlike traditional ones, the data of compound event barrier coverage comes from different types of sensors. It will be subject to multiple constraints under complex conditions in real-world applications. The main objective of this paper is to design an efficient algorithm for complex conditions that can combine the compound event confidence. Moreover, a multiplier method based on an active-set strategy (ASMP) is proposed to optimize the multiple constraints in compound event barrier coverage. The algorithm can calculate the coverage ratio efficiently and allocate the sensor resources reasonably in compound event barrier coverage. The proposed algorithm can simplify complex problems to reduce the computational load of the network and improve the network efficiency. The simulation results demonstrate that the proposed algorithm is more effective and efficient than existing methods, especially in the allocation of sensor resources. PMID:28029118

5 CFR 894.601 - When does my FEDVIP coverage stop?

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Termination or Cancellation of...) If you are enrolled with a combination dental and vision carrier with a restricted service area, and... carrier and you change to a dental only or vision only carrier, your existing combination plan coverage...

5 CFR 894.601 - When does my FEDVIP coverage stop?

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS (CONTINUED) FEDERAL EMPLOYEES DENTAL AND VISION INSURANCE PROGRAM Termination or Cancellation of...) If you are enrolled with a combination dental and vision carrier with a restricted service area, and... carrier and you change to a dental only or vision only carrier, your existing combination plan coverage...

Inferring rubella outbreak risk from seroprevalence data in Belgium.

PubMed

Abrams, Steven; Kourkouni, Eleni; Sabbe, Martine; Beutels, Philippe; Hens, Niel

2016-12-07

Rubella is usually a mild disease for which infections often pass by unnoticed. In approximately 50% of the cases, there are no or only few clinical symptoms. However, rubella contracted during early pregnancy could lead to spontaneous abortion, to central nervous system defects, or to one of a range of other serious and debilitating conditions in a newborn such as the congenital rubella syndrome. Before the introduction of mass vaccination, rubella was a common childhood infection occurring all over the world. However, since the introduction of rubella antigen-containing vaccines, the incidence of rubella has declined dramatically in high-income countries. Recent large-scale mumps outbreaks, one of the components in the combined measles-mumps-rubella vaccine, occurring in countries throughout Europe with high vaccination coverage, provide evidence of pathogen-specific waning of vaccine-induced immunity and primary vaccine failure. In addition, recent measles outbreaks affecting populations with suboptimal vaccination coverages stress the importance of maintaining high vaccination coverages. In this paper, we focus on the assessment of rubella outbreak risk using a previously developed method to identify geographic regions of high outbreak potential. The methodology relies on 2006 rubella seroprevalence data and vaccination coverage data from Belgium and information on primary and secondary vaccine failure obtained from extensive literature reviews. We estimated the rubella outbreak risk in Belgium to be low, however maintaining high levels of immunisation and surveillance are of utmost importance to avoid future outbreaks. Copyright © 2016 Elsevier Ltd. All rights reserved.

Wide coverage biomedical event extraction using multiple partially overlapping corpora

PubMed Central

2013-01-01

Background Biomedical events are key to understanding physiological processes and disease, and wide coverage extraction is required for comprehensive automatic analysis of statements describing biomedical systems in the literature. In turn, the training and evaluation of extraction methods requires manually annotated corpora. However, as manual annotation is time-consuming and expensive, any single event-annotated corpus can only cover a limited number of semantic types. Although combined use of several such corpora could potentially allow an extraction system to achieve broad semantic coverage, there has been little research into learning from multiple corpora with partially overlapping semantic annotation scopes. Results We propose a method for learning from multiple corpora with partial semantic annotation overlap, and implement this method to improve our existing event extraction system, EventMine. An evaluation using seven event annotated corpora, including 65 event types in total, shows that learning from overlapping corpora can produce a single, corpus-independent, wide coverage extraction system that outperforms systems trained on single corpora and exceeds previously reported results on two established event extraction tasks from the BioNLP Shared Task 2011. Conclusions The proposed method allows the training of a wide-coverage, state-of-the-art event extraction system from multiple corpora with partial semantic annotation overlap. The resulting single model makes broad-coverage extraction straightforward in practice by removing the need to either select a subset of compatible corpora or semantic types, or to merge results from several models trained on different individual corpora. Multi-corpus learning also allows annotation efforts to focus on covering additional semantic types, rather than aiming for exhaustive coverage in any single annotation effort, or extending the coverage of semantic types annotated in existing corpora. PMID:23731785

High-Resolution Spatial Distribution and Estimation of Access to Improved Sanitation in Kenya.

PubMed

Jia, Peng; Anderson, John D; Leitner, Michael; Rheingans, Richard

2016-01-01

Access to sanitation facilities is imperative in reducing the risk of multiple adverse health outcomes. A distinct disparity in sanitation exists among different wealth levels in many low-income countries, which may hinder the progress across each of the Millennium Development Goals. The surveyed households in 397 clusters from 2008-2009 Kenya Demographic and Health Surveys were divided into five wealth quintiles based on their national asset scores. A series of spatial analysis methods including excess risk, local spatial autocorrelation, and spatial interpolation were applied to observe disparities in coverage of improved sanitation among different wealth categories. The total number of the population with improved sanitation was estimated by interpolating, time-adjusting, and multiplying the surveyed coverage rates by high-resolution population grids. A comparison was then made with the annual estimates from United Nations Population Division and World Health Organization /United Nations Children's Fund Joint Monitoring Program for Water Supply and Sanitation. The Empirical Bayesian Kriging interpolation produced minimal root mean squared error for all clusters and five quintiles while predicting the raw and spatial coverage rates of improved sanitation. The coverage in southern regions was generally higher than in the north and east, and the coverage in the south decreased from Nairobi in all directions, while Nyanza and North Eastern Province had relatively poor coverage. The general clustering trend of high and low sanitation improvement among surveyed clusters was confirmed after spatial smoothing. There exists an apparent disparity in sanitation among different wealth categories across Kenya and spatially smoothed coverage rates resulted in a closer estimation of the available statistics than raw coverage rates. Future intervention activities need to be tailored for both different wealth categories and nationally where there are areas of greater needs when resources are limited.

Beyond new vaccine introduction: the uptake of pneumococcal conjugate vaccine in the African Region.

PubMed

Olayinka, Folake; Ewald, Leah; Steinglass, Robert

2017-01-01

The number of vaccines available to low-income countries has increased dramatically over the last decade. Overall infant immunization coverage in the WHO African region has stagnated in the past few years while countries' ability to maintain high immunization coverage rates following introduction of new vaccines has been uneven. This case study examines post-introduction coverage among African countries that introduced PCV between 2008 and 2013 and the factors affecting Pneumococcal Conjugate Vaccine (PCV) introduction. Nearly one-third of countries did not achieve 80% infant PCV3 coverage by two years post-introduction and 58% of countries experienced a decline in coverage between post introduction years two and four. Major factors affecting coverage rates included introduction without adequate preparation, insufficient supply chain capacity and management, poor communication between organizations and with the public, and data collection systems that were insufficient to meet information needs. Deliberately addressing these issues as well as longstanding weaknesses during new vaccine introduction can strengthen the immunization and broader health system. Further study is required to identify and address factors that affect maintenance of high coverage following introduction of new vaccines in the African region. Immunization with PCV is one of the most important interventions protecting against pneumonia, the second leading cause of death for children under five globally.

Participatory methods for the assessment of the ownership status of free-roaming dogs in Bali, Indonesia, for disease control and animal welfare.

PubMed

Morters, M K; Bharadwaj, S; Whay, H R; Cleaveland, S; Damriyasa, I Md; Wood, J L N

2014-09-01

The existence of unowned, free-roaming dogs capable of maintaining adequate body condition without direct human oversight has serious implications for disease control and animal welfare, including reducing effective vaccination coverage against rabies through limiting access for vaccination, and absolving humans from the responsibility of providing adequate care for a domesticated species. Mark-recapture methods previously used to estimate the fraction of unowned dogs in free-roaming populations have limitations, particularly when most of the dogs are owned. We used participatory methods, described as Participatory Rural Appraisal (PRA), as a novel alternative to mark-recapture methods in two villages in Bali, Indonesia. PRA was implemented at the banjar (or sub-village)-level to obtain consensus on the food sources of the free-roaming dogs. Specific methods included semi-structured discussion, visualisation tools and ranking. The PRA results agreed with the preceding household surveys and direct observations, designed to evaluate the same variables, and confirmed that a population of unowned, free-roaming dogs in sufficiently good condition to be sustained independently of direct human support was unlikely to exist. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Inequalities in child immunization coverage in Ghana: evidence from a decomposition analysis.

PubMed

Asuman, Derek; Ackah, Charles Godfred; Enemark, Ulrika

2018-04-11

Childhood vaccination has been promoted as a global intervention aimed at improving child survival and health, through the reduction of vaccine preventable deaths. However, there exist significant inequalities in achieving universal coverage of child vaccination among and within countries. In this paper, we examine rural-urban inequalities in child immunizations in Ghana. Using data from the recent two waves of the Ghana Demographic and Health Survey, we examine the probability that a child between 12 and 59 months receives the required vaccinations and proceed to decompose the sources of inequalities in the probability of full immunization between rural and urban areas. We find significant child-specific, maternal and household characteristics on a child's immunization status. The results show that children in rural areas are more likely to complete the required vaccinations. The direction and sources of inequalities in child immunizations have changed between the two survey waves. We find a pro-urban advantage in 2008 arising from differences in observed characteristics whilst a pro-rural advantage emerges in 2014 dominated by the differences in coefficients. Health system development and campaign efforts have focused on rural areas. There is a need to also specifically target vulnerable children in urban areas, to maintain focus on women empowerment and pay attention to children from high socio-economic households in less favourable economic times.

Factors associated with photoprotection by body clothing coverage, particularly in non-summer months, among a New Zealand community sample.

PubMed

Reeder, Anthony I; Gray, Andrew R; Liley, J Ben; Scragg, Robert K R; McKenzie, Richard L; Stewart, Alistair W

2016-03-01

Clothing coverage is important for reducing skin cancer risk, but may also influence vitamin D sufficiency, so associated plausible predictors require investigation. Volunteers (18 to 85 years), with approximately equal numbers by sex and four ethnicity groups, were recruited in cities from two latitude bands: Auckland (36.9°S) and Dunedin (45.9°S). Baseline questionnaire, anthropometric and spectrophotometer skin colour data were collected and weather data obtained. Percent body coverage was calculated from eight week diary records. Potential independent predictors (unadjusted p < 0.25) were included in adjusted models. Participants (n = 506: Auckland n = 334, Dunedin n = 172; mean age 48.4 years) were 62.7% female and had a median body clothing coverage of 81.6% (IQR 9.3%). Dunedin was cooler, less windy and had lower UVI levels than Auckland. From the fully adjusted model, increased coverage occurred in non-summer months (despite adjusting for weather), among Dunedin residents and Asians (compared to Europeans), during the middle of the day, with a dose response effect observed for greater age. Reduced coverage was associated with Pacific ethnicity and greater time spent outdoors. Additionally, higher temperatures were associated with reduced coverage, whereas increased cloud cover and wind speed were associated with increased coverage. Although the only potentially modifiable factors associated with clothing coverage were the time period and time spent outdoors, knowledge of these and other associated factors is useful for the framing and targeting of health promotion messages to potentially influence clothing coverage, facilitate erythema avoidance and maintain vitamin D sufficiency.

Examining public knowledge and preferences for adult preventive services coverage.

PubMed

Williams, Jessica A R; Ortiz, Selena E

2017-01-01

To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015-2017. A 17-item survey instrument was designed and used to evaluate respondents' knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small-around one service less than those with liberal ideologies. Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered.

Examining public knowledge and preferences for adult preventive services coverage

PubMed Central

Ortiz, Selena E.

2017-01-01

Introduction To examine (1) what individuals know about the existing adult preventive service coverage provisions of the Affordable Care Act (ACA), and (2) which preventive services individuals think should be covered without cost sharing. Methods An online panel from Survey Monkey was used to obtain a sample of 2,990 adults age 18 and older in March 2015, analyzed 2015–2017. A 17-item survey instrument was designed and used to evaluate respondents’ knowledge of the adult preventive services provision of the ACA. Additionally, we asked whether various preventive services should be covered. The data include age, sex, race/ethnicity, and educational attainment as well as measures of political ideology, previous insurance status, the number of chronic conditions, and usual source of care. Results Respondents correctly answered 38.6% of the questions about existing coverage under the ACA, while on average respondents thought 12.1 of 15 preventive services should be covered (SD 3.5). Respondents were more knowledgeable about coverage for routine screenings, such as blood pressure (63.4% correct) than potentially stigmatizing screenings, such as for alcohol misuse (28.8% correct). Blood pressure screening received the highest support of coverage (89.8%) while coverage of gym memberships received the lowest support (59.4%). Individuals with conservative ideologies thought fewer services on average should be covered, but the difference was small—around one service less than those with liberal ideologies. Conclusions Overwhelmingly, individuals think that most preventive services should be covered without cost sharing. Despite several years of coverage for preventive services, there is still confusion and lack of knowledge about which services are covered. PMID:29261757

Potential for reduction of burden and local elimination of malaria by reducing Plasmodium falciparum malaria transmission: a mathematical modelling study

PubMed Central

Griffin, Jamie T; Bhatt, Samir; Sinka, Marianne E; Gething, Peter W; Lynch, Michael; Patouillard, Edith; Shutes, Erin; Newman, Robert D; Alonso, Pedro; Cibulskis, Richard E; Ghani, Azra C

2016-01-01

Summary Background Rapid declines in malaria prevalence, cases, and deaths have been achieved globally during the past 15 years because of improved access to first-line treatment and vector control. We aimed to assess the intervention coverage needed to achieve further gains over the next 15 years. Methods We used a mathematical model of the transmission of Plasmodium falciparum malaria to explore the potential effect on case incidence and malaria mortality rates from 2015 to 2030 of five different intervention scenarios: remaining at the intervention coverage levels of 2011–13 (Sustain), for which coverage comprises vector control and access to treatment; two scenarios of increased coverage to 80% (Accelerate 1) and 90% (Accelerate 2), with a switch from quinine to injectable artesunate for management of severe disease and seasonal malaria chemoprevention where recommended for both Accelerate scenarios, and rectal artesunate for pre-referral treatment at the community level added to Accelerate 2; a near-term innovation scenario (Innovate), which included longer-lasting insecticidal nets and expansion of seasonal malaria chemoprevention; and a reduction in coverage to 2006–08 levels (Reverse). We did the model simulations at the first administrative level (ie, state or province) for the 80 countries with sustained stable malaria transmission in 2010, accounting for variations in baseline endemicity, seasonality in transmission, vector species, and existing intervention coverage. To calculate the cases and deaths averted, we compared the total number of each under the five scenarios between 2015 and 2030 with the predicted number in 2015, accounting for population growth. Findings With an increase to 80% coverage, we predicted a reduction in case incidence of 21% (95% credible intervals [CrI] 19–29) and a reduction in mortality rates of 40% (27–61) by 2030 compared with 2015 levels. Acceleration to 90% coverage and expansion of treatment at the community level was predicted to reduce case incidence by 59% (Crl 56–64) and mortality rates by 74% (67–82); with additional near-term innovation, incidence was predicted to decline by 74% (70–77) and mortality rates by 81% (76–87). These scenarios were predicted to lead to local elimination in 13 countries under the Accelerate 1 scenario, 20 under Accelerate 2, and 22 under Innovate by 2030, reducing the proportion of the population living in at-risk areas by 36% if elimination is defined at the first administrative unit. However, failing to maintain coverage levels of 2011–13 is predicted to raise case incidence by 76% (Crl 71–80) and mortality rates by 46% (39–51) by 2020. Interpretation Our findings show that decreases in malaria transmission and burden can be accelerated over the next 15 years if the coverage of key interventions is increased. Funding UK Medical Research Council, UK Department for International Development, the Bill & Melinda Gates Foundation, the Swiss Development Agency, and the US Agency for International Development. PMID:26809816

Power structure in Chilean news media

PubMed Central

Bahamonde, Jorge; Bollen, Johan; Ferres, Leo; Poblete, Barbara

2018-01-01

Even democracies endowed with the most active free press struggle to maintain diversity of news coverage. Consolidation and market forces may cause only a few dominant players to control the news cycle. Editorial policies may be biased by corporate ownership relations, narrowing news coverage and focus. To an increasing degree this problem also applies to social media news distribution, since it is subject to the same socio-economic drivers. To study the effects of consolidation and ownership on news diversity, we model the diversity of Chilean coverage on the basis of ownership records and social media data. We create similarity networks of news outlets on the basis of their ownership and the topics they cover. We then examine the relationships between the topology of ownership networks and content similarity to characterize how ownership affects news coverage. A network analysis reveals that Chilean media is highly concentrated both in terms of ownership as well as in terms of topics covered. Our method can be used to determine which groups of outlets and ownership exert the greatest influence on news coverage. PMID:29874241

Power structure in Chilean news media.

PubMed

Bahamonde, Jorge; Bollen, Johan; Elejalde, Erick; Ferres, Leo; Poblete, Barbara

2018-01-01

Even democracies endowed with the most active free press struggle to maintain diversity of news coverage. Consolidation and market forces may cause only a few dominant players to control the news cycle. Editorial policies may be biased by corporate ownership relations, narrowing news coverage and focus. To an increasing degree this problem also applies to social media news distribution, since it is subject to the same socio-economic drivers. To study the effects of consolidation and ownership on news diversity, we model the diversity of Chilean coverage on the basis of ownership records and social media data. We create similarity networks of news outlets on the basis of their ownership and the topics they cover. We then examine the relationships between the topology of ownership networks and content similarity to characterize how ownership affects news coverage. A network analysis reveals that Chilean media is highly concentrated both in terms of ownership as well as in terms of topics covered. Our method can be used to determine which groups of outlets and ownership exert the greatest influence on news coverage.

Impact of Adverse Events Following Immunization in Viet Nam in 2013 on chronic hepatitis B infection.

PubMed

Li, Xi; Wiesen, Eric; Diorditsa, Sergey; Toda, Kohei; Duong, Thi Hong; Nguyen, Lien Huong; Nguyen, Van Cuong; Nguyen, Tran Hien

2016-02-03

Adverse Events Following Immunization in Viet Nam in 2013 led to substantial reductions in hepatitis B vaccination coverage (both the birth dose and the three-dose series). In order to estimate the impact of the reduction in vaccination coverage on hepatitis B transmission and future mortality, a widely-used mathematical model was applied to the data from Viet Nam. Using the model, we estimated the number of chronic infections and deaths that are expected to occur in the birth cohort in 2013 and the number of excessive infections and deaths attributable to the drop in immunization coverage in 2013. An excess of 90,137 chronic infections and 17,456 future deaths were estimated to occur in the 2013 birth cohort due to the drop in vaccination coverage. This analysis highlights the importance of maintaining high vaccination coverage and swiftly responding to reported Adverse Events Following Immunization in order to regain consumer confidence in the hepatitis B vaccine. Copyright © 2015 World Health Organization; licensee Elsevier. Published by Elsevier Ltd.. All rights reserved.

Estimation of measles vaccination coverage using the Lot Quality Assurance Sampling (LQAS) method--Tamilnadu, India, 2002-2003.

PubMed

Sivasankaran, Saravanan; Manickam, P; Ramakrishnan, R; Hutin, Y; Gupte, M D

2006-04-28

As part of the global strategic plan to reduce the number of measles deaths in India, the state of Tamilnadu aims at > or =95% measles vaccination coverage. A study was conducted to measure overall coverage levels for the Poondi Primary Health Center (PPHC), a rural health-care facility in Tiruvallur District, and to determine whether any of the PPHC's six health subcenters had coverage levels <95%. The Lot Quality Assurance Sampling (LQAS) method was used to identify health subcenters in the PPHC area with measles vaccination coverage levels <95% among children aged 12-23 months. Lemeshow and Taber sampling plans were used to determine that the measles vaccination status of 73 children aged 12--23 months had to be assessed in each health subcenter coverage area, with a 5% level of significance and a decision value of two. If more than two children were unvaccinated, the null hypothesis (i.e., that coverage in the health subcenter was low [<95%]) was not rejected. If the number of unvaccinated children was two or fewer, the null hypothesis was rejected, and coverage in the subcenter was considered to be good (i.e., > or =95%). All data were pooled in a stratified sample to estimate overall total coverage in the PPHC area. For two (33.3%) of the six health subcenters, more than two children were unvaccinated (i.e., coverage was <95%). Combining results from all six health subcenters generated a coverage estimate of 97.7% (95% confidence interval = 95.7-98.8) on the basis of 428 (97.7%) of 438 children identified as vaccinated. LQAS techniques proved useful in identifying small health areas with lower vaccination coverage, which helps to target interventions. Monthly review of vaccination coverage by subcenter and village is recommended to identify pockets of unvaccinated children and to maintain uniform high coverage in the PPHC area.

Vaccination coverage among children in kindergarten--United States, 2009-10 school year.

PubMed

2011-06-03

Healthy People 2020 objectives include maintaining vaccination coverage among children in kindergarten (IID-10) (1). The target is ≥95% vaccination coverage for the following vaccines: poliovirus; diphtheria and tetanus toxoids and acellular pertussis (DTP/DTaP/DT); measles, mumps, and rubella (MMR); hepatitis B (HepB); and varicella (1). Data from school assessment surveys are used to monitor vaccination coverage and vaccination exemption levels among children enrolled in kindergarten. This report summarizes data from school assessment surveys submitted to CDC by 48 federal immunization program grantees (including 47 states and the District of Columbia) for the 2009-10 school year to describe vaccination coverage and exemption rates (2). For that period, 17 grantees reported coverage of ?95% for four vaccines (poliovirus, DTP/DTaP/DT, MMR, and HepB) and four grantees reported coverage of ≥95% for 2 doses of varicella vaccine. Total exemption rates, including medical, religious, and philosophical exemptions, ranged from <1% to 6.2% across grantees, and 15 grantees reported exemption rates<1%. Survey methods for vaccination coverage and exemption rates varied among grantees, making comparisons difficult and limiting the use of school assessment surveys to report aggregate national rates. Further standardization of school assessment survey methods will generate comparable data between grantees to monitor and track progress in reaching national objectives, and allow development of best practice guidelines for grantees to more effectively use and report school coverage and exemption data. CDC will continue to monitor vaccination coverage and exemption levels and assist grantees in identification of local areas with low vaccination coverage or high exemption rates for further evaluation or intervention.

42 CFR 407.40 - Enrollment under a State buy-in agreement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... group specified in the agreement. A buy-in group could include certain individuals receiving Federally... modification to include a coverage group broader than the one originally selected. (2) Section 945(e) of the... broader coverage group for an existing agreement. (3) Several laws enacted during 1980-1987 had the effect...

45 CFR 303.31 - Securing and enforcing medical support obligations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... dependent child(ren). (3) Cash medical support or the cost of private health insurance is considered...(ren) to the existing coverage or the difference between self-only and family coverage. (b) The State... insurance that is accessible to the child(ren), as defined by the State, and is available to the parent...

45 CFR 303.31 - Securing and enforcing medical support obligations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... dependent child(ren). (3) Cash medical support or the cost of private health insurance is considered...(ren) to the existing coverage or the difference between self-only and family coverage. (b) The State... insurance that is accessible to the child(ren), as defined by the State, and is available to the parent...

45 CFR 303.31 - Securing and enforcing medical support obligations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... dependent child(ren). (3) Cash medical support or the cost of private health insurance is considered...(ren) to the existing coverage or the difference between self-only and family coverage. (b) The State... insurance that is accessible to the child(ren), as defined by the State, and is available to the parent...

45 CFR 303.31 - Securing and enforcing medical support obligations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... dependent child(ren). (3) Cash medical support or the cost of private health insurance is considered...(ren) to the existing coverage or the difference between self-only and family coverage. (b) The State... insurance that is accessible to the child(ren), as defined by the State, and is available to the parent...

The effect of sample height on spray coverage in mature pecan trees

USDA-ARS?s Scientific Manuscript database

Pecan scab (caused by Fusicladium effusum) is the most damaging disease of pecan in the southeastern US. Large air-blast sprayers for orchards are used to apply fungicide to control the disease, but little quantitative information exists on the spray coverage achieved in the canopy of these trees. I...

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship—(i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

Usability-driven pruning of large ontologies: the case of SNOMED CT.

PubMed

López-García, Pablo; Boeker, Martin; Illarramendi, Arantza; Schulz, Stefan

2012-06-01

To study ontology modularization techniques when applied to SNOMED CT in a scenario in which no previous corpus of information exists and to examine if frequency-based filtering using MEDLINE can reduce subset size without discarding relevant concepts. Subsets were first extracted using four graph-traversal heuristics and one logic-based technique, and were subsequently filtered with frequency information from MEDLINE. Twenty manually coded discharge summaries from cardiology patients were used as signatures and test sets. The coverage, size, and precision of extracted subsets were measured. Graph-traversal heuristics provided high coverage (71-96% of terms in the test sets of discharge summaries) at the expense of subset size (17-51% of the size of SNOMED CT). Pre-computed subsets and logic-based techniques extracted small subsets (1%), but coverage was limited (24-55%). Filtering reduced the size of large subsets to 10% while still providing 80% coverage. Extracting subsets to annotate discharge summaries is challenging when no previous corpus exists. Ontology modularization provides valuable techniques, but the resulting modules grow as signatures spread across subhierarchies, yielding a very low precision. Graph-traversal strategies and frequency data from an authoritative source can prune large biomedical ontologies and produce useful subsets that still exhibit acceptable coverage. However, a clinical corpus closer to the specific use case is preferred when available.

The Cost of Doing Business: Cost Structure of Electronic Immunization Registries

PubMed Central

Fontanesi, John M; Flesher, Don S; De Guire, Michelle; Lieberthal, Allan; Holcomb, Kathy

2002-01-01

Objective To predict the true cost of developing and maintaining an electronic immunization registry, and to set the framework for developing future cost-effective and cost-benefit analysis. Data Sources/Study Setting Primary data collected at three immunization registries located in California, accounting for 90 percent of all immunization records in registries in the state during the study period. Study Design A parametric cost analysis compared registry development and maintenance expenditures to registry performance requirements. Data Collection/Extraction Methods Data were collected at each registry through interviews, reviews of expenditure records, technical accomplishments development schedules, and immunization coverage rates. Principal Findings The cost of building immunization registries is predictable and independent of the hardware/software combination employed. The effort requires four man-years of technical effort or approximately $250,000 in 1998 dollars. Costs for maintaining a registry were approximately $5,100 per end user per three-year period. Conclusions There is a predictable cost structure for both developing and maintaining immunization registries. The cost structure can be used as a framework for examining the cost-effectiveness and cost-benefits of registries. The greatest factor effecting improvement in coverage rates was ongoing, user-based administrative investment. PMID:12479497

Behavioral consequences of conflict-oriented health news coverage: the 2009 mammography guideline controversy and online information seeking.

PubMed

Weeks, Brian E; Friedenberg, Laura M; Southwell, Brian G; Slater, Jonathan S

2012-01-01

Building on channel complementarity theory and media-system dependency theory, this study explores the impact of conflict-oriented news coverage of health issues on information seeking online. Using Google search data as a measure of behavior, we demonstrate that controversial news coverage of the U.S. Preventive Services Task Force's November 2009 recommendations for changes in breast cancer screening guidelines strongly predicted the volume of same-day online searches for information about mammograms. We also found that this relationship did not exist 1 year prior to the coverage, during which mammography news coverage did not focus on the guideline controversy, suggesting that the controversy frame may have driven search behavior. We discuss the implications of these results for health communication scholars and practitioners.

Graded zooming

DOEpatents

Coffland, Douglas R.

2006-04-25

A system for increasing the resolution in the far field resolution of video or still frame images, while maintaining full coverage in the near field. The system includes a camera connected to a computer. The computer applies a specific zooming scale factor to each of line of pixels and continuously increases the scale factor of the line of pixels from the bottom to the top to capture the scene in the near field, yet maintain resolution in the scene in the far field.

The impact of the tax system on health insurance coverage.

PubMed

Gruber, J

2001-01-01

A central question in health economics is the extent to which this tax subsidization matters for the health insurance coverage of the U.S. population. I assess the impact of taxes on health insurance by using the considerable existing variation in tax subsidies, both at a point in time and across time. I do so by putting together data from more than a decade of Current Population Survey (CPS) data sets, and matching to workers in those data sets their tax subsidies to health insurance coverage. I find that the elasticity of insurance eligibility of workers is at least -0.6, and that the elasticity of own insurance coverage is roughly similar; the results imply that most of the impact of taxes on insurance coverage arise through firm offering and eligibility decisions. I also find that higher tax rates induce more private coverage through other sources, but less public coverage, so that overall there is a reduction in the rate of uninsurance that is comparable to the change in own employer-provided insurance coverage.

Vaccination Coverage Cluster Surveys in Middle Dreib – Akkar, Lebanon: Comparison of Vaccination Coverage in Children Aged 12-59 Months Pre- and Post-Vaccination Campaign

PubMed Central

Assaad, Ramia; Rebeschini, Arianna; Hamadeh, Randa

2016-01-01

Introduction With the high proportion of refugee population throughout Lebanon and continuous population movement, it is sensible to believe that, in particular vulnerable areas, vaccination coverage may not be at an optimal level. Therefore, we assessed the vaccination coverage in children under 5 in a district of the Akkar governorate before and after a vaccination campaign. During the vaccination campaign, conducted in August 2015, 2,509 children were vaccinated. Materials and Methods We conducted a pre- and post-vaccination campaign coverage surveys adapting the WHO EPI cluster survey to the Lebanese MoPH vaccination calendar. Percentages of coverage for each dose of each vaccine were calculated for both surveys. Factors associated with complete vaccination were explored. Results Comparing the pre- with the post-campaign surveys, coverage for polio vaccine increased from 51.9% to 84.3%, for Pentavalent from 49.0% to 71.9%, for MMR from 36.2% to 61.0%, while the percentage of children with fully updated vaccination calendar increased from 32.9% to 53.8%. While Lebanese children were found to be better covered for some antigens compared to Syrians at the first survey, this difference disappeared at the post-campaign survey. Awareness and logistic obstacles were the primary reported causes of not complete vaccination in both surveys. Discussion Vaccination campaigns remain a quick and effective approach to increase vaccination coverage in crisis-affected areas. However, campaigns cannot be considered as a replacement of routine vaccination services to maintain a good level of coverage. PMID:27992470

Use of a collagen matrix for recession coverage in patients who received orthodontic therapy: a case series.

PubMed

Tan, Wah C; Tan, Wah L; Ong, Marianne M A; Lang, Niklaus P

2017-02-01

The aim of the present study was to determine the percentage of recession coverage achieved following surgery with a collagen matrix, and patient-reported outcome measures. Five healthy adults who had completed orthodontic therapy with a gingival recession defect were recruited. Gingival recession coverage was performed using a two-layer, xenogeneic collagen matrix (Mucograft). During the first 2 weeks, the patients charted their perceptions on bleeding, swelling, pain, and bruising using a visual analog scale (VAS). Post-surgical complications were assessed clinically at 1 week, 2 weeks, and 1 month post-surgery. Recession dimensions were examined at 1, 3, 6, and 12 months. At 1 year, an average of 67% root coverage was achieved. The amount of recession coverage achieved was stable from 3 months. The results were maintained at 1 year. There were no post-surgical complications. All VAS parameters decreased to almost zero by day 14. From day 1, bleeding and pain decreased over time. However, there were peaks on days 2 and 3 for swelling and bruising, respectively, followed by a subsequent decrease. The use of Mucograft for recession coverage is effective and safe, with low morbidity and no post-surgical complications. Recession coverage achieved at 3 months remained stable in the 1-year follow-up period. © 2015 Wiley Publishing Asia Pty Ltd.

Forestry [Chapter 11

Treesearch

H. Gyde Lund; William A. Befort; James E. Brickell; William M. Ciesla; Elizabeth C. Collins; Raymond L. Czaplewski; Attilio Antonio Disperati; Robert W. Douglass; Charles W. Dull; Jerry D. Greer; Rachel Riemann Hershey; Vernon J. LaBau; Henry Lachowski; Peter A. Murtha; David J. Nowak; Marc A. Roberts; Pierre Schram; Mahadev D. Shedha; Ashbindu Singh; Kenneth C. Winterberger

1997-01-01

Foresters and other resource managers have used aerial photographs to help manage resources since the late 1920s. As discussed in chapter 1, however, it was not until the mid-1940s that their use became common. Obtaining photographic coverage was always a problem. For many areas of the world, reasonably complete coverage did not exist until after World War II. In...

[Spatial and temporal analysis of the coverage for neonatal hearing screening in Brazil (2008-2015)].

PubMed

Paschoal, Monique Ramos; Cavalcanti, Hannalice Gottschalck; Ferreira, Maria Ângela Fernandes

2017-11-01

This article seeks to establish the coverage of neonatal hearing screening in Brazil between January 2008 and June 2015. It is an ecological study that uses the country, through the Urban Articulation Regions, as a base. To calculate the screening coverage percentage, the Live Births Information System, the Outpatient Information System and the Beneficiaries of the National Supplementary Health Agency Information System were used. An exploratory analysis of maps and spatial statistical analysis was conducted using TerraView 4.2.2 software. The coverage of neonatal hearing screening saw an increase of 9.3% to 37.2% during the study period. In 2008-2009 it was observed that the percentage of coverage ranged from 0% to 79.92%, but most areas received coverage from 0% to 20%, though in 2014-2015 coverage ranged from 0% to 171.77%, and there was a visible increase in the percentage of coverage in the country, mainly in the Southern Region. The screening coverage has increased over time, but is still low with an uneven distribution in the territory, which may be explained by local laws and policies and by the existence of different types of auditory health service in the country.

Sensor-driven area coverage for an autonomous fixed-wing unmanned aerial vehicle.

PubMed

Paull, Liam; Thibault, Carl; Nagaty, Amr; Seto, Mae; Li, Howard

2014-09-01

Area coverage with an onboard sensor is an important task for an unmanned aerial vehicle (UAV) with many applications. Autonomous fixed-wing UAVs are more appropriate for larger scale area surveying since they can cover ground more quickly. However, their non-holonomic dynamics and susceptibility to disturbances make sensor coverage a challenging task. Most previous approaches to area coverage planning are offline and assume that the UAV can follow the planned trajectory exactly. In this paper, this restriction is removed as the aircraft maintains a coverage map based on its actual pose trajectory and makes control decisions based on that map. The aircraft is able to plan paths in situ based on sensor data and an accurate model of the on-board camera used for coverage. An information theoretic approach is used that selects desired headings that maximize the expected information gain over the coverage map. In addition, the branch entropy concept previously developed for autonomous underwater vehicles is extended to UAVs and ensures that the vehicle is able to achieve its global coverage mission. The coverage map over the workspace uses the projective camera model and compares the expected area of the target on the ground and the actual area covered on the ground by each pixel in the image. The camera is mounted on a two-axis gimbal and can either be stabilized or optimized for maximal coverage. Hardware-in-the-loop simulation results and real hardware implementation on a fixed-wing UAV show the effectiveness of the approach. By including the already developed automatic takeoff and landing capabilities, we now have a fully automated and robust platform for performing aerial imagery surveys.

Childhood Cancer Survivor Study participants' perceptions and understanding of the Affordable Care Act.

PubMed

Park, Elyse R; Kirchhoff, Anne C; Perez, Giselle K; Leisenring, Wendy; Weissman, Joel S; Donelan, Karen; Mertens, Ann C; Reschovsky, James D; Armstrong, Gregory T; Robison, Leslie L; Franklin, Mariel; Hyland, Kelly A; Diller, Lisa R; Recklitis, Christopher J; Kuhlthau, Karen A

2015-03-01

The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered "very important" are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as "very important" (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. © 2015 by American Society of Clinical Oncology.

Childhood Cancer Survivor Study Participants' Perceptions and Understanding of the Affordable Care Act

PubMed Central

Park, Elyse R.; Kirchhoff, Anne C.; Perez, Giselle K.; Leisenring, Wendy; Weissman, Joel S.; Donelan, Karen; Mertens, Ann C.; Reschovsky, James D.; Armstrong, Gregory T.; Robison, Leslie L.; Franklin, Mariel; Hyland, Kelly A.; Diller, Lisa R.; Recklitis, Christopher J.; Kuhlthau, Karen A.

2015-01-01

Purpose The Patient Protection and Affordable Care Act (ACA) established provisions intended to increase access to affordable health insurance and thus increase access to medical care and long-term surveillance for populations with pre-existing conditions. However, childhood cancer survivors' coverage priorities and familiarity with the ACA are unknown. Methods Between May 2011 and April 2012, we surveyed a randomly selected, age-stratified sample of 698 survivors and 210 siblings from the Childhood Cancer Survivor Study. Results Overall, 89.8% of survivors and 92.1% of siblings were insured. Many features of insurance coverage that survivors considered “very important” are addressed by the ACA, including increased availability of primary care (94.6%), no waiting period before coverage initiation (79.0%), and affordable premiums (88.1%). Survivors were more likely than siblings to deem primary care physician coverage and choice, protections from costs due to pre-existing conditions, and no start-up period as “very important” (P < .05 for all). Only 27.3% of survivors and 26.2% of siblings reported familiarity with the ACA (12.1% of uninsured v 29.0% of insured survivors; odds ratio, 2.86; 95% CI, 1.28 to 6.36). Only 21.3% of survivors and 18.9% of siblings believed the ACA would make it more likely that they would get quality coverage. Survivors' and siblings' concerns about the ACA included increased costs, decreased access to and quality of care, and negative impact on employers and employees. Conclusion Although survivors' coverage preferences match many ACA provisions, survivors, particularly uninsured survivors, were not familiar with the ACA. Education and assistance, perhaps through cancer survivor navigation, are critically needed to ensure that survivors access coverage and benefits. PMID:25646189

A new role for primary care teams in the United States after “Obamacare:” Track and improve health insurance coverage rates

PubMed Central

DeVoe, Jennifer; Angier, Heather; Hoopes, Megan; Gold, Rachel

2017-01-01

Maintaining continuous health insurance coverage is important. With recent expansions in access to coverage in the United States after “Obamacare,” primary care teams have a new role in helping to track and improve coverage rates and to provide outreach to patients. We describe efforts to longitudinally track health insurance rates using data from the electronic health record (EHR) of a primary care network and to use these data to support practice-based insurance outreach and assistance. Although we highlight a few examples from one network, we believe there is great potential for doing this type of work in a broad range of family medicine and community health clinics that provide continuity of care. By partnering with researchers through practice-based research networks and other similar collaboratives, primary care practices can greatly expand the use of EHR data and EHR-based tools targeting improvements in health insurance and quality health care. PMID:28966926

Adsorption of parahydrogen on graphene

NASA Astrophysics Data System (ADS)

Dusseault, Marisa; Boninsegni, Massimo

2018-05-01

We study the low-temperature properties of a single layer of parahydrogen adsorbed on graphene, by means of quantum Monte Carlo simulations. The computed phase diagram is very similar to that of helium on the same substrate, featuring commensurate solid phases with fillings 1/3 and 7/16, as well as domain-wall phases at intermediate coverages. At higher coverage the system transitions to an incommensurate, compressible phase. Evidence of promotion of molecules to the second layer is observed at a coverage ˜0.112 Å-2, significantly above existing theoretical estimates.

78 FR 19263 - Lender Placed Insurance, Terms and Conditions

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... or indirectly, remuneration associated with placing coverage with or maintaining placement with... servicers from receiving, directly or indirectly, remuneration associated with an insurance provider ceding... telephone numbers. Dated: March 25, 2013. Edward J. DeMarco, Acting Director, Federal Housing Finance Agency...

42 CFR 423.578 - Exceptions process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and medical and scientific evidence and the known relevant physical or mental characteristics of the... evidence and medical and scientific evidence and the known relevant physical or mental characteristics of... maintain reasonable and complete exceptions procedures subject to CMS' approval for this type of coverage...

Modelling the implications of moving towards universal coverage in Tanzania.

PubMed

Borghi, Josephine; Mtei, Gemini; Ally, Mariam

2012-03-01

A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to promote universal coverage will depend on the ability of the system to contain costs.

Online and mobile technologies for self-management in bipolar disorder: A systematic review.

PubMed

Gliddon, Emma; Barnes, Steven J; Murray, Greg; Michalak, Erin E

2017-09-01

Internet (eHealth) and smartphone-based (mHealth) approaches to self-management for bipolar disorder are increasingly common. Evidence-based self-management strategies are available for bipolar disorder and provide a useful framework for reviewing existing eHealth/mHealth programs to determine whether these strategies are supported by current technologies. This review assesses which self-management strategies are most supported by technology. Based on 3 previous studies, 7 categories of self-management strategies related to bipolar disorder were identified, followed by a systematic literature review to identify existing eHealth and mHealth programs for this disorder. Searches were conducted by using PubMed, CINAHL, PsycINFO, EMBASE, and the Cochrane Database of Systematic Reviews for relevant peer-reviewed articles published January 2005 to May 2015. eHealth and mHealth programs were summarized and reviewed to identify which of the 7 self-management strategy categories were supported by eHealth or mHealth programs. From 1,654 publications, 15 papers were identified for inclusion. From these, 9 eHealth programs and 2 mHealth programs were identified. The most commonly supported self-management strategy categories were "ongoing monitoring," "maintaining hope," "education," and "planning for and taking action"; the least commonly supported categories were "relaxation" and "maintaining a healthy lifestyle." eHealth programs appear to provide more comprehensive coverage of self-management strategies compared with mHealth programs. Both eHealth and mHealth programs present a wide range of self-management strategies for bipolar disorder, although individuals seeking comprehensive interventions might be best served by eHealth programs, while those seeking more condensed and direct interventions might prefer mHealth programs. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia.

PubMed

Arief, Riana A; Hampson, Katie; Jatikusumah, Andri; Widyastuti, Maria D W; Sunandar; Basri, Chaerul; Putra, Anak A G; Willyanto, Iwan; Estoepangestie, Agnes T S; Mardiana, I W; Kesuma, I K G N; Sumantra, I P; Doherty, Paul F; Salman, M D; Gilbert, Jeff; Unger, Fred

2016-01-01

Maintaining high vaccination coverage is key to successful rabies control, but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidence following successive island-wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. Rabies, however, has continued to circulate at low levels. In the push to eliminate rabies from Bali, high coverage needs to be maintained across all areas of the island. We carried out door-to-door (DTD) questionnaire surveys ( n  = 10,352 dog-owning households) and photographic mark-recapture surveys (536 line transects, 2,597 observations of free-roaming dogs) in 2011-2012 to estimate dog population sizes and assess rabies vaccination coverage and dog demographic characteristics in Bali, Indonesia. The median number of dogs per subvillage unit ( banjar ) was 43 (range 0-307) for owned dogs estimated from the DTD survey and 17 (range 0-83) for unconfined dogs (including both owned and unowned) from transects. Vaccination coverage of owned dogs was significantly higher in adults (91.4%) compared to juveniles (<1 year, 43.9%), likely due to insufficient targeting of pups and from puppies born subsequent to vaccination campaigns. Juveniles had a 10-70 times greater risk of not being vaccinated in urban, suburban, and rural areas [combined odds ratios (ORs): 9.9-71.1, 95% CI: 8.6-96.0]. Free-roaming owned dogs were also 2-3 times more likely to be not vaccinated compared to those confined (combined Ors: 1.9-3.6, 95% CI: 1.4-5.4), with more dogs being confined in urban (71.2%) than in suburban (16.1%) and rural areas (8.0%). Vaccination coverage estimates from transects were also much lower (30.9%) than household surveys (83.6%), possibly due to loss of collars used to identify the vaccination status of free-roaming dogs, but these unconfined dogs may also include dogs that were unowned or more difficult to vaccinate. Overall, coverage levels were high in the owned dog population, but for future campaigns in Bali to have the highest chance of eliminating rabies, concerted effort should be made to vaccinate free-roaming dogs particularly in suburban and rural areas, with advertising to ensure that owners vaccinate pups. Long-lasting, cheap, and quick methods are needed to mark vaccinated animals and reassure communities of the reach of vaccination campaigns.

Determinants of Vaccination Coverage and Consequences for Rabies Control in Bali, Indonesia

PubMed Central

Arief, Riana A.; Hampson, Katie; Jatikusumah, Andri; Widyastuti, Maria D. W.; Sunandar; Basri, Chaerul; Putra, Anak A. G.; Willyanto, Iwan; Estoepangestie, Agnes T. S.; Mardiana, I. W.; Kesuma, I. K. G. N.; Sumantra, I. P.; Doherty, Paul F.; Salman, M. D.; Gilbert, Jeff; Unger, Fred

2017-01-01

Maintaining high vaccination coverage is key to successful rabies control, but mass dog vaccination can be challenging and population turnover erodes coverage. Declines in rabies incidence following successive island-wide vaccination campaigns in Bali suggest that prospects for controlling and ultimately eliminating rabies are good. Rabies, however, has continued to circulate at low levels. In the push to eliminate rabies from Bali, high coverage needs to be maintained across all areas of the island. We carried out door-to-door (DTD) questionnaire surveys (n = 10,352 dog-owning households) and photographic mark–recapture surveys (536 line transects, 2,597 observations of free-roaming dogs) in 2011–2012 to estimate dog population sizes and assess rabies vaccination coverage and dog demographic characteristics in Bali, Indonesia. The median number of dogs per subvillage unit (banjar) was 43 (range 0–307) for owned dogs estimated from the DTD survey and 17 (range 0–83) for unconfined dogs (including both owned and unowned) from transects. Vaccination coverage of owned dogs was significantly higher in adults (91.4%) compared to juveniles (<1 year, 43.9%), likely due to insufficient targeting of pups and from puppies born subsequent to vaccination campaigns. Juveniles had a 10–70 times greater risk of not being vaccinated in urban, suburban, and rural areas [combined odds ratios (ORs): 9.9–71.1, 95% CI: 8.6–96.0]. Free-roaming owned dogs were also 2–3 times more likely to be not vaccinated compared to those confined (combined Ors: 1.9–3.6, 95% CI: 1.4–5.4), with more dogs being confined in urban (71.2%) than in suburban (16.1%) and rural areas (8.0%). Vaccination coverage estimates from transects were also much lower (30.9%) than household surveys (83.6%), possibly due to loss of collars used to identify the vaccination status of free-roaming dogs, but these unconfined dogs may also include dogs that were unowned or more difficult to vaccinate. Overall, coverage levels were high in the owned dog population, but for future campaigns in Bali to have the highest chance of eliminating rabies, concerted effort should be made to vaccinate free-roaming dogs particularly in suburban and rural areas, with advertising to ensure that owners vaccinate pups. Long-lasting, cheap, and quick methods are needed to mark vaccinated animals and reassure communities of the reach of vaccination campaigns. PMID:28119919

Usability-driven pruning of large ontologies: the case of SNOMED CT

PubMed Central

Boeker, Martin; Illarramendi, Arantza; Schulz, Stefan

2012-01-01

Objectives To study ontology modularization techniques when applied to SNOMED CT in a scenario in which no previous corpus of information exists and to examine if frequency-based filtering using MEDLINE can reduce subset size without discarding relevant concepts. Materials and Methods Subsets were first extracted using four graph-traversal heuristics and one logic-based technique, and were subsequently filtered with frequency information from MEDLINE. Twenty manually coded discharge summaries from cardiology patients were used as signatures and test sets. The coverage, size, and precision of extracted subsets were measured. Results Graph-traversal heuristics provided high coverage (71–96% of terms in the test sets of discharge summaries) at the expense of subset size (17–51% of the size of SNOMED CT). Pre-computed subsets and logic-based techniques extracted small subsets (1%), but coverage was limited (24–55%). Filtering reduced the size of large subsets to 10% while still providing 80% coverage. Discussion Extracting subsets to annotate discharge summaries is challenging when no previous corpus exists. Ontology modularization provides valuable techniques, but the resulting modules grow as signatures spread across subhierarchies, yielding a very low precision. Conclusion Graph-traversal strategies and frequency data from an authoritative source can prune large biomedical ontologies and produce useful subsets that still exhibit acceptable coverage. However, a clinical corpus closer to the specific use case is preferred when available. PMID:22268217

[Measles are eliminated in Denmark].

PubMed

Lauridsen, Julie Aaberg; Krause, Tyra Grove; Andersen, Peter Henrik

2018-03-19

Measles vaccination has led to a significant fall in the number of measles cases and measles-related deaths worldwide. However, many countries still struggle to eliminate the disease. To obtain elimination, a minimum of 95% vaccination coverage for both of the measles, mumps, and rubella (MMR) vaccines is necessary as well as an efficient surveillance system and timely public health response. Presenting data on reported cases and vaccination coverage in the latest 20 years, this article describes how measles are eliminated in Denmark and recommends, how the Danish measles surveillance system can be further improved to maintain the status.

Insurance and Risk Management at the National Outdoor Leadership School.

ERIC Educational Resources Information Center

Chu, Lantien

1990-01-01

Describes how an outdoor program specializing in wilderness expeditions approaches risk management, liability, and insurance. Discusses maintaining good communications with insurance agents, managing crisis situations, participating in program audits, reading the fine print, international insurance coverage, and the basis for insurance premiums.…

Land and federal mineral ownership coverage for the Uinta Basin, Wasatch Plateau and surrounding areas, northeastern Utah

USGS Publications Warehouse

Biewick, L.H.; Green, G.A.

1999-01-01

This Arc/Info coverage contains land status and Federal and State mineral ownership for approximately 25,900 square miles in northeastern Utah. The polygon coverage (which is also provided here as a shapefile) contains three attributes of ownership information for each polygon. One attribute indicates whether the surface is State owned, privately owned, consists of Tribal and Indian lands, or, if Federally owned, which Federal agency manages the land surface. Another attribute indicates where the Utah School and Institutional Trust Lands Administration (SITLA) maintains full or partial subsurface mineral rights. The third attribute indicates which energy minerals, if any, are owned by the Federal govenment. This coverage is based on land management status and Federal and State mineral ownership data compiled by the U.S. Geological Survey (USGS), the former U.S. Bureau of Mines (USBM), and the Utah School and Institutional Trust Lands Administration at a scale of 1:100,000. This coverage was compiled primarily to serve the USGS National Oil and Gas Resource Assessment Project in the Uinta-Piceance Basin Province and the USGS National Coal Resource Assessment Project in the Colorado Plateau.

Potential for reduction of burden and local elimination of malaria by reducing Plasmodium falciparum malaria transmission: a mathematical modelling study.

PubMed

Griffin, Jamie T; Bhatt, Samir; Sinka, Marianne E; Gething, Peter W; Lynch, Michael; Patouillard, Edith; Shutes, Erin; Newman, Robert D; Alonso, Pedro; Cibulskis, Richard E; Ghani, Azra C

2016-04-01

Rapid declines in malaria prevalence, cases, and deaths have been achieved globally during the past 15 years because of improved access to first-line treatment and vector control. We aimed to assess the intervention coverage needed to achieve further gains over the next 15 years. We used a mathematical model of the transmission of Plasmodium falciparum malaria to explore the potential effect on case incidence and malaria mortality rates from 2015 to 2030 of five different intervention scenarios: remaining at the intervention coverage levels of 2011-13 (Sustain), for which coverage comprises vector control and access to treatment; two scenarios of increased coverage to 80% (Accelerate 1) and 90% (Accelerate 2), with a switch from quinine to injectable artesunate for management of severe disease and seasonal malaria chemoprevention where recommended for both Accelerate scenarios, and rectal artesunate for pre-referral treatment at the community level added to Accelerate 2; a near-term innovation scenario (Innovate), which included longer-lasting insecticidal nets and expansion of seasonal malaria chemoprevention; and a reduction in coverage to 2006-08 levels (Reverse). We did the model simulations at the first administrative level (ie, state or province) for the 80 countries with sustained stable malaria transmission in 2010, accounting for variations in baseline endemicity, seasonality in transmission, vector species, and existing intervention coverage. To calculate the cases and deaths averted, we compared the total number of each under the five scenarios between 2015 and 2030 with the predicted number in 2015, accounting for population growth. With an increase to 80% coverage, we predicted a reduction in case incidence of 21% (95% credible intervals [CrI] 19-29) and a reduction in mortality rates of 40% (27-61) by 2030 compared with 2015 levels. Acceleration to 90% coverage and expansion of treatment at the community level was predicted to reduce case incidence by 59% (Crl 56-64) and mortality rates by 74% (67-82); with additional near-term innovation, incidence was predicted to decline by 74% (70-77) and mortality rates by 81% (76-87). These scenarios were predicted to lead to local elimination in 13 countries under the Accelerate 1 scenario, 20 under Accelerate 2, and 22 under Innovate by 2030, reducing the proportion of the population living in at-risk areas by 36% if elimination is defined at the first administrative unit. However, failing to maintain coverage levels of 2011-13 is predicted to raise case incidence by 76% (Crl 71-80) and mortality rates by 46% (39-51) by 2020. Our findings show that decreases in malaria transmission and burden can be accelerated over the next 15 years if the coverage of key interventions is increased. UK Medical Research Council, UK Department for International Development, the Bill & Melinda Gates Foundation, the Swiss Development Agency, and the US Agency for International Development. Copyright © Griffin et al. Open Access article distributed under the terms of CC BY. 2015. World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the Article's original URL.

Uncritical and unbalanced coverage of synthetic biology in the Nordic press.

PubMed

Ancillotti, Mirko; Holmberg, Niklas; Lindfelt, Mikael; Eriksson, Stefan

2017-02-01

Synthetic biology will probably have a high impact on a variety of fields, such as healthcare, environment, biofuels, agriculture, and so on. A driving theme in European research policy is the importance of maintaining public legitimacy and support. Media can influence public attitudes and are therefore an important object of study. Through qualitative content analysis, this study investigates the press coverage of synthetic biology in the major Nordic countries between 2009 and 2014. The press coverage was found to be event-driven and there were striking similarities between countries when it comes to framing, language use, and treated themes. Reporters showed a marked dependence on their sources, mainly scientists and stakeholders, who thus drives the media agenda. The media portrayal was very positive, with an optimistic look at future benefits and very little discussion of possible risks.

The Changing Dynamics Of US Health Insurance And Implications For The Future Of The Affordable Care Act.

PubMed

Graves, John A; Nikpay, Sayeh S

2017-02-01

The introduction of Medicaid expansions and state Marketplaces under the Affordable Care Act (ACA) have reduced the uninsurance rate to historic lows, changing the choices Americans make about coverage. In this article we shed light on these changing dynamics. We drew upon multistate transition models fit to nationally representative longitudinal data to estimate coverage transition probabilities between major insurance types in the years leading up to and including 2014. We found that the ACA's unprecedented coverage changes increased transitions to Medicaid and nongroup coverage among the uninsured, while strengthening the existing employer-sponsored insurance system and improving retention of public coverage. However, our results suggest possible weakness of state Marketplaces, since people gaining nongroup coverage were disproportionately older than other potential enrollees. We identified key opportunities for policy makers and insurers to improve underlying Marketplace risk pools by focusing on people transitioning from employer-sponsored coverage; these people are disproportionately younger and saw almost no change in their likelihood of becoming uninsured in 2014 compared to earlier years. Project HOPE—The People-to-People Health Foundation, Inc.

A Max-Flow Based Algorithm for Connected Target Coverage with Probabilistic Sensors

PubMed Central

Shan, Anxing; Xu, Xianghua; Cheng, Zongmao; Wang, Wensheng

2017-01-01

Coverage is a fundamental issue in the research field of wireless sensor networks (WSNs). Connected target coverage discusses the sensor placement to guarantee the needs of both coverage and connectivity. Existing works largely leverage on the Boolean disk model, which is only a coarse approximation to the practical sensing model. In this paper, we focus on the connected target coverage issue based on the probabilistic sensing model, which can characterize the quality of coverage more accurately. In the probabilistic sensing model, sensors are only be able to detect a target with certain probability. We study the collaborative detection probability of target under multiple sensors. Armed with the analysis of collaborative detection probability, we further formulate the minimum ϵ-connected target coverage problem, aiming to minimize the number of sensors satisfying the requirements of both coverage and connectivity. We map it into a flow graph and present an approximation algorithm called the minimum vertices maximum flow algorithm (MVMFA) with provable time complex and approximation ratios. To evaluate our design, we analyze the performance of MVMFA theoretically and also conduct extensive simulation studies to demonstrate the effectiveness of our proposed algorithm. PMID:28587084

A Max-Flow Based Algorithm for Connected Target Coverage with Probabilistic Sensors.

PubMed

Shan, Anxing; Xu, Xianghua; Cheng, Zongmao; Wang, Wensheng

2017-05-25

Coverage is a fundamental issue in the research field of wireless sensor networks (WSNs). Connected target coverage discusses the sensor placement to guarantee the needs of both coverage and connectivity. Existing works largely leverage on the Boolean disk model, which is only a coarse approximation to the practical sensing model. In this paper, we focus on the connected target coverage issue based on the probabilistic sensing model, which can characterize the quality of coverage more accurately. In the probabilistic sensing model, sensors are only be able to detect a target with certain probability. We study the collaborative detection probability of target under multiple sensors. Armed with the analysis of collaborative detection probability, we further formulate the minimum ϵ -connected target coverage problem, aiming to minimize the number of sensors satisfying the requirements of both coverage and connectivity. We map it into a flow graph and present an approximation algorithm called the minimum vertices maximum flow algorithm (MVMFA) with provable time complex and approximation ratios. To evaluate our design, we analyze the performance of MVMFA theoretically and also conduct extensive simulation studies to demonstrate the effectiveness of our proposed algorithm.

Microstructural and geometric influences in the protective scales of Atractosteus spatula

PubMed Central

Sherman, Vincent R.; Yaraghi, Nicholas A.; Kisailus, David

2016-01-01

Atractosteus spatula has been described as a living fossil (having existed for 100 Myr), retaining morphological characteristics of early ancestors such as the ability to breathe air and survive above water for hours. Its highly effective armour consists of ganoid scales. We analyse the protective function of the scales and identify key features which lead to their resistance to failure. Microstructural features include: a twisted cross-plied mineral arrangement that inhibits crack propagation in the external ganoine layer, mineral crystals that deflect cracks in the bony region in order to activate the strength of mineralized collagen fibrils, and saw-tooth ridges along the interface between the two scale layers which direct cracks away from the intrinsically weak interface. The macroscale geometry is additionally evaluated and it is shown that the scales retain full coverage in spite of minimal overlap between adjacent scales while conforming to physiologically required strain and maintaining flexibility via a process in which adjacent rows of scales slide and concurrently reorient. PMID:27974575

Microstructural and geometric influences in the protective scales of Atractosteus spatula.

PubMed

Sherman, Vincent R; Yaraghi, Nicholas A; Kisailus, David; Meyers, Marc A

2016-12-01

Atractosteus spatula has been described as a living fossil (having existed for 100 Myr), retaining morphological characteristics of early ancestors such as the ability to breathe air and survive above water for hours. Its highly effective armour consists of ganoid scales. We analyse the protective function of the scales and identify key features which lead to their resistance to failure. Microstructural features include: a twisted cross-plied mineral arrangement that inhibits crack propagation in the external ganoine layer, mineral crystals that deflect cracks in the bony region in order to activate the strength of mineralized collagen fibrils, and saw-tooth ridges along the interface between the two scale layers which direct cracks away from the intrinsically weak interface. The macroscale geometry is additionally evaluated and it is shown that the scales retain full coverage in spite of minimal overlap between adjacent scales while conforming to physiologically required strain and maintaining flexibility via a process in which adjacent rows of scales slide and concurrently reorient. © 2016 The Author(s).

An efficient 3D R-tree spatial index method for virtual geographic environments

NASA Astrophysics Data System (ADS)

Zhu, Qing; Gong, Jun; Zhang, Yeting

A three-dimensional (3D) spatial index is required for real time applications of integrated organization and management in virtual geographic environments of above ground, underground, indoor and outdoor objects. Being one of the most promising methods, the R-tree spatial index has been paid increasing attention in 3D geospatial database management. Since the existing R-tree methods are usually limited by their weakness of low efficiency, due to the critical overlap of sibling nodes and the uneven size of nodes, this paper introduces the k-means clustering method and employs the 3D overlap volume, 3D coverage volume and the minimum bounding box shape value of nodes as the integrative grouping criteria. A new spatial cluster grouping algorithm and R-tree insertion algorithm is then proposed. Experimental analysis on comparative performance of spatial indexing shows that by the new method the overlap of R-tree sibling nodes is minimized drastically and a balance in the volumes of the nodes is maintained.

KeyWare: an open wireless distributed computing environment

NASA Astrophysics Data System (ADS)

Shpantzer, Isaac; Schoenfeld, Larry; Grindahl, Merv; Kelman, Vladimir

1995-12-01

Deployment of distributed applications in the wireless domain lack equivalent tools, methodologies, architectures, and network management that exist in LAN based applications. A wireless distributed computing environment (KeyWareTM) based on intelligent agents within a multiple client multiple server scheme was developed to resolve this problem. KeyWare renders concurrent application services to wireline and wireless client nodes encapsulated in multiple paradigms such as message delivery, database access, e-mail, and file transfer. These services and paradigms are optimized to cope with temporal and spatial radio coverage, high latency, limited throughput and transmission costs. A unified network management paradigm for both wireless and wireline facilitates seamless extensions of LAN- based management tools to include wireless nodes. A set of object oriented tools and methodologies enables direct asynchronous invocation of agent-based services supplemented by tool-sets matched to supported KeyWare paradigms. The open architecture embodiment of KeyWare enables a wide selection of client node computing platforms, operating systems, transport protocols, radio modems and infrastructures while maintaining application portability.

Vaccine vial stopper performance for fractional dose delivery of vaccines.

PubMed

Jarrahian, Courtney; Myers, Daniel; Creelman, Ben; Saxon, Eugene; Zehrung, Darin

2017-07-03

Shortages of vaccines such as inactivated poliovirus and yellow fever vaccines have been addressed by administering reduced-or fractional-doses, as recommended by the World Health Organization Strategic Advisory Group of Experts on Immunization, to expand population coverage in countries at risk. We evaluated 3 kinds of vaccine vial stoppers to assess their performance after increased piercing from repeated withdrawal of doses needed when using fractional doses (0.1 mL) from presentations intended for full-dose (0.5 mL) delivery. Self-sealing capacity and fragmentation of the stopper were assessed via modified versions of international standard protocols. All stoppers maintained self-sealing capacity after 100 punctures. The damage to stoppers measured as the fragmentation rate was within the target of ≤ 10% of punctures resulting in a fragment after as many as 50 punctures. We concluded that stopper failure is not likely to be a concern if existing vaccine vials containing up to 10 regular doses are used up to 50 times for fractional dose delivery.

Clustered lot quality assurance sampling to assess immunisation coverage: increasing rapidity and maintaining precision.

PubMed

Pezzoli, Lorenzo; Andrews, Nick; Ronveaux, Olivier

2010-05-01

Vaccination programmes targeting disease elimination aim to achieve very high coverage levels (e.g. 95%). We calculated the precision of different clustered lot quality assurance sampling (LQAS) designs in computer-simulated surveys to provide local health officers in the field with preset LQAS plans to simply and rapidly assess programmes with high coverage targets. We calculated sample size (N), decision value (d) and misclassification errors (alpha and beta) of several LQAS plans by running 10 000 simulations. We kept the upper coverage threshold (UT) at 90% or 95% and decreased the lower threshold (LT) progressively by 5%. We measured the proportion of simulations with < or =d individuals unvaccinated or lower if the coverage was set at the UT (pUT) to calculate beta (1-pUT) and the proportion of simulations with >d unvaccinated individuals if the coverage was LT% (pLT) to calculate alpha (1-pLT). We divided N in clusters (between 5 and 10) and recalculated the errors hypothesising that the coverage would vary in the clusters according to a binomial distribution with preset standard deviations of 0.05 and 0.1 from the mean lot coverage. We selected the plans fulfilling these criteria: alpha < or = 5% beta < or = 20% in the unclustered design; alpha < or = 10% beta < or = 25% when the lots were divided in five clusters. When the interval between UT and LT was larger than 10% (e.g. 15%), we were able to select precise LQAS plans dividing the lot in five clusters with N = 50 (5 x 10) and d = 4 to evaluate programmes with 95% coverage target and d = 7 to evaluate programmes with 90% target. These plans will considerably increase the feasibility and the rapidity of conducting the LQAS in the field.

Vaccination coverage among children in kindergarten - United States, 2013-14 school year.

PubMed

Seither, Ranee; Masalovich, Svetlana; Knighton, Cynthia L; Mellerson, Jenelle; Singleton, James A; Greby, Stacie M

2014-10-17

State and local vaccination requirements for school entry are implemented to maintain high vaccination coverage and protect schoolchildren from vaccine-preventable diseases. Each year, to assess state and national vaccination coverage and exemption levels among kindergartners, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013-14 school year. Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%. High exemption levels and suboptimal vaccination coverage leave children vulnerable to vaccine-preventable diseases. Although vaccination coverage among kindergartners for the majority of reporting states was at or near the 95% national Healthy People 2020 targets for 4 doses of DTaP, 2 doses of MMR, and 2 doses of varicella vaccine, low vaccination coverage and high exemption levels can cluster within communities. Immunization programs might have access to school vaccination coverage and exemption rates at a local level for counties, school districts, or schools that can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that vaccinations provide to their children.

Vaccination Coverage Among Children Aged 2 Years - U.S. Affiliated Pacific Islands, April-October, 2016.

PubMed

Tippins, Ashley; Murthy, Neil; Meghani, Mehreen; Solsman, Amy; Apaisam, Carter; Basilius, Merlyn; Eckert, Maribeth; Judicpa, Peter; Masunu, Yolanda; Pistotnik, Kelsey; Pedro, Daisy; Sasamoto, Jeremy; Underwood, J Michael

2018-05-25

Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the United States Affiliated Pacific Islands (USAPI).* CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, † USAPI immunization programs and CDC piloted a method for estimating up-to-date status among children aged 2 years using medical record abstraction to ascertain regional vaccination coverage. This was the first concurrent assessment of childhood vaccination coverage across five USAPI jurisdictions (American Samoa; Chuuk State, Federated States of Micronesia [FSM]; Commonwealth of the Northern Mariana Islands [CNMI]; Republic of the Marshall Islands [RMI]; and Republic of Palau). § Differences in vaccination coverage between main and outer islands ¶ were assessed for two jurisdictions where data were adequate.** Series coverage in this report includes the following doses of vaccines: ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP); ≥3 doses of inactivated poliovirus vaccine (IPV); ≥1 dose of measles, mumps, and rubella vaccine (MMR); ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; ≥3 doses of hepatitis B (HepB) vaccine; and ≥4 doses of pneumococcal conjugate vaccine (PCV); i.e., 4:3:1:3:3:4. Coverage with ≥3 doses of rotavirus vaccine was also assessed. Completion of the recommended series of each of these vaccines †† was <90% in all jurisdictions except Palau. Coverage with the full recommended six-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). In RMI and Chuuk, coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9 to 66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to guide programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions, is essential to maintain protection from VPD outbreaks in the region and the mainland United States.

India in search of right Universal Health Coverage (UHC) model: The risks of implementing UHC in the absence of political demand by the citizen.

PubMed

Kumar, Raman; Roy, Pritam

2016-01-01

Amid the global push for Universal Health Coverage (UHC), the agenda is being set for India's health care. In the absence of a constitutional mandate, a national policy and citizen-led political demand for UHC, there exist specific risks in rushing toward its implementation in India. As the debate of UHC continues, the health-care delivery system in India is at cross roads. UHC in India could take two different trajectories. The first one takes India toward becoming "Global Bazaar" of morbidity and ill health, founded on the pillars of a vibrant rapidly multiplying healthcare industry. The other path takes India on a course of preventing wasteful, expensive health-care expenditure by maintaining healthy populations. A poor professional blood donor cannot become rich by selling his or her own blood beyond medically permissible levels; similarly, India cannot become a developed economy by merely allowing exploitation of disease, illness, and morbidity of her citizen. It is the duty of the state and governments to protect individual citizen, population under consideration, as well as country's economy from wasteful and potentially harmful expenditure incurred to address ill health. In the economic sense, any sensible UHC implementation mechanism would seek to regulate wasteful preventable health-care expenditure for the purpose of future economic stability and growth of the country. Due diligence toward safeguarding "public health in public interest," during the process of UHC implementation, is the need of the hour.

Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates. National Immunization Survey. National Health Interview Survey/National Immunization Provider Record Check Study.

PubMed

Bartlett, D L; Ezzati-Rice, T M; Stokley, S; Zhao, Z

2001-05-01

The National Immunization Survey (NIS) and the National Health Interview Survey (NHIS) produce national coverage estimates for children aged 19 months to 35 months. The NIS is a cost-effective, random-digit-dialing telephone survey that produces national and state-level vaccination coverage estimates. The National Immunization Provider Record Check Study (NIPRCS) is conducted in conjunction with the annual NHIS, which is a face-to-face household survey. As the NIS is a telephone survey, potential coverage bias exists as the survey excludes children living in nontelephone households. To assess the validity of estimates of vaccine coverage from the NIS, we compared 1995 and 1996 NIS national estimates with results from the NHIS/NIPRCS for the same years. Both the NIS and the NHIS/NIPRCS produce similar results. The NHIS/NIPRCS supports the findings of the NIS.

Count every newborn; a measurement improvement roadmap for coverage data.

PubMed

Moxon, Sarah G; Ruysen, Harriet; Kerber, Kate J; Amouzou, Agbessi; Fournier, Suzanne; Grove, John; Moran, Allisyn C; Vaz, Lara M E; Blencowe, Hannah; Conroy, Niall; Gülmezoglu, A; Vogel, Joshua P; Rawlins, Barbara; Sayed, Rubayet; Hill, Kathleen; Vivio, Donna; Qazi, Shamim A; Sitrin, Deborah; Seale, Anna C; Wall, Steve; Jacobs, Troy; Ruiz Peláez, Juan; Guenther, Tanya; Coffey, Patricia S; Dawson, Penny; Marchant, Tanya; Waiswa, Peter; Deorari, Ashok; Enweronu-Laryea, Christabel; Arifeen, Shams; Lee, Anne C C; Mathai, Matthews; Lawn, Joy E

2015-01-01

The Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularly to track coverage, quality and equity. In a multistage process, a matrix of 70 indicators were assessed by the Every Newborn steering group. Indicators were graded based on their availability and importance to ENAP, resulting in 10 core and 10 additional indicators. A consultation process was undertaken to assess the status of each ENAP core indicator definition, data availability and measurement feasibility. Coverage indicators for the specific ENAP treatment interventions were assigned task teams and given priority as they were identified as requiring the most technical work. Consultations were held throughout. ENAP published 10 core indicators plus 10 additional indicators. Three core impact indicators (neonatal mortality rate, maternal mortality ratio, stillbirth rate) are well defined, with future efforts needed to focus on improving data quantity and quality. Three core indicators on coverage of care for all mothers and newborns (intrapartum/skilled birth attendance, early postnatal care, essential newborn care) have defined contact points, but gaps exist in measuring content and quality of the interventions. Four core (antenatal corticosteroids, neonatal resuscitation, treatment of serious neonatal infections, kangaroo mother care) and one additional coverage indicator for newborns at risk or with complications (chlorhexidine cord cleansing) lack indicator definitions or data, especially for denominators (population in need). To address these gaps, feasible coverage indicator definitions are presented for validity testing. Measurable process indicators to help monitor health service readiness are also presented. A major measurement gap exists to monitor care of small and sick babies, yet signal functions could be tracked similarly to emergency obstetric care. The ENAP Measurement Improvement Roadmap (2015-2020) outlines tools to be developed (e.g., improved birth and death registration, audit, and minimum perinatal dataset) and actions to test, validate and institutionalise proposed coverage indicators. The roadmap presents a unique opportunity to strengthen routine health information systems, crosslinking these data with civil registration and vital statistics and population-based surveys. Real measurement change requires intentional transfer of leadership to countries with the greatest disease burden and will be achieved by working with centres of excellence and existing networks.

25 CFR 141.44 - Insurance on pawn.

Code of Federal Regulations, 2010 CFR

2010-04-01

... OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES BUSINESS PRACTICES ON THE NAVAJO... pledge shall maintain invault all risk insurance coverage running in favor of the pledgor for such...) A copy of the insurance policy shall be available for inspection at the licensee's place of business...

14 CFR 291.22 - Aircraft accident liability insurance requirement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Aircraft accident liability insurance... for All-Cargo Air Transportation § 291.22 Aircraft accident liability insurance requirement. No air... and maintains in effect aircraft accident liability coverage that meets the requirements of part 205...

Measles in Poland in 2012.

PubMed

Rogalska, Justyna; Karasek, Ewa; Paradowska-Stankiewicz, Iwona

2014-01-01

In 1998 Poland, along with all other Member States in the WHO European Region, implemented Measles Elimination Program coordinated by WHO. It requires achieving and maintaining very high vaccine coverage (>95%), recording all cases and suspected cases of measles, and laboratory testing of all suspected measles cases in the WHO Reference Laboratory. In Poland it is a Laboratory of Department of Virology, NIPH-NIH. To assess epidemiological situation of measles in Poland in 2012, including vaccination coverage in Polish population, and Measles Elimination Program implementation status. The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2012" and "Vaccinations in Poland in 2012", and measles case-based reports from 2012 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations. In total, there were 70 measles cases registered in Poland in 2012 (incidence 0.18 per 100 000). The highest incidence rate was observed among infants (2.08 per 100 000) and children aged 1 year (2.47 per 100 000). In 2012, 37 cases (52,9%) were hospitalized due to measles. No deaths from measles were reported. Vaccination coverage of children and youth aged 2-11 years ranged from 83.6% do 99.6% (primary vaccination in children born in 2011-2006) and from 76.6% do 96.7% (booster dose in children born in 2003-2001). Performance of the surveillance system was insufficient with only 127 measles-compatible cases reported in 2012 (33% of expected reports). Fifty cases (71%) were confirmed by IgM ELISA test. The epidemiological situation of measles deteriorated in 2012 in comparison to proceding year. The results indicate a need to further promote Measles Elimination Program in Poland, maintain the high immunisation coverage and improve measles surveillance system.

Progress Toward Measles Elimination - Bangladesh, 2000-2016.

PubMed

Khanal, Sudhir; Bohara, Rajendra; Chacko, Stephen; Sharifuzzaman, Mohammad; Shamsuzzaman, Mohammad; Goodson, James L; Dabbagh, Alya; Kretsinger, Katrina; Dhongde, Deepak; Liyanage, Jayantha; Bahl, Sunil; Thapa, Arun

2017-07-21

In 2013, at the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR), a regional goal was established to eliminate measles and control rubella and congenital rubella syndrome* by 2020 (1). WHO-recommended measles elimination strategies in SEAR countries include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs) † ; 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets targets for recommended performance indicators; and 3) developing and maintaining an accredited measles laboratory network (2). In 2014, Bangladesh, one of 11 countries in SEAR, adopted a national goal for measles elimination by 2018 (2,3). This report describes progress and challenges toward measles elimination in Bangladesh during 2000-2016. Estimated coverage with the first MCV dose (MCV1) increased from 74% in 2000 to 94% in 2016. The second MCV dose (MCV2) was introduced in 2012, and MCV2 coverage increased from 35% in 2013 to 93% in 2016. During 2000-2016, approximately 108.9 million children received MCV during three nationwide SIAs conducted in phases. During 2000-2016, reported confirmed measles incidence decreased 82%, from 34.2 to 6.1 per million population. However, in 2016, 56% of districts did not meet the surveillance performance target of ≥2 discarded nonmeasles, nonrubella cases § per 100,000 population. Additional measures that include increasing MCV1 and MCV2 coverage to ≥95% in all districts with additional strategies for hard-to-reach populations, increasing sensitivity of measles case-based surveillance, and ensuring timely transport of specimens to the national laboratory will help achieve measles elimination.

Arctic Digital Elevation Models (DEMs) generated by Surface Extraction from TIN-Based Searchspace Minimization (SETSM) algorithm from RPCs-based Imagery

NASA Astrophysics Data System (ADS)

Noh, M. J.; Howat, I. M.; Porter, C. C.; Willis, M. J.; Morin, P. J.

2016-12-01

The Arctic is undergoing rapid change associated with climate warming. Digital Elevation Models (DEMs) provide critical information for change measurement and infrastructure planning in this vulnerable region, yet the existing quality and coverage of DEMs in the Arctic is poor. Low contrast and repeatedly-textured surfaces, such as snow and glacial ice and mountain shadows, all common in the Arctic, challenge existing stereo-photogrammetric techniques. Submeter resolution, stereoscopic satellite imagery with high geometric and radiometric quality, and wide spatial coverage are becoming increasingly accessible to the scientific community. To utilize these imagery for extracting DEMs at a large scale over glaciated and high latitude regions we developed the Surface Extraction from TIN-based Searchspace Minimization (SETSM) algorithm. SETSM is fully automatic (i.e. no search parameter settings are needed) and uses only the satellite rational polynomial coefficients (RPCs). Using SETSM, we have generated a large number of DEMs (> 100,000 scene pair) from WorldView, GeoEye and QuickBird stereo images collected by DigitalGlobe Inc. and archived by the Polar Geospatial Center (PGC) at the University of Minnesota through an academic licensing program maintained by the US National Geospatial-Intelligence Agency (NGA). SETSM is the primary DEM generation software for the US National Science Foundation's ArcticDEM program, with the objective of generating high resolution (2-8m) topography for the entire Arctic landmass, including seamless DEM mosaics and repeat DEM strips for change detection. ArcticDEM is collaboration between multiple US universities, governmental agencies and private companies, as well as international partners assisting with quality control and registration. ArcticDEM is being produced using the petascale Blue Waters supercomputer at the National Center for Supercomputer Applications at the University of Illinois. In this paper, we introduce the SETSM algorithm and the processing system used for the ArcticDEM project, as well as provide notable examples of ArcticDEM products.

Addressing the workplace needs of Western Australian midwives: a Delphi study.

PubMed

Hauck, Yvonne L; Bayes, Sara J; Robertson, Jeanette M

2012-05-01

To determine the workplace needs of Western Australian midwives working in public metropolitan secondary hospitals. Using a three-round Delphi approach, Round 1 incorporated focus groups and a questionnaire. Fifteen focus groups were conducted with midwives also having the option of contributing through an open-ended questionnaire. During Round 2, 38 items reflecting seven themes were prioritised with a final ranking performed in Round 3. In total, 114 midwives participated in Round 1, 72 in Round 2 and 89 in Round 3. During Round 1, workplace needs identified as being met included: working across all areas of midwifery; ability to work in areas of interest; opportunity to work with low to moderate risk women; supportive colleagues; accessible parking; hospital close to home and friendly work atmosphere. Round 2 items revealed the five top unmet needs as: adequate midwifery staff coverage; access to maintained equipment; competitive pay scales; patient safety issues and opportunities to implement midwifery models. The top ranked needs from Round 3 included: recognising the unpredictable nature of midwifery services; provision of competent medical coverage, and adequate midwifery staff coverage. Demand for maternity services is unpredictable; however, in order to maintain a sustainable maternity workforce, WA midwives' prioritised needs would suggest health management focus upon expanding the availability of midwifery models of care, fostering flexible working conditions and ensuring collaboration between maternity health professionals occurs within clinically safe staffing levels.

Progress Toward Measles Elimination - South-East Asia Region, 2003-2013.

PubMed

Thapa, Arun; Khanal, Sudhir; Sharapov, Umid; Swezy, Virginia; Sedai, Tika; Dabbagh, Alya; Rota, Paul; Goodson, James L; McFarland, Jeffrey

2015-06-12

In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region adopted the goal of measles elimination and rubella and congenital rubella syndrome control by 2020 after rigorous prior consultations. The recommended strategies include 1) achieving and maintaining ≥95% coverage with 2 doses of measles- and rubella-containing vaccine in every district through routine or supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely case-based measles surveillance system that meets recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. This report updates previous reports and summarizes progress toward measles elimination in the South-East Asia Region during 2003-2013. Within the region, coverage with the first dose of a measles-containing vaccine (MCV1) increased from 67% to 78%; an estimated 286 million children (95% of the target population) were vaccinated in SIAs; measles incidence decreased 73%, from 59 to 16 cases per million population; and estimated measles deaths decreased 63%. To achieve measles elimination in the region, additional efforts are needed in countries with <95% 2-dose routine MCV coverage, particularly in India and Indonesia, to strengthen routine immunization services, conduct periodic high-quality SIAs, and strengthen measles case-based surveillance and laboratory diagnosis of measles.

Acoustic window planning for ultrasound acquisition.

PubMed

Göbl, Rüdiger; Virga, Salvatore; Rackerseder, Julia; Frisch, Benjamin; Navab, Nassir; Hennersperger, Christoph

2017-06-01

Autonomous robotic ultrasound has recently gained considerable interest, especially for collaborative applications. Existing methods for acquisition trajectory planning are solely based on geometrical considerations, such as the pose of the transducer with respect to the patient surface. This work aims at establishing acoustic window planning to enable autonomous ultrasound acquisitions of anatomies with restricted acoustic windows, such as the liver or the heart. We propose a fully automatic approach for the planning of acquisition trajectories, which only requires information about the target region as well as existing tomographic imaging data, such as X-ray computed tomography. The framework integrates both geometrical and physics-based constraints to estimate the best ultrasound acquisition trajectories with respect to the available acoustic windows. We evaluate the developed method using virtual planning scenarios based on real patient data as well as for real robotic ultrasound acquisitions on a tissue-mimicking phantom. The proposed method yields superior image quality in comparison with a naive planning approach, while maintaining the necessary coverage of the target. We demonstrate that by taking image formation properties into account acquisition planning methods can outperform naive plannings. Furthermore, we show the need for such planning techniques, since naive approaches are not sufficient as they do not take the expected image quality into account.

Assessing the Value of Enhancing AirNow Data with NASA Satellite Data

NASA Astrophysics Data System (ADS)

Pasch, A. N.; Burke, B.; Huang, S.; Dye, T.; Dawes, S. S.; DeWinter, J. L.; Zahn, P. H.; Haderman, M.; Szykman, J.; White, J. E.; Dickerson, P.; van Donkelaar, A.; Martin, R.

2013-12-01

We will describe the methodology and findings from a study that addressed how satellite-enhanced air quality information provided through the U.S. Environmental Protection Agency's (EPA) AirNow Satellite Data Processor (ASDP) program could contribute to greater socioeconomic benefits. This study was funded by the National Aeronautics and Space Administration (NASA) and conducted, in partnership with the EPA, by the Center for Technology in Government at the University at Albany (CTG) and Sonoma Technology, Inc. (STI). AirNow is the national repository of real-time air quality data and forecasts for the United States. While mainly a public outreach and awareness tool, AirNow relies on the same network of ground-based air quality monitors that is used by federal, state, local, and tribal governments throughout the United States. Extensive as the monitoring network is, considerable gaps exist in certain parts of the United States. Even areas with monitors considered adequate for regulatory purposes can lack information needed to resolve localized air quality issues or give forecasters sufficient confidence about the potential air quality impact of specific events. Monitors are expensive to deploy and maintain; thus, EPA is seeking other ways to improve coverage and detail. Satellite-estimated data can provide information for many places where ground monitors do not exist, and supplement ground monitors, providing additional information for use in analysis and forecasting. ASDP uses satellite-derived estimates for fine-particle pollution (PM2.5) and provides coverage for a small window of time during the day. As satellite capabilities improve in terms of different types of sensors and increased coverage throughout the day, the ASDP program is prepared to extend its scope to additional pollutants and provide greater enhancements to the ground-based networks. In this study, CTG assessed the socioeconomic benefits of air quality data at a community level through three case studies in the Denver, Atlanta, and Kansas City regions by interviewing people at EPA regional offices, state environmental and public health agencies, local public health authorities, regional planning and non-profit outreach organizations, and universities. The interviews focused on the existing uses of air quality information and the potential value of incorporating NASA satellite-enhanced AirNow data to support and enhance the missions of the organizations interviewed. STI analyzed the economic benefit of using satellite data to fill in gaps in the current air quality monitoring network used to provide information to the public. This presentation will discuss how the findings can be used to improve estimation of the socioeconomic benefits derived from Earth observation science in policy and management decisions.

Imported Cutaneous Diphtheria, United Kingdom

PubMed Central

de Benoist, Anne-Claire; White, Joanne Margaret; Efstratiou, Androulla; Kelly, Carole; Mann, Ginder; Nazareth, Bernadette; Irish, Charles James; Kumar, Deepti

2004-01-01

Cutaneous diphtheria is endemic in tropical countries but unusual in the United Kingdom. Four cases occurred in the United Kingdom within 2 months in 2002. Because cutaneous diphtheria causes outbreaks of both cutaneous and pharyngeal forms, early diagnosis is essential for implementing control measures; high diphtheria vaccination coverage must also be maintained. PMID:15109425

42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

Code of Federal Regulations, 2014 CFR

2014-10-01

... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

Code of Federal Regulations, 2012 CFR

2012-10-01

... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

Code of Federal Regulations, 2013 CFR

2013-10-01

... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

42 CFR 410.47 - Pulmonary rehabilitation program: Conditions for coverage.

Code of Federal Regulations, 2011 CFR

2011-10-01

... means a doctor of medicine or osteopathy as defined in section 1861(r)(1) of the Act. Physician... physician that improves or maintains an individual's pulmonary functional level. Psychosocial assessment... certification including basic life support. (4) Is licensed to practice medicine in the State in which the...

Agencies collaborate, develop a cyanobacteria assessment network

USGS Publications Warehouse

Schaeffer, Blake A.; Loftin, Keith A.; Stumpf, Richard P.; Werdell, P. Jeremy

2015-01-01

Satellite remote sensing tools may enable policy makers and environmental managers to assess the sustainability of watershed ecosystems and the services they provide, now and in the future. Satellite technology allows us to develop early-warning indicators of cyanobacteria blooms at the local scale while maintaining continuous national coverage.

24 CFR 242.33 - Covenant for malpractice, fire, and other hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... for malpractice, fire, and other hazard insurance. The mortgage shall contain a covenant binding the mortgagor to maintain adequate liability, fire, and extended coverage insurance on the property. The... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Covenant for malpractice, fire, and...

7 CFR 1806.6 - Failure of borrower to provide insurance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Section 1806.6 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... insurance. When a borrower fails to provide and maintain property insurance which meets the requirements set forth in § 1806.2 of this subpart, every effort will be made to have the borrower provide coverage...

7 CFR 1806.6 - Failure of borrower to provide insurance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 1806.6 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... insurance. When a borrower fails to provide and maintain property insurance which meets the requirements set forth in § 1806.2 of this subpart, every effort will be made to have the borrower provide coverage...

7 CFR 1806.6 - Failure of borrower to provide insurance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 1806.6 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... insurance. When a borrower fails to provide and maintain property insurance which meets the requirements set forth in § 1806.2 of this subpart, every effort will be made to have the borrower provide coverage...

7 CFR 1806.6 - Failure of borrower to provide insurance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Section 1806.6 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... insurance. When a borrower fails to provide and maintain property insurance which meets the requirements set forth in § 1806.2 of this subpart, every effort will be made to have the borrower provide coverage...

7 CFR 1806.6 - Failure of borrower to provide insurance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Section 1806.6 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE... insurance. When a borrower fails to provide and maintain property insurance which meets the requirements set forth in § 1806.2 of this subpart, every effort will be made to have the borrower provide coverage...

A Smart and Balanced Energy-Efficient Multihop Clustering Algorithm (Smart-BEEM) for MIMO IoT Systems in Future Networks.

PubMed

Xu, Lina; O'Hare, Gregory M P; Collier, Rem

2017-07-05

Wireless Sensor Networks (WSNs) are typically composed of thousands of sensors powered by limited energy resources. Clustering techniques were introduced to prolong network longevity offering the promise of green computing. However, most existing work fails to consider the network coverage when evaluating the lifetime of a network. We believe that balancing the energy consumption in per unit area rather than on each single sensor can provide better-balanced power usage throughout the network. Our former work-Balanced Energy-Efficiency (BEE) and its Multihop version BEEM can not only extend the network longevity, but also maintain the network coverage. Following WSNs, Internet of Things (IoT) technology has been proposed with higher degree of diversities in terms of communication abilities and user scenarios, supporting a large range of real world applications. The IoT devices are embedded with multiple communication interfaces, normally referred as Multiple-In and Multiple-Out (MIMO) in 5G networks. The applications running on those devices can generate various types of data. Every interface has its own characteristics, which may be preferred and beneficial in some specific user scenarios. With MIMO becoming more available on the IoT devices, an advanced clustering solution for highly dynamic IoT systems is missing and also pressingly demanded in order to cater for differing user applications. In this paper, we present a smart clustering algorithm (Smart-BEEM) based on our former work BEE(M) to accomplish energy efficient and Quality of user Experience (QoE) supported communication in cluster based IoT networks. It is a user behaviour and context aware approach, aiming to facilitate IoT devices to choose beneficial communication interfaces and cluster headers for data transmission. Experimental results have proved that Smart-BEEM can further improve the performance of BEE and BEEM for coverage sensitive longevity.

Matching seed to site by climate similarity: techniques to prioritize plant materials development and use in restoration

USGS Publications Warehouse

Doherty, Kyle; Butterfield, Bradley J.; Wood, Troy E.

2017-01-01

Land management agencies are increasing the use of native plant materials for vegetation treatments to restore ecosystem function and maintain natural ecological integrity. This shift toward the use of natives has highlighted a need to increase the diversity of materials available. A key problem is agreeing on how many, and which, new accessions should be developed. Here we describe new methods that address this problem. Our methods use climate data to calculate a climate similarity index between two points in a defined extent. This index can be used to predict relative performance of available accessions at a target site. In addition, the index can be used in combination with standard cluster analysis algorithms to quantify and maximize climate coverage (mean climate similarity), given a modeled range extent and a specified number of accessions. We demonstrate the utility of this latter feature by applying it to the extents of 11 western North American species with proven or potential use in restoration. First, a species-specific seed transfer map can be readily generated for a species by predicting performance for accessions currently available; this map can be readily updated to accommodate new accessions. Next, the increase in climate coverage achieved by adding successive accessions can be explored, yielding information that managers can use to balance ecological and economic considerations in determining how many accessions to develop. This approach identifies sampling sites, referred to as climate centers, which contribute unique, complementary, climate coverage to accessions on hand, thus providing explicit sampling guidance for both germplasm preservation and research. We examine how these and other features of our approach add to existing methods used to guide plant materials development and use. Finally, we discuss how these new methods provide a framework that could be used to coordinate native plant materials development, evaluation, and use across agencies, regions, and research groups.

A Smart and Balanced Energy-Efficient Multihop Clustering Algorithm (Smart-BEEM) for MIMO IoT Systems in Future Networks †

PubMed Central

O’Hare, Gregory M. P.; Collier, Rem

2017-01-01

Wireless Sensor Networks (WSNs) are typically composed of thousands of sensors powered by limited energy resources. Clustering techniques were introduced to prolong network longevity offering the promise of green computing. However, most existing work fails to consider the network coverage when evaluating the lifetime of a network. We believe that balancing the energy consumption in per unit area rather than on each single sensor can provide better-balanced power usage throughout the network. Our former work—Balanced Energy-Efficiency (BEE) and its Multihop version BEEM can not only extend the network longevity, but also maintain the network coverage. Following WSNs, Internet of Things (IoT) technology has been proposed with higher degree of diversities in terms of communication abilities and user scenarios, supporting a large range of real world applications. The IoT devices are embedded with multiple communication interfaces, normally referred as Multiple-In and Multiple-Out (MIMO) in 5G networks. The applications running on those devices can generate various types of data. Every interface has its own characteristics, which may be preferred and beneficial in some specific user scenarios. With MIMO becoming more available on the IoT devices, an advanced clustering solution for highly dynamic IoT systems is missing and also pressingly demanded in order to cater for differing user applications. In this paper, we present a smart clustering algorithm (Smart-BEEM) based on our former work BEE(M) to accomplish energy efficient and Quality of user Experience (QoE) supported communication in cluster based IoT networks. It is a user behaviour and context aware approach, aiming to facilitate IoT devices to choose beneficial communication interfaces and cluster headers for data transmission. Experimental results have proved that Smart-BEEM can further improve the performance of BEE and BEEM for coverage sensitive longevity. PMID:28678164

[Anti-pneumococcal vaccine coverage for hospitalized risk patients: Assessment and suggestions for improvements].

PubMed

Richard, C; Le Garlantezec, P; Lamand, V; Rasamijao, V; Rapp, C

2016-05-01

Streptococcus pneumoniae can cause invasive infections. Incidence and severity are linked to patients' risk factors. Due to the resistance to leading antibiotics, the anti-pneumococcal vaccination has become a major public health issue. The purpose of this survey was to evaluate the anti-pneumococcal vaccine coverage in a population of adults with risk factors. This was a prospective study that included patients with at least one recommendation for pneumococcal vaccination as indicated by the Weekly Epidemiological Bulletin (BEH), to which three further US recommendations were added (diabetes, obesity and age>65years). One hundred and thirty-four patients with an average age of 70 years were included. The physician could only confirm 68 % of the patients' vaccination status. Vaccination coverage as recommended by the BEH board was 30 % (n=54). All HIV patients were vaccinated (n=2) and the vaccination coverage was 75 % (n=8) for patients treated for autoimmune diseases and only 10 % (n=20) for patients treated with chemotherapy. Patients with no vaccination didn't know the existence of the vaccine or didn't know that vaccination was recommended to them. This study has highlighted a deficit in pneumococcal vaccination coverage and a high level of ignorance of the existence of recommended vaccination. In addition to awareness campaign for patients and caregiver training, the expansion of the vaccine e-book utilization could improve the vaccination status. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Reproducibility and Consistency of In Vitro Nucleosome Reconstitutions Demonstrated by Invitrosome Isolation and Sequencing

PubMed Central

Kempton, Colton E.; Heninger, Justin R.; Johnson, Steven M.

2014-01-01

Nucleosomes and their positions in the eukaryotic genome play an important role in regulating gene expression by influencing accessibility to DNA. Many factors influence a nucleosome's final position in the chromatin landscape including the underlying genomic sequence. One of the primary reasons for performing in vitro nucleosome reconstitution experiments is to identify how the underlying DNA sequence will influence a nucleosome's position in the absence of other compounding cellular factors. However, concerns have been raised about the reproducibility of data generated from these kinds of experiments. Here we present data for in vitro nucleosome reconstitution experiments performed on linear plasmid DNA that demonstrate that, when coverage is deep enough, these reconstitution experiments are exquisitely reproducible and highly consistent. Our data also suggests that a coverage depth of 35X be maintained for maximal confidence when assaying nucleosome positions, but lower coverage levels may be generally sufficient. These coverage depth recommendations are sufficient in the experimental system and conditions used in this study, but may vary depending on the exact parameters used in other systems. PMID:25093869

Federal Employees Health Benefits and Federal Employees Dental and Vision Insurance Programs' Coverage Exception for Children of Same-Sex Domestic Partners. Interim final rule.

PubMed

2016-12-02

This action amends the rule to create a regulatory exception that allows children of same-sex domestic partners living overseas to maintain their Federal Employees Health Benefits (FEHB) and Federal Employees Dental and Vision Program (FEDVIP) coverage until September 30, 2018. Due to a recent Supreme Court decision, as of January 1, 2016, coverage of children of same-sex domestic partners under the FEHB Program and FEDVIP will generally only be allowed if the couple is married, as discussed in Benefits Administration Letter (BAL) 15-207 dated October 5, 2015. OPM recognizes there are additional requirements placed on overseas federal employees that may not apply to other civilian employees with duty stations in the United States making it difficult to travel to the United States to marry same-sex partners.

Clinical evaluation of the efficacy of a GTR membrane (HEALIGUIDE) and demineralised bone matrix (OSSEOGRAFT) as a space maintainer in the treatment of Miller's Class I gingival recession.

PubMed

Nanditha, S; Priya, M S; Sabitha, S; Arun, K V; Avaneendra, T

2011-04-01

Periodontal plastic surgical procedures aimed at coverage of exposed root surface have evolved into routine treatment modalities. The present study was designed to evaluate the effectiveness and predictability of using a collagen barrier along with a demineralized bone matrix in the treatment of recession defects in a single surgical procedure. Seventeen patients with Miller's class I recession were treated with a combination of a collagen barrier used along with a bone graft and coronally advanced flap technique. Clinical parameters were recorded at baseline, 3 months, 6 months, and 9 months. The study showed a highly significant reduction in the recession depth (70.29 ± 21.96%) at the end of the study. This study showed that the use of this technique for recession coverage is highly predictable and highly esthetic root coverage can be obtained.

Family planning, abortion, and HIV in Ghanaian print media: a 15-month content analysis of a national Ghanaian newspaper.

PubMed

Laar, Amos K

2010-12-01

This study assessed coverage of reproductive health (RH) issues--family planning (FP), abortion, and HIV--in the Ghanaian Daily Graphic newspaper. Using the composite week sampling technique, the researcher analyzed the contents of 62 editions of the paper. Prominence was measured using various attributes, and differences in mean coverage over time were assessed using analysis of variance. This review shows that coverage of RH issues was extraordinarily poor, less than 1 percent each for FP, abortion, and HIV. RH news that was covered was given little prominence. These findings support the popular impression that the Daily Graphic does not give priority to reproductive health issues in its coverage. RH advocates need to develop innovative means of integrating RH content into existing media outlets.

Learning Time-Varying Coverage Functions

PubMed Central

Du, Nan; Liang, Yingyu; Balcan, Maria-Florina; Song, Le

2015-01-01

Coverage functions are an important class of discrete functions that capture the law of diminishing returns arising naturally from applications in social network analysis, machine learning, and algorithmic game theory. In this paper, we propose a new problem of learning time-varying coverage functions, and develop a novel parametrization of these functions using random features. Based on the connection between time-varying coverage functions and counting processes, we also propose an efficient parameter learning algorithm based on likelihood maximization, and provide a sample complexity analysis. We applied our algorithm to the influence function estimation problem in information diffusion in social networks, and show that with few assumptions about the diffusion processes, our algorithm is able to estimate influence significantly more accurately than existing approaches on both synthetic and real world data. PMID:25960624

Learning Time-Varying Coverage Functions.

PubMed

Du, Nan; Liang, Yingyu; Balcan, Maria-Florina; Song, Le

2014-12-08

Coverage functions are an important class of discrete functions that capture the law of diminishing returns arising naturally from applications in social network analysis, machine learning, and algorithmic game theory. In this paper, we propose a new problem of learning time-varying coverage functions, and develop a novel parametrization of these functions using random features. Based on the connection between time-varying coverage functions and counting processes, we also propose an efficient parameter learning algorithm based on likelihood maximization, and provide a sample complexity analysis. We applied our algorithm to the influence function estimation problem in information diffusion in social networks, and show that with few assumptions about the diffusion processes, our algorithm is able to estimate influence significantly more accurately than existing approaches on both synthetic and real world data.

Comparing errors in Medicaid reporting across surveys: evidence to date.

PubMed

Call, Kathleen T; Davern, Michael E; Klerman, Jacob A; Lynch, Victoria

2013-04-01

To synthesize evidence on the accuracy of Medicaid reporting across state and federal surveys. All available validation studies. Compare results from existing research to understand variation in reporting across surveys. Synthesize all available studies validating survey reports of Medicaid coverage. Across all surveys, reporting some type of insurance coverage is better than reporting Medicaid specifically. Therefore, estimates of uninsurance are less biased than estimates of specific sources of coverage. The CPS stands out as being particularly inaccurate. Measuring health insurance coverage is prone to some level of error, yet survey overstatements of uninsurance are modest in most surveys. Accounting for all forms of bias is complex. Researchers should consider adjusting estimates of Medicaid and uninsurance in surveys prone to high levels of misreporting. © Health Research and Educational Trust.

75 FR 60341 - Deposit Insurance Regulations; Unlimited Coverage for Noninterest-bearing Transaction Accounts

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... mail for depositors who ordinarily receive account information in this manner. The notice may be in the... existing information collection, OMB No. 3064-0168, currently entitled SWEEP Accounts: Disclosure of... discontinue its existing ``Transaction Account Guarantee Program Extension'' information collection, OMB No...

Using Appropriate Digital Tools to Overcome Barriers to Collaborative Learning in Classrooms

ERIC Educational Resources Information Center

Wardlow, Liane; Harm, Eian

2015-01-01

Collaborative learning provides students with vital opportunities to create and build knowledge. Existing technologies can facilitate collaborative learning. However, barriers exist to enacting collaborative practices related to the coverage of material for assessments and classroom management concerns, among others. Teachers can overcome these…

Evolution of health coverage in Mexico: evidence of progress and challenges in the Mexican health system.

PubMed

Urquieta-Salomón, José E; Villarreal, Héctor J

2016-02-01

To consolidate an effective and efficient universal health care coverage requires a deep understanding of the challenges faced by the health care system in providing services demanded by population in need. This study analyses the dynamics of health insurance coverage and effective access coverage to some health interventions in Mexico. It examines the evolution of inequalities and heterogeneous performance of the insurance subsystems incorporated under the Mexican health care system. Two types of coverage indicators were selected: health insurance and effective access to preventive health interventions intended for normative population. Data were drawn from National Health and Nutrition Surveys 2006 and 2012. The economic inequality was estimated using the Standardized Concentration Index by household per capita consumption expenditure as socioeconomic-status indicator. Approximately 75% of the population reported being covered by one of the existing insurance schemes, representing a huge step forward from 2006, when as much as 51.62% of the population had no health insurance. About 87% of this growth was attributable to the expansion of Non Contributory Health Insurance whereas 7% emanated from the Social Security subsystem. The results revealed that inequality in access to health insurance was virtually eradicated; however, traces of unequal access persisted in some subpopulations groups. Coverage indicators of effective access showed a slight improvement in the period analysed, but prenatal care and interventions to prevent chronic disease still presented a serious shortage. Furthermore, there was no evidence that inequities in coverage of these interventions have decreased in recent years. The results provided a mixed picture, generalizable to the system as a whole, expansion of insurance status represents one of the most remarkable advances that have not been accompanied by a significant improvement in effective access. In addition, existing inequalities are part of the most important challenges to be faced by the Mexican health system. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

An Innovative Open Data-driven Approach for Improved Interpretation of Coverage Data at NASA JPL's PO.DAA

NASA Astrophysics Data System (ADS)

McGibbney, L. J.; Armstrong, E. M.

2016-12-01

Figuratively speaking, Scientific Datasets (SD) are shared by data producers in a multitude of shapes, sizes and flavors. Primarily however they exist as machine-independent manifestations supporting the creation, access, and sharing of array-oriented SD that can on occasion be spread across multiple files. Within the Earth Sciences, the most notable general examples include the HDF family, NetCDF, etc. with other formats such as GRIB being used pervasively within specific domains such as the Oceanographic, Atmospheric and Meteorological sciences. Such file formats contain Coverage Data e.g. a digital representation of some spatio-temporal phenomenon. A challenge for large data producers such as NASA and NOAA as well as consumers of coverage datasets (particularly surrounding visualization and interactive use within web clients) is that this is still not a straight-forward issue due to size, serialization and inherent complexity. Additionally existing data formats are either unsuitable for the Web (like netCDF files) or hard to interpret independently due to missing standard structures and metadata (e.g. the OPeNDAP protocol). Therefore alternative, Web friendly manifestations of such datasets are required.CoverageJSON is an emerging data format for publishing coverage data to the web in a web-friendly, way which fits in with the linked data publication paradigm hence lowering the barrier for interpretation by consumers via mobile devices and client applications, etc. as well as data producers who can build next generation Web friendly Web services around datasets. This work will detail how CoverageJSON is being evaluated at NASA JPL's PO.DAAC as an enabling data representation format for publishing SD as Linked Open Data embedded within SD landing pages as well as via semantic data repositories. We are currently evaluating how utilization of CoverageJSON within SD landing pages addresses the long-standing acknowledgement that SD producers are not currently addressing content-based optimization within their SD landing pages for better crawlability by commercial search engines.

Out-of-Pocket Financial Burden for Low-Income Families with Children: Socioeconomic Disparities and Effects of Insurance

PubMed Central

Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

2005-01-01

Objective To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. Data Source The Household Component of the 2001 Medical Expenditure Panel Survey. Study Design Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. Data Collection/Extraction We aggregated annual OOP expenditures for all members of 4,531 families with a child <18 years old. Family insurance coverage was categorized as follows: (1) all members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. Principal Findings A regressive gradient was noted for financial burden across income groups, with families with incomes <100 percent of the Federal Poverty Level (FPL) spending a mean of $119.66 OOP per $1,000 of family income and families with incomes 100–199 percent FPL spending $66.30 OOP per $1,000, compared with $37.75 for families with incomes >400 percent FPL. For low-income families (<200 percent FPL), there was a 785 percent decrease in financial burden for those with full-year public coverage compared with those with full-year private insurance (p<.001). Conclusions Socioeconomic disparities exist in the financial burden of OOP health care expenditures for families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage. PMID:16336545

Out-of-pocket financial burden for low-income families with children: socioeconomic disparities and effects of insurance.

PubMed

Galbraith, Alison A; Wong, Sabrina T; Kim, Sue E; Newacheck, Paul W

2005-12-01

To determine whether socioeconomic disparities exist in the financial burden of out-of-pocket (OOP) health care expenditures for families with children, and whether health insurance coverage decreases financial burden for low-income families. The Household Component of the 2001 Medical Expenditure Panel Survey. Cross-sectional family-level analysis. We used bivariate statistics to examine whether financial burden varied by poverty level. Multivariate regression models were used to assess whether family insurance coverage was associated with level of financial burden for low-income families. The main outcome was financial burden, defined as the proportion of family income spent on OOP health care expenditures, including premiums, for all family members. We aggregated annual OOP expenditures for all members of 4,531 families with a child <18 years old. Family insurance coverage was categorized as follows: (1) all members publicly insured all year, (2) all members privately insured all year, (3) all members uninsured all year, (4) partial coverage, or (5) mix of public and private with no uninsured periods. A regressive gradient was noted for financial burden across income groups, with families with incomes <100 percent of the Federal Poverty Level (FPL) spending a mean of 119.66 US dollars OOP per 1,000 US dollars of family income and families with incomes 100-199 percent FPL spending 66.30 US dollars OOP per 1,000 US dollars, compared with 37.75 US dollars for families with incomes >400 percent FPL. For low-income families (<200 percent FPL), there was a 785 percent decrease in financial burden for those with full-year public coverage compared with those with full-year private insurance (p < .001). Socioeconomic disparities exist in the financial burden of OOP health care expenditures for families with children. For low-income families, full-year public coverage provides significantly greater protection from financial burden than full-year private coverage.

A Flexible and Non-instrusive Approach for Computing Complex Structural Coverage Metrics

NASA Technical Reports Server (NTRS)

Whalen, Michael W.; Person, Suzette J.; Rungta, Neha; Staats, Matt; Grijincu, Daniela

2015-01-01

Software analysis tools and techniques often leverage structural code coverage information to reason about the dynamic behavior of software. Existing techniques instrument the code with the required structural obligations and then monitor the execution of the compiled code to report coverage. Instrumentation based approaches often incur considerable runtime overhead for complex structural coverage metrics such as Modified Condition/Decision (MC/DC). Code instrumentation, in general, has to be approached with great care to ensure it does not modify the behavior of the original code. Furthermore, instrumented code cannot be used in conjunction with other analyses that reason about the structure and semantics of the code under test. In this work, we introduce a non-intrusive preprocessing approach for computing structural coverage information. It uses a static partial evaluation of the decisions in the source code and a source-to-bytecode mapping to generate the information necessary to efficiently track structural coverage metrics during execution. Our technique is flexible; the results of the preprocessing can be used by a variety of coverage-driven software analysis tasks, including automated analyses that are not possible for instrumented code. Experimental results in the context of symbolic execution show the efficiency and flexibility of our nonintrusive approach for computing code coverage information

Suboptimal MMR2 vaccine coverage in six counties in Norway detected through the national immunisation registry, April 2014 to April 2017

PubMed Central

Hagerup-Jenssen, Maria; Kongsrud, Sigrun; Riise, Øystein Rolandsen

2017-01-01

In 2014, Norway became aware of potential low vaccination coverage for the second dose of measles-mumps-rubella vaccine (MMR2) in six of 19 counties. This was detected by comparing the national coverage (NC) for 16-year-olds extracted from the national immunisation registry SYSVAK with the annual status update for elimination of measles and rubella (ASU) reported to the World Health Organization (WHO). The existing method for calculating NC in 2014 did not show MMR2 coverage. ASU reporting on MMR2 was significantly lower then the NC and below the WHO-recommended 95% coverage. SYSVAK is based on the Norwegian personal identification numbers, which allows monitoring of vaccinations at aggregateded as well as individual level. It is an important tool for active surveillance of the performance of the Norwegian Childhood Immunisation Programme (NCIP). The method for calculating NC was improved in 2015 to reflect MMR2 coverage for 16-year-olds. As a result, Norway has improved its real-time surveillance and monitoring of the actual MMR2 coverage also through SYSVAK (the annual publication of NC). Vaccinators receive feedback for follow-up if 15-year-olds are missing MMR2. In 2017, only three counties had an MMR2 coverage below 90%. PMID:28489000

A cross-sectional vaccination coverage study in preschool children attending nurseries-kindergartens: Implications on economic crisis effect

PubMed Central

Menegas, Damianos; Katsioulis, Antonis; Theodoridou, Maria; Kremastinou, Jenny; Hadjichristodoulou, Christos

2017-01-01

ABSTRACT Vaccination coverage studies are important in determining a population's vaccination status and strategically adjusting national immunization programs. This study assessed full and timely vaccination coverage of preschool children aged 2–3 y attending nurseries-kindergartens (N-K) nationwide at the socioeconomic crisis onset. Geographically stratified cluster sampling was implemented considering prefectures as strata and N-K as clusters. The N-K were selected by simple random sampling from the sampling frame while their number was proportional to the stratum size. In total, 185 N-K (response rate 93.9%) and 2539 children (response rate 81.5%) participated. Coverage with traditional vaccines for diphtheria-tetanus-pertussis, polio and measles-mumps-rubella was very high (>95%), followed by Haemophilus influenzae type b and varicella vaccines. Despite very high final coverage, delayed vaccination was observed for hepatitis B (48.3% completed by 12 months). Significant delay was observed for the booster dose of pneumococcal conjugate vaccines (PCV) and meningococcal C conjugate vaccines (MCC). Of the total population studied, 82.3% received 3 PCV doses by 12 months, while 62.3% received the fourth dose by 24 months and 76.2% by 30 months. However, 89.6% received at least one MCC dose over 12 months. Timely vaccinated for hepatitis A with 2 doses by 24 months were 6.1%. Coverage was significantly low for Rotavirus (<20%) and influenza (23.1% one dose). High vaccination coverage is maintained for most vaccines at the beginning of the crisis in Greece. Coverage and timeliness show an increasing trend compared to previous studies. Sustained efforts are needed to support the preventive medicine system as socioeconomic instability continues. PMID:27669156

Does ITV vaginal procedure ensure dosimetric coverage during IMRT of post-operative gynaecological tumours without instructions concerning rectal filling?

PubMed

Verges, Ramona; Giraldo, Alexandra; Seoane, Alejandro; Toral, Elisabet; Ruiz, M Carmen; Pons, Ariadna; Giralt, Jordi

2018-01-01

To find out whether the internal target volume (ITV) vaginal procedure ensures dosimetric coverage during intensity-modulated radiation therapy (IMRT) of post-operative gynaecological tumours without instructions on rectal filling. The ITV vaginal procedure does not necessarily include all movements of the bladder, and does not include changes in the rectal volume. We should know if the vaginal ITV is a useful tool in maintaining CTV coverage during treatment. A retrospective analysis of 24 patients treated between July 2012 and July 2014 with adjuvant IMRT for gynaecological cancer. All patients underwent empty and full bladder CT on simulation (CT-planning) and three weeks later (CT-control). ITV displacement was measured and the 3D vector was calculated. ITV coverage was then evaluated by comparing the volume covered by the prescription isodose on both CT's. Patients were asked to have full bladder but they did not follow recommendations for the rectum. The mean 3D vector was 0.64 ± 0.32 cm (0.09-1.30). The mean ITV coverage loss was 5.8 ± 5.7% (0-20.2). We found a significant positive correlation between the 3D vector and the loss of coverage (Pearson correlation, r  = 0.493, 95% CI: 0.111-0.748, p  = 0.0144). We did not find any significant correlation between the bladder and rectal parameters with the 3D vector and loss of dosimetric coverage. We found a trend between the maximum rectal diameter in CT-planning and 3D vector ( r  = 0.400, 95% CI: -0.004 to 0.692, p  = 0.0529). ITV vaginal procedure contributed to ensuring a good dose coverage without instructions on rectal filling.

Four applications of permutation methods to testing a single-mediator model.

PubMed

Taylor, Aaron B; MacKinnon, David P

2012-09-01

Four applications of permutation tests to the single-mediator model are described and evaluated in this study. Permutation tests work by rearranging data in many possible ways in order to estimate the sampling distribution for the test statistic. The four applications to mediation evaluated here are the permutation test of ab, the permutation joint significance test, and the noniterative and iterative permutation confidence intervals for ab. A Monte Carlo simulation study was used to compare these four tests with the four best available tests for mediation found in previous research: the joint significance test, the distribution of the product test, and the percentile and bias-corrected bootstrap tests. We compared the different methods on Type I error, power, and confidence interval coverage. The noniterative permutation confidence interval for ab was the best performer among the new methods. It successfully controlled Type I error, had power nearly as good as the most powerful existing methods, and had better coverage than any existing method. The iterative permutation confidence interval for ab had lower power than do some existing methods, but it performed better than any other method in terms of coverage. The permutation confidence interval methods are recommended when estimating a confidence interval is a primary concern. SPSS and SAS macros that estimate these confidence intervals are provided.

Invitation coverage and participation in Italian cervical, breast and colorectal cancer screening programmes.

PubMed

Giorgi Rossi, Paolo; Carrozzi, Giuliano; Federici, Antonio; Mancuso, Pamela; Sampaolo, Letizia; Zappa, Marco

2018-03-01

Objectives In Italy, regional governments organize cervical, breast and colorectal cancer screening programmes, but there are difficulties in regularly inviting all the target populations and participation remains low. We analysed the determinants associated with invitation coverage of and participation in these programmes. Methods We used data on screening programmes from annual Ministry of Health surveys, 1999-2012 for cervical, 1999-2011 for breast and 2005-2011 for colorectal cancer. For recent years, we linked these data to the results of the national routine survey on preventive behaviours to evaluate the effect of spontaneous screening at Province level. Invitation and participation relative risk were calculated using Generalized Linear Models. Results There is a strong decreasing trend in invitation coverage and participation in screening programmes from North to South Italy. In metropolitan areas, both invitation coverage (rate ratio 0.35-0.96) and participation (rate ratio 0.63-0.88) are lower. An inverse association exists between spontaneous screening and both screening invitation coverage (1-3% decrease in invitation coverage per 1% spontaneous coverage increase) and participation (2% decrease in participation per 1% spontaneous coverage increase) for the three programmes. High recall rate has a negative effect on invitation coverage in the next round for breast cancer (1% decrease in invitation per 1% recall increase). Conclusions Organizational and cultural changes are needed to better implement cancer screening in southern Italy.

Routine Vaccination Coverage in Northern Nigeria: Results from 40 District-Level Cluster Surveys, 2014-2015

PubMed Central

Ogbuanu, Ikechukwu U.; Adegoke, Oluwasegun J.; Scobie, Heather M.; Uba, Belinda V.; Wannemuehler, Kathleen A.; Ruiz, Alicia; Elmousaad, Hashim; Ohuabunwo, Chima J.; Mustafa, Mahmud; Nguku, Patrick; Waziri, Ndadilnasiya Endie; Vertefeuille, John F.

2016-01-01

Background Despite recent success towards controlling poliovirus transmission, Nigeria has struggled to achieve uniformly high routine vaccination coverage. A lack of reliable vaccination coverage data at the operational level makes it challenging to target program improvement. To reliably estimate vaccination coverage, we conducted district-level vaccine coverage surveys using a pre-existing infrastructure of polio technical staff in northern Nigeria. Methods Household-level cluster surveys were conducted in 40 polio high risk districts of Nigeria during 2014–2015. Global positioning system technology and intensive supervision by a pool of qualified technical staff were used to ensure high survey quality. Vaccination status of children aged 12–23 months was documented based on vaccination card or caretaker’s recall. District-level coverage estimates were calculated using survey methods. Results Data from 7,815 children across 40 districts were analyzed. District-level coverage with the third dose of diphtheria-pertussis-tetanus vaccine (DPT3) ranged widely from 1–63%, with all districts having DPT3 coverage below the target of 80%. Median coverage across all districts for each of eight vaccine doses (1 Bacille Calmette-Guérin dose, 3 DPT doses, 3 oral poliovirus vaccine doses, and 1 measles vaccine dose) was <50%. DPT3 coverage by survey was substantially lower (range: 28%–139%) than the 2013 administrative coverage reported among children aged <12 months. Common reported reasons for non-vaccination included lack of knowledge about vaccines and vaccination services (50%) and factors related to access to routine immunization services (15%). Conclusions Survey results highlighted vaccine coverage gaps that were systematically underestimated by administrative reporting across 40 polio high risk districts in northern Nigeria. Given the limitations of administrative coverage data, our approach to conducting quality district-level coverage surveys and providing data to assess and remediate issues contributing to poor vaccination coverage could serve as an example in countries with sub-optimal vaccination coverage, similar to Nigeria. PMID:27936077

Routine Vaccination Coverage in Northern Nigeria: Results from 40 District-Level Cluster Surveys, 2014-2015.

PubMed

Gunnala, Rajni; Ogbuanu, Ikechukwu U; Adegoke, Oluwasegun J; Scobie, Heather M; Uba, Belinda V; Wannemuehler, Kathleen A; Ruiz, Alicia; Elmousaad, Hashim; Ohuabunwo, Chima J; Mustafa, Mahmud; Nguku, Patrick; Waziri, Ndadilnasiya Endie; Vertefeuille, John F

2016-01-01

Despite recent success towards controlling poliovirus transmission, Nigeria has struggled to achieve uniformly high routine vaccination coverage. A lack of reliable vaccination coverage data at the operational level makes it challenging to target program improvement. To reliably estimate vaccination coverage, we conducted district-level vaccine coverage surveys using a pre-existing infrastructure of polio technical staff in northern Nigeria. Household-level cluster surveys were conducted in 40 polio high risk districts of Nigeria during 2014-2015. Global positioning system technology and intensive supervision by a pool of qualified technical staff were used to ensure high survey quality. Vaccination status of children aged 12-23 months was documented based on vaccination card or caretaker's recall. District-level coverage estimates were calculated using survey methods. Data from 7,815 children across 40 districts were analyzed. District-level coverage with the third dose of diphtheria-pertussis-tetanus vaccine (DPT3) ranged widely from 1-63%, with all districts having DPT3 coverage below the target of 80%. Median coverage across all districts for each of eight vaccine doses (1 Bacille Calmette-Guérin dose, 3 DPT doses, 3 oral poliovirus vaccine doses, and 1 measles vaccine dose) was <50%. DPT3 coverage by survey was substantially lower (range: 28%-139%) than the 2013 administrative coverage reported among children aged <12 months. Common reported reasons for non-vaccination included lack of knowledge about vaccines and vaccination services (50%) and factors related to access to routine immunization services (15%). Survey results highlighted vaccine coverage gaps that were systematically underestimated by administrative reporting across 40 polio high risk districts in northern Nigeria. Given the limitations of administrative coverage data, our approach to conducting quality district-level coverage surveys and providing data to assess and remediate issues contributing to poor vaccination coverage could serve as an example in countries with sub-optimal vaccination coverage, similar to Nigeria.

Light and Shadows of the Korean Healthcare System

PubMed Central

2012-01-01

This article reviewed achievements and challenges of the National Health Insurance of the Republic of Korea and shared thoughts on its future directions. Starting with large workplaces of 500 or more employees in 1977, Korea's National Health Insurance successfully achieved universal coverage within just 12 yr in 1989. This amazing pace of growth was possible due to a positive combination of strong political will and rapid economic growth. Key features of Korea's experience in achieving universal coverage include 1) gradual expansion of coverage, 2) careful consideration to maintain sound insurance finances, and 3) introducing multiple health insurance societies (multiple payer system) at the initial stage. Introduction of the health insurance has dramatically improved Korea's health indicators and has fueled the rapid growth of basic medical infrastructure including medical institutions and professionals. On the other hand, the successful expansion was not free from side-effects. Although coverage has gradually expanded, benefits are still relatively low. The current situation warrants concern because coverage expansion is driven by welfare populism asserted by irresponsible political slogans and lacks a social consensus on basic principles and philosophy regarding the expansion. Concentration of patients to a few large prestigious hospitals as well as the inefficiencies resulting from a colossal single-payer system should also be pointed out. PMID:22661868

Light and shadows of the Korean healthcare system.

PubMed

Moon, Tai Joon

2012-05-01

This article reviewed achievements and challenges of the National Health Insurance of the Republic of Korea and shared thoughts on its future directions. Starting with large workplaces of 500 or more employees in 1977, Korea's National Health Insurance successfully achieved universal coverage within just 12 yr in 1989. This amazing pace of growth was possible due to a positive combination of strong political will and rapid economic growth. Key features of Korea's experience in achieving universal coverage include 1) gradual expansion of coverage, 2) careful consideration to maintain sound insurance finances, and 3) introducing multiple health insurance societies (multiple payer system) at the initial stage. Introduction of the health insurance has dramatically improved Korea's health indicators and has fueled the rapid growth of basic medical infrastructure including medical institutions and professionals. On the other hand, the successful expansion was not free from side-effects. Although coverage has gradually expanded, benefits are still relatively low. The current situation warrants concern because coverage expansion is driven by welfare populism asserted by irresponsible political slogans and lacks a social consensus on basic principles and philosophy regarding the expansion. Concentration of patients to a few large prestigious hospitals as well as the inefficiencies resulting from a colossal single-payer system should also be pointed out.

The health insurance status of US Latino women: A profile from the 1982-1984 HHANES.

PubMed

de la Torre, A; Friis, R; Hunter, H R; Garcia, L

1996-04-01

This research studied the correlates of health insurance status among three major subpopulations (Mexican, Puerto Rican, and Cuban) of adult (ages of 20 to 64) Latino women. Data from the Hispanic Health and Nutrition Examination Survey (HHANES), 1982-1984, were examined to determine the percentages of health insurance coverage among the sample populations and to assess the relationship between access to coverage and selected sociodemographic employment/income, ancestry, and acculturation variables. Variations in health insurance coverage existed by Latina subpopulation. While Puerto Rican women had the highest percentage of any health insurance coverage, Mexican-origin women (particularly those 50 to 64 years old) had the lowest. For all three Latina groups, health insurance coverage was greater among those who reported a family income above the poverty level than among those whose income fell below the poverty level; employment location, acculturation variables, and ancestry were also related to coverage. Eligibility requirements, particularly for Mexican-and Cuban-origin women, need to be streamlined, and innovative health insurance programs need to be developed to increase access of Latinas to health insurance.

Impact of Coverage-Dependent Marginal Costs on Optimal HPV Vaccination Strategies

PubMed Central

Ryser, Marc D.; McGoff, Kevin; Herzog, David P.; Sivakoff, David J.; Myers, Evan R.

2015-01-01

The effectiveness of vaccinating males against the human papillomavirus (HPV) remains a controversial subject. Many existing studies conclude that increasing female coverage is more effective than diverting resources into male vaccination. Recently, several empirical studies on HPV immunization have been published, providing evidence of the fact that marginal vaccination costs increase with coverage. In this study, we use a stochastic agent-based modeling framework to revisit the male vaccination debate in light of these new findings. Within this framework, we assess the impact of coverage-dependent marginal costs of vaccine distribution on optimal immunization strategies against HPV. Focusing on the two scenarios of ongoing and new vaccination programs, we analyze different resource allocation policies and their effects on overall disease burden. Our results suggest that if the costs associated with vaccinating males are relatively close to those associated with vaccinating females, then coverage-dependent, increasing marginal costs may favor vaccination strategies that entail immunization of both genders. In particular, this study emphasizes the necessity for further empirical research on the nature of coverage-dependent vaccination costs. PMID:25979280

Determinants of inequality in the up-to-date fully immunization coverage among children aged 24-35 months: Evidence from Zhejiang province, East China.

PubMed

Hu, Yu; Wang, Ying; Chen, Yaping; Li, Qian

2017-08-03

This study aimed to determine the degree and determinants of inequality in up-to-date fully immunization (UTDFI) coverage among children of Zhejiang province, east China. We used data from the Zhejiang provincial vaccination coverage survey of 2014 and the health outcome was the UTDFI status among children aged 24-35 months. The household income per month was used as an index of socio-economic status for the inequality analysis. The concentration index (CI) was used to quantify the degree of inequality and the decomposition approach was applied to quantify the contributions from demographic factors to inequality in UTDFI coverage. The UTDFI coverage was 80.63% and the CI for UTDFI coverage was 0.12028 (95% CI: 0.10852-0.13175), indicating that immunization practice significantly favored children with relatively higher socio-economic status. The results of decomposition analysis suggested that 68.2% of the socio-economic inequality in UTDFI coverage should be explained by the mother's education level. Furthermore, factors such as birth order, ethnic group, maternal employment status, residence, immigration status, GDP per-capital and percentage of public health spending of the total health spending also could explain the disparity in UTDFI coverage. There exists inequality in UTDFI coverage among the socio-economic disadvantage children. Health interventions of narrowing the socio-economic inequality in UTDFI coverage will benefit from being supplemented with strategies aimed at poverty and illiteracy reduction.

Modeling the state dependent impulse control for computer virus propagation under media coverage

NASA Astrophysics Data System (ADS)

Liang, Xiyin; Pei, Yongzhen; Lv, Yunfei

2018-02-01

A state dependent impulsive control model is proposed to model the spread of computer virus incorporating media coverage. By the successor function, the sufficient conditions for the existence and uniqueness of order-1 periodic solution are presented first. Secondly, for two classes of periodic solutions, the geometric property of successor function and the analogue of the Poincaré criterion are employed to obtain the stability results. These results show that the number of the infective computers is under the threshold all the time. Finally, the theoretic and numerical analysis show that media coverage can delay the spread of computer virus.

26 CFR 1.1311(b)-3 - Existence of relationship in case of adjustment by way of deficiency assessment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... maintained. If the inconsistent position was not thus maintained, then the relationship must exist on the... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Existence of relationship in case of adjustment... Between Years and Special Limitations § 1.1311(b)-3 Existence of relationship in case of adjustment by way...

Workers' decisions to take-up offered health insurance coverage: assessing the importance of out-of-pocket premium costs.

PubMed

Cooper, Philip F; Vistnes, Jessica

2003-07-01

Many proposed policy initiatives involve subsidies directed toward encouraging employers to offer coverage and toward workers to encourage enrollment in offered plans. Given that insurance coverage reflects employers' decisions to offer coverage, eligibility requirements for such coverage, and employees' take-up decisions, all three elements are important when considering mechanisms to decrease the number of uninsured individuals. In this study, we examine the relationship between workers' decisions to take-up offers of health insurance and annual out-of-pocket contributions, total premiums, and employer and workforce characteristics. We model the take-up decision using cross-sectional data from approximately 18,000 establishments per year from the 1997 to 1999 Medical Expenditure Panel Survey - Insurance Component. We find that workers are less likely to enroll in coverage as single employee contributions increase. Our results for family contributions are much smaller than for single contributions and are not statistically significant in all years. Our simulation results suggest that reducing employee contribution levels for single coverage from existing levels in 1999 to zero would yield an increase in take-up rates of roughly 6% points in establishments that had required a positive level of contributions. Our results also indicate that of the 13.8 million private sector workers who decline coverage from their employers, 2.5 million would potentially enroll in employer-sponsored coverage if the cost of single coverage were to fall to zero. Reducing employee contributions will increase take-up rates; however, even when employees pay nothing for their coverage, some employees elect not to enroll.

45 CFR 152.39 - Maintenance of effort.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-EXISTING CONDITION INSURANCE PLAN PROGRAM Relationship to Existing Laws and Programs § 152.39 Maintenance... the contract is entered. (b) Failure to maintain efforts. In situations where a State enters into a..., against any State that fails to maintain funding levels for existing State high risk pools as required...

The Law and the IEP: Establishing and Maintaining High Expectations for Deaf Students with Disabilities

ERIC Educational Resources Information Center

Fitzpatrick, Michael; Theoharis, Raschelle

2014-01-01

The No Child Left Behind Act (NCLB) and the Individuals with Disabilities Education Improvement Act (IDEIA) have significant implications for students with and without disabilities. Despite extensive research, journal articles, editorials, media coverage, and litigation, deaf and hard of hearing students with additional disabilities continue to be…

Defense.gov Special Report: Unified Combatant Commands

Science.gov Websites

in support of U.S. strategic objectives. Their mission is to maintain command and control of U.S coverage and more information. Unified Combatant Command strategic map U.S. Northern Command NORTHCOM U.S U.S. Strategic Command STRATCOM . Main Menu Home Today in DOD About DOD Leaders Biographies

From Our President. Scuds, Sorties, and Yellow Ribbons: The Costs of War for Children.

ERIC Educational Resources Information Center

Hostetler, Lana

1991-01-01

Maintains that early childhood professionals must confront the challenges of alleviating children's fears about the Persian Gulf War. Topics addressed include emotional support for children with parents stationed in the Gulf; effects of the media's war coverage on children; and fiscal and human costs of the war. (BB)

78 FR 78255 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... amendments: PART 1--INCOME TAXES 0 Paragraph 1. The authority citation for part 1 is amended by correcting... final regulations provide guidance to individual taxpayers on the liability under section 5000A of the... clarification. List of Subjects in 26 CFR Part 1 Income taxes, Reporting and recordkeeping requirements...

24 CFR 200.86 - Covenant for fire and other hazard insurance.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Covenant for fire and other hazard insurance. The mortgage shall contain a covenant binding the mortgagor to maintain fire and extended coverage insurance on the property in accordance with terms and... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Covenant for fire and other hazard...

29 CFR 825.209 - Maintenance of employee benefits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... maintain the employee's coverage under any group health plan (as defined in the Internal Revenue Code of... of “group health plan” is set forth in § 825.800. For purposes of FMLA, the term “group health plan... not increase in the event the employment relationship terminates. (b) The same group health plan...

29 CFR 825.212 - Employee failure to pay health plan premium payments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Family and Medical Leave Act § 825.212 Employee failure to pay health plan premium payments. (a)(1) In... obligations to maintain health insurance coverage cease under FMLA if an employee's premium payment is more... an employee's insurance in accordance with this section and fails to restore the employee's health...

42 CFR 418.204 - Special coverage requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Periods of crisis. Nursing care may be covered on a continuous basis for as much as 24 hours a day during periods of crisis as necessary to maintain an individual at home. Either homemaker or home health aide... periods of crisis but care during these periods must be predominantly nursing care. A period of crisis is...

78 FR 53646 - Shared Responsibility Payment for Not Maintaining Minimum Essential Coverage

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-30

... disabled child who requires an institutional level of care (such as that provided in a nursing facility... because their income is too high. Children eligible for Medicaid under this option are entitled to the... eligibility to individuals with high medical expenses who would otherwise be eligible for Medicaid but for...

Exploring the population-level impact of antiretroviral treatment: the influence of baseline intervention context.

PubMed

Mishra, Sharmistha; Mountain, Elisa; Pickles, Michael; Vickerman, Peter; Shastri, Suresh; Gilks, Charles; Dhingra, Nandini K; Washington, Reynold; Becker, Marissa L; Blanchard, James F; Alary, Michel; Boily, Marie-Claude

2014-01-01

To compare the potential population-level impact of expanding antiretroviral treatment (ART) in HIV epidemics concentrated among female sex workers (FSWs) and clients, with and without existing condom-based FSW interventions. Mathematical model of heterosexual HIV transmission in south India. We simulated HIV epidemics in three districts to assess the 10-year impact of existing ART programs (ART eligibility at CD4 cell count ≤350) beyond that achieved with high condom use, and the incremental benefit of expanding ART by either increasing ART eligibility, improving access to care, or prioritizing ART expansion to FSWs/clients. Impact was estimated in the total population (including FSWs and clients). In the presence of existing condom-based interventions, existing ART programs (medium-to-good coverage) were predicted to avert 11-28% of remaining HIV infections between 2014 and 2024. Increasing eligibility to all risk groups prevented an incremental 1-15% over existing ART programs, compared with 29-53% when maximizing access to all risk groups. If there was no condom-based intervention, and only poor ART coverage, then expanding ART prevented a larger absolute number but a smaller relative fraction of HIV infections for every additional person-year of ART. Across districts and baseline interventions, for every additional person-year of treatment, prioritizing access to FSWs was most efficient (and resource saving), followed by prioritizing access to FSWs and clients. The relative and absolute benefit of ART expansion depends on baseline condom use, ART coverage, and epidemic size. In south India, maximizing FSWs' access to care, followed by maximizing clients' access are the most efficient ways to expand ART for HIV prevention, across baseline intervention context.

Node Self-Deployment Algorithm Based on Pigeon Swarm Optimization for Underwater Wireless Sensor Networks

PubMed Central

Yu, Shanen; Xu, Yiming; Jiang, Peng; Wu, Feng; Xu, Huan

2017-01-01

At present, free-to-move node self-deployment algorithms aim at event coverage and cannot improve network coverage under the premise of considering network connectivity, network reliability and network deployment energy consumption. Thus, this study proposes pigeon-based self-deployment algorithm (PSA) for underwater wireless sensor networks to overcome the limitations of these existing algorithms. In PSA, the sink node first finds its one-hop nodes and maximizes the network coverage in its one-hop region. The one-hop nodes subsequently divide the network into layers and cluster in each layer. Each cluster head node constructs a connected path to the sink node to guarantee network connectivity. Finally, the cluster head node regards the ratio of the movement distance of the node to the change in the coverage redundancy ratio as the target function and employs pigeon swarm optimization to determine the positions of the nodes. Simulation results show that PSA improves both network connectivity and network reliability, decreases network deployment energy consumption, and increases network coverage. PMID:28338615

Reliability of Fault Tolerant Control Systems. Part 1

NASA Technical Reports Server (NTRS)

Wu, N. Eva

2001-01-01

This paper reports Part I of a two part effort, that is intended to delineate the relationship between reliability and fault tolerant control in a quantitative manner. Reliability analysis of fault-tolerant control systems is performed using Markov models. Reliability properties, peculiar to fault-tolerant control systems are emphasized. As a consequence, coverage of failures through redundancy management can be severely limited. It is shown that in the early life of a syi1ein composed of highly reliable subsystems, the reliability of the overall system is affine with respect to coverage, and inadequate coverage induces dominant single point failures. The utility of some existing software tools for assessing the reliability of fault tolerant control systems is also discussed. Coverage modeling is attempted in Part II in a way that captures its dependence on the control performance and on the diagnostic resolution.

Comparing Errors in Medicaid Reporting across Surveys: Evidence to Date

PubMed Central

Call, Kathleen T; Davern, Michael E; Klerman, Jacob A; Lynch, Victoria

2013-01-01

Objective To synthesize evidence on the accuracy of Medicaid reporting across state and federal surveys. Data Sources All available validation studies. Study Design Compare results from existing research to understand variation in reporting across surveys. Data Collection Methods Synthesize all available studies validating survey reports of Medicaid coverage. Principal Findings Across all surveys, reporting some type of insurance coverage is better than reporting Medicaid specifically. Therefore, estimates of uninsurance are less biased than estimates of specific sources of coverage. The CPS stands out as being particularly inaccurate. Conclusions Measuring health insurance coverage is prone to some level of error, yet survey overstatements of uninsurance are modest in most surveys. Accounting for all forms of bias is complex. Researchers should consider adjusting estimates of Medicaid and uninsurance in surveys prone to high levels of misreporting. PMID:22816493

SU-E-J-125: A Novel IMRT Planning Technique to Spare Sacral Bone Marrow in Pelvic Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

McGuire, S; Bhatia, S; Sun, W

Purpose: Develop an IMRT planning technique that can preferentially spare sacral bone marrow for pelvic cancer patients. Methods: Six pelvic cancer patients (two each with anal, cervical, and rectal cancer) were enrolled in an IRB approved protocol to obtain FLT PET images at simulation, during, and post chemoradiation therapy. Initially, conventional IMRT plans were created to maintain target coverage and reduce dose to OARs such as bladder, bowel, rectum, and femoral heads. Simulation FLT PET images were used to create IMRT plans to spare bone marrow identified as regions with SUV of 2 or greater (IMRT-BMS) within the pelvic bonesmore » from top of L3 to 5mm below the greater trochanter without compromising PTV coverage or OAR sparing when compared to the initial IMRT plan. IMRT-BMS plans used 8–10 beam angles that surrounded the subject. These plans were used for treatment. Retrospectively, the same simulation FLT PET images were used to create IMRT plans that spared bone marrow located in the sacral pelvic bone region (IMRT-FAN) also without compromising PTV coverage or OAR sparing. IMRT-FAN plans used 16 beam angles every 12° anteriorly from 90° – 270°. Optimization objectives for the sacral bone marrow avoidance region were weighted to reduce ≥V10. Results: IMRT-FAN reduced dose to the sacral bone marrow for all six subjects. The average V5, V10, V20, and V30 differences from the IMRT-BMS plan were −2.2 ± 1.7%, −11.4 ± 3.6%, −17.6 ± 5.1%, and −19.1 ± 8.1% respectively. Average PTV coverage change was 0.5% ± 0.8% from the conventional IMRT plan. Conclusion: An IMRT planning technique that uses beams from the anterior and lateral directions reduced the volume of sacral bone marrow that receives ≤10Gy while maintaining PTV coverage and OAR sparing. Additionally, the volume of sacral bone marrow that received 20 or 30 Gy was also reduced.« less

Count every newborn; a measurement improvement roadmap for coverage data

PubMed Central

2015-01-01

Background The Every Newborn Action Plan (ENAP), launched in 2014, aims to end preventable newborn deaths and stillbirths, with national targets of ≤12 neonatal deaths per 1000 live births and ≤12 stillbirths per 1000 total births by 2030. This requires ambitious improvement of the data on care at birth and of small and sick newborns, particularly to track coverage, quality and equity. Methods In a multistage process, a matrix of 70 indicators were assessed by the Every Newborn steering group. Indicators were graded based on their availability and importance to ENAP, resulting in 10 core and 10 additional indicators. A consultation process was undertaken to assess the status of each ENAP core indicator definition, data availability and measurement feasibility. Coverage indicators for the specific ENAP treatment interventions were assigned task teams and given priority as they were identified as requiring the most technical work. Consultations were held throughout. Results ENAP published 10 core indicators plus 10 additional indicators. Three core impact indicators (neonatal mortality rate, maternal mortality ratio, stillbirth rate) are well defined, with future efforts needed to focus on improving data quantity and quality. Three core indicators on coverage of care for all mothers and newborns (intrapartum/skilled birth attendance, early postnatal care, essential newborn care) have defined contact points, but gaps exist in measuring content and quality of the interventions. Four core (antenatal corticosteroids, neonatal resuscitation, treatment of serious neonatal infections, kangaroo mother care) and one additional coverage indicator for newborns at risk or with complications (chlorhexidine cord cleansing) lack indicator definitions or data, especially for denominators (population in need). To address these gaps, feasible coverage indicator definitions are presented for validity testing. Measurable process indicators to help monitor health service readiness are also presented. A major measurement gap exists to monitor care of small and sick babies, yet signal functions could be tracked similarly to emergency obstetric care. Conclusions The ENAP Measurement Improvement Roadmap (2015-2020) outlines tools to be developed (e.g., improved birth and death registration, audit, and minimum perinatal dataset) and actions to test, validate and institutionalise proposed coverage indicators. The roadmap presents a unique opportunity to strengthen routine health information systems, crosslinking these data with civil registration and vital statistics and population-based surveys. Real measurement change requires intentional transfer of leadership to countries with the greatest disease burden and will be achieved by working with centres of excellence and existing networks. PMID:26391444

Poliomyelitis eradication in China: 1953-2012.

PubMed

Yu, Wen-Zhou; Wen, Ning; Zhang, Yong; Wang, Hai-Bo; Fan, Chun-Xiang; Zhu, Shuang-Li; Xu, Wen-Bo; Liang, Xiao-Feng; Luo, Hui-Ming; Li, Li

2014-11-01

Poliomyelitis has historically been endemic in China and has been considered an important cause of disability and death. We reviewed strategies and measures of poliomyelitis control and eradication from 1953 to 2012. Data from notifiable disease and routine immunization reporting systems and acute flaccid paralysis (AFP) surveillance were analyzed. About 20 000 poliomyelitis cases were reported annually in the prevaccine era. During 1965-1977, live, attenuated oral poliomyelitis vaccine (OPV) was administered to children through annual mass campaigns in the winter, and the number of poliomyelitis cases started to decline. A cold chain system was established during 1982, and OPV coverage increased during the early stage of the Expanded Programme on Immunization, from 1978 to 1988. Between 1989 and 1999, routine immunization was strengthened, supplementary immunization activities (SIAs) were conducted, and the AFP surveillance system was established. China reported a last indigenous poliomyelitis case in 1994 and was certified as free of polio in 2000. To maintain its polio-free status, China kept >90% coverage of 3 doses of OPV, conducted SIAs in high-risk areas, and maintained high-quality of AFP surveillance. China succeeded in stopping the outbreak in Xinjiang in 2011. China's polio-free status was achieved and maintained through strengthening routine immunization and implementing SIAs and AFP surveillance. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Crude childhood vaccination coverage in West Africa: Trends and predictors of completeness.

PubMed

Kazungu, Jacob S; Adetifa, Ifedayo M O

2017-02-15

Background : Africa has the lowest childhood vaccination coverage worldwide. If the full benefits of childhood vaccination programmes are to be enjoyed in sub-Saharan Africa, all countries need to improve on vaccine delivery to achieve and sustain high coverage. In this paper, we review trends in vaccination coverage, dropouts between vaccine doses and explored the country-specific predictors of complete vaccination in West Africa.  Methods : We utilized datasets from the Demographic and Health Surveys Program, available for Benin, Burkina Faso, The Gambia, Ghana, Guinea, Cote d'Ivoire, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone and Togo, to obtain coverage for Bacillus Calmette-Guerin, polio, measles, and diphtheria, pertussis and tetanus (DPT) vaccines in children aged 12 - 23 months. We also calculated the DPT1-to-DPT3 and DPT1-to-measles dropouts, and proportions of the fully immunised child (FIC). Factors predictive of FIC were explored using Chi-squared tests and multivariable logistic regression.  Results : Overall, there was a trend of increasing vaccination coverage. The proportion of FIC varied significantly by country (range 24.1-81.4%, mean 49%). DPT1-to-DPT3 dropout was high (range 5.1% -33.9%, mean 16.3%). Similarly, DPT1-measles dropout exceeded 10% in all but four countries. Although no single risk factor was consistently associated with FIC across these countries, maternal education, delivery in a health facility, possessing a vaccine card and a recent post delivery visit to a health facility were the key predictors of complete vaccination.  Conclusions : The low numbers of fully immunised children and high dropout between vaccine doses highlights weaknesses and the need to strengthen the healthcare and routine immunization delivery systems in this region. Country-specific correlates of complete vaccination should be explored further to identify interventions required to increase vaccination coverage. Despite the promise of an increasing trend in vaccination coverage in West African countries, more effort is required to attain and maintain global vaccination coverage targets.

[Impact of a targeted technical assistance to improve vaccine coverage in Cameroon, Côte d'Ivoire, and Mauritania in 2014].

PubMed

Ahanhanzo, Y Glèlè; Palenfo, D; Saussier, C; Gbèdonou, P; Tonda, A; Da Silva, A; Aplogan, A

2016-08-01

Within the framework of its strategic goal of vaccine coverage (VC) improvement, GAVI, The Vaccine Alliance has entrusted the Agence de médecine préventive (agency for preventive medicine, AMP) with technical assistance services to Cameroon, Cote d'Ivoire (Ivory Coast), and Mauritania. This support was provided to selected priority districts (PDs) with the worst Penta3 coverage performances. In 2014, PDs benefited from technical and management capacities in vaccinology strengthening for district medical officers, supportive supervisions and technical assistance in health logistics, data management and quality. We analyzed the effects of the AMP technical assistance on the improvement of the cumulative Penta3 coverage, which is the key performance indicator of the expanded programme on immunization (EPI) performance. We compared Penta3 coverage between PDs and other non-priority districts (NPDs), Penta3 coverage evolution within each PD, and the distribution of PDs and NPDs according to Penta3 coverage category between January and December 2014. Technical assistance had a positive effect on the EPI performance. Indeed Penta3 coverage progression was higher in PDs than in NPDs throughout the period. Besides, between January and December 2014, the Penta3 VC increased in 70%, 100% and 86% of DPs in Cameroon, Côte d'Ivoire and Mauritania, respectively. Furthermore, the increase in the number of PDs with a Penta3 coverage over 80% was higher in DPs than in NPDs: 20% versus 8% for Cameroon, 58% versus 29% for Côte d'Ivoire and 17% versus 8% for Mauritania. Despite positive and encouraging results, this technical assistance service can be improved and efforts are needed to ensure that all health districts have a VC above 80% for all EPI vaccines. The current challenge is for African countries to mobilize resources for maintaining the knowledge and benefits and scaling such interventions in the public health area.

Progress Toward Measles Elimination - Nepal, 2007-2014.

PubMed

Khanal, Sudhir; Sedai, Tika Ram; Choudary, Ganga Ram; Giri, Jagat Narain; Bohara, Rajendra; Pant, Rajendra; Gautam, Mukunda; Sharapov, Umid M; Goodson, James L; Alexander, James; Dabbagh, Alya; Strebel, Peter; Perry, Robert T; Bah, Sunil; Abeysinghe, Nihal; Thapa, Arun

2016-03-04

In 2013, the 66th session of the Regional Committee of the World Health Organization (WHO) South-East Asia Region (SEAR) established a goal to eliminate measles and to control rubella and congenital rubella syndrome (CRS) in SEAR by 2020. Current recommended measles elimination strategies in the region include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) in every district, delivered through the routine immunization program or through supplementary immunization activities (SIAs); 2) developing and sustaining a sensitive and timely measles case-based surveillance system that meets minimum recommended performance indicators; 3) developing and maintaining an accredited measles laboratory network; and 4) achieving timely identification, investigation, and response to measles outbreaks. In 2013, Nepal, one of the 11 SEAR member states, adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007-2014. During 2007-2014, estimated coverage with the first MCV dose (MCV1) increased from 81% to 88%. Approximately 3.9 and 9.7 million children were vaccinated in SIAs conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13% during 2007-2014, from 54 to 47 cases per 1 million population. However, in 2014, 81% of districts did not meet the measles case-based surveillance performance indicator target of ≥2 discarded non-measles cases per 100,000 population per year. To achieve and maintain measles elimination, additional measures are needed to strengthen routine immunization services to increase coverage with MCV1 and a recently introduced second dose of MCV (MCV2) to ≥95% in all districts, and to enhance sensitivity of measles case-based surveillance by adopting a more sensitive case definition, expanding case-based surveillance sites nationwide, and ensuring timely transport of specimens to the accredited national laboratory.

Overview of Global, Regional, and National Routine Vaccination Coverage Trends and Growth Patterns From 1980 to 2009: Implications for Vaccine-Preventable Disease Eradication and Elimination Initiatives

PubMed Central

Wallace, Aaron S.; Ryman, Tove K.; Dietz, Vance

2015-01-01

Background Review of the historical growth in annual vaccination coverage across countries and regions can better inform decision makers’ development of future goals and strategies to improve routine vaccination services. Methods Using the World Health Organization (WHO) and the United Nations Children's Fund estimates of annual national third dose of diphtheria-tetanus-pertussis–containing vaccine (DTP3) and third dose of polio vaccine (POL3) coverage for 1980–2009, we calculated the mean absolute annual rate of change in national DTP3 coverage among all countries (globally) and among countries within each WHO region, as well as the number of years taken by each region to reach specific regional coverage levels. Last, we assessed differences in mean absolute annual rate of change in DTP3 coverage, stratified by baseline level of DTP3 coverage. Results During the 1980s, global DTP3 coverage increased a mean of 5.3 percentage points/year. Annual rate of change decreased to 0.5 percentage points/year in the 1990s and then increased to 0.9 percentage points/year during the 2000s. Mean annual rate of change in coverage across all countries was highest (9.2 percentage points) when national coverage levels were 26%–30% and lowest (−0.9 percentage points) when national coverage levels were 96%–100%. Regional differences existed as both WHO South-East Asia Region and WHO African Region countries experienced mean negative DTP3 coverage growth at lower coverage levels (81%–85%) than other regions. The regions that have achieved 95% DTP3 coverage (Americas, Western Pacific, and European) took 25–29 years to reach that level from a level of 50% DTP3 coverage. POL3 coverage change trends were similar to described DTP3 coverage change trends. Conclusions Mean national coverage growth patterns across all regions are nonlinear as coverage levels increase. Saturation points of mean 0 percentage-point growth in annual coverage varies by region and require further investigation. The achievement of >90% routine coverage is observed to take decades, which has implications for disease eradication and elimination initiatives. PMID:25316875

48 CFR 9904.410-63 - Effective date.

Code of Federal Regulations, 2013 CFR

2013-10-01

...: (a) Contract I—Since Contract I was in existence prior to January 1, 1978, the G&A expense pool shall... this contract was in existence prior to January 1, 1978, the G&A expense pool shall be allocated to it..., 1992. Contractors with prior CAS-covered contracts with full coverage shall continue this Standard's...

Income-related disparities in kidney transplant graft failures are eliminated by Medicare's immunosuppression coverage

PubMed Central

Woodward, Robert S.; Page, Timothy F.; Soares, Ricardo; Schnitzler, Mark A.; Lentine, Krista L.; Brennan, Daniel C.

2011-01-01

Beginning January 1, 2000, Medicare extended coverage of immunosuppression medications from 3-years to lifetime based on age >65 years or disability. Using USRDS data for Medicare-insured recipients of kidney transplants between July 1995 and December 2000, we identified four Cohorts of Medicare-insured kidney transplant recipients. Patients in Cohort 1 were individuals who were both eligible and received lifetime-coverage. Patients in Cohort 2 would have been eligible, but their three-year coverage expired before lifetime-coverage was available. Patients in Cohort 3 were ineligible for lifetime-coverage because of youth or lack of disability. Patients in Cohort 4 were transplanted 1996–1996 and were ineligible for lifetime-coverage. Incomes were categorized by ZIP-code median household income from census data. Lifetime-extension of Medicare immunosuppression was associated with improved allograft survival among low-income transplant recipients in the sense that the previously existing income-related disparities in graft survival in Cohort 2 were not apparent in Cohort 1. Ineligible individuals served as a control group; the income-related disparities in graft survival observed in the early Cohort 4 persisted in more recent Cohort 3. Multivariate proportional-hazards models confirmed these findings. Future work should evaluate the cost-effectiveness of these coverage increases, as well as that of benefits extensions to broader patient groups. PMID:19032227

Suboptimal MMR2 vaccine coverage in six counties in Norway detected through the national immunisation registry, April 2014 to April 2017.

PubMed

Hagerup-Jenssen, Maria; Kongsrud, Sigrun; Riise, Øystein Rolandsen

2017-04-27

In 2014, Norway became aware of potential low vaccination coverage for the second dose of measles-mumps-rubella vaccine (MMR2) in six of 19 counties. This was detected by comparing the national coverage (NC) for 16-year-olds extracted from the national immunisation registry SYSVAK with the annual status update for elimination of measles and rubella (ASU) reported to the World Health Organization (WHO). The existing method for calculating NC in 2014 did not show MMR2 coverage. ASU reporting on MMR2 was significantly lower then the NC and below the WHO-recommended 95% coverage. SYSVAK is based on the Norwegian personal identification numbers, which allows monitoring of vaccinations at aggregateded as well as individual level. It is an important tool for active surveillance of the performance of the Norwegian Childhood Immunisation Programme (NCIP). The method for calculating NC was improved in 2015 to reflect MMR2 coverage for 16-year-olds. As a result, Norway has improved its real-time surveillance and monitoring of the actual MMR2 coverage also through SYSVAK (the annual publication of NC). Vaccinators receive feedback for follow-up if 15-year-olds are missing MMR2. In 2017, only three counties had an MMR2 coverage below 90%. This article is copyright of The Authors, 2017.

State budget transfers to health insurance funds: extending universal health coverage in low- and middle-income countries of the WHO European Region.

PubMed

Mathauer, Inke; Theisling, Mareike; Mathivet, Benoit; Vilcu, Ileana

2016-04-02

Many low-and middle-income countries (LMIC) of the World Health Organization (WHO) European Region have introduced social health insurance payroll taxes after the political transition in the late 1980s, combined with budget transfers to allow for exempting specific population groups from paying contributions, such as those outside formal sector work and in particular vulnerable groups. This paper assesses the institutional design aspects of such financing arrangements and their performance with respect to universal health coverage progress in LMIC of the European region. The study is based on a literature review and review of secondary databases for the performance assessment. Such financing arrangements currently exist in 13 LMIC of that region, with strong commonalities in institutional design: This includes a wide range of different eligible population groups, mostly mandatory membership, integrated pools for both the exempted and contributors, and relatively comprehensive benefit packages. Performance is more varied. Enrolment rates range from about 65 % to above 95 %, and access to care and financial protection has improved in several countries. Yet, inequities between income quintiles persist. Budget transfers to health insurance arrangements have helped to deepen UHC or maintain achievements with respect to UHC in these European LMICs by covering those outside formal sector work, and in particular vulnerable population groups. However, challenges remain: a comprehensive benefit package on paper is not enough as long as supply side constraints and quality gaps as well as informal payments prevail. A key policy question is how to reach those so far uncovered.

Submarine cable OBS using a retired submarine telecommunication cable: GeO-TOC program

NASA Astrophysics Data System (ADS)

Kasahara, Junzo; Utada, Hisashi; Sato, Toshinori; Kinoshita, Hajimu

1998-06-01

In order to study the Earth's structure and subduction zone tectonics, seismic data from the oceanic region are extremely important. The present seismograph distribution in the oceanic region, however, provides a very poor coverage. To improve this poor seismic coverage, a cable OBS system using a retired submarine telecommunication cable is proposed. The GeO-TOC cable runs from Ninomiya, Japan, to Guam through the Izu-Bonin forearc and the Marina Trough. The total length of the cable is 2659 km. An OBS, IZU, using the GeO-TOC cable, was successfully installed at the landward slope of the Izu-Bonin Trench in January 1997. The IZU OBS is located approximately 400 km south of Tokyo. The installation method is similar to repair work on submarine cables. The IZU OBS is equipped with three accelerometers, a hydrophone, a quartz pressure gauge, and a quartz precision thermometer with a few temperature sensors to monitor overheating of the internal electronics. After installation, the voltage increase is 90 V when the current is maintained at a constant 370 mA. Data from accelerometers are digitized by 24-bit A/D converters and sent to Ninomiya at 9600 bps for each component. Hydrophone data are sent to Ninomiya as analog signals using the AM (Amplitude Modulation) method for safety reasons. Hydrophone data are digitized at the shore station. Other slow-rate data are multiplexed and sent to the shore at 9600 bps. The instrument can be controlled by a shore computer. All data will be transmitted from Ninomiya to Tokyo and combined with other existing seismic data.

Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi.

PubMed

Beltman, J J; Fitzgerald, M; Buhendwa, L; Moens, M; Massaquoi, M; Kazima, J; Alide, N; van Roosmalen, J

2010-11-01

Round the clock (24 hours×7 days) HIV testing is vital to maintain a high prevention of mother to child transmission (PMTCT) coverage for women delivering in district health facilities. PMTCT coverage increases when most of the pregnant women will have their HIV status tested. Therefore routine offering of HIV testing should be integrated and seen as a part of comprehensive antenatal care. For women who miss antenatal care and deliver in a health facility without having had their HIV status tested, the labour and maternity ward could still serve as other entry points.

A QoS-guaranteed coverage precedence routing algorithm for wireless sensor networks.

PubMed

Jiang, Joe-Air; Lin, Tzu-Shiang; Chuang, Cheng-Long; Chen, Chia-Pang; Sun, Chin-Hong; Juang, Jehn-Yih; Lin, Jiun-Chuan; Liang, Wei-Wen

2011-01-01

For mission-critical applications of wireless sensor networks (WSNs) involving extensive battlefield surveillance, medical healthcare, etc., it is crucial to have low-power, new protocols, methodologies and structures for transferring data and information in a network with full sensing coverage capability for an extended working period. The upmost mission is to ensure that the network is fully functional providing reliable transmission of the sensed data without the risk of data loss. WSNs have been applied to various types of mission-critical applications. Coverage preservation is one of the most essential functions to guarantee quality of service (QoS) in WSNs. However, a tradeoff exists between sensing coverage and network lifetime due to the limited energy supplies of sensor nodes. In this study, we propose a routing protocol to accommodate both energy-balance and coverage-preservation for sensor nodes in WSNs. The energy consumption for radio transmissions and the residual energy over the network are taken into account when the proposed protocol determines an energy-efficient route for a packet. The simulation results demonstrate that the proposed protocol is able to increase the duration of the on-duty network and provide up to 98.3% and 85.7% of extra service time with 100% sensing coverage ratio comparing with LEACH and the LEACH-Coverage-U protocols, respectively.

Coverage and control of constellations of elliptical inclined frozen lunar orbits

NASA Technical Reports Server (NTRS)

Ely, Todd A.

2005-01-01

A great deal of scientific interest exists regarding the permanently shadowed craters near the poles of the Moon where there may be frozen volatiles. These regions, particularly the Moon's South Pole, have been proposed for extensive robotic and human exploration. Unfortunately, they are typically not in view of Earth, and would require some form of communication relay to facilitate exploration via robotic and/or human missions. One solution for such a relay is a long-lived constellation of lunar telecommunication orbiters providing focused coverage at the pole of interest. Robust support requires this coverage to be continuous, redundant, and, in order to minimize costs, this constellation should consist of 3 satellites or fewer.

Achieving Crossed Strong Barrier Coverage in Wireless Sensor Network.

PubMed

Han, Ruisong; Yang, Wei; Zhang, Li

2018-02-10

Barrier coverage has been widely used to detect intrusions in wireless sensor networks (WSNs). It can fulfill the monitoring task while extending the lifetime of the network. Though barrier coverage in WSNs has been intensively studied in recent years, previous research failed to consider the problem of intrusion in transversal directions. If an intruder knows the deployment configuration of sensor nodes, then there is a high probability that it may traverse the whole target region from particular directions, without being detected. In this paper, we introduce the concept of crossed barrier coverage that can overcome this defect. We prove that the problem of finding the maximum number of crossed barriers is NP-hard and integer linear programming (ILP) is used to formulate the optimization problem. The branch-and-bound algorithm is adopted to determine the maximum number of crossed barriers. In addition, we also propose a multi-round shortest path algorithm (MSPA) to solve the optimization problem, which works heuristically to guarantee efficiency while maintaining near-optimal solutions. Several conventional algorithms for finding the maximum number of disjoint strong barriers are also modified to solve the crossed barrier problem and for the purpose of comparison. Extensive simulation studies demonstrate the effectiveness of MSPA.

Can investments in health systems strategies lead to changes in immunization coverage?

PubMed

Brenzel, Logan

2014-04-01

National immunization programs in developing countries have made major strides to immunize the world's children, increasing full coverage to 83% of children. However, the World Health Organization estimates that 22 million children less than five years of age are left unvaccinated, and coverage levels have been plateauing for nearly a decade. This paper describes the evidence on factors contributing to low vaccination uptake, and describes the connection between these factors and the documented strategies and interventions that can lead to changes in immunization outcomes. The author suggests that investments in these areas may contribute more effectively to immunization coverage and also have positive spill-over benefits for health systems. The paper concludes that while some good quality evidence exists of what works and may contribute to immunization outcomes, the quality of evidence needs to improve and major gaps need to be addressed.

Impact of Medicare on the Use of Medical Services by Disabled Beneficiaries, 1972-1974

PubMed Central

Deacon, Ronald W.

1979-01-01

The extension of Medicare coverage in 1973 to disabled persons receiving cash benefits under the Social Security Act provided an opportunity to examine the impact of health insurance coverage on utilization and expenses for Part B services. Data on medical services used both before and after coverage, collected through the Current Medicare Survey, were analyzed. Results indicate that access to care (as measured by the number of persons using services) increased slightly, while the rate of use did not. The large increase in the number of persons eligible for Medicare reflected the large increase in the number of cash beneficiaries. Significant increases also were found in the amount charged for medical services. The absence of large increases in access and service use may be attributed, in part, to the already existing source of third party payment available to disabled cash beneficiaries in 1972, before Medicare coverage. PMID:10316939

Health Insurance family style: public approaches to reaching the uninsured.

PubMed

Ryan, J M

2001-09-24

This issue brief explores existing and potential opportunities to further expand the availability of health coverage for the uninsured and the under insured, given the current economy and the resulting state budget shortfalls. It also considers the implications of the Health Insurance Flexibility and Accountability initiative recently announced by the Centers for Medicare and Medicaid Services and the legislative options for health care reform being debated in Washington, including tax-credit incentives and additional federal funding for public coverage expansions through Medicaid and the State Children's Health Insurance Program. The Forum session will explore state, federal, and academic perspectives on public coverage expansions and the variety of paths available to support such expansions. The meeting will also address the cost implications of the differing perspectives in the context of the shifting economy. This is expected to lead to a discussion among presenters and participants of the future of and priorities for public financing of health insurance coverage.

Directory of selected forestry-related bibliographic data bases

Treesearch

Peter A. Evans

1979-01-01

This compilation lists 117 bibliographic data bases maintained by scientists of the Forest Service, U.S. Department of Agriculture. For each data base, the following information is provided; name of the data base; originator; date started; coverage by subject; geographic area, and size of collection; base format; retrieval format; ways to query; who to query; and...

A Brief History of Anti-Intellectualism in American Media

ERIC Educational Resources Information Center

Claussen, Dane S.

2011-01-01

Standard media coverage of higher education hasn't changed that much since the 1940s, and it doesn't serve the core functions of higher education well. US news media could not maintain their anti-intellectualism without widespread public acceptance, but schools of journalism must accept their share of the blame. US journalists historically came…

A Rotating Space Interferometer with Variable Baselines and Low Power Consumption

NASA Technical Reports Server (NTRS)

Gezari, Daniel Y.

1999-01-01

A new concept is presented here for a large, rotating space interferometer which would achieve full u, v plane coverage with reasonably uniform integration times, yet once set in motion no additional energy would be required to change collector separations, maintain constant baseline rotation rates, or to counteract centrifugal forces on the collectors.

77 FR 16554 - Endangered and Threatened Wildlife and Plants; Receipt of Applications for Incidental Take...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-21

... tiered sand-filled geotextile containers as its core that is regularly maintained with 3 feet of beach...--such as mitigation, sea turtle monitoring, physical monitoring, maintenance of sand coverage, and removal of the dune core container system--are assured by: (a) Funds that will be placed annually in an...

A spatial evaluation of global wildfire-water risks to human and natural systems

Treesearch

Francois-Nicolas Robinne; Kevin D. Bladon; Carol Miller; Marc-Andre Parisien; Jerome Mathieu; Mike D. Flannigan

2017-01-01

The large mediatic coverage of recent massive wildfires across the world has emphasized the vulnerability of freshwater resources. The extensive hydrogeomorphic effects from a wildfire can impair the ability of watersheds to provide safe drinking water to downstream communities and high-quality water to maintain riverine ecosystem health. Safeguarding water use for...

Introducing Vi polysaccharide typhoid fever vaccine to primary school children in North Jakarta, Indonesia, via an existent school-based vaccination platform.

PubMed

Agtini, M D; Ochiai, R L; Soeharno, R; Lee, H J; Sundoro, J; Hadinegoro, S R; Han, O P; Tana, L; Halim, F X S; Ghani, L; Delima; Lestari, W; Sintawati, F X; Kusumawardani, N; Malik, R; Santoso, T S; Nadjib, M; Soeroso, S; Wangsasaputra, F; Ali, M; Ivanoff, B; Galindo, C M; Pang, T; Clemens, J D; Suwandono, A; Acosta, C J

2006-11-01

To report results on coverage, safety and logistics of a large-scale, school-based Vi polysaccharide immunization campaign in North Jakarta. Of 443 primary schools in North Jakarta, Indonesia, 18 public schools were randomly selected for this study. Exclusion criteria were fever 37.5 degrees C or higher at the time of vaccination or a known history of hypersensitivity to any vaccine. Adverse events were monitored and recorded for 1 month after immunization. Because this was a pilot programme, resource use was tracked in detail. During the February 2004 vaccination campaign, 4828 students were immunized (91% of the target population); another 394 students (7%) were vaccinated during mop-up programmes. Informed consent was obtained for 98% of the target population. In all, 34 adverse events were reported, corresponding to seven events per 1000 doses injected; none was serious. The manufacturer recommended cold chain was maintained throughout the programme. This demonstration project in two sub-districts of North Jakarta shows that a large-scale, school-based typhoid fever Vi polysaccharide vaccination campaign is logistically feasible, safe and minimally disruptive to regular school activities, when used in the context of an existing successful immunization platform. The project had high parental acceptance. Nonetheless, policy-relevant questions still need to be answered before implementing a widespread Vi polysaccharide vaccine programme in Indonesia.

Developing a National Tiger Action Plan for the Union of Myanmar

NASA Astrophysics Data System (ADS)

Lynam, Antony J.; Khaing, Saw Tun; Zaw, Khin Maung

2006-01-01

A century ago, tigers were considered pests in Myanmar. Hunters claimed thousands, yet populations persisted. In the past century, because of habitat loss and prey depletion, coupled with the recent demand for traditional medicines, tiger populations have been reduced to a few hundred individuals. As a first step toward long-term planning for tigers, and to guide efforts to increase protected area coverage, the Myanmar government in 1998 initiated a project to develop a revised National Tiger Action Plan. Extensive surveys confirmed tigers in only 4 of 17 survey locations. Significant populations are thought to persist in the far North and far South of the country, where large, intact forests offer the potential for tiger recovery. With partnerships and collaborations, tiger populations can be protected in the short term (<5 years) by expanding protected areas and corridors, mobilizing enforcement staff to reduce poaching of tigers and prey, and amending existing wildlife legislation in accordance with international laws. Over the long term (5-20 years), recovery of Myanmar’s tiger populations will depend on increasing support from local people, zoning tiger areas to reduce habitat loss and disturbance, and maintaining connectivity of existing national and transboundary forests. This article reviews the development of a new National Tiger Action Plan for the Union of Myanmar and discusses a blueprint for conservation measures aimed at saving tigers from extinction.

Developing a national tiger action plan for The Union of Myanmar.

PubMed

Lynam, Antony J; Khaing, Saw Tun; Zaw, Khin Maung

2006-01-01

A century ago, tigers were considered pests in Myanmar. Hunters claimed thousands, yet populations persisted. In the past century, because of habitat loss and prey depletion, coupled with the recent demand for traditional medicines, tiger populations have been reduced to a few hundred individuals. As a first step toward long-term planning for tigers, and to guide efforts to increase protected area coverage, the Myanmar government in 1998 initiated a project to develop a revised National Tiger Action Plan. Extensive surveys confirmed tigers in only 4 of 17 survey locations. Significant populations are thought to persist in the far North and far South of the country, where large, intact forests offer the potential for tiger recovery. With partnerships and collaborations, tiger populations can be protected in the short term (<5 years) by expanding protected areas and corridors, mobilizing enforcement staff to reduce poaching of tigers and prey, and amending existing wildlife legislation in accordance with international laws. Over the long term (5-20 years), recovery of Myanmar's tiger populations will depend on increasing support from local people, zoning tiger areas to reduce habitat loss and disturbance, and maintaining connectivity of existing national and transboundary forests. This article reviews the development of a new National Tiger Action Plan for the Union of Myanmar and discusses a blueprint for conservation measures aimed at saving tigers from extinction.

Effective coverage of primary care services in eight high-mortality countries

PubMed Central

Malata, Address; Ndiaye, Youssoupha; Kruk, Margaret E

2017-01-01

Introduction Measurement of effective coverage (quality-corrected coverage) of essential health services is critical to monitoring progress towards the Sustainable Development Goal for health. We combine facility and household surveys from eight low-income and middle-income countries to examine effective coverage of maternal and child health services. Methods We developed indices of essential clinical actions for antenatal care, family planning and care for sick children from existing guidelines and used data from direct observations of clinical visits conducted in Haiti, Kenya, Malawi, Namibia, Rwanda, Senegal, Tanzania and Uganda between 2007 and 2015 to measure quality of care delivered. We calculated healthcare coverage for each service from nationally representative household surveys and combined quality with utilisation estimates at the subnational level to quantify effective coverage. Results Health facility and household surveys yielded over 40 000 direct clinical observations and over 100 000 individual reports of healthcare utilisation. Coverage varied between services, with much greater use of any antenatal care than family planning or sick-child care, as well as within countries. Quality of care was poor, with few regions demonstrating more than 60% average performance of basic clinical practices in any service. Effective coverage across all eight countries averaged 28% for antenatal care, 26% for family planning and 21% for sick-child care. Coverage and quality were not strongly correlated at the subnational level; effective coverage varied by as much as 20% between regions within a country. Conclusion Effective coverage of three primary care services for women and children in eight countries was substantially lower than crude service coverage due to major deficiencies in care quality. Better performing regions can serve as examples for improvement. Systematic increases in the quality of care delivered—not just utilisation gains—will be necessary to progress towards truly beneficial universal health coverage. PMID:29632704

Evaluating the Theoretical Content of Online Physical Activity Information for People with Multiple Sclerosis

PubMed Central

Baillie, Colin P.T.; Galaviz, Karla; Jarvis, Jocelyn W.; Latimer-Cheung, Amy E.

2015-01-01

Background: Physical activity can aid people with multiple sclerosis (MS) in managing symptoms and maintaining functional abilities. The Internet is a preferred source of physical activity information for people with MS and, therefore, a method for the dissemination of behavior change techniques. The purpose of this study was to examine the coverage and quality of physical activity behavior change techniques delivered on the Internet for adults with MS using Abraham and Michie's taxonomy of behavior change techniques. Methods: Using the taxonomy, 20 websites were coded for quality (ie, accuracy of information) and coverage (ie, completeness of information) of theoretical behavior change techniques. Results: Results indicated that most websites covered a mean of 8.05 (SD 3.86, range 3–16) techniques out of a possible 20. Only one of the techniques, provide information on behavior–health link and consequences, was delivered on all websites. The websites demonstrated low mean coverage and quality across all behavior change techniques, with means of 0.64 (SD 0.67) and 0.62 (SD 0.37) on a scale of 0 to 2, respectively. However, coverage and quality improved when websites were examined solely for the techniques that they covered, as opposed to all 20 techniques. Conclusions: This study, which examined quality and coverage of physical activity behavior change techniques described online for people with MS, illustrated that the dissemination of these techniques requires improvement. PMID:25892979

Routing design and fleet allocation optimization of freeway service patrol: Improved results using genetic algorithm

NASA Astrophysics Data System (ADS)

Sun, Xiuqiao; Wang, Jian

2018-07-01

Freeway service patrol (FSP), is considered to be an effective method for incident management and can help transportation agency decision-makers alter existing route coverage and fleet allocation. This paper investigates the FSP problem of patrol routing design and fleet allocation, with the objective of minimizing the overall average incident response time. While the simulated annealing (SA) algorithm and its improvements have been applied to solve this problem, they often become trapped in local optimal solution. Moreover, the issue of searching efficiency remains to be further addressed. In this paper, we employ the genetic algorithm (GA) and SA to solve the FSP problem. To maintain population diversity and avoid premature convergence, niche strategy is incorporated into the traditional genetic algorithm. We also employ elitist strategy to speed up the convergence. Numerical experiments have been conducted with the help of the Sioux Falls network. Results show that the GA slightly outperforms the dual-based greedy (DBG) algorithm, the very large-scale neighborhood searching (VLNS) algorithm, the SA algorithm and the scenario algorithm.

Vaccine vial stopper performance for fractional dose delivery of vaccines

PubMed Central

Jarrahian, Courtney; Myers, Daniel; Creelman, Ben; Saxon, Eugene; Zehrung, Darin

2017-01-01

ABSTRACT Shortages of vaccines such as inactivated poliovirus and yellow fever vaccines have been addressed by administering reduced—or fractional—doses, as recommended by the World Health Organization Strategic Advisory Group of Experts on Immunization, to expand population coverage in countries at risk. We evaluated 3 kinds of vaccine vial stoppers to assess their performance after increased piercing from repeated withdrawal of doses needed when using fractional doses (0.1 mL) from presentations intended for full-dose (0.5 mL) delivery. Self-sealing capacity and fragmentation of the stopper were assessed via modified versions of international standard protocols. All stoppers maintained self-sealing capacity after 100 punctures. The damage to stoppers measured as the fragmentation rate was within the target of ≤ 10% of punctures resulting in a fragment after as many as 50 punctures. We concluded that stopper failure is not likely to be a concern if existing vaccine vials containing up to 10 regular doses are used up to 50 times for fractional dose delivery. PMID:28463054

Utilizing ERTS-A imagery for tectonic analysis through study of Big Horn Mountains region

NASA Technical Reports Server (NTRS)

Hoppin, R. A. (Principal Investigator)

1973-01-01

The author has identified the following significant results. MSS scene 1085-17294 of the Big Horn region has been subjected to detailed structural analysis. Band 7 is particularly good for revealing structural and drainage patterns because of enhance topographic detail and the subdued vegetational contrasts. Considerable stereo coverage through sidelap with adjoining scenes adds to the effectiveness of the study and has been used on both positive transparencies and enlarged prints. Negative prints of Band 7 positive transparencies have proven to be much more useful than positive prints because the higher resolution of the positive transparencies can be maintained. The Bighorn Mountains are crisscrossed by a number of prominent topographic linears, most of which can be correlated with known fault and shear zones in the Precambrian crystalline core. Many of these do not appear to continue into the flanking sedimentary rocks and a few that do (Tensleep, Tongue River lineaments) are very difficult to trace farther out into the basins. The Tongue River lineament, long a source of speculation and uncertainty as to its existence, appears as a very prominent discontinuity in the imagery.

California's “Bridge to Reform”: Identifying Challenges and Defining Strategies for Providers and Policymakers Implementing the Affordable Care Act in Low-Income HIV/AIDS Care and Treatment Settings

PubMed Central

Hazelton, Patrick T.; Steward, Wayne T.; Collins, Shane P.; Gaffney, Stuart; Morin, Stephen F.; Arnold, Emily A.

2014-01-01

Background In preparation for full Affordable Care Act implementation, California has instituted two healthcare initiatives that provide comprehensive coverage for previously uninsured or underinsured individuals. For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income Health Programs or from Medicaid fee-for-service to Medicaid managed care. Patient advocates have expressed concern that these transitions may present implementation challenges that will need to be addressed if ambitious HIV prevention and treatment goals are to be achieved. Methods 30 semi-structured, in-depth interviews were conducted between October, 2012, and February, 2013, with policymakers and providers in 10 urban, suburban, and rural California counties. Interview topics included: continuity of patient care, capacity to handle payer source transitions, and preparations for healthcare reform implementation. Study team members reviewed interview transcripts to produce emergent themes, develop a codebook, build inter-rater reliability, and conduct analyses. Results Respondents supported the goals of the ACA, but reported clinic and policy-level challenges to maintaining patient continuity of care during the payer source transitions. They also identified strategies for addressing these challenges. Areas of focus included: gaps in communication to reach patients and develop partnerships between providers and policymakers, perceived inadequacy in new provider networks for delivering quality HIV care, the potential for clinics to become financially insolvent due to lower reimbursement rates, and increased administrative burdens for clinic staff and patients. Conclusions California's new healthcare initiatives represent ambitious attempts to expand and improve health coverage for low-income individuals. The state's challenges in maintaining quality care and treatment for people living with HIV experiencing these transitions demonstrate the importance of setting effective policies in anticipation of full ACA implementation in 2014. PMID:24599337

California's "Bridge to Reform": identifying challenges and defining strategies for providers and policymakers implementing the Affordable Care Act in low-income HIV/AIDS care and treatment settings.

PubMed

Hazelton, Patrick T; Steward, Wayne T; Collins, Shane P; Gaffney, Stuart; Morin, Stephen F; Arnold, Emily A

2014-01-01

In preparation for full Affordable Care Act implementation, California has instituted two healthcare initiatives that provide comprehensive coverage for previously uninsured or underinsured individuals. For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income Health Programs or from Medicaid fee-for-service to Medicaid managed care. Patient advocates have expressed concern that these transitions may present implementation challenges that will need to be addressed if ambitious HIV prevention and treatment goals are to be achieved. 30 semi-structured, in-depth interviews were conducted between October, 2012, and February, 2013, with policymakers and providers in 10 urban, suburban, and rural California counties. Interview topics included: continuity of patient care, capacity to handle payer source transitions, and preparations for healthcare reform implementation. Study team members reviewed interview transcripts to produce emergent themes, develop a codebook, build inter-rater reliability, and conduct analyses. Respondents supported the goals of the ACA, but reported clinic and policy-level challenges to maintaining patient continuity of care during the payer source transitions. They also identified strategies for addressing these challenges. Areas of focus included: gaps in communication to reach patients and develop partnerships between providers and policymakers, perceived inadequacy in new provider networks for delivering quality HIV care, the potential for clinics to become financially insolvent due to lower reimbursement rates, and increased administrative burdens for clinic staff and patients. California's new healthcare initiatives represent ambitious attempts to expand and improve health coverage for low-income individuals. The state's challenges in maintaining quality care and treatment for people living with HIV experiencing these transitions demonstrate the importance of setting effective policies in anticipation of full ACA implementation in 2014.

Child-only coverage and the Affordable Care Act: lessons for policymakers.

PubMed

Keith, Katie; Lucia, Kevin W; Corlette, Sabrina

2012-10-01

The Affordable Care Act prohibited insurers from denying or limiting cover­age for children under the age of 19 in 2010. In response, some insurers ceased to offer coverage to children in need of individual health insurance, known as a "child-only" pol­icy. This issue brief examines new state legislative and regulatory action to promote the availability of child-only policies in response to this market disruption. The analysis finds that 22 states and the District of Columbia passed new legislation or issued a new regula­tion or subregulatory guidance. As a result, child-only coverage is available in nearly all of these states. These findings suggest that states have flexibility to take innovative actions to maintain or improve their markets and insurers are highly sensitive to the risk of adverse selection. The findings also suggest the need for meaningful regulatory incentives to avoid market disruption in successfully implementing broader reforms in 2014.

Historical record of Landsat global coverage

USGS Publications Warehouse

Goward, Samuel; Arvidson, Terry; Williams, Darrel; Faundeen, John; Irons, James; Franks, Shannon

2006-01-01

The long-term, 34+ year record of global Landsat remote sensing data is a critical resource to study the Earth system and human impacts on this system. The National Satellite Land Remote Sensing Data Archive (NSLRSDA) is charged by public law to: “maintain a permanent, comprehensive Government archive of global Landsat and other land remote sensing data for long-term monitoring and study of the changing global environment” (U.S. Congress, 1992). The advisory committee for NSLRSDA requested a detailed analysis of observation coverage within the U.S. Landsat holdings, as well as that acquired and held by International Cooperator (IC) stations. Our analyses, to date, have found gaps of varying magnitude in U.S. holdings of Landsat global coverage data, which appear to reflect technical or administrative variations in mission operations. In many cases it may be possible to partially fill these gaps in U.S. holdings through observations that were acquired and are now being held at International Cooperator stations.

Clinical evaluation of the efficacy of a GTR membrane (HEALIGUIDE®) and demineralised bone matrix (OSSEOGRAFT®) as a space maintainer in the treatment of Miller's Class I gingival recession

PubMed Central

Nanditha, S.; Priya, M. S.; Sabitha, S.; Arun, K. V.; Avaneendra, T.

2011-01-01

Background: Periodontal plastic surgical procedures aimed at coverage of exposed root surface have evolved into routine treatment modalities. The present study was designed to evaluate the effectiveness and predictability of using a collagen barrier along with a demineralized bone matrix in the treatment of recession defects in a single surgical procedure. Materials and Methods: Seventeen patients with Miller's class I recession were treated with a combination of a collagen barrier used along with a bone graft and coronally advanced flap technique. Clinical parameters were recorded at baseline, 3 months, 6 months, and 9 months. Results: The study showed a highly significant reduction in the recession depth (70.29 ± 21.96%) at the end of the study. This study showed that the use of this technique for recession coverage is highly predictable and highly esthetic root coverage can be obtained. PMID:21976841

Findings from a hepatitis B birth dose assessment in health facilities in the Philippines: opportunities to engage the private sector.

PubMed

Patel, Minal K; Capeding, Rosario Z; Ducusin, Joyce U; de Quiroz Castro, Maricel; Garcia, Luzviminda C; Hennessey, Karen

2014-09-03

Hepatitis B vaccination in the Philippines was introduced in 1992 to reduce the high burden of chronic hepatitis B virus (HBV) infection in the population; in 2007, a birth dose (HepB-BD) was introduced to decrease perinatal HBV transmission. Timely HepB-BD coverage, defined as doses given within 24h of birth, was 40% nationally in 2011. A first step in improving timely HepB-BD coverage is to ensure that all newborns born in health facilities are vaccinated. In order to assess ways of improving the Philippines' HepB-BD program, we evaluated knowledge, attitudes, and practices surrounding HepB-BD administration in health facilities. Teams visited selected government clinics, government hospitals, and private hospitals in regions with low reported HepB-BD coverage and interviewed immunization and maternity staff. HepB-BD coverage was calculated in each facility for a 3-month period in 2011. Of the 142 health facilities visited, 12 (8%) did not provide HepB-BD; seven were private hospitals and five were government hospitals. Median timely HepB-BD coverage was 90% (IQR 80%-100%) among government clinics, 87% (IQR 50%-97%) among government hospitals, and 50% (IQR 0%-90%) among private hospitals (p=0.02). The private hospitals were least likely to receive supervision (53% vs. 6%-31%, p=0.0005) and to report vaccination data to the national Expanded Programme on Immunization (36% vs. 96%-100%, p<0.0001). Private sector hospitals in the Philippines, which deliver 18% of newborns, had the lowest timely HepB-BD coverage. Multiple avenues exist to engage the private sector in hepatitis B prevention including through existing laws, newborn health initiatives, hospital accreditation processes, and raising awareness of the government's free vaccine program. Copyright © 2013 World Health Organization (WHO). Published by Elsevier Ltd.. All rights reserved.

Determining the dimensions of essential medical coverage required by military body armour plates utilising Computed Tomography.

PubMed

Breeze, J; Lewis, E A; Fryer, R

2016-09-01

Military body armour is designed to prevent the penetration of ballistic projectiles into the most vulnerable structures within the thorax and abdomen. Currently the OSPREY and VIRTUS body armour systems issued to United Kingdom (UK) Armed Forces personnel are provided with a single size front and rear ceramic plate regardless of the individual's body dimensions. Currently limited information exists to determine whether these plates overprotect some members of the military population, and no method exists to accurately size plates to an individual. Computed Tomography (CT) scans of 120 male Caucasian UK Armed Forces personnel were analysed to measure the dimensions of internal thoraco-abdominal anatomical structures that had been defined as requiring essential medical coverage. The boundaries of these structures were related to three potential anthropometric landmarks on the skin surface and statistical analysis was undertaken to validate the results. The range of heights of each individual used in this study was comparable to previous anthropometric surveys, confirming that a representative sample had been used. The vertical dimension of essential medical coverage demonstrated good correlation to torso height (suprasternal notch to iliac crest) but not to stature (r(2)=0.53 versus 0.04). Horizontal coverage did not correlate to either measure of height. Surface landmarks utilised in this study were proven to be reliable surrogate markers for the boundaries of the underlying anatomical structures potentially requiring essential protection by a plate. Providing a range of plate sizes, particularly multiple heights, should optimise the medical coverage and thus effectiveness of body armour for UK Armed Forces personnel. The results of this work provide evidence that a single width of plate if chosen correctly will provide the essential medical coverage for the entire military population, whilst recognising that it still could overprotect the smallest individuals. With regards to anthropometric measurements; it is recommended, based on this work, that torso height is used instead of stature for sizing body armour. Coverage assessments should now be undertaken for side protection as well as for other non-Caucasian populations and females, with anthropometric surveys utilising the three landmarks recommended in this study. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Towards universal health coverage: the role of within-country wealth-related inequality in 28 countries in sub-Saharan Africa.

PubMed

Hosseinpoor, Ahmad Reza; Victora, Cesar G; Bergen, Nicole; Barros, Aluisio J D; Boerma, Ties

2011-12-01

To measure within-country wealth-related inequality in the health service coverage gap of maternal and child health indicators in sub-Saharan Africa and quantify its contribution to the national health service coverage gap. Coverage data for child and maternal health services in 28 sub-Saharan African countries were obtained from the 2000-2008 Demographic Health Survey. For each country, the national coverage gap was determined for an overall health service coverage index and select individual health service indicators. The data were then additively broken down into the coverage gap in the wealthiest quintile (i.e. the proportion of the quintile lacking a required health service) and the population attributable risk (an absolute measure of within-country wealth-related inequality). In 26 countries, within-country wealth-related inequality accounted for more than one quarter of the national overall coverage gap. Reducing such inequality could lower this gap by 16% to 56%, depending on the country. Regarding select individual health service indicators, wealth-related inequality was more common in services such as skilled birth attendance and antenatal care, and less so in family planning, measles immunization, receipt of a third dose of vaccine against diphtheria, pertussis and tetanus and treatment of acute respiratory infections in children under 5 years of age. The contribution of wealth-related inequality to the child and maternal health service coverage gap differs by country and type of health service, warranting case-specific interventions. Targeted policies are most appropriate where high within-country wealth-related inequality exists, and whole-population approaches, where the health-service coverage gap is high in all quintiles.

The Impact of the Affordable Care Act's Dependent Coverage Mandate on Use of Dental Treatments and Preventive Services.

PubMed

Shane, Dan M; Wehby, George L

2017-09-01

Oral health problems are the leading chronic conditions among children and younger adults. Lack of dental coverage is thought to be an important barrier to care but little empirical evidence exists on the causal effect of private dental coverage on use of dental services. We explore the relationship between dental coverage and dental services utilization with an analysis of a natural experiment of increasing private dental coverage stemming from the Affordable Care Act's (ACA)-dependent coverage mandate. To evaluate whether increased private dental insurance due to the spillover effect of the ACA-dependent coverage health insurance mandate affected utilization of dental services among a group of affected young adults. 2006-2013 Medical Expenditure Panel Surveys. We used a difference-in-difference regression approach comparing changes in dental care utilization for 25-year olds affected by the policy to unaffected 27-year olds. We evaluate effects on dental treatments and preventive services RESULTS:: Compared to 27-year olds, 25-year olds were 8 percentage points more likely to have private dental coverage in the 3 years following the mandate. We do not find compelling evidence that young adults increased their use of preventive dental services in response to gaining insurance. We do find a nearly 5 percentage point increase in the likelihood of dental treatments among 25-year olds following the mandate, an effect that appears concentrated among women. Increases in private dental coverage due to the ACA's-dependent coverage mandate do not appear to be driving significant changes in overall preventive dental services utilization but there is evidence of an increase in restorative care.

State medicaid coverage for tobacco cessation treatments and barriers to coverage - United States, 2008-2014.

PubMed

Singleterry, Jennifer; Jump, Zach; Lancet, Elizabeth; Babb, Stephen; MacNeil, Allison; Zhang, Lei

2014-03-28

Medicaid enrollees have a higher smoking prevalence than the general population (30.1% of adult Medicaid enrollees aged <65 years smoke, compared with 18.1% of U.S. adults of all ages), and smoking-related disease is a major contributor to increasing Medicaid costs. Evidence-based cessation treatments exist, including individual, group, and telephone counseling and seven Food and Drug Administration (FDA)-approved medications. A Healthy People 2020 objective (TU-8) calls for all state Medicaid programs to adopt comprehensive coverage of these treatments. However, most states do not provide such coverage. To monitor trends in state Medicaid cessation coverage, the American Lung Association collected data on coverage of all evidence-based cessation treatments except telephone counseling by state Medicaid programs (for a total of nine treatments), as well as data on barriers to accessing these treatments (such as charging copayments or limiting the number of covered quit attempts) from December 31, 2008, to January 31, 2014. As of 2014, all 50 states and the District of Columbia cover some cessation treatments for at least some Medicaid enrollees, but only seven states cover all nine treatments for all enrollees. Common barriers in 2014 include duration limits (40 states for at least some populations or plans), annual limits (37 states), prior authorization requirements (36 states), and copayments (35 states). Comparing 2008 with 2014, 33 states added treatments to coverage, and 22 states removed treatments from coverage; 26 states removed barriers to accessing treatments, and 29 states added new barriers. The evidence from previous analyses suggests that states could reduce smoking-related morbidity and health-care costs among Medicaid enrollees by providing Medicaid coverage for all evidence-based cessation treatments, removing all barriers to accessing these treatments, promoting the coverage, and monitoring its use.

Employee responses to health insurance premium increases.

PubMed

Goldman, Dana P; Leibowitz, Arleen A; Robalino, David A

2004-01-01

To determine the sensitivity of employees' health insurance decisions--including the decision to not choose health maintenance organization or fee-for-service coverage--during periods of rapidly escalating healthcare costs. A retrospective cohort study of employee plan choices at a single large firm with a "cafeteria-style" benefits plan wherein employees paid all the additional cost of purchasing more generous insurance. We modeled the probability that an employee would drop coverage or switch plans in response to employee premium increases using data from a single large US company with employees across 47 states during the 3-year period of 1989 through 1991, a time of large premium increases within and across plans. Premium increases induced substantial plan switching. Single employees were more likely to respond to premium increases by dropping coverage, whereas families tended to switch to another plan. Premium increases of 10% induced 7% of single employees to drop or severely cut back on coverage; 13% to switch to another plan; and 80% to remain in their existing plan. Similar figures for those with family coverage were 11%, 12%, and 77%, respectively. Simulation results that control for known covariates show similar increases. When faced with a dramatic increase in premiums--on the order of 20%--nearly one fifth of the single employees dropped coverage compared with 10% of those with family coverage. Employee coverage decisions are sensitive to rapidly increasing premiums, and single employees may be likely to drop coverage. This finding suggests that sustained premium increases could induce substantial increases in the number of uninsured individuals.

Disparity in Dental Coverage Among Older Adult Populations: A Comparative Analysis Across Selected European Countries and the United States

PubMed Central

Manski, Richard; Moeller, John; Chen, Haiyan; Widström, Eeva; Lee, Jinkook; Listl, Stefan

2014-01-01

Background Insurance against the cost risks associated with prevention and treatment of oral diseases can reduce inequalities in dental care use and oral health. The purpose of this study was to examine the extent of variation in dental insurance coverage for older adult populations within and between the United States and various European countries. Method The analyses relied on 2006/2007 data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and 2004-2006 data from of the Health and Retirement Study (HRS) in the United States for respondents aged 51 years and older. A series of logistic regression models was estimated to identify disparities in dental coverage. Results The highest extent of significant insurance differences between various population subgroups was found for the United States. In comparison with countries belonging to the Eastern and Southern welfare state regimes, a lower number of significant coverage differences occurred for Scandinavian countries. Countries categorized as having comprehensive public insurance coverage showed a tendency towards less insurance variation within their populations than countries categorized as not having comprehensive public coverage, exceptions being Poland and Switzerland. Conclusions The findings of the present study suggest that significant variations in dental coverage exist within all elderly populations examined and the extent of inequalities also differs between countries. By and large, the observed variations corroborate the perception that population dental coverage is more equally distributed under public subsidy. This could be relevant information for decision makers who seek to improve policies towards more equitable dental coverage. PMID:25363376

Vaccination Coverage Disparities Between Foreign-Born and U.S.-Born Children Aged 19-35 Months, United States, 2010-2012.

PubMed

Varan, Aiden K; Rodriguez-Lainz, Alfonso; Hill, Holly A; Elam-Evans, Laurie D; Yankey, David; Li, Qian

2017-08-01

Healthy People 2020 targets high vaccination coverage among children. Although reductions in coverage disparities by race/ethnicity have been described, data by nativity are limited. The National Immunization Survey is a random-digit-dialed telephone survey that estimates vaccination coverage among U.S. children aged 19-35 months. We assessed coverage among 52,441 children from pooled 2010-2012 data for individual vaccines and the combined 4:3:1:3*:3:1:4 series (which includes ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine/diphtheria and tetanus toxoids vaccine/diphtheria, tetanus toxoids, and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, ≥3 or ≥4 doses of Haemophilus influenzae type b vaccine (depending on product type of vaccine; denoted as 3* in the series name), ≥3 doses of hepatitis B vaccine, ≥1 dose of varicella vaccine, and ≥4 doses of pneumococcal conjugate vaccine). Coverage estimates controlling for sociodemographic factors and multivariable logistic regression modeling for 4:3:1:3*:3:1:4 series completion are presented. Significantly lower coverage among foreign-born children was detected for DTaP, hepatitis A, hepatitis B, Hib, pneumococcal conjugate, and rotavirus vaccines, and for the combined series. Series completion disparities persisted after control for demographic, access-to-care, poverty, and language effects. Substantial and potentially widening disparities in vaccination coverage exist among foreign-born children. Improved immunization strategies targeting this population and continued vaccination coverage monitoring by nativity are needed.

Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study.

PubMed

Geldsetzer, Pascal; Vaikath, Maria; De Neve, Jan-Walter; Bossert, Thomas J; Sibandze, Sibusiso; Bärnighausen, Till

2017-08-01

To ascertain household coverage achieved by Swaziland's national community health worker (CHW) programme and differences in household coverage across clients' sociodemographic characteristics. Household survey from June to September 2015 in two of Swaziland's four administrative regions using two-stage cluster random sampling. Interviewers administered a questionnaire to all household members in 1542 households across 85 census enumeration areas. While the CHW programme aims to cover all households in the country, only 44.5% (95% confidence interval: 38.0% to 51.1%) reported that they had ever been visited by a CHW. In both uni- and multivariable regressions, coverage was negatively associated with household wealth (OR for most vs. least wealthy quartile: 0.30 [0.16 to 0.58], P < 0.001) and education (OR for >secondary schooling vs. no schooling: 0.65 [0.47 to 0.90], P = 0.009), and positively associated with residing in a rural area (OR: 2.95 [1.77 to 4.91], P < 0.001). Coverage varied widely between census enumeration areas. Swaziland's national CHW programme is falling far short of its coverage goal. To improve coverage, the programme would likely need to recruit additional CHWs and/or assign more households to each CHW. Alternatively, changing the programme's ambitious coverage goal to visiting only certain types of households would likely reduce existing arbitrary differences in coverage between households and communities. This study highlights the need to evaluate and reform large long-standing CHW programmes in sub-Saharan Africa. © 2017 John Wiley & Sons Ltd.

Explaining socio-economic inequalities in immunization coverage in Nigeria.

PubMed

Ataguba, John E; Ojo, Kenneth O; Ichoku, Hyacinth E

2016-11-01

Globally, in 2013 over 6 million children younger than 5 years died from either an infectious cause or during the neonatal period. A large proportion of these deaths occurred in developing countries, especially in sub-Saharan Africa. Immunization is one way to reduce childhood morbidity and deaths. In Nigeria, however, although immunization is provided without a charge at public facilities, coverage remains low and deaths from vaccine preventable diseases are high. This article seeks to assess inequalities in full and partial immunization coverage in Nigeria. It also assesses inequality in the 'intensity' of immunization coverage and it explains the factors that account for disparities in child immunization coverage in the country. Using nationally representative data, this article shows that disparities exist in the coverage of immunization to the advantage of the rich. Also, factors such as mother's literacy, region and location of the child, and socio-economic status explain the disparities in immunization coverage in Nigeria. Apart from addressing these issues, the article notes the importance of addressing other social determinants of health to reduce the disparities in immunization coverage in the country. These should be in line with the social values of communities so as to ensure acceptability and compliance. We argue that any policy that addresses these issues will likely reduce disparities in immunization coverage and put Nigeria on the road to sustainable development. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Race, stability of health insurance coverage, and prescription medication use.

PubMed

Winters, Karen P; Wyatt, Sharon B; Nick, Todd G; Hewlett, Peggy O; Hyde, John C; Fletcher, Audwin B

2010-01-01

To determine the effects of health insurance and race on prescription medication use and expense. An observational, non-experimental design was used. Multivariable regression analyses were conducted to evaluate the independent effects of health insurance status and race on prescription medication use and expense while controlling for sociodemographic, geographic, and health status characteristics. The sample consisted of 19,035 participants in the 1996 through 2003 Medical Expenditure Panel Survey. European Americans spent about $300 to $400 more and used three to four more prescriptions annually compared to other racial groups. Prescription medication expenses increased as time spent uninsured increased. Participants with part-year coverage filled four fewer prescriptions than those with full-year health insurance coverage. Participants with private coverage spent less on prescription medications compared to those with public and those with dual public and private coverage ($1,194 vs. $1,931 and $2,076, respectively; p < or = 0.001). Significant racial and health insurance status disparities in prescription medication use and expenses exist after controlling for sociodemographic, geographic, and health status characteristics.

Characterization of a Planet: Dependence on Coverage Fraction

NASA Astrophysics Data System (ADS)

Lorenz, R. D.

1996-03-01

I investigate, by means of numerical experiments and a real-time quiz of colleagues (to be repeated at the poster presentation associated with this abstract), how well-characterized a planet may be considered, as a function of how much of its surface has been studied. Most measures seem to indicate that characterization quality increases steeply up to about 30% coverage. Beyond 30%, additional coverage has a lower marginal value as a 'complete' knowledge of the surface is asymptotically reached. These studies are pertinent where tradeoffs of coverage against other scientific objectives exist, for example the orbital tour design of the Cassini mission. The tour design affects how much of Titan's surface (after the Galileo mission, Titan's surface becomes the largest mappable, but unmapped, area in the solar system) may be covered by the Cassini radar. The mission has too few flybys to cover all of Titan's surface: the Radar team aims to have 30% coverage at 1km resolution or better. I also find that long, thin swaths sample a planet better than square blocks of equivalent area.

Addressing Medicaid/marketplace churn through multimarket plans: assessing the current state of play.

PubMed

Rosenbaum, Sara

2015-02-01

Both before and after the Affordable Care Act (ACA), the US health insurance system is characterized by fragmentation. Pre-ACA, this fragmentation included major coverage gaps, causing significant periods of coverage interruption, especially for lower-income people. The ACA does not end the problem of churning among sources of public financing, but it does hold the potential for enabling people to move among sources of coverage rather than go without insurance. Several strategies for reducing coverage churn exist, but none is foolproof and all are in their early stages. Thus the ability of issuers to participate across multiple public financing arrangements and to offer stable provider networks becomes crucial to achieving continuity of care. Interviews with nine companies involved in developing or operating multimarket strategies confirm the feasibility of this approach while revealing major challenges, especially the challenge of finding providers willing to treat members regardless of the source of coverage. Strategies for increasing multimarket plans and networks represent one of the great areas of future policy and operational focus. Copyright © 2015 by Duke University Press.

Circulating vaccine-derived polioviruses: current state of knowledge.

PubMed Central

Kew, Olen M.; Wright, Peter F.; Agol, Vadim I.; Delpeyroux, Francis; Shimizu, Hiroyuki; Nathanson, Neal; Pallansch, Mark A.

2004-01-01

Within the past 4 years, poliomyelitis outbreaks associated with circulating vaccine-derived polioviruses (cVDPVs) have occurred in Hispaniola (2000-01), the Philippines (2001), and Madagascar (2001-02). Retrospective studies have also detected the circulation of endemic cVDPV in Egypt (1988-93) and the likely localized spread of oral poliovirus vaccine (OPV)-derived virus in Belarus (1965-66). Gaps in OPV coverage and the previous eradication of the corresponding serotype of indigenous wild poliovirus were the critical risk factors for all cVDPV outbreaks. The cVDPV outbreaks were stopped by mass immunization campaigns using OPV. To increase sensitivity for detecting vaccine-derived polioviruses (VDPVs), in 2001 the Global Polio Laboratory Network implemented additional testing requirements for all poliovirus isolates under investigation. This approach quickly led to the recognition of the Philippines and Madagascar cVDPV outbreaks, but of no other current outbreaks. The potential risk of cVDPV emergence has increased dramatically in recent years as wild poliovirus circulation has ceased in most of the world. The risk appears highest for the type 2 OPV strain because of its greater tendency to spread to contacts. The emergence of cVDPVs underscores the critical importance of eliminating the last pockets of wild poliovirus circulation, maintaining universally high levels of polio vaccine coverage, stopping OPV use as soon as it is safely possible to do so, and continuing sensitive poliovirus surveillance into the foreseeable future. Particular attention must be given to areas where the risks for wild poliovirus circulation have been highest, and where the highest rates of polio vaccine coverage must be maintained to suppress cVDPV emergence. PMID:15106296

15 years of zooming in and zooming out: Developing a new single scale national active fault database of New Zealand

NASA Astrophysics Data System (ADS)

Ries, William; Langridge, Robert; Villamor, Pilar; Litchfield, Nicola; Van Dissen, Russ; Townsend, Dougal; Lee, Julie; Heron, David; Lukovic, Biljana

2014-05-01

In New Zealand, we are currently reconciling multiple digital coverages of mapped active faults into a national coverage at a single scale (1:250,000). This seems at first glance to be a relatively simple task. However, methods used to capture data, the scale of capture, and the initial purpose of the fault mapping, has produced datasets that have very different characteristics. The New Zealand digital active fault database (AFDB) was initially developed as a way of managing active fault locations and fault-related features within a computer-based spatial framework. The data contained within the AFDB comes from a wide range of studies, from plate tectonic (1:500,000) to cadastral (1:2,000) scale. The database was designed to allow capture of field observations and remotely sourced data without a loss in data resolution. This approach has worked well as a method for compiling a centralised database for fault information but not for providing a complete national coverage at a single scale. During the last 15 years other complementary projects have used and also contributed data to the AFDB, most notably the QMAP project (a national series of geological maps completed over 19 years that include coverage of active and inactive faults at 1:250,000). AFDB linework and attributes was incorporated into this series but simplification of linework and attributes has occurred to maintain map clarity at 1:250,000 scale. Also, during this period on-going mapping of active faults has improved upon these data. Other projects of note that have used data from the AFDB include the National Seismic Hazard Model of New Zealand and the Global Earthquake Model (GEM). The main goal of the current project has been to provide the best digital spatial representation of a fault trace at 1:250,000 scale and combine this with the most up to date attributes. In some areas this has required a simplification of very fine detailed data and in some cases new mapping to provide a complete coverage. Where datasets have conflicting line work and/or attributes, data was reviewed through consultation with authors or review of published research to ensure the most to date representation was maintained. The current project aims to provide a coverage that will be consistent between the AFDB and QMAP digital and provide a free download of these data on the AFDB website (http://data.gns.cri.nz/af/).

Optimal insecticide-treated bed-net coverage and malaria treatment in a malaria-HIV co-infection model.

PubMed

Mohammed-Awel, Jemal; Numfor, Eric

2017-03-01

We propose and study a mathematical model for malaria-HIV co-infection transmission and control, in which malaria treatment and insecticide-treated nets are incorporated. The existence of a backward bifurcation is established analytically, and the occurrence of such backward bifurcation is influenced by disease-induced mortality, insecticide-treated bed-net coverage and malaria treatment parameters. To further assess the impact of malaria treatment and insecticide-treated bed-net coverage, we formulate an optimal control problem with malaria treatment and insecticide-treated nets as control functions. Using reasonable parameter values, numerical simulations of the optimal control suggest the possibility of eliminating malaria and reducing HIV prevalence significantly, within a short time horizon.

Universal Health Coverage and Primary Healthcare: Lessons From Japan

PubMed Central

Bloom, Gerald

2017-01-01

A recent editorial by Naoki Ikegami has proposed three key lessons from Japan’s experience of achieving virtually universal coverage with primary healthcare services: the need to integrate the existing providers of primary healthcare services into the organised health system; the need to limit government commitments to finance hospital services and the need to empower providers of primary healthcare to influence decisions that influence their livelihoods. Although the context of low- and middle-income countries (LMICs) differs in many ways from Japan in the late 19th and early 20th centuries, the lesson that short-term initiatives to achieve universal coverage need to be complemented by an understanding of the factors influencing long-term change management remains highly relevant. PMID:28812806

Testing Strategies for Model-Based Development

NASA Technical Reports Server (NTRS)

Heimdahl, Mats P. E.; Whalen, Mike; Rajan, Ajitha; Miller, Steven P.

2006-01-01

This report presents an approach for testing artifacts generated in a model-based development process. This approach divides the traditional testing process into two parts: requirements-based testing (validation testing) which determines whether the model implements the high-level requirements and model-based testing (conformance testing) which determines whether the code generated from a model is behaviorally equivalent to the model. The goals of the two processes differ significantly and this report explores suitable testing metrics and automation strategies for each. To support requirements-based testing, we define novel objective requirements coverage metrics similar to existing specification and code coverage metrics. For model-based testing, we briefly describe automation strategies and examine the fault-finding capability of different structural coverage metrics using tests automatically generated from the model.

Modelling preventive effectiveness to estimate the equity tipping point: at what coverage can individual preventive interventions reduce socioeconomic disparities in diabetes risk?

PubMed

Manuel, D G; Ho, T H; Harper, S; Anderson, G M; Lynch, J; Rosella, L C

2014-07-01

Most individual preventive therapies potentially narrow or widen health disparities depending on the difference in community effectiveness across socioeconomic position (SEP). The equity tipping point (defined as the point at which health disparities become larger) can be calculated by varying components of community effectiveness such as baseline risk of disease, intervention coverage and/or intervention efficacy across SEP. We used a simple modelling approach to estimate the community effectiveness of diabetes prevention across SEP in Canada under different scenarios of intervention coverage. Five-year baseline diabetes risk differed between the lowest and highest income groups by 1.76%. Assuming complete coverage across all income groups, the difference was reduced to 0.90% (144 000 cases prevented) with lifestyle interventions and 1.24% (88 100 cases prevented) with pharmacotherapy. The equity tipping point was estimated to be a coverage difference of 30% for preventive interventions (100% and 70% coverage among the highest and lowest income earners, respectively). Disparities in diabetes risk could be measurably reduced if existing interventions were equally adopted across SEP. However, disparities in coverage could lead to increased inequity in risk. Simple modelling approaches can be used to examine the community effectiveness of individual preventive interventions and their potential to reduce (or increase) disparities. The equity tipping point can be used as a critical threshold for disparities analyses.

Community-Level Sanitation Coverage More Strongly Associated with Child Growth and Household Drinking Water Quality than Access to a Private Toilet in Rural Mali.

PubMed

Harris, Michael; Alzua, Maria Laura; Osbert, Nicolas; Pickering, Amy

2017-06-20

Sanitation access can provide positive externalities; for example, safe disposal of feces by one household prevents disease transmission to households nearby. However, little empirical evidence exists to characterize the potential health benefits from sanitation externalities. This study investigated the effect of community sanitation coverage versus individual household sanitation access on child health and drinking water quality. Using a census of 121 villages in rural Mali, we analyzed the association of community latrine coverage (defined by a 200 m radius surrounding a household) and individual household latrine ownership with child growth and household stored water quality. Child height-for-age had a significant and positive linear relationship with community latrine coverage, while child weight-for-age and household water quality had nonlinear relationships that leveled off above 60% coverage (p < 0.01; generalized additive models). Child growth and water quality were not associated with individual household latrine ownership. The relationship between community latrine coverage and child height was strongest among households without a latrine; for these households, each 10% increase in latrine coverage was associated with a 0.031 (p-value = 0.040) increase in height-for-age z-score. In this study, the level of sanitation access of surrounding households was more important than private latrine access for protecting water quality and child health.

Community-Level Sanitation Coverage More Strongly Associated with Child Growth and Household Drinking Water Quality than Access to a Private Toilet in Rural Mali

PubMed Central

2017-01-01

Sanitation access can provide positive externalities; for example, safe disposal of feces by one household prevents disease transmission to households nearby. However, little empirical evidence exists to characterize the potential health benefits from sanitation externalities. This study investigated the effect of community sanitation coverage versus individual household sanitation access on child health and drinking water quality. Using a census of 121 villages in rural Mali, we analyzed the association of community latrine coverage (defined by a 200 m radius surrounding a household) and individual household latrine ownership with child growth and household stored water quality. Child height-for-age had a significant and positive linear relationship with community latrine coverage, while child weight-for-age and household water quality had nonlinear relationships that leveled off above 60% coverage (p < 0.01; generalized additive models). Child growth and water quality were not associated with individual household latrine ownership. The relationship between community latrine coverage and child height was strongest among households without a latrine; for these households, each 10% increase in latrine coverage was associated with a 0.031 (p-value = 0.040) increase in height-for-age z-score. In this study, the level of sanitation access of surrounding households was more important than private latrine access for protecting water quality and child health. PMID:28514143

Effect of the accountable care act of 2010 on clinical trial insurance coverage.

PubMed

Kircher, Sheetal M; Benson, Al B; Farber, Matthew; Nimeiri, Halla S

2012-02-10

The Affordable Care Act (ACA) of 2010 implemented dramatic changes in our health care system. The new law requires that insurers and health plans provide coverage for individuals participating in clinical trials. Currently, there are states that already have laws or agreements requiring clinical trial coverage, but there remain deficiencies that will need to be addressed to achieve compliance with the new law. State mandates were reviewed to determine current laws and agreements. The ACA was reviewed to outline its provisions, and these were compared with current mandates to identify deficiencies. Eighteen states meet the requirements set forth by the ACA either through a state law or agreement; 33 states do not meet the requirements. Of these 33 states, 15 do not have any existing laws or agreements in place regarding clinical trials. In states that have deficient policies in place, the most common deficiency is the lack of phase I coverage. The second most common deficiency in policy is coverage of only therapeutic studies. Most states currently do not meet the requirements of the ACA and will be required to make changes by 2014. The implications of the ACA with regard to insurance coverage of clinical trials remain unclear as implementation of the legislation unfolds. State governments can take steps to ensure insurance coverage by creating and expanding agreements with insurance companies.

Node Redeployment Algorithm Based on Stratified Connected Tree for Underwater Sensor Networks

PubMed Central

Liu, Jun; Jiang, Peng; Wu, Feng; Yu, Shanen; Song, Chunyue

2016-01-01

During the underwater sensor networks (UWSNs) operation, node drift with water environment causes network topology changes. Periodic node location examination and adjustment are needed to maintain good network monitoring quality as long as possible. In this paper, a node redeployment algorithm based on stratified connected tree for UWSNs is proposed. At every network adjustment moment, self-examination and adjustment on node locations are performed firstly. If a node is outside the monitored space, it returns to the last location recorded in its memory along straight line. Later, the network topology is stratified into a connected tree that takes the sink node as the root node by broadcasting ready information level by level, which can improve the network connectivity rate. Finally, with synthetically considering network coverage and connectivity rates, and node movement distance, the sink node performs centralized optimization on locations of leaf nodes in the stratified connected tree. Simulation results show that the proposed redeployment algorithm can not only keep the number of nodes in the monitored space as much as possible and maintain good network coverage and connectivity rates during network operation, but also reduce node movement distance during node redeployment and prolong the network lifetime. PMID:28029124

Childhood cancer survivors' familiarity with and opinions of the Patient Protection and Affordable Care Act.

PubMed

Warner, Echo L; Park, Elyse R; Stroup, Antoinette; Kinney, Anita Y; Kirchhoff, Anne C

2013-09-01

The Patient Protection and Affordable Care Act (ACA) offers avenues to increase insurance options and access to care; however, it is unknown whether populations with pre-existing conditions, such as cancer survivors, will benefit from the expanded coverage options. We explored childhood cancer survivors' familiarity with and opinion of the ACA to understand how survivors' insurance coverage may be affected. From April to July 2012 we conducted in-depth, semistructured telephone interviews with 53 adult survivors recruited from the Utah Cancer SEER Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at time of diagnosis. Interviews were recorded, transcribed, and analyzed with NVivo 9 by two coders (kappa=0.94). We report on the 49 participants who had heard of the ACA. Most survivors were unaware of ACA provisions beyond the insurance mandate. Few knew about coverage for children up to age 26 or pre-existing insurance options. Although one third believed the ACA could potentially benefit them via expanded insurance coverage, many were concerned that the ACA would lead to rising health care costs and decreasing quality of care. Survivors had concerns specific to their cancer history, including fears of future health care rationing if they developed subsequent health problems. Childhood cancer survivors have a low level of familiarity with the ACA and are unaware of how it may affect them given their cancer history. These survivors require targeted education to increase knowledge about the ACA.

A testing-coverage software reliability model considering fault removal efficiency and error generation.

PubMed

Li, Qiuying; Pham, Hoang

2017-01-01

In this paper, we propose a software reliability model that considers not only error generation but also fault removal efficiency combined with testing coverage information based on a nonhomogeneous Poisson process (NHPP). During the past four decades, many software reliability growth models (SRGMs) based on NHPP have been proposed to estimate the software reliability measures, most of which have the same following agreements: 1) it is a common phenomenon that during the testing phase, the fault detection rate always changes; 2) as a result of imperfect debugging, fault removal has been related to a fault re-introduction rate. But there are few SRGMs in the literature that differentiate between fault detection and fault removal, i.e. they seldom consider the imperfect fault removal efficiency. But in practical software developing process, fault removal efficiency cannot always be perfect, i.e. the failures detected might not be removed completely and the original faults might still exist and new faults might be introduced meanwhile, which is referred to as imperfect debugging phenomenon. In this study, a model aiming to incorporate fault introduction rate, fault removal efficiency and testing coverage into software reliability evaluation is developed, using testing coverage to express the fault detection rate and using fault removal efficiency to consider the fault repair. We compare the performance of the proposed model with several existing NHPP SRGMs using three sets of real failure data based on five criteria. The results exhibit that the model can give a better fitting and predictive performance.

GeneImp: Fast Imputation to Large Reference Panels Using Genotype Likelihoods from Ultralow Coverage Sequencing

PubMed Central

Spiliopoulou, Athina; Colombo, Marco; Orchard, Peter; Agakov, Felix; McKeigue, Paul

2017-01-01

We address the task of genotype imputation to a dense reference panel given genotype likelihoods computed from ultralow coverage sequencing as inputs. In this setting, the data have a high-level of missingness or uncertainty, and are thus more amenable to a probabilistic representation. Most existing imputation algorithms are not well suited for this situation, as they rely on prephasing for computational efficiency, and, without definite genotype calls, the prephasing task becomes computationally expensive. We describe GeneImp, a program for genotype imputation that does not require prephasing and is computationally tractable for whole-genome imputation. GeneImp does not explicitly model recombination, instead it capitalizes on the existence of large reference panels—comprising thousands of reference haplotypes—and assumes that the reference haplotypes can adequately represent the target haplotypes over short regions unaltered. We validate GeneImp based on data from ultralow coverage sequencing (0.5×), and compare its performance to the most recent version of BEAGLE that can perform this task. We show that GeneImp achieves imputation quality very close to that of BEAGLE, using one to two orders of magnitude less time, without an increase in memory complexity. Therefore, GeneImp is the first practical choice for whole-genome imputation to a dense reference panel when prephasing cannot be applied, for instance, in datasets produced via ultralow coverage sequencing. A related future application for GeneImp is whole-genome imputation based on the off-target reads from deep whole-exome sequencing. PMID:28348060

Financing universal coverage in Malaysia: a case study.

PubMed

Chua, Hong Teck; Cheah, Julius Chee Ho

2012-01-01

One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges.The WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population, and the Malaysian National Health Accounts (2008) provided the latest Malaysian data on health spending. Measuring against the four target indicators outlined, Malaysia fared credibly with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population.Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Malaysia, outmigration of public health workers particularly specialist doctors remains an issue and financing strategies critically needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources.

Financing Universal Coverage in Malaysia: a case study

PubMed Central

2012-01-01

One of the challenges to maintain an agenda for universal coverage and equitable health system is to develop effective structuring and management of health financing. Global experiences with different systems of health financing suggests that a strong public role in health financing is essential for health systems to protect the poor and health systems with the strongest state role are likely the more equitable and achieve better aggregate health outcomes. Using Malaysia as a case study, this paper seeks to evaluate the progress and capacity of a middle income country in terms of health financing for universal coverage, and also to highlight some of the key underlying health systems challenges. The WHO Health Financing Strategy for the Asia Pacific Region (2010-2015) was used as the framework to evaluate the Malaysian healthcare financing system in terms of the provision of universal coverage for the population, and the Malaysian National Health Accounts (2008) provided the latest Malaysian data on health spending. Measuring against the four target indicators outlined, Malaysia fared credibly with total health expenditure close to 5% of its GDP (4.75%), out-of-pocket payment below 40% of total health expenditure (30.7%), comprehensive social safety nets for vulnerable populations, and a tax-based financing system that fundamentally poses as a national risk-pooled scheme for the population. Nonetheless, within a holistic systems framework, the financing component interacts synergistically with other health system spheres. In Malaysia, outmigration of public health workers particularly specialist doctors remains an issue and financing strategies critically needs to incorporate a comprehensive workforce compensation strategy to improve the health workforce skill mix. Health expenditure information is systematically collated, but feedback from the private sector remains a challenge. Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health and maintain the focus on the attainment of universal coverage, as well as making healthcare financing more accountable to the public, particularly in regards to inefficiencies and better utilisation of public funds and resources. PMID:22992444

Improved spatial coverage for brain 3D PRESS MRSI by automatic placement of outer-volume suppression saturation bands.

PubMed

Ozhinsky, Eugene; Vigneron, Daniel B; Nelson, Sarah J

2011-04-01

To develop a technique for optimizing coverage of brain 3D (1) H magnetic resonance spectroscopic imaging (MRSI) by automatic placement of outer-volume suppression (OVS) saturation bands (sat bands) and to compare the performance for point-resolved spectroscopic sequence (PRESS) MRSI protocols with manual and automatic placement of sat bands. The automated OVS procedure includes the acquisition of anatomic images from the head, obtaining brain and lipid tissue maps, calculating optimal sat band placement, and then using those optimized parameters during the MRSI acquisition. The data were analyzed to quantify brain coverage volume and data quality. 3D PRESS MRSI data were acquired from three healthy volunteers and 29 patients using protocols that included either manual or automatic sat band placement. On average, the automatic sat band placement allowed the acquisition of PRESS MRSI data from 2.7 times larger brain volumes than the conventional method while maintaining data quality. The technique developed helps solve two of the most significant problems with brain PRESS MRSI acquisitions: limited brain coverage and difficulty in prescription. This new method will facilitate routine clinical brain 3D MRSI exams and will be important for performing serial evaluation of response to therapy in patients with brain tumors and other neurological diseases. Copyright © 2011 Wiley-Liss, Inc.

Estimating Premium Sensitivity for Children's Public Health Insurance Coverage: Selection but No Death Spiral

PubMed Central

Marton, James; Ketsche, Patricia G; Snyder, Angela; Adams, E Kathleen; Zhou, Mei

2015-01-01

Objective To estimate the effect of premium increases on the probability that near-poor and moderate-income children disenroll from public coverage. Data Sources Enrollment, eligibility, and claims data for Georgia's PeachCare for Kids™ (CHIP) program for multiple years. Study Design We exploited policy-induced variation in premiums generated by cross-sectional differences and changes over time in enrollee age, family size, and income to estimate the duration of enrollment as a function of the effective (per child) premium. We classify children as being of low, medium, or high illness severity. Principal Findings A dollar increase in the per-child premium is associated with a slight increase in a typical child's monthly probability of exiting coverage from 7.70 to 7.83 percent. Children with low illness severity have a significantly higher monthly baseline probability of exiting than children with medium or high illness severity, but the enrollment response to premium increases is similar across all three groups. Conclusions Success in achieving coverage gains through public programs is tempered by persistent problems in maintaining enrollment, which is modestly affected by premium increases. Retention is subject to adverse selection problems, but premium increases do not appear to significantly magnify the selection problem in this case. PMID:25130764

Novel Visual Sensor Coverage and Deployment in Time Aware PTZ Wireless Visual Sensor Networks.

PubMed

Yap, Florence G H; Yen, Hong-Hsu

2016-12-30

In this paper, we consider the visual sensor deployment algorithm in Pan-Tilt-Zoom (PTZ) Wireless Visual Sensor Networks (WVSNs). With PTZ capability, a sensor's visual coverage can be extended to reduce the number of visual sensors that need to be deployed. The coverage zone of a visual sensor in PTZ WVSN is composed of two regions, a Direct Coverage Region (DCR) and a PTZ Coverage Region (PTZCR). In the PTZCR, a visual sensor needs a mechanical pan-tilt-zoom operation to cover an object. This mechanical operation can take seconds, so the sensor might not be able to adjust the camera in time to capture the visual data. In this paper, for the first time, we study this PTZ time-aware PTZ WVSN deployment problem. We formulate this PTZ time-aware PTZ WVSN deployment problem as an optimization problem where the objective is to minimize the total visual sensor deployment cost so that each area is either covered in the DCR or in the PTZCR while considering the PTZ time constraint. The proposed Time Aware Coverage Zone (TACZ) model successfully captures the PTZ visual sensor coverage in terms of camera focal range, angle span zone coverage and camera PTZ time. Then a novel heuristic, called Time Aware Deployment with PTZ camera (TADPTZ) algorithm, is proposed to solve the problem. From our computational experiments, we found out that TACZ model outperforms the existing M coverage model under all network scenarios. In addition, as compared to the optimal solutions, the TACZ model is scalable and adaptable to the different PTZ time requirements when deploying large PTZ WVSNs.

Novel Visual Sensor Coverage and Deployment in Time Aware PTZ Wireless Visual Sensor Networks

PubMed Central

Yap, Florence G. H.; Yen, Hong-Hsu

2016-01-01

In this paper, we consider the visual sensor deployment algorithm in Pan-Tilt-Zoom (PTZ) Wireless Visual Sensor Networks (WVSNs). With PTZ capability, a sensor’s visual coverage can be extended to reduce the number of visual sensors that need to be deployed. The coverage zone of a visual sensor in PTZ WVSN is composed of two regions, a Direct Coverage Region (DCR) and a PTZ Coverage Region (PTZCR). In the PTZCR, a visual sensor needs a mechanical pan-tilt-zoom operation to cover an object. This mechanical operation can take seconds, so the sensor might not be able to adjust the camera in time to capture the visual data. In this paper, for the first time, we study this PTZ time-aware PTZ WVSN deployment problem. We formulate this PTZ time-aware PTZ WVSN deployment problem as an optimization problem where the objective is to minimize the total visual sensor deployment cost so that each area is either covered in the DCR or in the PTZCR while considering the PTZ time constraint. The proposed Time Aware Coverage Zone (TACZ) model successfully captures the PTZ visual sensor coverage in terms of camera focal range, angle span zone coverage and camera PTZ time. Then a novel heuristic, called Time Aware Deployment with PTZ camera (TADPTZ) algorithm, is proposed to solve the problem. From our computational experiments, we found out that TACZ model outperforms the existing M coverage model under all network scenarios. In addition, as compared to the optimal solutions, the TACZ model is scalable and adaptable to the different PTZ time requirements when deploying large PTZ WVSNs. PMID:28042829

Design, methods, and baseline characteristics of the Kids' Health Insurance by Educating Lots of Parents (Kids' HELP) trial: a randomized, controlled trial of the effectiveness of parent mentors in insuring uninsured minority children.

PubMed

Flores, Glenn; Walker, Candy; Lin, Hua; Lee, Michael; Fierro, Marco; Henry, Monica; Massey, Kenneth; Portillo, Alberto

2015-01-01

Six million US children have no health insurance, and substantial racial/ethnic disparities exist. The design, methods, and baseline characteristics are described for Kids' Health Insurance by Educating Lots of Parents (Kids' HELP), the first randomized, clinical trial of the effectiveness of Parent Mentors (PMs) in insuring uninsured minority children. Latino and African-American children eligible for but not enrolled in Medicaid/CHIP were randomized to PMs, or a control group receiving traditional Medicaid/CHIP outreach. PMs are experienced parents with ≥1 Medicaid/CHIP-covered children. PMs received two days of training, and provide intervention families with information on Medicaid/CHIP eligibility, assistance with application submission, and help maintaining coverage. Primary outcomes include obtaining health insurance, time interval to obtain coverage, and parental satisfaction. A blinded assessor contacts subjects monthly for one year to monitor outcomes. Of 49,361 candidates screened, 329 fulfilled eligibility criteria and were randomized. The mean age is seven years for children and 32 years for caregivers; 2/3 are Latino, 1/3 are African-American, and the mean annual family income is $21,857. Half of caregivers were unaware that their uninsured child is Medicaid/CHIP eligible, and 95% of uninsured children had prior insurance. Fifteen PMs completed two-day training sessions. All PMs are female and minority, 60% are unemployed, and the mean annual family income is $20,913. Post-PM-training, overall knowledge/skills test scores significantly increased, and 100% reported being very satisfied/satisfied with the training. Kids' HELP successfully reached target populations, met participant enrollment goals, and recruited and trained PMs. Copyright © 2014 Elsevier Inc. All rights reserved.

Petascale Diagnostic Assessment of the Global Portfolio Rainfall Space Missions' Ability to Support Flood Forecasting

NASA Astrophysics Data System (ADS)

Reed, P. M.; Chaney, N.; Herman, J. D.; Wood, E. F.; Ferringer, M. P.

2015-12-01

This research represents a multi-institutional collaboration between Cornell University, The Aerospace Corporation, and Princeton University that has completed a Petascale diagnostic assessment of the current 10 satellite missions providing rainfall observations. Our diagnostic assessment has required four core tasks: (1) formally linking high-resolution astrodynamics design and coordination of space assets with their global hydrological impacts within a Petascale "many-objective" global optimization framework, (2) developing a baseline diagnostic evaluation of a 1-degree resolution global implementation of the Variable Infiltration Capacity (VIC) model to establish the required satellite observation frequencies and coverage to maintain acceptable global flood forecasts, (3) evaluating the limitations and vulnerabilities of the full suite of current satellite precipitation missions including the recently approved Global Precipitation Measurement (GPM) mission, and (4) conceptualizing the next generation spaced-based platforms for water cycle observation. Our team exploited over 100 Million hours of computing access on the 700,000+ core Blue Waters machine to radically advance our ability to discover and visualize key system tradeoffs and sensitivities. This project represents to our knowledge the first attempt to develop a 10,000 member Monte Carlo global hydrologic simulation at one degree resolution that characterizes the uncertain effects of changing the available frequencies of satellite precipitation on drought and flood forecasts. The simulation—optimization components of the work have set a theoretical baseline for the best possible frequencies and coverages for global precipitation given unlimited investment, broad international coordination in reconfiguring existing assets, and new satellite constellation design objectives informed directly by key global hydrologic forecasting requirements. Our research poses a step towards realizing the integrated global water cycle observatory long sought by the World Climate Research Programme, which has to date eluded the world's space agencies.

Global Coastal and Marine Spatial Planning (CMSP) from Space Based AIS Ship Tracking

NASA Astrophysics Data System (ADS)

Schwehr, K. D.; Foulkes, J. A.; Lorenzini, D.; Kanawati, M.

2011-12-01

All nations need to be developing long term integrated strategies for how to use and preserve our natural resources. As a part of these strategies, we must evalutate how communities of users react to changes in rules and regulations of ocean use. Global characterization of the vessel traffic on our Earth's oceans is essential to understanding the existing uses to develop international Coast and Marine Spatial Planning (CMSP). Ship traffic within 100-200km is beginning to be effectively covered in low latitudes by ground based receivers collecting position reports from the maritime Automatic Identification System (AIS). Unfortunately, remote islands, high latitudes, and open ocean Marine Protected Areas (MPA) are not covered by these ground systems. Deploying enough autonomous airborne (UAV) and surface (USV) vessels and buoys to provide adequate coverage is a difficult task. While the individual device costs are plummeting, a large fleet of AIS receivers is expensive to maintain. The global AIS coverage from SpaceQuest's low Earth orbit satellite receivers combined with the visualization and data storage infrastructure of Google (e.g. Maps, Earth, and Fusion Tables) provide a platform that enables researchers and resource managers to begin answer the question of how ocean resources are being utilized. Near real-time vessel traffic data will allow managers of marine resources to understand how changes to education, enforcement, rules, and regulations alter usage and compliance patterns. We will demonstrate the potential for this system using a sample SpaceQuest data set processed with libais which stores the results in a Fusion Table. From there, the data is imported to PyKML and visualized in Google Earth with a custom gx:Track visualization utilizing KML's extended data functionality to facilitate ship track interrogation. Analysts can then annotate and discuss vessel tracks in Fusion Tables.

Design, methods, and baseline characteristics of the Kids’ Health Insurance by Educating Lots of Parents (Kids’ HELP) trial: A randomized, controlled trial of the effectiveness of parent mentors in insuring uninsured minority children✰

PubMed Central

Flores, Glenn; Walker, Candy; Lin, Hua; Lee, Michael; Fierro, Marco; Henry, Monica; Massey, Kenneth; Portillo, Alberto

2014-01-01

Background & objectives Six million US children have no health insurance, and substantial racial/ethnic disparities exist. The design, methods, and baseline characteristics are described for Kids’ Health Insurance by Educating Lots of Parents (Kids’ HELP), the first randomized, clinical trial of the effectiveness of Parent Mentors (PMs) in insuring uninsured minority children. Methods & research design Latino and African-American children eligible for but not enrolled in Medicaid/CHIP were randomized to PMs, or a control group receiving traditional Medicaid/CHIP outreach. PMs are experienced parents with ≥ 1 Medicaid/CHIP-covered children. PMs received two days of training, and provide intervention families with information on Medicaid/CHIP eligibility, assistance with application submission, and help maintaining coverage. Primary outcomes include obtaining health insurance, time interval to obtain coverage, and parental satisfaction. A blinded assessor contacts subjects monthly for one year to monitor outcomes. Results Of 49,361 candidates screened, 329 fulfilled eligibility criteria and were randomized. The mean age is seven years for children and 32 years for caregivers; 2/3 are Latino, 1/3 are African-American, and the mean annual family income is $21,857. Half of caregivers were unaware that their uninsured child is Medicaid/CHIP eligible, and 95% of uninsured children had prior insurance. Fifteen PMs completed two-day training sessions. All PMs are female and minority, 60% are unemployed, and the mean annual family income is $20,913. Post-PM-training, overall knowledge/skills test scores significantly increased, and 100% reported being very satisfied/satisfied with the training. Conclusions Kids’ HELP successfully reached target populations, met participant enrollment goals, and recruited and trained PMs. PMID:25476583

The epidemiological characteristics of the 2007 foot-and-mouth disease epidemic in Sarpang and Zhemgang districts of Bhutan.

PubMed

Dukpa, K; Robertson, I D; Ellis, T M

2011-02-01

This study was undertaken to compare the epidemiological characteristics of the 2007 foot-and-mouth disease outbreak in two districts of Sarpang and Zhemgang in Bhutan. Zhemgang district recorded a significantly higher cumulative incidence in all species (26.9%) as well as for cattle (29.3%) compared to Sarpang (6.5% and 7.4%, respectively). The case fatality for cattle in Zhemgang (14.1%) was significantly higher than in Sarpang (3.3%). A total of 404 cattle and 73 pigs died of FMD in Zhemgang, whereas only 21 cattle died in Sarpang. Although all four species were affected in Sarpang, no sheep or goats were affected in Zhemgang. Spatiotemporal analyses showed the existence of four significant clusters, a primary one in Sarpang and three secondary clusters in Zhemgang. The virus belonged to the PanAsia strain of the Middle-East South-Asia topotype (O serotype), and the strain was closely related to the PanAsia strain that circulated in Bhutan during the 2003/2004 outbreaks. The severity of FMD infection in Zhemgang district could be attributed to low vaccination coverage (36.5% in 2006 when compared to 87.6% in Sarpang), inadequate biosecurity, poor nursing care of the sick animals and delayed reporting to the livestock centre. This study highlights the ability of the PanAsia strain of the O serotype to cause unprecedented morbidity and mortality, especially in a naïve population. The study also highlights the benefits of maintaining good herd immunity in the susceptible population, through adequate vaccination coverage, to minimize the severity of infection and limit the spread of disease from infected to non-infected herds. © 2010 Blackwell Verlag GmbH.

[Acceptance and rejection of vasectomy in rural males].

PubMed

García Moreno, Juan; Solano Sainos, Luis Miguel

2005-01-01

One problem in rural population is the gap between coverage of contraception and scant masculine participation, which could be due to lack of information of to other sociocultural factors. We investigated, in two stages, the characteristics or the profile of the sexual and reproductive behavior of males in an exploratory study by means of focus groups to determine their relevant motivations and characteristics and subsequently, a structured questionnaire to ascertain the magnitude of the factors explored. The population corresponded to zones of rural hospital medical services zones of medical services in seven ethnic groups of the Mexican Republic and included men who accepted and who rejected vasectomy. The profile of males who accepted vasectomy allowed to determine that there exist a unsatisfied demand for contraceptive protection and the desire of not having additional children; in addition, we found that the decision to accept vasectomy is determined to a greater extent for reasons different from that of information on the contraceptive method. The important proportion of males who were non-users of contraceptive methods who accepted vasectomy supposed information on contraception to be the most consistent reason; nonetheless, this information was not considered sufficient and timely; thus, adverse economic situation, a certain condition related with the couple such as health or love for the female partner are the more weighty reasons for deciding to accept vasectomy, while the fear of poor sexual performance is the most powerful factor for rejection of vasectomy. Masculine participation in family planning is a factor that conditions contraceptive coverage and its respective benefits. The profile of the male who accepts vasectomy aids in identifying candidates forthe procedure and in reducing unsatisfied demand. Greater diffusion of information of the contraceptive method of vasectomy, greater links between male needs and vasectomy, and maintaining or increasing access to family planning are required.

Arms control movements and the media: From the Cold War to the nuclear freeze

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rojecki, A.

1993-12-31

The dissertation examines news coverage of the two most recent arms control movements: The test ban (1957-1963) and the nuclear freeze (1981-1984). Four questions guide the research: (1) To what extent do the news media maintain a space for oppositional politics that is independent of elite influence? (2) DOes the existence and characters of the space matter to policy outcomes? (3) Has the character of voices permitted into this space changed over time? (4) Are there differences between the more elite-oriented media and those aiming for mass audiences? The study begins by tracing the formation of arms control policy inmore » the three presidential administrations that span the two movements. Finally, it examines the news frames used to depict movement messages and participants. The study found that space provided to movement politics varied both with administration policy formation and editorial policy. Because news coverage followed the contours of elite policy, the movements succeeded only in placing their issues on the policy agenda but not in achieving their desired goals. There were significant differences in the types of voiced permitted into the news across the two movements. Moral authority to participate in and influence arms control policy debates was virtually unquestioned during the cold war, but by the 1980s, the media were more likely to defer to expert opinion, despite its underlying partisan interest. The most significant difference in news treatment was between the elite press and television news: The simplicity of the television report was more likely to elicit core issues. But neither the press, the opposition party in Congress, nor the movement used these to challenge the rationale of administration policy or to explore the ethical implications of the influence of defense industry PACs on policy-making.« less

Climsat rationale

NASA Technical Reports Server (NTRS)

Hansen, James

1993-01-01

We summarize reasons for the Climsat proposition; we also stress the need for certain climate monitoring other than that supplied by Climsat, especially solar irradiance, and we stress the complementarity of Climsat monitoring to plans for detailed EOS measurements. Existing and planned observations will not provide measurements of most climate forcing and feedback parameters with the accuracy needed to measure plausible decadal changes. Stratospheric water vapor and aerosol requirements are not met, for example, even though the present SAGE II instrument on the ERBS spacecraft measures those two parameters accurately, because ERBS is not expected to last more than a few years and it does not provide global coverage. We stress the imminence of a potential data gap even of those parameters, such as solar irradiance and stratospheric aerosols, for which monitoring capability has been proven and currently is in place. We find that most of the missing global climate forcings and feedbacks can be measured by three small instruments, which would need to be deployed on two spacecraft to obtain adequate sampling and global coverage. The monitoring must be maintained continuously for at least two decades. Such continuity can be attained by replacing a satellite after it fails, the functioning satellite providing calibration transfer to the new satellite. Certain complementary monitoring data are also needed, including solar monitoring from space, in order to fully meet requirements for monitoring all the climate forcings and feedbacks. The complementary data needs are discussed toward the end of this section. We summarize the proposed Climsat measurements and compare the expected accuracies to those which are needed to analyze changes of the global thermal energy cycle on decadal time scales. We stress the need to get broader participation of the scientific community in the monitoring and analysis activity. Finally, we discuss related climate process and diagnostic measurements.

National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19-35 Months - United States, 2014.

PubMed

Hill, Holly A; Elam-Evans, Laurie D; Yankey, David; Singleton, James A; Kolasa, Maureen

2015-08-28

The reduction in morbidity and mortality associated with vaccine-preventable diseases in the United States has been described as one of the 10 greatest public health achievements of the first decade of the 21st century. A recent analysis concluded that routine childhood vaccination will prevent 322 million cases of disease and about 732,000 early deaths among children born during 1994-2013, for a net societal cost savings of $1.38 trillion. The National Immunization Survey (NIS) has monitored vaccination coverage among U.S. children aged 19-35 months since 1994. This report presents national, regional, state, and selected local area vaccination coverage estimates for children born from January 2011 through May 2013, based on data from the 2014 NIS. For most vaccinations, there was no significant change in coverage between 2013 and 2014. The exception was hepatitis A vaccine (HepA), for which increases were observed in coverage with both ≥1 and ≥2 doses. As in previous years, <1% of children received no vaccinations. National coverage estimates indicate that the Healthy People 2020 target* of 90% was met for ≥3 doses of poliovirus vaccine (93.3%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.5%), ≥3 doses of hepatitis B vaccine (HepB) (91.6%), and ≥1 dose of varicella vaccine (91.0%). Coverage was below target for ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP), the full series of Haemophilus influenzae type b (Hib) vaccine, hepatitis B (HepB) birth dose,† ≥4 doses pneumococcal conjugate vaccine (PCV), ≥2 doses of HepA, the full series of rotavirus vaccine, and the combined vaccine series.§ Examination of coverage by child's race/ethnicity revealed lower estimated coverage among non-Hispanic black children compared with non-Hispanic white children for several vaccinations, including DTaP, the full series of Hib, PCV, rotavirus vaccine, and the combined series. Children from households classified as below the federal poverty level had lower estimated coverage for almost all of the vaccinations assessed, compared with children living at or above the poverty level. Significant variation in coverage by state¶ was observed for several vaccinations, including HepB birth dose, HepA, and rotavirus. High vaccination coverage must be maintained across geographic and sociodemographic groups if progress in reducing the impact of vaccine-preventable diseases is to be sustained.

Modeling Cervical Cancer Prevention in Developed Countries

PubMed Central

Kim, Jane J.; Brisson, Marc; Edmunds, W. John; Goldie, Sue J.

2009-01-01

Cytology-based screening has reduced cervical cancer mortality in countries able to implement, sustain and financially support organized programs that achieve broad coverage. These ongoing secondary prevention efforts considerably complicate the question of whether vaccination against Human Papillomavirus (HPV) types -16 and 18 should be introduced. Policy questions focus primarily on the target ages of vaccination, appropriate ages for a temporary “catch-up” program, possible revisions in screening policies to optimize synergies with vaccination, including the increased used of HPV DNA testing, and the inclusion of boys in the vaccination program. Decision-analytic models are increasingly being developed to simulate disease burden and interventions in different settings in order to evaluate the benefits and cost-effectiveness of primary and secondary interventions for informed decision-making. This article is a focused review on existing mathematical models that have been used to evaluate HPV vaccination in the context of developed countries with existing screening programs. Despite variations in model assumptions and uncertainty in existing data, pre-adolescent vaccination of girls is consistently found to be attractive in the context of current screening practices, provided there is complete and lifelong vaccine protection and widespread vaccination coverage. Questions related to catch-up vaccination programs, potential benefits of other non-cervical cancer outcomes and inclusion of boys are subject to far more uncertainty, and results from these analyses have reached conflicting conclusions. Most analyses find that some catch-up vaccination is warranted but becomes increasingly unattractive as the catch-up age is extended, and vaccination of boys is unlikely to be cost-effective if reasonable levels of coverage are achieved in girls or coverage among girls can be improved. The objective of the review is to highlight points of consensus and qualitative themes, to discuss the areas of divergent findings, and to provide insight into critical decisions related to cervical cancer prevention. PMID:18847560

The patient protection and affordable care act: how will it affect private health insurance for cancer patients?

PubMed

Schwartz, Karyn; Claxton, Gary

2010-01-01

The Patient Protection and Affordable Care Act will make health coverage more available and affordable while also strengthening regulations on the scope of private health insurance coverage. Most of the law's key provisions take effect in 2014, at which time health insurers will be barred from charging more or denying coverage for individuals with a pre-existing condition. Also in 2014, qualifying individuals will receive subsidies to purchase private insurance through newly created health insurance exchanges. New rules related to caps on benefits and stronger rights to appeal insurance company decisions take effect in 2010. In 2014, all insurance policies sold to individuals and small groups will have to cover an essential benefits package defined by the federal government. Although many Patient Protection and Affordable Care Act provisions do not apply to all types of private coverage, overall the law will provide more protections to cancer patients and survivors in the private health insurance marketplace.

Underwater Sensor Network Redeployment Algorithm Based on Wolf Search

PubMed Central

Jiang, Peng; Feng, Yang; Wu, Feng

2016-01-01

This study addresses the optimization of node redeployment coverage in underwater wireless sensor networks. Given that nodes could easily become invalid under a poor environment and the large scale of underwater wireless sensor networks, an underwater sensor network redeployment algorithm was developed based on wolf search. This study is to apply the wolf search algorithm combined with crowded degree control in the deployment of underwater wireless sensor networks. The proposed algorithm uses nodes to ensure coverage of the events, and it avoids the prematurity of the nodes. The algorithm has good coverage effects. In addition, considering that obstacles exist in the underwater environment, nodes are prevented from being invalid by imitating the mechanism of avoiding predators. Thus, the energy consumption of the network is reduced. Comparative analysis shows that the algorithm is simple and effective in wireless sensor network deployment. Compared with the optimized artificial fish swarm algorithm, the proposed algorithm exhibits advantages in network coverage, energy conservation, and obstacle avoidance. PMID:27775659

Emergency room coverage: an evolving crisis.

PubMed

Davison, Steven P

2004-08-01

Historically, a newly graduated plastic surgeon in the United States could build a practice from his or her emergency room coverage. The historical cliche was for the surgeon to be affable, able, and available, and from that basis one's practice would grow. Emergency room exposure was an avenue for starting a practice, developing recognition, and, after that, building a referral pattern. Recently, the cross-shifting influence of management care, rising malpractice insurance costs, and risk ratio are changing this cliche to a crisis. An evaluation of a 2 1/2-year exposure to emergency room coverage has revealed a completely different profile. A total of 300 patient visits resulting in 69 surgical operations were evaluated for insurance and remuneration history. The findings indicated a significant remuneration dilemma for emergency room coverage. Interestingly, a remuneration problem exists in a market different from what one would expect. In this study, a sample from a suburban hospital, rather than an inner-city university hospital, is the greater problem.

Impact of low altitude coverage requirements on air-ground communications

NASA Astrophysics Data System (ADS)

Magenheim, B.

1981-03-01

A representative area of Appalachia surrounding Charleston, West Virginia is analyzed in terms of existing helicopter traffic patterns and communications facilities. Traffic patterns were established from telephone interviews with pilots flying this area regularly. Communications coverage was established from computer generated coverage contours obtained from the Electromagnetic Compatibility Analysis Center (ECAC) and verified by pilot interviews and one flight test (as reported by the FAA Technical Center). Techniques for improving coverage are discussed. These include two new remote communication outlets located in the mountains west and south of Beckley, W. Va., a high gain antenna at Charleston pointed in a southerly direction, the use of mobile radio telephone to permit pilots to access nearby telephone facilities when on the ground at a remote site, short range less than 150 miles, hf radio, and a discrete frequency for exclusive use by low-flying aircraft. FAA activities directed at improving communications to helicopter flying to and from offshore oil and gas platforms in the Gulf of Mexico is presented in an Appendix.

Automated discovery and construction of surface phase diagrams using machine learning

DOE PAGES

Ulissi, Zachary W.; Singh, Aayush R.; Tsai, Charlie; ...

2016-08-24

Surface phase diagrams are necessary for understanding surface chemistry in electrochemical catalysis, where a range of adsorbates and coverages exist at varying applied potentials. These diagrams are typically constructed using intuition, which risks missing complex coverages and configurations at potentials of interest. More accurate cluster expansion methods are often difficult to implement quickly for new surfaces. We adopt a machine learning approach to rectify both issues. Using a Gaussian process regression model, the free energy of all possible adsorbate coverages for surfaces is predicted for a finite number of adsorption sites. Our result demonstrates a rational, simple, and systematic approachmore » for generating accurate free-energy diagrams with reduced computational resources. Finally, the Pourbaix diagram for the IrO 2(110) surface (with nine coverages from fully hydrogenated to fully oxygenated surfaces) is reconstructed using just 20 electronic structure relaxations, compared to approximately 90 using typical search methods. Similar efficiency is demonstrated for the MoS 2 surface.« less

Policies Related to Opioid Agonist Therapy for Opioid Use Disorders: The Evolution of State Policies from 2004 to 2013

PubMed Central

Burns, Rachel M.; Pacula, Rosalie L.; Bauhoff, Sebastian; Gordon, Adam J.; Hendrikson, Hollie; Leslie, Douglas L.; Stein, Bradley D.

2015-01-01

Background State Medicaid policies play an important role in Medicaid-enrollees' access to and use of opioid agonists, such as methadone and buprenorphine, in the treatment of opioid use disorders. Little information is available, however, regarding the evolution of state policies facilitating or hindering access to opioid agonists among Medicaid-enrollees. Methods During 2013-14, we surveyed state Medicaid officials and other designated state substance abuse treatment specialists about their state's recent history of Medicaid coverage and policies pertaining to methadone and buprenorphine. We describe the evolution of such coverage and policies and present an overview of the Medicaid policy environment with respect to opioid agonist therapy from 2004 to 2013. Results Among our sample of 45 states with information on buprenorphine and methadone coverage, we found a gradual trend toward adoption of coverage for opioid agonist therapies in state Medicaid agencies. In 2013, only 11% of states in our sample (n=5) had Medicaid policies that excluded coverage for methadone and buprenorphine, while 71% (n=32) had adopted or maintained policies to cover both buprenorphine and methadone among Medicaid-enrollees. We also noted an increase in policies over the time period that may have hindered access to buprenorphine and/or methadone. Conclusions There appears to be a trend for states to enact policies increasing Medicaid coverage of opioid agonist therapies, while in recent years also enacting policies, such as prior authorization requirements, that potentially serve as barriers to opioid agonist therapy utilization. Greater empirical information about the potential benefits and potential unintended consequences of such policies can provide policymakers and others with a more informed understanding of their policy decisions. PMID:26566761

Node Deployment Algorithm Based on Connected Tree for Underwater Sensor Networks

PubMed Central

Jiang, Peng; Wang, Xingmin; Jiang, Lurong

2015-01-01

Designing an efficient deployment method to guarantee optimal monitoring quality is one of the key topics in underwater sensor networks. At present, a realistic approach of deployment involves adjusting the depths of nodes in water. One of the typical algorithms used in such process is the self-deployment depth adjustment algorithm (SDDA). This algorithm mainly focuses on maximizing network coverage by constantly adjusting node depths to reduce coverage overlaps between two neighboring nodes, and thus, achieves good performance. However, the connectivity performance of SDDA is irresolute. In this paper, we propose a depth adjustment algorithm based on connected tree (CTDA). In CTDA, the sink node is used as the first root node to start building a connected tree. Finally, the network can be organized as a forest to maintain network connectivity. Coverage overlaps between the parent node and the child node are then reduced within each sub-tree to optimize coverage. The hierarchical strategy is used to adjust the distance between the parent node and the child node to reduce node movement. Furthermore, the silent mode is adopted to reduce communication cost. Simulations show that compared with SDDA, CTDA can achieve high connectivity with various communication ranges and different numbers of nodes. Moreover, it can realize coverage as high as that of SDDA with various sensing ranges and numbers of nodes but with less energy consumption. Simulations under sparse environments show that the connectivity and energy consumption performances of CTDA are considerably better than those of SDDA. Meanwhile, the connectivity and coverage performances of CTDA are close to those depth adjustment algorithms base on connected dominating set (CDA), which is an algorithm similar to CTDA. However, the energy consumption of CTDA is less than that of CDA, particularly in sparse underwater environments. PMID:26184209

Funding, coverage, and access under Thailand's universal health insurance program: an update after ten years.

PubMed

Damrongplasit, Kannika; Melnick, Glenn

2015-04-01

In 2001, Thailand implemented a universal coverage program by expanding government-funded health coverage to uninsured citizens and limited their out-of-pocket payments to 30 Baht per encounter and, in 2006, eliminated out-of-pocket payments entirely. Prior research covering the early years of the program showed that the program effectively expanded coverage while a more recent paper of the early effects of the program found that improved access from the program led to a reduction in infant mortality. We expand and update previous analyses of the effects of the 30 Baht program on access and out-of-pocket payments. We analyze national survey and governmental budgeting data through 2011 to examine trends in health care financing, coverage and access, including out-of-pocket payments. By 2011, only 1.64 % of the population remained uninsured in Thailand (down from 2.61 % in 2009). While government funding increased 75 % between 2005 and 2010, budgetary requests by health care providers exceeded approved amounts in many years. The 30 Baht program beneficiaries paid zero out-of-pocket payments for both outpatient and inpatient care. Inpatient and outpatient contact rates across all insurance categories fell slightly over time. Overall, the statistical results suggest that the program is continuing to achieve its goals after 10 years of operation. Insurance coverage is now virtually universal, access has been more or less maintained, government funding has continued to grow, though at rates below requested levels and 30 Baht patients are still guaranteed access to care with limited or no out-of-pocket costs. Important issues going forward are the ability of the government to sustain continued funding increases while minimizing cost sharing.

Formal methods for test case generation

NASA Technical Reports Server (NTRS)

Rushby, John (Inventor); De Moura, Leonardo Mendonga (Inventor); Hamon, Gregoire (Inventor)

2011-01-01

The invention relates to the use of model checkers to generate efficient test sets for hardware and software systems. The method provides for extending existing tests to reach new coverage targets; searching *to* some or all of the uncovered targets in parallel; searching in parallel *from* some or all of the states reached in previous tests; and slicing the model relative to the current set of coverage targets. The invention provides efficient test case generation and test set formation. Deep regions of the state space can be reached within allotted time and memory. The approach has been applied to use of the model checkers of SRI's SAL system and to model-based designs developed in Stateflow. Stateflow models achieving complete state and transition coverage in a single test case are reported.

From the parents' perspective: a user-satisfaction survey of immunization services in Guatemala.

PubMed

Barrera, Lissette; Trumbo, Silas Pierson; Bravo-Alcántara, Pamela; Velandia-González, Martha; Danovaro-Holliday, M Carolina

2014-03-06

Immunization coverage levels in Guatemala have increased over the last two decades, but national targets of ≥95% have yet to be reached. To determine factors related to undervaccination, Guatemala's National Immunization Program conducted a user-satisfaction survey of parents and guardians of children aged 0-5 years. Variables evaluated included parental immunization attitudes, preferences, and practices; the impact of immunization campaigns and marketing strategies; and factors inhibiting immunization. Based on administrative coverage levels and socio-demographic indicators in Guatemala's 22 geographical departments, five were designated as low-coverage and five as high-coverage areas. Overall, 1194 parents and guardians of children aged 0-5 years were interviewed in these 10 departments. We compared indicators between low- and high-coverage areas and identified risk factors associated with undervaccination. Of the 1593 children studied, 29 (1.8%) were determined to be unvaccinated, 458 (28.8%) undervaccinated, and 1106 (69.4%) fully vaccinated. In low-coverage areas, children of less educated (no education: RR=1.49, p=0.01; primary or less: 1.39, p=0.009), older (aged>39 years: RR=1.31, p=0.05), and single (RR=1.32, p=0.03) parents were more likely to have incomplete vaccination schedules. Similarly, factors associated with undervaccination in high-coverage areas included the caregiver's lack of education (none: RR=1.72, p=0.0007; primary or less: RR=1.30, p=0.05) and single marital status (RR=1.36, p=0.03), as well as the child's birth order (second: RR=1.68, p=0.003). Although users generally approved of immunization services, problems in service quality were identified. According to participants, topics such as the risk of adverse events (47.4%) and next vaccination appointments (32.3%) were inconsistently communicated to parents. Additionally, 179 (15.0%) participants reported the inability to vaccinate their child on at least one occasion. Compared to high-coverage areas, participants in low-coverage areas reported poorer service, longer wait times, and greater distances to health centers. In high-coverage areas, participants reported less knowledge about the availability of services. Generally, immunization barriers in Guatemala are related to problems in accessing and attaining high-quality immunization services rather than to a population that does not adequately value vaccination. We provide recommendations to aid the country in maintaining its achievements and addressing new challenges.

26 CFR 1.410(b)-10 - Effective dates and transition rules.

Code of Federal Regulations, 2010 CFR

2010-04-01

... section 1112 of the Tax Reform Act of 1986 apply to plan years beginning on or after January 1, 1989. (2... section 1112(e)(2) of the Tax Reform Act of 1986, in the case of a plan maintained pursuant to one or more... March 1, 1986, the minimum coverage rules of section 410(b) as amended by section 1112 of the Tax Reform...

Asian Women and Their Work: A Geography of Gender and Development. Pathways in Geography Resource Publication: No. 17.

ERIC Educational Resources Information Center

Prorok, Carolyn V, Ed.; Chhokar, Kiran Banga, Ed.

This guide provides essays and learning activities relating to gender issues and economic development in Asian nations. This collection of essays provides broad coverage of Asia from Iran to Malaysia to Korea, while maintaining a focus on South Asia for contrast. They represent a variety of Asian cultural and religious groups while focusing on the…

26 CFR 1.125-3 - Effect of the Family and Medical Leave Act (FMLA) on the operation of cafeteria plans.

Code of Federal Regulations, 2010 CFR

2010-04-01

...: FMLA does not require an employer to maintain an employee's non-health benefits (e.g., life insurance...: May an employee revoke coverage or cease payment of his or her share of group health plan premiums... returns to work. FMLA also provides the employee a right to be reinstated in the group health plan...

Positioning accuracy and daily dose assessment for prostate cancer treatment using in-room CT image guidance at a proton therapy facility.

PubMed

Maeda, Yoshikazu; Sato, Yoshitaka; Minami, Hiroki; Yasukawa, Yutaka; Yamamoto, Kazutaka; Tamamura, Hiroyasu; Shibata, Satoshi; Bou, Sayuri; Sasaki, Makoto; Tameshige, Yuji; Kume, Kyo; Ooto, Hiroshi; Kasahara, Shigeru; Shimizu, Yasuhiro; Saga, Yusuke; Omoya, Akira; Saitou, Makoto

2018-05-01

To evaluate the effectiveness of CT image-guided proton radiotherapy for prostate cancer by analyzing the positioning uncertainty and assessing daily dose change due to anatomical variations. Patients with prostate cancer were treated by opposed lateral proton beams based on a passive scattering method using an in-room CT image-guided system. The system employs a single couch for both CT scanning and beam delivery. The patient was positioned by matching the boundary between the prostate and the rectum's anterior region identified in the CT images to the corresponding boundary in the simulator images after bone matching. We acquired orthogonal kV x-ray images after couch movement and confirmed the body position by referring to the bony structure prior to treatment. In offline analyses, we contoured the targeted anatomical structures on 375 sets of daily in-room CT images for 10 patients. The uncertainty of the image-matching procedure was evaluated using the prostate contours and actual couch corrections. We also performed dose calculations using the same set of CT images, and evaluated daily change of dose-volume histograms (DVHs) to compare the effectiveness of the treatment using prostate matching to the bone-matching procedure. The isocenter shifts by prostate matching after bone matching were 0.5 ± 1.8 and -0.8 ± 2.6 mm along the superior-inferior (SI) and anterior-posterior (AP) directions, respectively. The body movement errors (σ) after couch movement were 0.7, 0.5, and 0.3 mm along the lateral, SI and AP direction, respectively, for 30 patients. The estimated errors (σ) in the prostate matching were 1.0 and 1.3 mm, and, in conjunction with the movement errors, the total positioning uncertainty was estimated to be 1.0 and 1.4 mm along the SI and AP directions, respectively. Daily DVH analyses showed that in the prostate matching, 98.7% and 86.1% of the total 375 irradiations maintained a dose condition of V 95%  > 95% for the prostate and a dose constraint of V 77%  < 18% for the rectum, whereas 90.4% and 66.1% of the total irradiations did so when bone matching was used. The dose constraint of the rectum and dose coverage of the prostate were better maintained by prostate matching than bone matching (P < 0.001). The daily variation in the dose to the seminal vesicles (SVs) was large, and only 40% of the total irradiations maintained the initial planned values of V 95% for high-risk treatment. Nevertheless, the deviations from the original value were -4 ± 7% and -5 ± 11% in the prostate and bone matching, respectively, and a better dose coverage of the SV was achieved by the prostate matching. The correction of repositioning along the AP and SI direction from conventional bone matching in CT image-guided proton therapy was found to be effective to maintain the dose constraint of the rectum and the dose coverage of the prostate. This work indicated that prostate cancer treatment by prostate matching using CT image guidance may be effective to reduce the rectal complications and achieve better tumor control of the prostate. However, an adaptive approach is desirable to maintain better dose coverage of the SVs. © 2018 American Association of Physicists in Medicine.

[Coverage of cervical cancer screening in Catalonia, Spain (2008-2011)].

PubMed

Rodríguez-Salés, Vanesa; Roura, Esther; Ibáñez, Raquel; Peris, Mercè; Bosch, F Xavier; Coma E, Ermengol; Silvia de Sanjosé

2014-01-01

To estimate cervical cytology coverage for the period 2008-2011 by age groups and health regions from data recorded in the medical records of women attending centers within the Catalan national health system. The data used to estimate coverage were obtained from the primary care information system. This information was anonymous and included age, center, date, and the results of cytological smears for a total of 2,292,564 women aged 15 years or more. A total of 758,690 smears were performed in 595,868 women. Among women aged 25-65 years, the estimated coverage was 32.4% of the assigned population and was 40.8% in the population attended. Geographical variation was observed, with higher coverage among health regions closer to Barcelona. Abnormal Pap smears increased slightly from 2008 to 2011 (from 3% to 3.5%, respectively, p <0.001). In women with a negative first smear, the mean interval until the second smear was 2.4 years, but only 50% of women with a negative first smear in 2008 attended a second round during the study period. Cervical screening coverage in the National Health Service of Catalonia includes one in three women. Second round participation was poor. Existing computer systems in primary care centers can ensure monitoring of population-based screening programs for cervical cancer. These systems could be used to plan an organized screening program to ensure wider coverage and better follow-up. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Clothing Protection from Ultraviolet Radiation: A New Method for Assessment.

PubMed

Gage, Ryan; Leung, William; Stanley, James; Reeder, Anthony; Barr, Michelle; Chambers, Tim; Smith, Moira; Signal, Louise

2017-11-01

Clothing modifies ultraviolet radiation (UVR) exposure from the sun and has an impact on skin cancer risk and the endogenous synthesis of vitamin D. There is no standardized method available for assessing body surface area (BSA) covered by clothing, which limits generalizability between study findings. We calculated the body cover provided by 38 clothing items using diagrams of BSA, adjusting the values to account for differences in BSA by age. Diagrams displaying each clothing item were developed and incorporated into a coverage assessment procedure (CAP). Five assessors used the CAP and Lund & Browder chart, an existing method for estimating BSA, to calculate the clothing coverage of an image sample of 100 schoolchildren. Values of clothing coverage, inter-rater reliability and assessment time were compared between CAP and Lund & Browder methods. Both methods had excellent inter-rater reliability (>0.90) and returned comparable results, although the CAP method was significantly faster in determining a person's clothing coverage. On balance, the CAP method appears to be a feasible method for calculating clothing coverage. Its use could improve comparability between sun-safety studies and aid in quantifying the health effects of UVR exposure. © 2017 The American Society of Photobiology.

Periodic domain boundary ordering in a dense molecular adlayer: Sub-saturation carbon monoxide on Pd(111)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Xu, Pan; Liu, Shizhong; Hong, Sung -Young

Here, we describe a previously unreported ordered phase of carbon monoxide adsorbed on the (111) facet of single crystal palladium at near-saturation coverage. The adlayer superstructure is identified from low energy electron diffraction to be c(16×2) with respect to the underlying Pd(111) surface net. The ideal coverage is determined to be 0.6875 ML, approximately 92% of the 0.75–ML saturation coverage. Density functional theory calculations support a model for the molecular packing characterized by strips of locally-saturated (2×2) regions, with the CO bound near high-symmetry surface sites, separated by antiphase domain boundaries. The structure exists in a narrow coverage range andmore » is prepared by heating the saturated adlayer to desorb a small fraction of the CO. Comparison of the c(16×2) domain-boundary structure with structural motifs at lower coverages suggests that between 0.6 and 0.6875 ML the adlayer order may be more strongly influenced by interadsorbate repulsion than by adsorption-site-specific interactions. The system is an example of the structural complexity that results from the compromise between adsorbate–substrate and adsorbate–adsorbate interactions.« less

Periodic domain boundary ordering in a dense molecular adlayer: Sub-saturation carbon monoxide on Pd(111)

DOE PAGES

Xu, Pan; Liu, Shizhong; Hong, Sung -Young; ...

2016-12-31

Here, we describe a previously unreported ordered phase of carbon monoxide adsorbed on the (111) facet of single crystal palladium at near-saturation coverage. The adlayer superstructure is identified from low energy electron diffraction to be c(16×2) with respect to the underlying Pd(111) surface net. The ideal coverage is determined to be 0.6875 ML, approximately 92% of the 0.75–ML saturation coverage. Density functional theory calculations support a model for the molecular packing characterized by strips of locally-saturated (2×2) regions, with the CO bound near high-symmetry surface sites, separated by antiphase domain boundaries. The structure exists in a narrow coverage range andmore » is prepared by heating the saturated adlayer to desorb a small fraction of the CO. Comparison of the c(16×2) domain-boundary structure with structural motifs at lower coverages suggests that between 0.6 and 0.6875 ML the adlayer order may be more strongly influenced by interadsorbate repulsion than by adsorption-site-specific interactions. The system is an example of the structural complexity that results from the compromise between adsorbate–substrate and adsorbate–adsorbate interactions.« less

77 FR 70061 - Groundfish Fisheries of the Exclusive Economic Zone Off Alaska and Pacific Halibut Fisheries...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

...NMFS publishes regulations to implement Amendment 86 to the Fishery Management Plan for Groundfish of the Bering Sea and Aleutian Islands Management Area and Amendment 76 to the Fishery Management Plan for Groundfish of the Gulf of Alaska (Amendments 86/76). Amendments 86/ 76 add a funding and deployment system for observer coverage to the existing North Pacific Groundfish Observer Program (Observer Program) and amend existing observer coverage requirements for vessels and processing plants. The new funding and deployment system allows NMFS to determine when and where to deploy observers according to management and conservation needs, with funds provided through a system of fees based on the ex-vessel value of groundfish and halibut in fisheries covered by the new system. This action is necessary to resolve data quality and cost equity concerns with the Observer Program's existing funding and deployment structure. This action is intended to promote the goals and objectives of the Magnuson-Stevens Fishery Conservation and Management Act, the Northern Pacific Halibut Act of 1982, the fishery management plans, and other applicable law.

Effect of the Medicare Part D coverage gap on medication use among patients with hypertension and hyperlipidemia.

PubMed

Li, Pengxiang; McElligott, Sean; Bergquist, Henry; Schwartz, J Sanford; Doshi, Jalpa A

2012-06-05

Prior studies of the Medicare Part D coverage gap are limited in generalizability and scope. To determine the effect of the coverage gap on drugs used for asymptomatic (antihypertensive and lipid-lowering drugs) and symptomatic (pain relievers, acid suppressants, and antidepressants) conditions in elderly patients with hypertension and hyperlipidemia. Quasi-experimental study using pre-post design and contemporaneous control group. Medicare claims files from 2005 and 2006 for 5% random sample of Medicare beneficiaries. Part D plan enrollees with hypertension or hyperlipidemia aged 65 years or older who had no coverage, generic-only coverage, or both brand-name and generic coverage during the gap in 2006. Patients who were fully eligible for the low-income subsidy served as the control group. Monthly 30-day supply prescriptions available, medication adherence, and continuous medication gaps of 30 days or more for antihypertensive or lipid-lowering drugs; monthly 30-day supply prescriptions available for pain relievers, acid suppressants, or antidepressants before and after coverage gap entry. Patients with no gap coverage had a decrease in monthly antihypertensive and lipid-lowering drug prescriptions during the coverage gap. Nonadherence also increased in this group (antihypertensives: odds ratio [OR], 1.60 [95% CI, 1.50 to 1.71]; lipid-lowering drugs: OR, 1.59 [CI, 1.50 to 1.68]). The proportion of patients with no gap coverage who had continuous medication gaps in lipid-lowering medication use and antihypertensive use increased by an absolute 7.3% (OR, 1.38 [CI, 1.29 to 1.46]) and 3.2% (OR, 1.35 [CI, 1.25 to 1.45]), respectively, because of the coverage gap. Decreases in use were smaller for pain relievers and antidepressants and larger for acid suppressants in patients with no gap coverage. Patients with generic-only coverage had decreased use of cardiovascular medications but no change in use of drugs for symptomatic conditions. No measures changed in the brand-name and generic coverage groups. Results of sensitivity analyses were consistent with the main findings. Because this study was nonrandomized, unobserved differences may still exist between study groups. The Part D coverage gap was associated with decreased use of medications for hypertension and hyperlipidemia in patients with no gap coverage and generic-only gap coverage. The proposed phasing out of the gap by 2020 will benefit such patients; however, use of low-value medications may also increase. Penn-Pfizer Alliance and American Heart Association.

Two stage surgical procedure for root coverage

PubMed Central

George, Anjana Mary; Rajesh, K. S.; Hegde, Shashikanth; Kumar, Arun

2012-01-01

Gingival recession may present problems that include root sensitivity, esthetic concern, and predilection to root caries, cervical abrasion and compromising of a restorative effort. When marginal tissue health cannot be maintained and recession is deep, the need for treatment arises. This literature has documented that recession can be successfully treated by means of a two stage surgical approach, the first stage consisting of creation of attached gingiva by means of free gingival graft, and in the second stage, a lateral sliding flap of grafted tissue to cover the recession. This indirect technique ensures development of an adequate width of attached gingiva. The outcome of this technique suggests that two stage surgical procedures are highly predictable for root coverage in case of isolated deep recession and lack of attached gingiva. PMID:23162343

Towards the Geospatial Web: Media Platforms for Managing Geotagged Knowledge Repositories

NASA Astrophysics Data System (ADS)

Scharl, Arno

International media have recognized the visual appeal of geo-browsers such as NASA World Wind and Google Earth, for example, when Web and television coverage on Hurricane Katrina used interactive geospatial projections to illustrate its path and the scale of destruction in August 2005. Yet these early applications only hint at the true potential of geospatial technology to build and maintain virtual communities and to revolutionize the production, distribution and consumption of media products. This chapter investigates this potential by reviewing the literature and discussing the integration of geospatial and semantic reference systems, with an emphasis on extracting geospatial context from unstructured text. A content analysis of news coverage based on a suite of text mining tools (webLyzard) sheds light on the popularity and adoption of geospatial platforms.

The employer's decision to provide health insurance under the health reform law.

PubMed

Pang, Gaobo; Warshawsky, Mark J

2013-01-01

This article considers the employer's decision to continue or to drop health insurance coverage for its workers under the provisions of the 2010 health reform law, on the presumption that the primary influence on that decision is what will produce a higher worker standard of living during working years and retirement. The authors incorporate the most recent empirical estimates of health care costs into their long-horizon, optimal savings consumption model for workers. Their results show that the employer sponsorship of health plans is valuable for maintaining a consistent and higher living standard over the life cycle for middle- and upper-income households considered here, whereas exchange-purchased and subsidized coverage is more beneficial for lower income households (roughly 4-6% of illustrative single workers and 15-22% of working families).

Analysis of error in TOMS total ozone as a function of orbit and attitude parameters

NASA Technical Reports Server (NTRS)

Gregg, W. W.; Ardanuy, P. E.; Braun, W. C.; Vallette, B. J.; Bhartia, P. K.; Ray, S. N.

1991-01-01

Computer simulations of orbital scenarios were performed to examine the effects of orbital altitude, equator crossing time, attitude uncertainty, and orbital eccentricity on ozone observations by future satellites. These effects were assessed by determining changes in solar and viewing geometry and earth daytime coverage loss. The importance of these changes on ozone retrieval was determined by simulating uncertainties in the TOMS ozone retrieval algorithm. The major findings are as follows: (1) Drift of equator crossing time from local noon would have the largest effect on the quality of ozone derived from TOMS. The most significant effect of this drift is the loss of earth daytime coverage in the winter hemisphere. The loss in coverage increases from 1 degree latitude for + or - 1 hour from noon, 6 degrees for + or - 3 hours from noon, to 53 degrees for + or - 6 hours from noon. An additional effect is the increase in ozone retrieval errors due to high solar zenith angles. (2) To maintain contiguous earth coverage, the maximum scan angle of the sensor must be increased with decreasing orbital altitude. The maximum scan angle required for full coverage at the equator varies from 60 degrees at 600 km altitude to 45 degrees at 1200 km. This produces an increase in spacecraft zenith angle, theta, which decreases the ozone retrieval accuracy. The range in theta was approximately 72 degrees for 600 km to approximately 57 degrees at 1200 km. (3) The effect of elliptical orbits is to create gaps in coverage along the subsatellite track. An elliptical orbit with a 200 km perigee and 1200 km apogee produced a maximum earth coverage gap of about 45 km at the perigee at nadir. (4) An attitude uncertainty of 0.1 degree in each axis (pitch, roll, yaw) produced a maximum scan angle to view the pole, and maximum solar zenith angle).

How effective is integrated vector management against malaria and lymphatic filariasis where the diseases are transmitted by the same vector?

PubMed

Stone, Christopher M; Lindsay, Steve W; Chitnis, Nakul

2014-12-01

The opportunity to integrate vector management across multiple vector-borne diseases is particularly plausible for malaria and lymphatic filariasis (LF) control where both diseases are transmitted by the same vector. To date most examples of integrated control targeting these diseases have been unanticipated consequences of malaria vector control, rather than planned strategies that aim to maximize the efficacy and take the complex ecological and biological interactions between the two diseases into account. We developed a general model of malaria and LF transmission and derived expressions for the basic reproductive number (R0) for each disease. Transmission of both diseases was most sensitive to vector mortality and biting rate. Simulating different levels of coverage of long lasting-insecticidal nets (LLINs) and larval control confirms the effectiveness of these interventions for the control of both diseases. When LF was maintained near the critical density of mosquitoes, minor levels of vector control (8% coverage of LLINs or treatment of 20% of larval sites) were sufficient to eliminate the disease. Malaria had a far greater R0 and required a 90% population coverage of LLINs in order to eliminate it. When the mosquito density was doubled, 36% and 58% coverage of LLINs and larval control, respectively, were required for LF elimination; and malaria elimination was possible with a combined coverage of 78% of LLINs and larval control. Despite the low level of vector control required to eliminate LF, simulations suggest that prevalence of LF will decrease at a slower rate than malaria, even at high levels of coverage. If representative of field situations, integrated management should take into account not only how malaria control can facilitate filariasis elimination, but strike a balance between the high levels of coverage of (multiple) interventions required for malaria with the long duration predicted to be required for filariasis elimination.

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 needs careful design to ensure its long-term sustainability.

Evaluation of a national universal coverage campaign of long-lasting insecticidal nets in a rural district in north-west Tanzania.

PubMed

West, Philippa A; Protopopoff, Natacha; Rowland, Mark W; Kirby, Matthew J; Oxborough, Richard M; Mosha, Franklin W; Malima, Robert; Kleinschmidt, Immo

2012-08-10

Insecticide-treated nets (ITN) are one of the most effective measures for preventing malaria. Mass distribution campaigns are being used to rapidly increase net coverage in at-risk populations. This study had two purposes: to evaluate the impact of a universal coverage campaign (UCC) of long-lasting insecticidal nets (LLINs) on LLIN ownership and usage, and to identify factors that may be associated with inadequate coverage. In 2011 two cross-sectional household surveys were conducted in 50 clusters in Muleba district, north-west Tanzania. Prior to the UCC 3,246 households were surveyed and 2,499 afterwards. Data on bed net ownership and usage, demographics of household members and household characteristics including factors related to socio-economic status were gathered, using an adapted version of the standard Malaria Indicator Survey. Specific questions relating to the UCC process were asked. The proportion of households with at least one ITN increased from 62.6% (95% Confidence Interval (CI) = 60.9-64.2) before the UCC to 90.8% (95% CI = 89.0-92.3) afterwards. ITN usage in all residents rose from 40.8% to 55.7%. After the UCC 58.4% (95% CI = 54.7-62.1) of households had sufficient ITNs to cover all their sleeping places. Households with children under five years (OR = 2.4, 95% CI = 1.9-2.9) and small households (OR = 1.9, 95% CI = 1.5-2.4) were most likely to reach universal coverage. Poverty was not associated with net coverage. Eighty percent of households surveyed received LLINs from the campaign. The UCC in Muleba district of Tanzania was equitable, greatly improving LLIN ownership and, more moderately, usage. However, the goal of universal coverage in terms of the adequate provision of nets was not achieved. Multiple, continuous delivery systems and education activities are required to maintain and improve bed net ownership and usage.

How would mental health parity affect the marginal price of care?

PubMed Central

Zuvekas, S H; Banthin, J S; Selden, T M

2001-01-01

OBJECTIVE: To determine the impact of parity in mental health benefits on the marginal prices that consumers face for mental health treatment. DATA SOURCES/DATA COLLECTION: We used detailed information on health plan benefits for a nationally representative sample of the privately insured population under age 65 taken from the 1987 National Medical Expenditure Survey (Edwards and Berlin 1989). The survey was carefully aged and reweighted to represent 1995 population and coverage characteristics. STUDY DESIGN: We computed marginal out-of-pocket costs from the cost-sharing benefits described by policy booklets under current coverage and under parity for various mental health treatment expenditure levels using the MEDSIM health care microsimulation model developed by researchers at the Agency for Healthcare Research and Quality. Descriptive analyses and two-limit Tobit regression models are used to examine how insurance generosity varies across individuals by demographic and socioeconomic characteristics. Our analyses are limited to a description of how parity would change the marginal incentives faced by consumers under their existing plan's cost-sharing arrangements for mental and physical health care. We do not attempt to simulate how parity might affect the level of benefits, including whether benefits are offered at all, or the level of managed care that affects the actual benefits that plan members receive. Rather, we focus only on the nominal benefits described in their policy booklets. PRINCIPAL FINDINGS: Our results show that as of 1995 parity coverage would substantially reduce the share of mental health expenditures that consumers would pay at the margin under their existing plan's cost-sharing provisions, with larger changes for outpatient care than for inpatient care. Because current mental health coverage generally becomes less generous as expenditures rise, while coverage for other medical care becomes more generous (due to stop-loss provisions), the difference in incentives between current mental health coverage and the assumed parity coverage widens as total expenditure grows. We also find that the impact of parity on marginal incentives would vary greatly across the privately insured population. CONCLUSIONS: Based on the large variation in the impact of parity on marginal incentives across the population under current plan cost-sharing arrangements, changes in the demand for mental health treatment will likely also vary across the population. PMID:11221816

Securitising health: Australian newspaper coverage of pandemic influenza.

PubMed

Stephenson, Niamh; Jamieson, Michelle

2009-05-01

This paper analyses contemporary Australian newspaper coverage of the threat of pandemic influenza in humans, specifically in the light of recent transformations in biomedical and public health understandings of infectious disease as continuously emerging. Our analysis suggests that the spectre of pandemic influenza is characterised, in newspaper accounts, as invoking a specific form of nation building. The Australian nation is depicted as successfully securing itself in the face of a threat from Asia (and in the absence of an effective international health body). What is described in newspaper accounts reflects a shift in the public health response to infectious disease. This response does not entail a direct focus on protecting either the population or national territory. Instead, it involves the continuous rehearsal of readiness to react to disasters through the networking of government and private agencies responsible for maintaining critical infrastructure. In this way, coverage of pandemic influenza positions health as central to national security, with little reporting of the reasons for or the potential implications of this alliance. Thus, the imperative to 'be prepared' is presented as self-evident.

Evidence-based alternatives for autogenous grafts around teeth: outcomes, attachment, and stability.

PubMed

McGuire, Michael K

2014-06-01

Although the use of autogenous harvested tissues has proven to be the gold standard for soft tissue augmentation procedures involving root coverage or generation of keratinized tissue, harvest site morbidity and limited supply have prompted clinicians to seek graft alternatives. Using a hierarchy of evidence, the author reviews both clinical and patient-reported results for harvest graft substitutes and, considering his own research experience, reviews autogenous graft substitute outcomes, attachment, and stability over time. Overall, when the goal is keratinized-tissue generation, living cellular constructs and xenogeneic collagen matrices have provided acceptable clinical results, but with better esthetics and patient preference than autogenous free gingival grafts. For root coverage therapy, enamel matrix derivatives, platelet-derived growth factors, and xenogeneic collagen matrices have provided acceptable results with equivalent esthetics to autogenous connective tissue grafts, while also being preferred by patients. Longterm results for enamel matrix derivatives, platelet-derived growth factors, and xenogeneic collagen matrices indicate root coverage can be maintained over time. In the author's hands, xenogeneic collagen matrices have been the only harvest graft alternatives that can be used either covered or uncovered by soft tissue.

Evaluation of storing hepatitis B vaccine outside the cold chain in the Solomon Islands: Identifying opportunities and barriers to implementation.

PubMed

Breakwell, Lucy; Anga, Jenniffer; Dadari, Ibrahim; Sadr-Azodi, Nahad; Ogaoga, Divinal; Patel, Minal

2017-05-15

Monovalent Hepatitis B vaccine (HepB) is heat stable, making it suitable for storage outside cold chain (OCC) at 37°C for 1month. We conducted an OCC project in the Solomon Islands to determine the feasibility of and barriers to national implementation and to evaluate impact on coverage. Healthcare workers at 13 facilities maintained monovalent HepB birth dose (HepB-BD) OCC for up to 28days over 7months. Vaccination data were recorded for children born during the project and those born during 7months before the project. Timely HepB-BD coverage among facility and home births increased from 30% to 68% and from 4% to 24%, respectively. Temperature excursions above 37°C were rare, but vaccine wastage was high and shortages common. Storing HepB OCC can increase HepB-BD coverage in countries with insufficient cold chain capacity or numerous home births. High vaccine wastage and unreliable vaccine supply must be addressed for successful implementation. Published by Elsevier Ltd.

Community cooperatives and insecticide-treated materials for malaria control: a new experience in Latin America.

PubMed

Kroeger, Axel; Aviñna, Ana; Ordoñnez-Gonzalez, José; Escandon, Celia

2002-11-15

Insecticide-treated materials (ITMs) are effective in substantially reducing the burden of malaria and other vector-borne diseases; but how can high coverage rates of ITMs be achieved and maintained? In south Mexico and on the Pacific and Atlantic coasts of Colombia 14 community-based cooperatives offering three different kinds of ITM services (sale of impregnation services; sale of impregnated nets; production of nets and sale of impregnated nets) were formed and supervised by a national health service (IMSS-SOLIDARIDAD, Mexico) and by an academic institution (the Colombian Institute of Tropical Medicine) along with local district health services. The objectives of this research were to analyse the processes and results of this approach and to identify the favourable and limiting factors. The methods used for data collection and analysis were group discussions, individual and semi-structured interviews with users and non-users of ITMs, individual in-depth interviews with cooperative members and supervisors, checks of sales book and observation of impregnation services. Coverage with unimpregnated nets was above 50% in all study areas. The fastest increase of ITM coverage was achieved through the exclusive sale of impregnation services. Low-cost social marketing techniques were used to increase demand. The large-scale production of nets in two cooperatives was only possible with the aid of an international NGO which ordered impregnated bednets for their target group. A number of favourable and limiting factors relating to the success of ITM cooperatives were identified. Of particular importance for the more successful Mexican cooperatives were: a) support by health services, b) smaller size, c) lesser desire for quick returns and d) lower ITM unit costs. ITM community cooperatives supported and supervised by the health services have good potential in the Latin American context for achieving and maintaining high impregnation rates.

Certification of poliomyelitis eradication in Singapore and the challenges ahead.

PubMed

Lee, Hwee Ching; Tay, Joanne; Kwok, Cynthia Y H; Wee, Moi Kim; Ang, Li Wei; Kita, Yuske; Cutter, Jeffery L; Chan, Kwai Peng; Chew, Suok Kai; Goh, Kee Tai

2012-11-01

This study reviewed the epidemiological trends of poliomyelitis from 1946 to 2010, and the impact of the national immunisation programme in raising the population herd immunity against poliovirus. We also traced the efforts Singapore has made to achieve certification of poliomyelitis eradication by the World Health Organisation. Epidemiological data on all reported cases of poliomyelitis were obtained from the Communicable Diseases Division of the Ministry of Health as well as historical records. Coverage of the childhood immunisation programme against poliomyelitis was based on the immunisation data maintained by the National Immunisation Registry, Health Promotion Board. To assess the herd immunity of the population against poliovirus, 6 serological surveys were conducted in 1962, 1978, 1982 to 1984, 1989, 1993 and from 2008 to 2010. Singapore was among the fi rst countries in the world to introduce live oral poliovirus vaccine (OPV) on a mass scale in 1958. With the comprehensive coverage of the national childhood immunisation programme, the incidence of paralytic poliomyelitis declined from 74 cases in 1963 to 5 cases from 1971 to 1973. The immunisation coverage for infants, preschool and primary school children has been maintained at 92% to 97% over the past decade. No indigenous poliomyelitis case had been reported since 1978 and all cases reported subsequently were imported. Singapore was certified poliomyelitis free along with the rest of the Western Pacific Region in 2000 after fulfilling all criteria for poliomyelitis eradication, including the establishment of a robust acute flaccid paralysis surveillance system. However, post-certification challenges remain, with the risk of wild poliovirus importation. Furthermore, it is timely to consider the replacement of OPV with the inactivated poliovirus vaccine in Singapore's national immunisation programme given the risk of vaccine-associated paralytic poliomyelitis and circulating vaccine-derived polioviruses.

Saturn's Misbegotten Moonlets

NASA Astrophysics Data System (ADS)

Spitale, Joseph N.

2017-06-01

Saturn's rings are interspersed with numerous narrow (tens of km wide) gaps. Two of the largest of these gaps -- Encke and Keeler -- contain satellites -- Pan and Daphnis -- that maintain their respective gaps via the classical Goldreich/Tremaine-style shepherding mechanism wherein angular momentum is transferred across the essentially empty gap via torques acting between the satellites and the ring. Other prominent gaps are shepherded by resonances with external satellites or planetary modes: Mimas shepherds the outer edge of the B ring, clearing the inner part of the Cassini Division, Titan shepherds the Columbo ringlet / gap, and the Maxwell ringlet / gap is likely maintained by a resonance with a planetary mode. Prior to Cassini, it was expected that all of the gaps would be shepherded in a similar manner.However, many small gaps do not correspond with known resonances, and no satellites were spotted within those gaps during Cassini's prime and extended mission. To address this issue, a series of Cassini imaging observations were planned to examine 11 gaps in the C ring and Cassini division at a resolution and longitudinal coverage sufficient to either discover the shepherds or rule out their presence. The survey discovered no embedded satellites. Longitudinal coverage was incomplete, but within longitudes covered by the survey, satellites are ruled out to sizes in the 100-m range, far too small keep the observed gaps open. It is possible (about even odds) that there could be a larger satellite residing at a longitude not covered in the survey, but the probability that the survey was unfortunate enough to miss significant satellites in all 11 gaps is exceedingly small (~0.002%). Moreover, these gaps appear in earlier imaging sequences, with some high-resolution coverage, so the true probability is smaller yet. Therefore, a new theory is likely needed to explain the presence of the gaps.

76 FR 74057 - Clean Water Act Section 303(d): Availability of List Decisions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-30

... for which existing technology-based pollution controls are not stringent enough to attain or maintain... marine criterion for dissolved oxygen was not attained in these segments. EPA is providing the public the... which existing technology-based pollution controls are not stringent enough to attain or maintain State...

Maintaining a Cybersecurity Curriculum: Professional Certifications as Valuable Guidance

ERIC Educational Resources Information Center

Knapp, Kenneth J.; Maurer, Christopher; Plachkinova, Miloslava

2017-01-01

Much has been published about developing a cybersecurity curriculum for institutes of higher learning (IHL). Now that a growing number of IHLs globally offer such programs, a need exists on how to guide, maintain, and improve the relevancy of existing curricula. Just as cybersecurity professionals must be hone their skills continually to keep with…

Ground track maintenance for BeiDou IGSO satellites subject to tesseral resonances and the luni-solar perturbations

NASA Astrophysics Data System (ADS)

Fan, Li; Jiang, Chao; Hu, Min

2017-02-01

Eight inclined geosynchronous satellite orbit (IGSO) satellites in the Chinese BeiDou Navigation Satellite System (BDS) have been put in orbit until now. IGSO is a special class of geosynchronous circular orbit, with the inclination not equal to zero. It can provide high elevation angle coverage to high-latitude areas. The geography longitude of the ground track cross node is the main factor to affect the ground coverage areas of the IGSO satellites. In order to ensure the navigation performance of the IGSO satellites, the maintenance control of the ground track cross node is required. Considering the tesseral resonances and the luni-solar perturbations, a control approach is proposed to maintain the ground track for the long-term evolution. The drifts of the ground track cross node of the IGSO satellites are analyzed, which is formulated as a function of the bias of the orbit elements and time. Based on the derived function, a method by offsetting the semi-major axis is put forward to maintain the longitude of the ground track cross node, and the offset calculation equation is presented as well. Moreover, the orbit inclination is adjusted to maintain the location angle intervals between each two IGSO satellites. Finally, the precision of the offset calculation equation is analyzed to achieve the operational deployment. Simulation results show that the semi-major axis offset method is effective, and its calculation equation is accurate. The proposed approach has been applied to the maintenance control of BeiDou IGSO satellites.

Environmental metabarcodes for insects: in silico PCR reveals potential for taxonomic bias.

PubMed

Clarke, Laurence J; Soubrier, Julien; Weyrich, Laura S; Cooper, Alan

2014-11-01

Studies of insect assemblages are suited to the simultaneous DNA-based identification of multiple taxa known as metabarcoding. To obtain accurate estimates of diversity, metabarcoding markers ideally possess appropriate taxonomic coverage to avoid PCR-amplification bias, as well as sufficient sequence divergence to resolve species. We used in silico PCR to compare the taxonomic coverage and resolution of newly designed insect metabarcodes (targeting 16S) with that of existing markers [16S and cytochrome oxidase c subunit I (COI)] and then compared their efficiency in vitro. Existing metabarcoding primers amplified in silico <75% of insect species with complete mitochondrial genomes available, whereas new primers targeting 16S provided >90% coverage. Furthermore, metabarcodes targeting COI appeared to introduce taxonomic PCR-amplification bias, typically amplifying a greater percentage of Lepidoptera and Diptera species, while failing to amplify certain orders in silico. To test whether bias predicted in silico was observed in vitro, we created an artificial DNA blend containing equal amounts of DNA from 14 species, representing 11 insect orders and one arachnid. We PCR-amplified the blend using five primer sets, targeting either COI or 16S, with high-throughput amplicon sequencing yielding more than 6 million reads. In vitro results typically corresponded to in silico PCR predictions, with newly designed 16S primers detecting 11 insect taxa present, thus providing equivalent or better taxonomic coverage than COI metabarcodes. Our results demonstrate that in silico PCR is a useful tool for predicting taxonomic bias in mixed template PCR and that researchers should be wary of potential bias when selecting metabarcoding markers. © 2014 John Wiley & Sons Ltd.

A testing-coverage software reliability model considering fault removal efficiency and error generation

PubMed Central

Li, Qiuying; Pham, Hoang

2017-01-01

In this paper, we propose a software reliability model that considers not only error generation but also fault removal efficiency combined with testing coverage information based on a nonhomogeneous Poisson process (NHPP). During the past four decades, many software reliability growth models (SRGMs) based on NHPP have been proposed to estimate the software reliability measures, most of which have the same following agreements: 1) it is a common phenomenon that during the testing phase, the fault detection rate always changes; 2) as a result of imperfect debugging, fault removal has been related to a fault re-introduction rate. But there are few SRGMs in the literature that differentiate between fault detection and fault removal, i.e. they seldom consider the imperfect fault removal efficiency. But in practical software developing process, fault removal efficiency cannot always be perfect, i.e. the failures detected might not be removed completely and the original faults might still exist and new faults might be introduced meanwhile, which is referred to as imperfect debugging phenomenon. In this study, a model aiming to incorporate fault introduction rate, fault removal efficiency and testing coverage into software reliability evaluation is developed, using testing coverage to express the fault detection rate and using fault removal efficiency to consider the fault repair. We compare the performance of the proposed model with several existing NHPP SRGMs using three sets of real failure data based on five criteria. The results exhibit that the model can give a better fitting and predictive performance. PMID:28750091

Childhood Cancer Survivors' Familiarity With and Opinions of the Patient Protection and Affordable Care Act

PubMed Central

Warner, Echo L.; Park, Elyse R.; Stroup, Antoinette; Kinney, Anita Y.; Kirchhoff, Anne C.

2013-01-01

Purpose: The Patient Protection and Affordable Care Act (ACA) offers avenues to increase insurance options and access to care; however, it is unknown whether populations with pre-existing conditions, such as cancer survivors, will benefit from the expanded coverage options. We explored childhood cancer survivors' familiarity with and opinion of the ACA to understand how survivors' insurance coverage may be affected. Materials and Methods: From April to July 2012 we conducted in-depth, semistructured telephone interviews with 53 adult survivors recruited from the Utah Cancer SEER Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at time of diagnosis. Interviews were recorded, transcribed, and analyzed with NVivo 9 by two coders (kappa = 0.94). We report on the 49 participants who had heard of the ACA. Results: Most survivors were unaware of ACA provisions beyond the insurance mandate. Few knew about coverage for children up to age 26 or pre-existing insurance options. Although one third believed the ACA could potentially benefit them via expanded insurance coverage, many were concerned that the ACA would lead to rising health care costs and decreasing quality of care. Survivors had concerns specific to their cancer history, including fears of future health care rationing if they developed subsequent health problems. Conclusion: Childhood cancer survivors have a low level of familiarity with the ACA and are unaware of how it may affect them given their cancer history. These survivors require targeted education to increase knowledge about the ACA. PMID:23943900

Assessment of DSN Communication Coverage for Space Missions to Potentially Hazardous Asteroids

NASA Technical Reports Server (NTRS)

Kegege, Obadiah; Bittner, David; Gati, Frank; Bhasin, Kul

2012-01-01

A communication coverage gap exists for Deep Space Network (DSN) antennas. This communication coverage gap is on the southern hemisphere, centered at approximate latitude of -47deg and longitude of -45deg. The area of this communication gap varies depending on the altitude from the Earth s surface. There are no current planetary space missions that fall within the DSN communication gap because planetary bodies in the Solar system lie near the ecliptic plane. However, some asteroids orbits are not confined to the ecliptic plane. In recent years, Potentially Hazardous Asteroids (PHAs) have passed within 100,000 km of the Earth. NASA s future space exploration goals include a manned mission to asteroids. It is important to ensure reliable and redundant communication coverage/capabilities for manned space missions to dangerous asteroids that make a sequence of close Earth encounters. In this paper, we will describe simulations performed to determine whether near-Earth objects (NEO) that have been classified as PHAs fall within the DSN communication coverage gap. In the study, we reviewed literature for a number of PHAs, generated binary ephemeris for selected PHAs using JPL s HORIZONS tool, and created their trajectories using Satellite Took Kit (STK). The results show that some of the PHAs fall within DSN communication coverage gap. This paper presents the simulation results and our analyses

Determining the effective coverage of maternal and child health services in Kenya, using demographic and health survey data sets: tracking progress towards universal health coverage.

PubMed

Nguhiu, Peter K; Barasa, Edwine W; Chuma, Jane

2017-04-01

Effective coverage (EC) is a measure of health systems' performance that combines need, use and quality indicators. This study aimed to assess the extent to which the Kenyan health system provides effective and equitable maternal and child health services, as a means of tracking the country's progress towards universal health coverage. The Demographic Health Surveys (2003, 2008-2009 and 2014) and Service Provision Assessment surveys (2004, 2010) were the main sources of data. Indicators of need, use and quality for eight maternal and child health interventions were aggregated across interventions and economic quintiles to compute EC. EC has increased from 26.7% in 2003 to 50.9% in 2014, but remains low for the majority of interventions. There is a reduction in economic inequalities in EC with the highest to lowest wealth quintile ratio decreasing from 2.41 in 2003 to 1.65 in 2014, but maternal health services remain highly inequitable. Effective coverage of key maternal and child health services remains low, indicating that individuals are not receiving the maximum possible health gain from existing health services. There is an urgent need to focus on the quality and reach of maternal and child health services in Kenya to achieve the goals of universal health coverage. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

PubMed Central

Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

2007-01-01

Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

Coverage and Consumption of Micronutrient Powders, Fortified Staples, and Iodized Salt Among Children Aged 6 to 23 Months in Selected Neighborhoods of Nairobi County, Kenya.

PubMed

Leyvraz, Magali; David-Kigaru, Dorcus M; Macharia-Mutie, Catherine; Aaron, Grant J; Roefs, Marlene; Tumilowicz, Alison

2018-03-01

Intake of micronutrient-rich foods among children aged 6 to 23 months in Nairobi is low. This study aimed to assess existing coverage and utilization of micronutrient powders (MNPs), fortified staples, and iodized salt among children aged 6 to 23 months prior to implementation of an MNP program. A cross-sectional survey among caregivers of children aged 6 to 23 months (n = 618) was implemented in 7 neighborhoods within Nairobi County, representing the implementation area of the new MNP program. Results for MNP coverage and utilization showed 28.5% of all caregivers were aware of MNP, 18.5% had ever received MNP for their child, and 10.8% had fed MNP to their child in the previous 7 days. Effective coverage (ie, the child had been given the MNP at least 3 times in the previous 7 days) was 5.8%. Effective coverage of infants and young children with poor feeding practices was significantly lower as compared to those with non-poor feeding practices (coverage ratio, 0.34; confidence interval, 0.12-0.70). Most households purchased iodized salt (96.9%), fortified oil (61.0%), and fortified maize flour (93.9%). An estimated 23.9% of vitamin A requirements of children (6-23 months) were provided from fortified oil and 50.7% of iron from fortified maize flour. Most households consumed processed milk (81%). Coverage of MNPs in the surveyed neighborhoods was low. Coverage of fortified salt, oil, and maize flour was high and provided significant amount of micronutrients to children. Processed milk has potential as a vehicle for food fortification.

Measles in Poland in 2013.

PubMed

Rogalska, Justyna

2015-01-01

Since 1998, Poland has been actively participating in the Measles Elimination Program, coordinated by the World Health Organization (WHO). It requires achieving and maintaining very high vaccine coverage (>95%), recording all cases and suspected cases of measles, and laboratory testing of all suspected measles cases in the WHO Reference Laboratory. In Poland it is a Laboratory of Department of Virology, NIPH-NIH. In order to confirm or exclude the case of measles specific measles IgM antibodies should be measured using Elisa test, or molecular testing (PCR) should be performed to detect the presence measles virus RNA in biological material. To assess epidemiological situation of measles in Poland in 2013, including vaccination coverage in Polish population, and Measles Elimination Program implementation status. The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletins "Infectious diseases and poisonings in Poland in 2013" and "Vaccinations in Poland in 2013", and measles case-based reports from 2013 sent to the Department of Epidemiology NIPH-NIH by Sanitary-Epidemiological Stations. In total, there were 84 measles cases registered in Poland in 2013 (incidence 0.22 per 100,000). The highest incidence rate was observed among infants (2.18 per 100,000) and children aged 1 year (1.27 per 100,000). In 2013, 56 cases (66.7%) were hospitalized due to measles. No deaths from measles were reported. Vaccination coverage of children and youth aged 2-11 years ranged from 82.8% do 99.5% (primary vaccination in children born in 2012-2007) and from 73.6% to 93.2% (booster dose in children born in 2004-2001). In 2013, 127 measles-compatible cases were reported (67% of expected reports). Two hundred seven cases (80%) were confirmed by IgM ELISA test. In 2013, the epidemiological situation of measles deteriorated in comparison to proceding year. The sensitivity of measles surveillance improved but is still insufficient. It is necessary to further promote Measles Elimination Program in Poland, to improve measles surveillance system and to maintain the high immunisation coverage.

Analysis of esophageal-sparing treatment plans for patients with high-grade esophagitis.

PubMed

Niedzielski, Joshua; Bluett, Jaques B; Williamson, Ryan T; Liao, Zhongxing; Gomez, Daniel R; Court, Laurence E

2013-07-08

We retrospectively generated IMRT plans for 14 NSCLC patients who had experienced grade 2 or 3 esophagitis (CTCAE version 3.0). We generated 11-beam and reduced esophagus dose plan types to compare changes in the volume and length of esophagus receiving doses of 50, 55, 60, 65, and 70 Gy. Changes in planning target volume (PTV) dose coverage were also compared. If necessary, plans were renormalized to restore 95% PTV coverage. The critical organ doses examined were mean lung dose, mean heart dose, and volume of spinal cord receiving 50 Gy. The effect of interfractional motion was determined by applying a three-dimensional rigid shift to the dose grid. For the esophagus plan, the mean reduction in esophagus V50, V55, V60, V65, and V70 Gy was 2.8, 4.1, 5.9, 7.3, and 9.5 cm(3), respectively, compared with the clinical plan. The mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 2.0, 3.0, 3.8, 4.0, and 4.6 cm, respectively. The mean heart and lung dose decreased 3.0 Gy and 2.4 Gy, respectively. The mean decreases in 90% and 95% PTV coverage were 1.7 Gy and 2.8 Gy, respectively. The normalized plans' mean reduction of esophagus V50, V55, V60, V65, and V70 Gy were 1.6, 2.0, 2.9, 3.9, and 5.5 cm(3), respectively, compared with the clinical plans. The normalized plans' mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 4.9, 5.2, 5.4, 4.9, and 4.8 cm, respectively. The mean reduction in maximum esophagus dose with simulated interfractional motion was 3.0 Gy and 1.4 Gy for the clinical plan type and the esophagus plan type, respectively. In many cases, the esophagus dose can be greatly reduced while maintaining critical structure dose constraints. PTV coverage can be restored by increasing beam output, while still obtaining a dose reduction to the esophagus and maintaining dose constraints.

SU-E-T-575: To Analyze the Clinical Impact of Esophageal Sparing on Treatment Plans for Patients with Grade 3 Esophagitis.

PubMed

Niedzielski, J; Bluett, J; Williamson, R; Liao, Z; Gomez, D; Court, L

2012-06-01

To analyze the clinical impact of esophageal sparing on treatment plans for patients with grade 3 esophagitis. The treatment plans of 8 patients (project total: 20 patients) who were treated with IMRT and exhibited stage 3 esophagitis were re-planned to give a simulated clinical plan with dose distribution that mirrored our current clinical practice (74Gy to the target, and 5mm margins), and a plan that emphasized esophageal sparing. Doses to the esophagus, heart, cord, lung and PTV were compared. Comparing the esophageal sparing plan to the simulated clinical plan, the mean reduction in esophageal volume receiving 50, 55, 60, 65, and 70Gy were 2.0, 3.2, 5.0, 7.2, and 10.9 cm 3 , respectively. The mean reduction in the continuous length of esophagus receiving 50, 55, 60, 65, and 70Gy were 12, 24, 38, 40, and 47mm, respectively. The associated reduction in dose to 90% and 95% of the PTV was 2.2 and 3.8Gy, respectively. Of the 8 patients examined, 2 showed a significant decrease in PTV coverage (4.6Gy, 12.3Gy for 90% of PTV), 4 showed decreases under 1.1Gy, but 2 showed an increase of 1.4Gy and 0.5Gy for 90% PTV. Cord dose was maintained below 50Gy, and there was a slight increase in mean heart dose and mean lung dose of 2.4Gy, and 2.7Gy, respectively. Data will also be presented comparing these plans with the actual treated plans (for which the patients had grade 3 esophagitis) and plans that emphasize PTV coverage. Treatment planning to emphasize esophageal sparing can reduce the volume and continuous length of the esophagus which receives high doses. There is some associated modest reduction in PTV coverage. In summary, in many cases esophageal sparing can be accomplished for lung cancer cases while maintaining adequate PTV coverage, although there is variability between patients. © 2012 American Association of Physicists in Medicine.

Analysis of esophageal‐sparing treatment plans for patients with high‐grade esophagitis

PubMed Central

Bluett, Jaques B.; Williamson, Ryan T.; Liao, Zhongxing; Gomez, Daniel R.; Court, Laurence E.

2013-01-01

We retrospectively generated IMRT plans for 14 NSCLC patients who had experienced grade 2 or 3 esophagitis (CTCAE version 3.0). We generated 11‐beam and reduced esophagus dose plan types to compare changes in the volume and length of esophagus receiving doses of 50, 55, 60, 65, and 70 Gy. Changes in planning target volume (PTV) dose coverage were also compared. If necessary, plans were renormalized to restore 95% PTV coverage. The critical organ doses examined were mean lung dose, mean heart dose, and volume of spinal cord receiving 50 Gy. The effect of interfractional motion was determined by applying a three‐dimensional rigid shift to the dose grid. For the esophagus plan, the mean reduction in esophagus V50, V55, V60, V65, and V70 Gy was 2.8, 4.1, 5.9, 7.3, and 9.5 cm3, respectively, compared with the clinical plan. The mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 2.0, 3.0, 3.8, 4.0, and 4.6 cm, respectively. The mean heart and lung dose decreased 3.0 Gy and 2.4 Gy, respectively. The mean decreases in 90% and 95% PTV coverage were 1.7 Gy and 2.8 Gy, respectively. The normalized plans’ mean reduction of esophagus V50, V55, V60, V65, and V70 Gy were 1.6, 2.0, 2.9, 3.9, and 5.5 cm3, respectively, compared with the clinical plans. The normalized plans’ mean reductions in LE50, LE55, LE60, LE65, and LE70 Gy were 4.9, 5.2, 5.4, 4.9, and 4.8 cm, respectively. The mean reduction in maximum esophagus dose with simulated interfractional motion was 3.0 Gy and 1.4 Gy for the clinical plan type and the esophagus plan type, respectively. In many cases, the esophagus dose can be greatly reduced while maintaining critical structure dose constraints. PTV coverage can be restored by increasing beam output, while still obtaining a dose reduction to the esophagus and maintaining dose constraints. PACS number: 87.53 Tf PMID:23835390

Hydrocarbon lakes on Titan

NASA Astrophysics Data System (ADS)

Mitri, Giuseppe; Showman, Adam P.; Lunine, Jonathan I.; Lorenz, Ralph D.

2007-02-01

The Huygens Probe detected dendritic drainage-like features, methane clouds and a high surface relative humidity (∼50% ) on Titan in the vicinity of its landing site [Tomasko, M.G., and 39 colleagues, 2005. Nature 438, 765-778; Niemann, H.B., and 17 colleagues, 2005. Nature 438, 779-784], suggesting sources of methane that replenish this gas against photo- and charged-particle chemical loss on short (10-100) million year timescales [Atreya, S.K., Adams, E.Y., Niemann, H.B., Demick-Montelara, J.E., Owen, T.C., Fulchignoni, M., Ferri, F., Wilson, E.H., 2006. Planet. Space Sci. In press]. On the other hand, Cassini Orbiter remote sensing shows dry and even desert-like landscapes with dunes [Lorenz, R.D., and 39 colleagues, 2006a. Science 312, 724-727], some areas worked by fluvial erosion, but no large-scale bodies of liquid [Elachi, C., and 34 colleagues, 2005. Science 308, 970-974]. Either the atmospheric methane relative humidity is declining in a steady fashion over time, or the sources that maintain the relative humidity are geographically restricted, small, or hidden within the crust itself. In this paper we explore the hypothesis that the present-day methane relative humidity is maintained entirely by lakes that cover a small part of the surface area of Titan. We calculate the required minimum surface area coverage of such lakes, assess the stabilizing influence of ethane, and the implications for moist convection in the atmosphere. We show that, under Titan's surface conditions, methane evaporates rapidly enough that shorelines of any existing lakes could potentially migrate by several hundred m to tens of km per year, rates that could be detected by the Cassini orbiter. We furthermore show that the high relative humidity of methane in Titan's lower atmosphere could be maintained by evaporation from lakes covering only 0.002-0.02 of the whole surface.

Towards Universal Health Coverage via Social Health Insurance in China: Systemic Fragmentation, Reform Imperatives, and Policy Alternatives.

PubMed

He, Alex Jingwei; Wu, Shaolong

2017-12-01

China's remarkable progress in building a comprehensive social health insurance (SHI) system was swift and impressive. Yet the country's decentralized and incremental approach towards universal coverage has created a fragmented SHI system under which a series of structural deficiencies have emerged with negative impacts. First, contingent on local conditions and financing capacity, benefit packages vary considerably across schemes, leading to systematic inequity. Second, the existence of multiple schemes, complicated by massive migration, has resulted in weak portability of SHI, creating further barriers to access. Third, many individuals are enrolled on multiple schemes, which causes inefficient use of government subsidies. Moral hazard and adverse selection are not effectively managed. The Chinese government announced its blueprint for integrating the urban and rural resident schemes in early 2016, paving the way for the ultimate consolidation of all SHI schemes and equal benefits for all. This article proposes three policy alternatives to inform the consolidation: (1) a single-pool system at the prefectural level with significant government subsidies, (2) a dual-pool system at the prefectural level with risk-equalization mechanisms, and (3) a household approach without merging existing pools. Vertical integration to the provincial level is unlikely to happen in the near future. Two caveats are raised to inform this transition towards universal health coverage.

Prevention, screening and treatment of colorectal cancer: a global and regional generalized cost effectiveness analysis

PubMed Central

2010-01-01

Background Regional generalized cost-effectiveness estimates of prevention, screening and treatment interventions for colorectal cancer are presented. Methods Standardised WHO-CHOICE methodology was used. A colorectal cancer model was employed to provide estimates of screening and treatment effectiveness. Intervention effectiveness was determined via a population state-transition model (PopMod) that simulates the evolution of a sub-regional population accounting for births, deaths and disease epidemiology. Economic costs of procedures and treatment were estimated, including programme overhead and training costs. Results In regions characterised by high income, low mortality and high existing treatment coverage, the addition of screening to the current high treatment levels is very cost-effective, although no particular intervention stands out in cost-effectiveness terms relative to the others. In regions characterised by low income, low mortality with existing treatment coverage around 50%, expanding treatment with or without screening is cost-effective or very cost-effective. Abandoning treatment in favour of screening (no treatment scenario) would not be cost effective. In regions characterised by low income, high mortality and low treatment levels, the most cost-effective intervention is expanding treatment. Conclusions From a cost-effectiveness standpoint, screening programmes should be expanded in developed regions and treatment programmes should be established for colorectal cancer in regions with low treatment coverage. PMID:20236531

Operationalizing universal health coverage in Nigeria through social health insurance

PubMed Central

Okpani, Arnold Ikedichi; Abimbola, Seye

2015-01-01

Nigeria faces challenges that delay progress toward the attainment of the national government's declared goal of universal health coverage (UHC). One such challenge is system-wide inequities resulting from lack of financial protection for the health care needs of the vast majority of Nigerians. Only a small proportion of Nigerians have prepaid health care. In this paper, we draw on existing evidence to suggest steps toward reforming health care financing in Nigeria to achieve UHC through social health insurance. This article sets out to demonstrate that a viable path to UHC through expanding social health insurance exists in Nigeria. We argue that encouraging the states which are semi-autonomous federating units to setup and manage their own insurance schemes presents a unique opportunity for rapidly scaling up prepaid coverage for Nigerians. We show that Nigeria's federal structure which prescribes a sharing of responsibilities for health care among the three tiers of government presents serious challenges for significantly extending social insurance to uncovered groups. We recommend that rather than allowing this governance structure to impair progress toward UHC, it should be leveraged to accelerate the process by supporting the states to establish and manage their own insurance funds while encouraging integration with the National Health Insurance Scheme. PMID:26778879

The status of evolutionary medicine education in North American medical schools.

PubMed

Hidaka, Brandon H; Asghar, Anila; Aktipis, C Athena; Nesse, Randolph M; Wolpaw, Terry M; Skursky, Nicole K; Bennett, Katelyn J; Beyrouty, Matthew W; Schwartz, Mark D

2015-03-08

Medical and public health scientists are using evolution to devise new strategies to solve major health problems. But based on a 2003 survey, medical curricula may not adequately prepare physicians to evaluate and extend these advances. This study assessed the change in coverage of evolution in North American medical schools since 2003 and identified opportunities for enriching medical education. In 2013, curriculum deans for all North American medical schools were invited to rate curricular coverage and perceived importance of 12 core principles, the extent of anticipated controversy from adding evolution, and the usefulness of 13 teaching resources. Differences between schools were assessed by Pearson's chi-square test, Student's t-test, and Spearman's correlation. Open-ended questions sought insight into perceived barriers and benefits. Despite repeated follow-up, 60 schools (39%) responded to the survey. There was no evidence of sample bias. The three evolutionary principles rated most important were antibiotic resistance, environmental mismatch, and somatic selection in cancer. While importance and coverage of principles were correlated (r = 0.76, P < 0.01), coverage (at least moderate) lagged behind importance (at least moderate) by an average of 21% (SD = 6%). Compared to 2003, a range of evolutionary principles were covered by 4 to 74% more schools. Nearly half (48%) of responders anticipated igniting controversy at their medical school if they added evolution to their curriculum. The teaching resources ranked most useful were model test questions and answers, case studies, and model curricula for existing courses/rotations. Limited resources (faculty expertise) were cited as the major barrier to adding more evolution, but benefits included a deeper understanding and improved patient care. North American medical schools have increased the evolution content in their curricula over the past decade. However, coverage is not commensurate with importance. At a few medical schools, anticipated controversy impedes teaching more evolution. Efforts to improve evolution education in medical schools should be directed toward boosting faculty expertise and crafting resources that can be easily integrated into existing curricula.

Health Care Reform and Young Adults' Access to Sexual Health Care: An Exploration of Potential Confidentiality Implications of the Affordable Care Act

PubMed Central

Garcia, Carolyn M.; Long, Sharon K.; Lechner, Kate E.; Lust, Katherine; Eisenberg, Marla E.

2012-01-01

One provision of the 2010 Affordable Care Act is extension of dependent coverage for young adults aged up to 26 years on their parent’s private insurance plan. This change, meant to increase insurance coverage for young adults, might yield unintended consequences. Confidentiality concerns may be triggered by coverage through parental insurance, particularly regarding sexual health. The existing literature and our original research suggest that actual or perceived limits to confidentiality could influence the decisions of young adults about whether, and where, to seek care for sexual health issues. Further research is needed on the scope and outcomes of these concerns. Possible remedial actions include enhanced policies to protect confidentiality in billing and mechanisms to communicate confidentiality protections to young adults. PMID:22897544

Guidance control of small UAV with energy and maneuverability limitations for a search and coverage mission

NASA Astrophysics Data System (ADS)

Gramajo, German G.

This thesis presents an algorithm for a search and coverage mission that has increased autonomy in generating an ideal trajectory while explicitly considering the available energy in the optimization. Further, current algorithms used to generate trajectories depend on the operator providing a discrete set of turning rate requirements to obtain an optimal solution. This work proposes an additional modification to the algorithm so that it optimizes the trajectory for a range of turning rates instead of a discrete set of turning rates. This thesis conducts an evaluation of the algorithm with variation in turn duration, entry-heading angle, and entry point. Comparative studies of the algorithm with existing method indicates improved autonomy in choosing the optimization parameters while producing trajectories with better coverage area and closer final distance to the desired terminal point.

3 CFR 8999 - Proclamation 8999 of July 25, 2013. Anniversary of the Americans With Disabilities Act, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... technology is accessible. We must rededicate ourselves to building supportive classrooms and putting an end... insurers to deny coverage to children with disabilities because of pre-existing conditions, medical history...

Effectiveness of a new long-lasting insecticidal nets delivery model in two rural districts of Mozambique: a before-after study.

PubMed

Arroz, Jorge A H; Candrinho, Baltazar; Mendis, Chandana; Varela, Pablo; Pinto, João; Martins, Maria do Rosário O

2018-02-05

In 2015, Mozambique piloted a new model of long-lasting insecticidal nets (LLINs) delivery in a campaign. The new delivery model was used in two rural districts were, and two others were considered as control, maintaining the old delivery model. The aim of this study is to compare the coverage of ownership and use of LLINs in intervention and control districts in Mozambique. A before-after design with control group was carried out 6 months after LLINs distribution. Using systematic probabilistic sampling, 1547 households were surveyed by means of a questionnaire. To find associations between the district categories (intervention and control) and the main outcomes of the study (LLIN ownership, use, and universal coverage achievement), odds ratio (OR) and respective confidence intervals were calculated. Of the 760 households surveyed in the intervention districts, 98.8% had at least one LLIN; of the 787 households surveyed in the control districts, 89.6% had at least one LLIN [OR: 9.7, 95% (CI 4.84-19.46)]. Around 95 and 87% of households owning at least one LLIN reported having slept under the LLIN the previous night in the intervention and control districts, respectively [OR: 3.2; 95% (CI 2.12-4.69)]. Seventy-one percent of the households surveyed achieved universal coverage in the intervention districts against 59.6% in the control districts [OR: 1.6; 95% (CI 1.33-2.03)]. The universal coverage campaign piloted with the new delivery model has increased LLINs ownership, use, and progression for reaching universal coverage targets in the community.

Effect of Coadsorbed Water on the Photodecomposition of Acetone on TiO2(110)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henderson, Michael A.

2008-06-10

The influence of coadsorbed water on the photodecomposition of acetone on TiO2 was examined using temperature programmed desorption (TPD) and the rutile TiO2(110) surface as a model photocatalyst. Of the two major influences ascribed to water in the heterogeneous photocatalysis literature (promotion via OH radical supply and inhibition due to site blocking), only the negative influence of water was observed. As long as the total water and acetone coverage was maintained well below the first layer saturation coverage (‘1 ML’), little inhibition of acetone photodecomposition was observed. However, as the total water+acetone coverage exceeded 1 ML, acetone was preferentially displacedmore » from the first layer to physisorbed states by water and the extent of acetone photodecomposition attenuated. The displacement originated from water compressing acetone into high coverage regions where increased acetone-acetone repulsions caused displacement from the first layer. The immediate product of acetone photodecomposition was adsorbed acetate, which occupies twice as many surface sites per molecule as compared to acetone. Since the acetate intermediate was more stable on the TiO2(110) surface than either water or acetone (as gauged by TPD) and since its photodecomposition rate was less than that of acetone, additional surface sites were not opened up during acetone photodecomposition for previously displaced acetone molecules to re-enter the first layer. Results in this study suggest that increased molecular-level repulsions between organic molecules brought about by increased water coverage are as influential in the inhibiting effect of water on photooxidation rates as are water-organic repulsions.« less

Elimination of African onchocerciasis: modeling the impact of increasing the frequency of ivermectin mass treatment.

PubMed

Coffeng, Luc E; Stolk, Wilma A; Hoerauf, Achim; Habbema, Dik; Bakker, Roel; Hopkins, Adrian D; de Vlas, Sake J

2014-01-01

The African Programme for Onchocerciasis Control (APOC) is currently shifting its focus from morbidity control to elimination of infection. To enhance the likelihood of elimination and speed up its achievement, programs may consider to increase the frequency of ivermectin mass treatment from annual to 6-monthly or even higher. In a computer simulation study, we examined the potential impact of increasing the mass treatment frequency for different settings. With the ONCHOSIM model, we simulated 92,610 scenarios pertaining to different assumptions about transmission conditions, history of mass treatment, the future mass treatment strategy, and ivermectin efficacy. Simulation results were used to determine the minimum remaining program duration and number of treatment rounds required to achieve 99% probability of elimination. Doubling the frequency of treatment from yearly to 6-monthly or 3-monthly was predicted to reduce remaining program duration by about 40% or 60%, respectively. These reductions come at a cost of additional treatment rounds, especially in case of 3-monthly mass treatment. Also, aforementioned reductions are highly dependent on maintained coverage, and could be completely nullified if coverage of mass treatment were to fall in the future. In low coverage settings, increasing treatment coverage is almost just as effective as increasing treatment frequency. We conclude that 6-monthly mass treatment may only be worth the effort in situations where annual treatment is expected to take a long time to achieve elimination in spite of good treatment coverage, e.g. because of unfavorable transmission conditions or because mass treatment started recently.

Coccolith arrangement follows Eulerian mathematics in the coccolithophore Emiliania huxleyi.

PubMed

Xu, Kai; Hutchins, David; Gao, Kunshan

2018-01-01

The globally abundant coccolithophore, Emiliania huxleyi , plays an important ecological role in oceanic carbon biogeochemistry by forming a cellular covering of plate-like CaCO 3 crystals (coccoliths) and fixing CO 2 . It is unknown how the cells arrange different-sized coccoliths to maintain full coverage, as the cell surface area of the cell changes during daily cycle. We used Euler's polyhedron formula and CaGe simulation software, validated with the geometries of coccoliths, to analyze and simulate the coccolith topology of the coccosphere and to explore the arrangement mechanisms. There were only small variations in the geometries of coccoliths, even when the cells were cultured under variable light conditions. Because of geometric limits, small coccoliths tended to interlock with fewer and larger coccoliths, and vice versa. Consequently, to sustain a full coverage on the surface of cell, each coccolith was arranged to interlock with four to six others, which in turn led to each coccosphere contains at least six coccoliths. The number of coccoliths per coccosphere must keep pace with changes on the cell surface area as a result of photosynthesis, respiration and cell division. This study is an example of natural selection following Euler's polyhedral formula, in response to the challenge of maintaining a CaCO 3 covering on coccolithophore cells as cell size changes.

The USNO-UKIRT K-band Hemisphere Survey

NASA Astrophysics Data System (ADS)

Dahm, Scott; Bruursema, Justice; Munn, Jeffrey A.; Vrba, Fred J.; Dorland, Bryan; Dye, Simon; Kerr, Tom; Varricatt, Watson; Irwin, Mike; Lawrence, Andy; McLaren, Robert; Hodapp, Klaus; Hasinger, Guenther

2018-01-01

We present initial results from the United States Naval Observatory (USNO) and UKIRT K-band Hemisphere Survey (U2HS), currently underway using the Wide Field Camera (WFCAM) installed on UKIRT on Maunakea. U2HS is a collaborative effort undertaken by USNO, the Institute for Astronomy, University of Hawaii, the Cambridge Astronomy Survey Unit (CASU) and the Wide Field Astronomy Unit (WFAU) in Edinburgh. The principal objective of the U2HS is to provide continuous northern hemisphere K-band coverage over a declination range of δ=0o – +60o by combining over 12,700 deg2 of new imaging with the existing UKIRT Infrared Deep Sky Survey (UKIDSS) Large Area Survey (LAS), Galactic Plane Survey (GPS) and Galactic Cluster Survey (GCS). U2HS will achieve a 5-σ point source sensitivity of K~18.4 mag (Vega), over three magnitudes deeper than the Two Micron All Sky Survey (2MASS). In this contribution we discuss survey design, execution, data acquisition and processing, photometric calibration and quality control. The data obtained by the U2HS will be made publicly available through the Wide Field Science Archive (WSA) maintained by the WFAU.

Pneumococcal vaccination and chronic respiratory diseases.

PubMed

Froes, Filipe; Roche, Nicolas; Blasi, Francesco

2017-01-01

Patients with COPD and other chronic respiratory diseases are especially vulnerable to viral and bacterial pulmonary infections, which are major causes of exacerbations, hospitalization, disease progression, and mortality in COPD patients. Effective vaccines could reduce the burden of respiratory infections and acute exacerbations in COPD patients, but what is the evidence for this? This article reviews and discusses the existing evidence for pneumococcal vaccination efficacy and its changing role in patients with chronic respiratory diseases, especially COPD. Specifically, the recent Community-Acquired Pneumonia Immunization Trial in Adults (CAPITA) showed the efficacy of pneumococcal conjugate vaccine in older adults, many of whom had additional risk factors for pneumococcal disease, including chronic lung diseases. Taken together, the evidence suggests that pneumococcal and influenza vaccinations can prevent community-acquired pneumonia and acute exacerbations in COPD patients, while pneumococcal vaccination early in the course of COPD could help maintain stable health status. Despite the need to prevent pulmonary infections in patients with chronic respiratory diseases and evidence for the efficacy of pneumococcal conjugate vaccine, pneumococcal vaccine coverage and awareness are low and need to be improved. Respiratory physicians need to communicate the benefits of vaccination more effectively to their patients who suffer from chronic respiratory diseases.

The international Genome sample resource (IGSR): A worldwide collection of genome variation incorporating the 1000 Genomes Project data

PubMed Central

Clarke, Laura; Fairley, Susan; Zheng-Bradley, Xiangqun; Streeter, Ian; Perry, Emily; Lowy, Ernesto; Tassé, Anne-Marie; Flicek, Paul

2017-01-01

The International Genome Sample Resource (IGSR; http://www.internationalgenome.org) expands in data type and population diversity the resources from the 1000 Genomes Project. IGSR represents the largest open collection of human variation data and provides easy access to these resources. IGSR was established in 2015 to maintain and extend the 1000 Genomes Project data, which has been widely used as a reference set of human variation and by researchers developing analysis methods. IGSR has mapped all of the 1000 Genomes sequence to the newest human reference (GRCh38), and will release updated variant calls to ensure maximal usefulness of the existing data. IGSR is collecting new structural variation data on the 1000 Genomes samples from long read sequencing and other technologies, and will collect relevant functional data into a single comprehensive resource. IGSR is extending coverage with new populations sequenced by collaborating groups. Here, we present the new data and analysis that IGSR has made available. We have also introduced a new data portal that increases discoverability of our data—previously only browseable through our FTP site—by focusing on particular samples, populations or data sets of interest. PMID:27638885

40 CFR 63.11527 - What are the monitoring requirements for new and existing sources?

Code of Federal Regulations, 2010 CFR

2010-07-01

... an existing affected source, you may install, operate, and maintain a bag leak detection system for.... If you own or operate a new affected source, you must install, operate, and maintain a bag leak... foot) or less. (ii) The bag leak detection system sensor must provide output of relative PM loadings...

Assessment of population coverage of hypertension screening in Thailand based on the effective coverage framework.

PubMed

Charoendee, Kulpimol; Sriratanaban, Jiruth; Aekplakorn, Wichai; Hanvoravongchai, Piya

2018-03-27

Hypertension (HT) is a major risk factor, and accessible and effective HT screening services are necessary. The effective coverage framework is an assessment tool that can be used to assess health service performance by considering target population who need and receive quality service. The aim of this study is to measure effective coverage of hypertension screening services at the provincial level in Thailand. Over 40 million individual health service records in 2013 were acquired. Data on blood pressure measurement, risk assessment, HT diagnosis and follow up were analyzed. The effectiveness of the services was assessed based on a set of quality criteria for pre-HT, suspected HT, and confirmed HT cases. Effective coverage of HT services for all non-HT Thai population aged 15 or over was estimated for each province and for all Thailand. Population coverage of HT screening is 54.6%, varying significantly across provinces. Among those screened, 28.9% were considered pre-HT, and another 6.0% were suspected HT cases. The average provincial effective coverage was at 49.9%. Around four-fifths (82.6%) of the pre-HT group received HT and Cardiovascular diseases (CVD) risk assessment. Among the suspected HT cases, less than half (38.0%) got a follow-up blood pressure measurement within 60 days from the screening date. Around 9.2% of the suspected cases were diagnosed as having HT, and only one-third of them (36.5%) received treatment within 6 months. Within this group, 21.8% obtained CVD risk assessment, and half of them had their blood pressure under control (50.8%) with less than 1 % (0.7%) of them managed to get the CVD risk reduced. Our findings suggest that hypertension screening coverage, post-screening service quality, and effective coverage of HT screening in Thailand were still low and they vary greatly across provinces. It is imperative that service coverage and its effectiveness are assessed, and both need improvement. Despite some limitations, measurement of effective coverage could be done with existing data, and it can serve as a useful tool for performance measurement of public health services.

Medicare Part D: successes and continuing challenges. Impact of Medicare Part D on Massachusetts health programs and beneficiaries.

PubMed

Thomas, Cindy Parks; Sussman, Jeffrey

2007-05-30

On January 1, 2006, the Centers for Medicare and Medicaid Services (CMS) implemented the Medicare Drug Benefit, or "Medicare Part D." The program offers prescription drug coverage for the one million Medicare beneficiaries in Massachusetts. Part D affects Massachusetts state health programs and beneficiaries in a number of ways. The program: (1) provides prescription drug insurance, including catastrophic coverage, through a choice of private prescription drug plans (PDPs) or integrated Medicare Advantage (MA-PD) health plans; (2) shifts prescription drug coverage for dual-eligible Medicare / Medicaid beneficiaries from Medicaid to Medicare Part D drug plans; (3) requires a maintenance-of-effort, or "clawback" payments from states to CMS designed to capture a portion of states' Medicaid savings to help finance the benefit; (4) offers additional help for premiums and cost sharing to low income beneficiaries through the Low Income Subsidy (LIS); and (5) provides a subsidy to employer groups that maintain their own prescription drug coverage for retired beneficiaries. This paper summarizes the activities involved in implementing Medicare Part D, the impact it has had on Massachusetts health programs, and the experiences of beneficiaries and others conducting outreach and enrollment. The data are drawn from interviews with officials and documents provided by state health programs, CMS and the Social Security Administration, and representatives of provider and advocacy groups involved in the enrollment and ongoing support of Medicare beneficiaries.

Planetary Transits of the Trans-Atlantic Exoplanet Survey Candidate TrES-1b

NASA Astrophysics Data System (ADS)

Price, A.; Bissinger, R.; Laughlin, G. P.; Gary, B. L.; Vanmunster, T.; Henden, A. A.; Starkey, D. R.; Kaiser, D. H.; Holtzman, J. A.; Marschall, L. A.; Michalik, T.; Wellington, T.; Paakkonen, P.

2005-08-01

The AAVSO compiled 10,560 CCD observations of the suspected exoplanet transit object TrES-1b covering seven complete transit windows, three windows of partial coverage, and coverage of baseline non-transit periods. Visual inspection of the light curves reveals the presence of slight humps at the egress points of some transits. A boot strap Monte Carlo simulation was applied to the data to confirm that the humps exist to a statistically significant degree. However, it does not rule out systemic effects which will be tested with campaigns in the 2005 observing season.

Health reform through tax reform: a primer.

PubMed

Furman, Jason

2008-01-01

Tax incentives for employer-sponsored insurance and other medical spending cost about $200 billion annually and have pervasive effects on coverage and costs. This paper surveys a range of proposals to reform health care, either by adding new tax incentives or by limiting or replacing the existing tax incentives. Replacing the current tax preference for insurance with an income-related, refundable tax credit has the potential to expand coverage and reduce inefficient spending at no net federal cost. But such an approach by itself would entail substantial risks, so complementary reforms to the insurance market are essential to ensure success.

The Status of Long-Term Disability Plans in Higher Education.

ERIC Educational Resources Information Center

Cook, Thomas J.

1981-01-01

Long-term disability income coverage is seen as the most rapidly growing staff benefit in recent years. A Teachers Insurance and Annuity Association's survey of existing long-term disability plans, which provide adequate income replacement, is discussed. (MLW)

A content analysis of cognitive health promotion in popular magazines.

PubMed

Friedman, Daniela B; Laditka, Sarah B; Laditka, James N; Price, Anna E

2011-01-01

Health behaviors, particularly physical activity, may promote cognitive health. The public agenda for health behaviors is influenced by popular media. We analyzed the cognitive health content of 20 United States magazines, examining every page of every 2006-2007 issue of the highest circulating magazines for general audiences, women, men, African Americans, and the health conscious (n = 178). Diet was the greatest focus. Physical activity coverage was limited. Important behavior-related cognitive health risks, including hypertension and diabetes, were not mentioned. Publications for African Americans had little cognitive health content. Coverage of cognitive health was not commensurate with growing evidence that health behaviors may help to maintain it. Findings may be useful to public health officials, health care providers, non-profit organizations that promote cognitive health, individuals evaluating cognitive health information in popular media, and those responsible for magazines or other media.

Tobacco Industry Efforts to Defeat the Occupational Safety and Health Administration Indoor Air Quality Rule

PubMed Central

Bryan-Jones, Katherine; Bero, Lisa A.

2003-01-01

Objectives. We describe tobacco industry strategies to defeat the Occupational Safety and Health Administration (OSHA) Indoor Air Quality rule and the implementation of those strategies. Methods. We analyzed tobacco industry documents, public commentary on, and media coverage of the OSHA rule. Results. The tobacco industry had 5 strategies: (1) maintain scientific debate about the basis of the rule, (2) delay deliberation on the rule, (3) redefine the scope of the rule, (4) recruit and assist labor and business organizations in opposing the rule, and (5) increase media coverage of the tobacco industry position. The tobacco industry successfully implemented all 5 strategies. Conclusions. Our findings suggest that regulatory authorities must take into account the source, motivation, and validity of arguments used in the regulatory process in order to make accurately informed decisions. PMID:12660202

Measles elimination in Italy: projected impact of the National Elimination Plan.

PubMed Central

Manfredi, P.; Williams, J. R.; Ciofi Degli Atti, M. L.; Salmaso, S.

2005-01-01

A mathematical model was used to evaluate the impact of the Italian Measles National Elimination Plan (NEP), and possible sources of failure in achieving its targets. The model considered two different estimates of force of infection, and the possible effect on measles transmission of the current Italian demographic situation, characterized by a below-replacement fertility. Results suggest that reaching all NEP targets will allow measles elimination to be achieved. In addition, the model suggests that achieving elimination by reaching a 95 % first-dose coverage appears unlikely; and that conducting catch-up activities, reaching high vaccination coverage, could interrupt virus circulation, but could not prevent the infection re-emerging before 2020. Also, the introduction of the second dose of measles vaccine seems necessary for achieving and maintaining elimination. Furthermore, current Italian demography appears to be favourable for reaching elimination. PMID:15724715

[Benchmarking of performance of Mexican states with effective coverage].

PubMed

Lozano, Rafael; Soliz, Patricia; Gakidou, Emmanuela; Abbott-Klafter, Jesse; Feehan, Dennis M; Vidal, Cecilia; Ortiz, Juan Pablo; Murray, Christopher J L

2007-01-01

Benchmarking of the performance of states, provinces, or districts in a decentralised health system is important for fostering of accountability, monitoring of progress, identification of determinants of success and failure, and creation of a culture of evidence. The Mexican Ministry of Health has, since 2001, used a benchmarking approach based on the World Health Organization (WHO) concept of effective coverage of an intervention, which is defined as the proportion of potential health gain that could be delivered by the health system to that which is actually delivered. Using data collection systems, including state representative examination surveys, vital registration, and hospital discharge registries, we have monitored the delivery of 14 interventions for 2005-06. Overall effective coverage ranges from 54.0% in Chiapas, a poor state, to 65.1% in the Federal District. Effective coverage for maternal and child health interventions is substantially higher than that for interventions that target other health problems. Effective coverage for the lowest wealth quintile is 52% compared with 61% for the highest quintile. Effective coverage is closely related to public-health spending per head across states; this relation is stronger for interventions that are not related to maternal and child health than those for maternal and child health. Considerable variation also exists in effective coverage at similar amounts of spending. We discuss the implications of these issues for the further development of the Mexican health-information system. Benchmarking of performance by measuring effective coverage encourages decision-makers to focus on quality service provision, not only service availability. The effective coverage calculation is an important device for health-system stewardship. In adopting this approach, other countries should select interventions to be measured on the basis of the criteria of affordability, effect on population health, effect on health inequalities, and capacity to measure the effects of the intervention. The national institutions undertaking this benchmarking must have the mandate, skills, resources, and independence to succeed.

Benchmarking of performance of Mexican states with effective coverage.

PubMed

Lozano, Rafael; Soliz, Patricia; Gakidou, Emmanuela; Abbott-Klafter, Jesse; Feehan, Dennis M; Vidal, Cecilia; Ortiz, Juan Pablo; Murray, Christopher J L

2006-11-11

Benchmarking of the performance of states, provinces, or districts in a decentralised health system is important for fostering of accountability, monitoring of progress, identification of determinants of success and failure, and creation of a culture of evidence. The Mexican Ministry of Health has, since 2001, used a benchmarking approach based on the WHO concept of effective coverage of an intervention, which is defined as the proportion of potential health gain that could be delivered by the health system to that which is actually delivered. Using data collection systems, including state representative examination surveys, vital registration, and hospital discharge registries, we have monitored the delivery of 14 interventions for 2005-06. Overall effective coverage ranges from 54.0% in Chiapas, a poor state, to 65.1% in the Federal District. Effective coverage for maternal and child health interventions is substantially higher than that for interventions that target other health problems. Effective coverage for the lowest wealth quintile is 52% compared with 61% for the highest quintile. Effective coverage is closely related to public-health spending per head across states; this relation is stronger for interventions that are not related to maternal and child health than those for maternal and child health. Considerable variation also exists in effective coverage at similar amounts of spending. We discuss the implications of these issues for the further development of the Mexican health-information system. Benchmarking of performance by measuring effective coverage encourages decision-makers to focus on quality service provision, not only service availability. The effective coverage calculation is an important device for health-system stewardship. In adopting this approach, other countries should select interventions to be measured on the basis of the criteria of affordability, effect on population health, effect on health inequalities, and capacity to measure the effects of the intervention. The national institutions undertaking this benchmarking must have the mandate, skills, resources, and independence to succeed.

Præventis, the immunisation register of the Netherlands: a tool to evaluate the National Immunisation Programme.

PubMed

van Lier, A; Oomen, P; de Hoogh, P; Drijfhout, I; Elsinghorst, B; Kemmeren, J; Conyn-van Spaendonck, M; de Melker, H

2012-04-26

Vaccination coverage is an important performance indicator of any national immunisation programme (NIP). To monitor the vaccination coverage in the Netherlands, an electronic national immunisation register called ‘Præventis’ was implemented in 2005. Præventis has a link with the population register and can produce letters of invitation for the NIP, register and validate administered vaccinations. The database is used to monitor the vaccination process, produce reminder letters, control the stock of vaccines and provides information used for paying the fees to the different executive organisations involved. Præventis provides a crucial tool for the evaluation of the NIP by producing (sub)national vaccination coverage estimates with high accuracy and allowing additional research: identifying populations at high risk for low coverage based on existing data, conducting specific studies where individuals included in the immunisation register are approached for further research, using vaccination coverage data for the interpretation of (sero)surveillance data, and linking the immunisation register with disease registers to address vaccine safety or vaccine effectiveness. The ability to combine Præventis data with data from other databases or disease registers and the ability to approach individuals with additional research questions offers opportunities to identify areas of priority for improving the Dutch NIP.

Strategies to improve health coverage and narrow the equity gap in child survival, health, and nutrition.

PubMed

Chopra, Mickey; Sharkey, Alyssa; Dalmiya, Nita; Anthony, David; Binkin, Nancy

2012-10-13

Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the effective coverage of essential interventions. First, we identify four different intervention delivery channels--ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions' deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to examine the evidence for a range of strategies designed to overcome supply and demand bottlenecks to effective coverage of interventions that improve child survival, health, and nutrition. Although knowledge gaps exist, several strategies show promise for improving coverage of effective interventions-and, in some cases, health outcomes in children-including expanded roles for lay health workers, task shifting, reduction of financial barriers, increases in human-resource availability and geographical access, and use of the private sector. Policy makers and planners should be informed of this evidence as they choose strategies in which to invest their scarce resources. Copyright © 2012 Elsevier Ltd. All rights reserved.

40 CFR 63.11438 - What are the standards for new and existing sources?

Code of Federal Regulations, 2010 CFR

2010-07-01

... (a)(1) and (2) of this section: (1) Use natural gas, or equivalent clean-burning fuel, as the kiln fuel; or (2) Use an electric-powered kiln. (b) You must maintain annual wet glaze usage records for... for new and existing sources? (a) For each kiln that fires glazed ceramic ware, you must maintain the...

Datacube Interoperability, Encoding Independence, and Analytics

NASA Astrophysics Data System (ADS)

Baumann, Peter; Hirschorn, Eric; Maso, Joan

2017-04-01

Datacubes are commonly accepted as an enabling paradigm which provides a handy abstraction for accessing and analyzing the zillions of image files delivered by the manifold satellite instruments and climate simulations, among others. Additionally, datacubes are the classic model for statistical and OLAP datacubes, so a further information category can be integrated. From a standards perspective, spatio-temporal datacubes naturally are included in the concept of coverages which encompass regular and irregular grids, point clouds, and general meshes - or, more abstractly, digital representations of spatio-temporally varying phenomena. ISO 19123, which is identical to OGC Abstract Topic 6, gives a high-level abstract definition which is complemented by the OGC Coverage Implementation Schema (CIS) which is an interoperable, yet format independent concretization of the abstract model. Currently, ISO is working on adopting OGC CIS as ISO 19123-2; the existing ISO 19123 standard is under revision by one of the abstract authors and will become ISO 19123-1. The roadmap agreed by ISO further foresees adoption of the OGC Web Coverage Service (WCS) as an ISO standard so that a complete data and service model will exist. In 2016, INSPIRE has adopted WCS as Coverage Download Service, including the datacube analytics language Web Coverage Processing Service (WCPS). The rasdaman technology (www.rasdaman.org) is both OGC and INSPIRE Reference Implementation. In the global EarthServer initiative rasdaman database sizes are exceeding 250 TB today, heading for the Petabyte frontier well in 2017. Technically, CIS defines a compact, efficient model for representing multi-dimensional datacubes in several ways. The classical coverage cube defines a domain set (where are values?), a range set (what are these values?), and range type (what do the values mean?), as well as a "bag" for arbitrary metadata. With CIS 1.1, coordinate/value pair sequences have been added, as well as tiled representations. Further, CIS 1.1 offers a unified model for any kind of regular and irregular grids, also allowing sensor models as per SensorML. Encodings include ASCII formats like GML, JSON, RDF as well as binary formats like GeoTIFF, NetCDF, JPEG2000, and GRIB2; further, a container concept allows mixed representations within one coverage file utilizing zip or other convenient package formats. Through the tight integration with the Sensor Web Enablement (SWE), a lossless "transport" from sensor into coverage world is ensured. The corresponding service model of WCS supports datacube operations ranging from simple data extraction to complex ad-hoc analytics with WPCS. Notably, W3C is working has set out on a coverage model as well; it has been designed relatively independently from the abovementioned standards, but there is informal agreement to link it into the CIS universe (which allows for different, yet interchangeable representations). Particularly interesting in the W3C proposal is the detailed semantic modeling of metadata; as CIS 1.1 supports RDF, a tight coupling seems feasible.

Characterization and Management of Mandibular Fractures: Lessons Learned from Iraq and Afghanistan

DTIC Science & Technology

2013-03-01

Anatomic reduction is the goal. In complex fractures, maintain large segments of bone and obtain soft tissue coverage. Atlas Oral Maxillofacial Surg...conflicts of Iraq and Afghanistan. J Oral Maxillofac Surg 2010;68(1):3e7; with permission.) Fig. 2 Complex facial injury with avulsive tissue loss...a point distant from the site of injury Complicated (complex)dfracture with considerable injury to the adjacent soft tissue or adjacent parts, may

Is U.S. climatic diversity well represented within the existing federal protection network?

PubMed

Batllori, Enric; Miller, Carol; Parisien, Marc-Andre; Parks, Sean A; Moritz, Max A

Establishing protection networks to ensure that biodiversity and associated ecosystem services persist under changing environments is a major challenge for conservation planning. The potential consequences of altered climates for the structure and function of ecosystems necessitates new and complementary approaches be incorporated into traditional conservation plans. The conterminous United States of America (CONUS) has an extensive system of protected areas managed by federal agencies, but a comprehensive assessment of how this network represents CONUS climate is lacking. We present a quantitative classification of the climate space that is independent from the geographic locations to evaluate the climatic representation of the existing protected area network. We use this classification to evaluate the coverage of each agency's jurisdiction and to identify current conservation deficits. Our findings reveal that the existing network poorly represents CONUS climatic diversity. Although rare climates are generally well represented by the network, the most common climates are particularly underrepresented. Overall, 83% of the area of the CONUS corresponds to climates underrepresented by the network. The addition of some currently unprotected federal lands to the network would enhance the coverage of CONUS climates. However, to fully palliate current conservation deficits, large-scale private-land conservation initiatives will be critical.

Why a national high-risk insurance pool is not a workable alternative to the marketplace.

PubMed

Hall, Jean P

2014-12-01

The Pre-Existing Condition Insurance Plan (PCIP) was a national high-risk pool established under the Affordable Care Act (ACA) to provide coverage for individuals with preexisting conditions who had been uninsured for at least six months. It was intended to be a temporary program: PCIPs opened in 2010 and closed in April 2014. At that point, those with preexisting conditions could shop for health insurance in the marketplaces, where plans are prevented from using applicants' health status to deny coverage or charge more. This issue brief draws on the PCIP experience to outline why national high-risk pools, which continue to be proposed as policy alternatives to ACA coverage expansions, are expensive to enrollees as well as their administrators and ultimately unsustainable. The key lesson--and the principle on which the ACA is built--is that insurance works best when risk is evenly spread across a broad population.

A case of conflicting norms? Mobilizing and accountability information in newspaper coverage of the autism-vaccine controversy.

PubMed

Clarke, Christopher E

2011-09-01

When reporting health risks, the news media are often criticized for omitting "mobilizing" information that allows readers to act on existing attitudes. Using American and British newspaper coverage of the autism-vaccine controversy as a case study, this article takes a "behind the scenes" look at normative pressures that may influence whether such information appears in coverage. In particular, can holding health officials accountable for their actions potentially "crowd out" mobilizing information? A content analysis suggests that mobilizing information (at least one of four examples) was present in only 16% of articles, compared to 38% that mentioned accountability messages (at least one of two examples). US newspapers were significantly more likely to mention at least one mobilization example. Finally, although only 11% discussed both, articles were more likely to discuss certain mobilizing and accountability examples together. Implications for journalism ethics and vaccine risk communication are discussed.

Understanding newsworthiness of an emerging pandemic: international newspaper coverage of the H1N1 outbreak.

PubMed

Smith, Katherine C; Rimal, Rajiv N; Sandberg, Helena; Storey, John D; Lagasse, Lisa; Maulsby, Catherine; Rhoades, Elizabeth; Barnett, Daniel J; Omer, Saad B; Links, Jonathan M

2013-09-01

During an evolving public health crisis, news organizations disseminate information rapidly, much of which is uncertain, dynamic, and difficult to verify. We examine factors related to international news coverage of H1N1 during the first month after the outbreak in late April 2009 and consider the news media's role as an information source during an emerging pandemic. Data on H1N1 news were compiled in real time from newspaper websites across twelve countries between April 29, 2009 and May 28, 2009. A news sample was purposively constructed to capture variation in countries' prior experience with avian influenza outbreaks and pandemic preparation efforts. We analyzed the association between H1N1 news volume and four predictor variables: geographic region, prior experience of a novel flu strain (H5N1), existence of a national pandemic plan, and existence of a localized H1N1 outbreak. H1N1 news was initially extensive but declined rapidly (OR = 0.85, P < .001). Pandemic planning did not predict newsworthiness. However, countries with prior avian flu experience had higher news volume (OR = 1.411, P < .05), suggesting that H1N1 newsworthiness was bolstered by past experiences. The proportion of H1N1 news was significantly lower in Europe than elsewhere (OR = 0.388, P < 0.05). Finally, coverage of H1N1 increased after a first in-country case (OR = 1.415, P < .01), interrupting the pattern of coverage decline. Findings demonstrate the enhanced newsworthiness of localized threats, even during an emerging pandemic. We discuss implications for news media's role in effective public health communication throughout an epidemic given the demonstrated precipitous decline in news interest. © 2012 John Wiley & Sons Ltd.

Secondary electron emission influenced by oxidation on the aluminum surface: the roles of the chemisorbed oxygen and the oxide layer

NASA Astrophysics Data System (ADS)

Li, Jiangtao; Hoekstra, Bart; Wang, Zhen-Bin; Qiu, Jie; Pu, Yi-Kang

2018-04-01

A relationship between the apparent secondary electron yield ({γ }{{se}}) and the oxygen coverage/oxide layer thickness on an aluminum cathode is obtained in an experiment under a controlled environment. The apparent secondary electron yield ({γ }{{se}}) is deduced from the breakdown voltage between two parallel plate electrodes in a 360 mTorr argon environment using a simple Townsend breakdown model with the assumption that the variation of the apparent secondary electron yield is dominated by the variation of the argon ion induced processes. The oxygen coverage/oxide layer thickness on the aluminum cathode is measured by a semi in situ x-ray photoemission spectroscopy equipment which is directly attached to the discharge chamber. It is found that three phases exist: (1) in the monomonolayer regime, as the oxygen coverage increases from 0 to 0.3, {γ }{{se}} decreases by nearly 40 % , (2) as the oxygen coverage increases from 0.3 to 1, {γ }{{se}} keeps nearly constant, (3) as the oxide layer thickness increases from about 0.3 nm to about 1.1 nm, {γ }{{se}} increases by 150 % . We propose that, in the submonolayer regime, the chemisorbed oxygen on the aluminum surface causes the decrease of {γ }{{se}} by creating a local potential barrier, which reduces the Auger neutralization rate and the energy gained by the Auger electrons. In the multilayer regime, as the oxide layer grows in thickness, there are three proposed mechanisms which cause the increase of {γ }{{se}}: (1) the work function decreases; (2) resonance neutralization and Auger de-excitation may exist. This is served as another channel for secondary electron production; (3) the kinetic energy of Auger electrons is increased on average, leading to a higher probability for electrons to overcome the surface potential barrier.

A Selected Psycholinguistic Bibliography.

ERIC Educational Resources Information Center

Fraser, Bruce; Klatt, Mary M.

This document "attempts to provide a representative, undogmatic, and fairly thorough coverage of selected areas of the psycholinguistic literature which are not accurately covered in existing bibliographies." Because the authors feel that psycholinguistics consists of the study of the acquisition, production, and understanding of a natural…

A National Approach to Reimbursement Decision-Making on Drugs for Rare Diseases in Canada? Insights from Across the Ponds.

PubMed

Short, Hilary; Stafinski, Tania; Menon, Devidas

2015-05-01

Regardless of the type of health system or payer, coverage decisions on drugs for rare diseases (DRDs) are challenging. While these drugs typically represent the only active treatment option for a progressive and/or life-threatening condition, evidence of clinical benefit is often limited because of small patient populations and the costs are high. Thus, decisions come with considerable uncertainty and risk. In Canada, interest in developing a pan-Canadian decision-making approach informed by international experiences exists. To develop an inventory of existing policies and processes for making coverage decisions on DRDs around the world. A systematic review of published and unpublished documents describing current policies and processes in the top 20 gross domestic product countries was conducted. Bibliographic databases, the Internet and government/health technology assessment organization websites in each country were searched. Two researchers independently extracted information and tabulated it to facilitate qualitative comparative analyses. Policy experts from each country were contacted and asked to review the information collected for accuracy and completeness. Almost all countries have multiple mechanisms through which coverage for a DRD may be sought. However, they typically begin with a review that follows the same process as drugs for more common conditions (i.e., the centralized review process), although specific submission requirements could differ (e.g., no need to submit a cost-effectiveness analysis). When drugs fail to receive a positive recommendation/decision, they are reconsidered by "safety net"-type programs. Eligibility criteria vary across countries, as do the decision options, which may be applied to individual patients or patient groups. With few exceptions, countries have not created separate centralized review processes for DRDs. Instead, they have modified components of existing mechanisms and added safety nets. Copyright © 2015 Longwoods Publishing.

A critical analysis of hazard resilience measures within sustainability assessment frameworks

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matthews, Elizabeth C., E-mail: echiso1@lsu.edu; Sattler, Meredith, E-mail: msattler@lsu.edu; Friedland, Carol J., E-mail: friedland@lsu.edu

Today, numerous sustainability assessment frameworks (SAFs) exist to guide designers in achieving sustainable performance in the design of structures and communities. SAFs are beneficial in educating users and are useful tools for incorporating sustainability strategies into planning, design, and construction; however, there is currently a substantial gap in the ability of existing SAFs to incorporate hazard resistance and hazard mitigation in the broader context of sustainable design. This paper analyzes the incorporation of hazard resistant design and hazard mitigation strategies within SAFs via a multi-level analysis of eleven SAFs. The SAFs analyzed range in scale of application (i.e. building, site,more » community). Three levels of analysis are presented: (1) macro-level analysis comparing the number of measures strictly addressing resilience versus sustainability, (2) meso-level analysis of the coverage of types of hazards within SAFs (e.g. flood, fire), and (3) micro-level analysis of SAF measures connected to flood-related hazard resilience. The results demonstrate that hazard resistance and hazard mitigation do not figure prominently in the intent of SAFs and that weaknesses in resilience coverage exist that have the potential to lead to the design of structures and communities that are still highly vulnerable to the impacts of extreme events. - Highlights: • Sustainability assessment frameworks (SAFs) were analyzed for resilience coverage • Hazard resistance and mitigation do not figure prominently in the intent of SAFs • Approximately 75% of SAFs analyzed address three or fewer hazards • Lack of economic measures within SAFs could impact resilience and sustainability • Resilience measures for flood hazards are not consistently included in SAFs.« less

Project Catch: A space based solution to combat illegal, unreported and unregulated fishing. Part I: Vessel monitoring system

NASA Astrophysics Data System (ADS)

Detsis, Emmanouil; Brodsky, Yuval; Knudtson, Peter; Cuba, Manuel; Fuqua, Heidi; Szalai, Bianca

2012-11-01

Space assets have a unique opportunity to play a more active role in global resource management. There is a clear need to develop resource management tools in a global framework. Illegal, Unregulated and Unreported (IUU) fishing is placing pressure on the health and size of fishing stocks around the world. Earth observation systems can provide fishery management organizations with cost effective monitoring of large swaths of ocean. Project Catch is a fisheries management project based upon the complimentary, but independent Catch-VMS and Catch-GIS systems. Catch-VMS is a Vessel Monitoring System with increased fidelity over existing offerings. Catch-GIS is a Geographical Information System that combines VMS information with existing Earth Observation data and other data sources to identify Illegal, Unregulated and Unreported (IUU) fishing. Project Catch was undertaken by 19 Masters students from the 2010 class of the International Space University. In this paper, the space-based system architecture of Project Catch is presented and analyzed. The rationale for the creation of the system, as well as the engineering trade-off studies in its creation, are discussed. The Catch-VMS proposal was envisaged in order to address two specific problems: (1) the expansion of illegal fishing to high-latitude regions where existing satellite systems coverage is an issue and (2) the lack of coverage in remote oceanic regions due to reliance on coastal-based monitoring. Catch-VMS utilizes ship-borne transponders and hosted-payload receivers on a Global Navigation Satellite System in order to monitor the position and activity of compliant fishing vessels. Coverage is global and continuous with multiple satellites in view providing positional verification through multilateration techniques. The second part of the paper briefly describes the Catch-GIS system and investigates its cost of implementation.

On the robust optimization to the uncertain vaccination strategy problem

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chaerani, D., E-mail: d.chaerani@unpad.ac.id; Anggriani, N., E-mail: d.chaerani@unpad.ac.id; Firdaniza, E-mail: d.chaerani@unpad.ac.id

2014-02-21

In order to prevent an epidemic of infectious diseases, the vaccination coverage needs to be minimized and also the basic reproduction number needs to be maintained below 1. This means that as we get the vaccination coverage as minimum as possible, thus we need to prevent the epidemic to a small number of people who already get infected. In this paper, we discuss the case of vaccination strategy in term of minimizing vaccination coverage, when the basic reproduction number is assumed as an uncertain parameter that lies between 0 and 1. We refer to the linear optimization model for vaccinationmore » strategy that propose by Becker and Starrzak (see [2]). Assuming that there is parameter uncertainty involved, we can see Tanner et al (see [9]) who propose the optimal solution of the problem using stochastic programming. In this paper we discuss an alternative way of optimizing the uncertain vaccination strategy using Robust Optimization (see [3]). In this approach we assume that the parameter uncertainty lies within an ellipsoidal uncertainty set such that we can claim that the obtained result will be achieved in a polynomial time algorithm (as it is guaranteed by the RO methodology). The robust counterpart model is presented.« less

Ecological restoration and its effects on a regional climate: the source region of the Yellow River, China.

PubMed

Li, Zhouyuan; Liu, Xuehua; Niu, Tianlin; Kejia, De; Zhou, Qingping; Ma, Tianxiao; Gao, Yunyang

2015-05-19

The source region of the Yellow River, China, experienced degradation during the 1980s and 1990s, but effective ecological restoration projects have restored the alpine grassland ecosystem. The local government has taken action to restore the grassland area since 1996. Remote sensing monitoring results show an initial restoration of this alpine grassland ecosystem with the structural transformation of land cover from 2000 to 2009 as low- and high-coverage grassland recovered. From 2000 to 2009, the low-coverage grassland area expanded by over 25% and the bare soil area decreased by approximately 15%. To examine the relationship between ecological structure and function, surface temperature (Ts) and evapotranspiration (ET) levels were estimated to study the dynamics of the hydro-heat pattern. The results show a turning point in approximately the year 2000 from a declining ET to a rising ET, eventually reaching the 1990 level of approximately 1.5 cm/day. We conclude that grassland coverage expansion has improved the regional hydrologic cycle as a consequence of ecological restoration. Thus, we suggest that long-term restoration and monitoring efforts would help maintain the climatic adjustment functions of this alpine grassland ecosystem.

Elasticity of the hair cover in air-retaining Salvinia surfaces

NASA Astrophysics Data System (ADS)

Ditsche, Petra; Gorb, Elena; Mayser, Matthias; Gorb, Stanislav; Schimmel, Thomas; Barthlott, Wilhelm

2015-11-01

Immersed in water superhydrophobic surfaces (e.g., lotus) maintain thin temporary air films. In certain aquatic plants and animals, these films are thicker and more persistent. Floating ferns of the genus Salvinia show elaborated hierarchical superhydrophobic surface structures: a hairy cover of complex trichomes. In the case of S. molesta, they are eggbeater shaped and topped by hydrophilic tips, which pin the air-water interface and prevent rupture of contact. It has been proposed that these trichomes can oscillate with the air-water interface, when turbulences occur and thereby stabilize the air film. The deformability of such arrays of trichomes requires a certain elasticity of the structures. In this study, we determined the stiffness of the trichome coverage of S. molesta and three other Salvinia species. Our results confirm the elasticity of the trichome coverage in all investigated Salvinia species. We did not reveal a clear relationship between the time of air retention and stiffness of the trichome coverage, which means that the air retention function is additionally dependent on different parameters, e.g., the trichome shape and surface free energy. These data are not only interesting for Salvinia biology, but also important for the development of biomimetic air-retaining surfaces.

Amniotic membrane - A Novel material for the root coverage: A case series

PubMed Central

Sharma, Anamika; Yadav, Komal

2015-01-01

Background: Periodontal plastic surgical procedures aimed at coverage of exposed root surface. Owing to the second surgical donor site and difficulty in procuring a sufficient graft for the treatment of root coverage procedures, various alternative additive membranes have been used. A recent resorbable amniotic membrane, not only maintains the structural and anatomical configuration of regenerated tissues, but also enhances gingival wound healing, provides a rich source of stem cells. Therefore, amniotic membrane is choice of material these days in augmenting the better results in various periodontal procedures. Aim: The aim of this observational case series was to evaluate the effectiveness, predictability and the use of a novel material, amniotic membrane in the treatment of shallow-to-moderate isolated recession defects. Materials and Methods: A total of three cases, showing Miller's Class I or Class II gingival recession, participated in this study. Recession depth, recession width, keratinized gingiva (KG) tissue width, clinical attachment level (CAL) were recorded at baseline, 3 and 6 months postoperatively. Results: Six months following root coverage procedures, the mean root coverage was found to be 70.2 ± 6.8%. CAL significantly decreased from 6.4 ± 0.54 mm preoperatively to 3.5 ± 0.9 mm postoperatively at 6 months while KG showed significant improvement from 3.2 ± 0.28 mm preoperatively to 5.9 ± 0.74 mm postoperatively at 6 months. Conclusion: Autogenous graft tissue procurement significantly increases patient morbidity while also lengthening the duration of surgery in placing the graft, while self-adherent nature of amniotic membrane significantly reduces surgical time and made the procedure easier to perform, making it membrane of choice. PMID:26392696