Investigating the Role of Pop Songs on Vocabulary Recall, Attitude and Retention of Iranian EFL Learners: The Case of Gender

ERIC Educational Resources Information Center

Shakerian, Pouya; Rezaei, Omid; Murnani, Zeinab Toghyani; Moeinmanesh, Hamid

2016-01-01

Pop songs are, in fact, an ideal source for incidental vocabulary learning because teenagers often spend large amounts of their free time listening to music and in particular to pop songs. Employing an experimental approach, this study attempted to investigate the role of pop songs on vocabulary recall, attitude and retention of Iranian advanced…

"To Take Their Heritage in Their Hands": Indigenous Self-Representation and Decolonization in the Community Museums of Oaxaca, Mexico

ERIC Educational Resources Information Center

Hoobler, Ellen

2006-01-01

This article features the museums of Oaxaca, the place where the community museum movement in Mexico got started. Oaxaca has the largest Indigenous population in Mexico, with about 36.6% of the population over five years old, or about 1.027 million people, speaking an Indigenous language. Tourists spend large amounts on group or personalized tours…

Facilities Spending Criticized as Uneven

ERIC Educational Resources Information Center

Greifner, Laura

2006-01-01

This article features a report on states and school districts spending almost $600 billion on building and renovating schools from 1995 to 2004, an amount that far exceed earlier expectations. The report also emphasized the uneven facilities spending between minority and affluent districts. Besides receiving the least money for facilities, the…

US Spending on Personal Health Care and Public Health, 1996-2013.

PubMed

Dieleman, Joseph L; Baral, Ranju; Birger, Maxwell; Bui, Anthony L; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I; Vos, Theo; Murray, Christopher J L

2016-12-27

US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. Encounter with US health care system. National spending estimates stratified by condition, age and sex group, and type of care. From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion-$106.5 billion) in spending, including 57.6% (UI, 53.8%-62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%-25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion-$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion-$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal health care spending increased for 143 of the 155 conditions from 1996 through 2013. Spending on low back and neck pain and on diabetes increased the most over the 18 years, by an estimated $57.2 billion (UI, $47.4 billion-$64.4 billion) and $64.4 billion (UI, $57.8 billion-$70.7 billion), respectively. From 1996 through 2013, spending on emergency care and retail pharmaceuticals increased at the fastest rates (6.4% [UI, 6.4%-6.4%] and 5.6% [UI, 5.6%-5.6%] annual growth rate, respectively), which were higher than annual rates for spending on inpatient care (2.8% [UI, 2.8%-2.8%] and nursing facility care (2.5% [UI, 2.5%-2.5%]). Modeled estimates of US spending on personal health care and public health showed substantial increases from 1996 through 2013; with spending on diabetes, ischemic heart disease, and low back and neck pain accounting for the highest amounts of spending by disease category. The rate of change in annual spending varied considerably among different conditions and types of care. This information may have implications for efforts to control US health care spending.

Hospital Community Benefit in the Context of the Larger Public Health System: A State-Level Analysis of Hospital and Governmental Public Health Spending Across the United States.

PubMed

Singh, Simone R; Bakken, Erik; Kindig, David A; Young, Gary J

2016-01-01

Achieving meaningful population health improvements has become a priority for communities across the United States, yet funding to sustain multisector initiatives is frequently not available. One potential source of funding for population health initiatives is the community benefit expenditures that are required of nonprofit hospitals to maintain their tax-exempt status. In this article, we explore the importance of nonprofit hospitals' community benefit dollars as a funding source for population health. Hospitals' community benefit expenditures were obtained from their 2009 IRS (Internal Revenue Service) Form 990 Schedule H and complemented with data on state and local public health spending from the Association of State and Territorial Health Officials and the National Association of County & City Health Officials. Key measures included indicators of hospitals' community health spending and governmental public health spending, all aggregated to the state level. Univariate and bivariate statistics were used to describe how much hospitals spent on programs and activities for the community at large and to understand the relationship between hospitals' spending and the expenditures of state and local health departments. Tax-exempt hospitals spent a median of $130 per capita on community benefit activities, of which almost $11 went toward community health improvement and community-building activities. In comparison, median state and local health department spending amounted to $82 and $48 per capita, respectively. Hospitals' spending thus contributed an additional 9% to the resources available for population health to state and local health departments. Spending, however, varied widely by state and was unrelated to governmental public health spending. Moreover, adding hospitals' spending to the financial resources available to governmental public health agencies did not reduce existing inequalities in population health funding across states. Hospitals' community health investments represent an important source for public health activities, yet inequalities in the availability of funding across communities remain.

34 CFR 628.46 - How shall a grantee calculate the amount of endowment fund income that it may withdraw and spend?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false How shall a grantee calculate the amount of endowment fund income that it may withdraw and spend? 628.46 Section 628.46 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF POSTSECONDARY EDUCATION, DEPARTMENT OF EDUCATION...

The benefits of bad economies: Business cycles and time-based work-life conflict.

PubMed

Barnes, Christopher M; Lefter, Alexandru M; Bhave, Devasheesh P; Wagner, David T

2016-04-01

Recent management research has indicated the importance of family, sleep, and recreation as nonwork activities of employees. Drawing from entrainment theory, we develop an expanded model of work-life conflict to contend that macrolevel business cycles influence the amount of time employees spend on both work and nonwork activities. Focusing solely on working adults, we test this model in a large nationally representative dataset from the Bureau of Labor Statistics that spans an 8-year period, which includes the "Great Recession" from 2007 through 2009. We find that during economic booms, employees work more and therefore spend less time with family, sleeping, and recreating. In contrast, in recessionary economies, employees spend less time working and therefore more time with family, sleeping, and recreating. Thus, we extend the theory on time-based work-to-family conflict, showing that there are potential personal and relational benefits for employees in recessionary economies. (c) 2016 APA, all rights reserved).

Nongovernment Philanthropic Spending on Public Health in the United States.

PubMed

Shaw-Taylor, Yoku

2016-01-01

The objective of this study was to estimate the dollar amount of nongovernment philanthropic spending on public health activities in the United States. Health expenditure data were derived from the US National Health Expenditures Accounts and the US Census Bureau. Results reveal that spending on public health is not disaggregated from health spending in general. The level of philanthropic spending is estimated as, on average, 7% of overall health spending, or about $150 billion annually according to National Health Expenditures Accounts data tables. When a point estimate of charity care provided by hospitals and office-based physicians is added, the value of nongovernment philanthropic expenditures reaches approximately $203 billion, or about 10% of all health spending annually.

National health expenditures, 1983

PubMed Central

Gibson, Robert M.; Levit, Katharine R.; Lazenby, Helen; Waldo, Daniel R.

1984-01-01

Although growing more slowly than in recent years, spending for health continued to account for an increasing share of the Nation's gross national product. In 1983, spending for health amounted to 10.8 percent of the gross national product, or $1,459 per person. Public programs financed 40 percent of all personal health care spending. Medicare and Medicaid expended $91 billion in benefits, 29 percent of all spending for personal health. New estimates of spending in calendar year 1983, along with revised measures of the benefits paid by private health insurers, are presented here. PMID:10310949

Child Care Costs as a Barrier to Women's Employment. Final Report.

ERIC Educational Resources Information Center

Brayfield, April

A study focused on how child care costs may restrict women's employment prospects, in terms of their current employment status and the amount of time they spend in paid work. It compared the effects of four dimensions of child care costs on women's labor supply: market price of care within a local area, amount of money parents spend on child care,…

US Spending on Personal Health Care and Public Health, 1996–2013

PubMed Central

Dieleman, Joseph L.; Baral, Ranju; Birger, Maxwell; Bui, Anthony L.; Bulchis, Anne; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Johnson, Elizabeth K.; Joseph, Jonathan; Lavado, Rouselle; Lomsadze, Liya; Reynolds, Alex; Squires, Ellen; Campbell, Madeline; DeCenso, Brendan; Dicker, Daniel; Flaxman, Abraham D.; Gabert, Rose; Highfill, Tina; Naghavi, Mohsen; Nightingale, Noelle; Templin, Tara; Tobias, Martin I.; Vos, Theo; Murray, Christopher J. L.

2017-01-01

IMPORTANCE US health care spending has continued to increase, and now accounts for more than 17% of the US economy. Despite the size and growth of this spending, little is known about how spending on each condition varies by age and across time. OBJECTIVE To systematically and comprehensively estimate US spending on personal health care and public health, according to condition, age and sex group, and type of care. DESIGN AND SETTING Government budgets, insurance claims, facility surveys, household surveys, and official US records from 1996 through 2013 were collected and combined. In total, 183 sources of data were used to estimate spending for 155 conditions (including cancer, which was disaggregated into 29 conditions). For each record, spending was extracted, along with the age and sex of the patient, and the type of care. Spending was adjusted to reflect the health condition treated, rather than the primary diagnosis. EXPOSURES Encounter with US health care system. MAIN OUTCOMES AND MEASURES National spending estimates stratified by condition, age and sex group, and type of care. RESULTS From 1996 through 2013, $30.1 trillion of personal health care spending was disaggregated by 155 conditions, age and sex group, and type of care. Among these 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion (uncertainty interval [UI], $96.7 billion–$106.5 billion) in spending, including 57.6% (UI, 53.8%–62.1%) spent on pharmaceuticals and 23.5% (UI, 21.7%–25.7%) spent on ambulatory care. Ischemic heart disease accounted for the second-highest amount of health care spending in 2013, with estimated spending of $88.1 billion (UI, $82.7 billion–$92.9 billion), and low back and neck pain accounted for the third-highest amount, with estimated health care spending of $87.6 billion (UI, $67.5 billion–$94.1 billion). The conditions with the highest spending levels varied by age, sex, type of care, and year. Personal health care spending increased for 143 of the 155 conditions from 1996 through 2013. Spending on low back and neck pain and on diabetes increased the most over the 18 years, by an estimated $57.2 billion (UI, $47.4 billion–$64.4 billion) and $64.4 billion (UI, $57.8 billion–$70.7 billion), respectively. From 1996 through 2013, spending on emergency care and retail pharmaceuticals increased at the fastest rates (6.4% [UI, 6.4%–6.4%] and 5.6% [UI, 5.6%–5.6%] annual growth rate, respectively), which were higher than annual rates for spending on inpatient care (2.8% [UI, 2.8%–2.8%] and nursing facility care (2.5% [UI, 2.5%–2.5%]). CONCLUSIONS AND RELEVANCE Modeled estimates of US spending on personal health care and public health showed substantial increases from 1996 through 2013; with spending on diabetes, ischemic heart disease, and low back and neck pain accounting for the highest amounts of spending by disease category. The rate of change in annual spending varied considerably among different conditions and types of care. This information may have implications for efforts to control US health care spending. PMID:28027366

Misery is not Miserly: Sad and Self-Focused Individuals Spend More

PubMed Central

Cryder, Cynthia E.; Lerner, Jennifer S; Gross, James J.; Dahl, Ronald E.

2014-01-01

Misery is not miserly: sadness increases the amount of money decision makers give up to acquire a commodity (Lerner, Small, & Loewenstein, 2004). The present research investigated when and why the “misery-is-not-miserly” effect occurs. Drawing on William James’s (1890) concept of the material self, we tested a model specifying relationships among sadness, self-focus, and the amount of money decision makers spend. Consistent with our Jamesian hypothesis, results revealed that self-focus both moderates and mediates the effect of sadness on spending. Results were consistent across males and females. Because the study used real commodities and real money, results hold implications for everyday decisions. They also hold implications for theoretical development. Economic theories of spending may benefit from incorporating psychological theories – specifically theories of emotion and the self. PMID:18578840

Nongovernment Philanthropic Spending on Public Health in the United States

PubMed Central

2016-01-01

The objective of this study was to estimate the dollar amount of nongovernment philanthropic spending on public health activities in the United States. Health expenditure data were derived from the US National Health Expenditures Accounts and the US Census Bureau. Results reveal that spending on public health is not disaggregated from health spending in general. The level of philanthropic spending is estimated as, on average, 7% of overall health spending, or about $150 billion annually according to National Health Expenditures Accounts data tables. When a point estimate of charity care provided by hospitals and office-based physicians is added, the value of nongovernment philanthropic expenditures reaches approximately $203 billion, or about 10% of all health spending annually. PMID:26562104

Requiring School Districts to Spend Comparable Amounts on Title I Schools Is Pushing on a String. Evidence Speaks Reports, Vol 1, #21

ERIC Educational Resources Information Center

Dynarski, Mark; Kainz, Kirsten

2016-01-01

Of all the rules that the U.S. Department of Education will have to formulate for the Every Student Succeeds Act, the proposed regulations to monitor that states and districts spend comparable amounts for schools eligible and not eligible to use Title I funds are attracting the most attention. Currently, districts can show comparability based on…

Perceived Impact on Student Engagement When Learning Middle School Science in an Outdoor Setting

ERIC Educational Resources Information Center

Abbatiello, James

2014-01-01

Human beings have an innate need to spend time outside, but in recent years children are spending less time outdoors. It is possible that this decline in time spent outdoors could have a negative impact on child development. Science teachers can combat the decline in the amount of time children spend outside by taking their science classes…

Intelligence Community Spending: Trends and Issues

DTIC Science & Technology

2016-11-08

who provide financial and economic expertise. Financial intelligence analysts focus on terrorist financing, counterfeiting, money laundering , funds...but also agreed that disclosure of numbers below the topline could cause damage to national security. It recommended that the amount of money spent...associated with intelligence spending. How Much is Enough? America’s intelligence agencies may spend more money on gathering and disseminating intelligence

Defense Spending in Latin America: Arms Race or Commodity Boom

DTIC Science & Technology

2008-12-01

over their territorial and maritime border, while many Peruvians and Bolivians still hold a grudge over the immense amount of Bolivian territory lost...and difficult to understand. Some were so complicated it was difficult distinguishing them from the RANDOM strategy. Unlike in football , where one...since the War of the Pacific when Chile annexed a large portion of Peruvian land and shut off access to the sea to Bolivia. Although Chile’s national

Impact of Barcode Medication Administration Technology on How Nurses Spend Their Time On Clinical Care

PubMed Central

Poon, Eric G; Keohane, Carol; Featherstone, Erica; Hays, Brandon; Dervan, Andrew; Woolf, Seth; Hayes, Judy; Bane, Anne; Newmark, Lisa; Gandhi, Tejal K

2006-01-01

In a time-motion study conducted in a hospital that recently implemented barcode medication administration (BCMA) technology, we found that the BCMA system did not increase the amount of time nurses spend on medication administration activities, and did not compromise the amount of time nurses spent on direct care of patients. Our results should allay concerns regarding the impact of BCMA on nursing workflow. PMID:17238684

Resource allocation for pharmaceutical procurement in the Brazilian Unified Health System.

PubMed

Vieira, Fabiola Sulpino; Zucchi, Paola

2011-10-01

To analyze resource allocation for pharmaceutical procurement by federative entities in the Brazilian Unified Health System. The amounts allocated to purchase pharmaceuticals during 2009 in two information systems were analyzed: Siga Brasil (Follow Brazil) for national data and Sistema de Informações sobre Orçamentos Públicos em Saúde (Information System on Public Health Budgets) for states, the Federal District and municipalities data. Per capita spending and the mean and median spending were calculated by municipalities, according to region and population size. The Spearman correlation coefficient was calculated for some variables. The statistical analysis included tests of normality and multiple comparisons for differences between groups. In 2009 the total amount spent by the three spheres of government for purchase of medicines was approximately R$ 8.9 billion. States and the Federal District were the main players, accounting for 47.1% of the total amount spent in the health system. Some states had per capita spending well above the mean (R$ 22.00 per resident/year) and the median (R$ 17.00 per resident/year). There were differences in municipal spending by region. The mean per capita expenditure of municipalities with less than 5,000 residents was 3.9 times that of municipalities with over 500,000 residents. Municipalities with less than 10,000 residents had higher per capita spending than other municipalities. Economic aspects such as the scale of procurement and bargaining power may explain differences in per capita spending between federal entities, especially among municipalities. The study indicates inefficiencies in the use of financial resources to procure medicines in the Brazilian Unified Health System.

Geographic Correlation Between Large-Firm Commercial Spending and Medicare Spending

PubMed Central

Chernew, Michael E.; Sabik, Lindsay M.; Chandra, Amitabh; Gibson, Teresa B.; Newhouse, Joseph P.

2012-01-01

Objective To investigate the correlation between geographic variation in inpatient days, total spending, and spending growth in traditional Medicare versus the large-firm commercial sector. Study Design Retrospective descriptive analysis. Methods Medicare spending data at the hospital referral region (HRR) level were obtained from the Dartmouth Atlas. Commercial claims data from large employers were obtained from Thomson Reuters MarketScan Database for 1996-2006 and aggregated to the HRR level. County-level data on inpatient days per capita and market characteristics were obtained from the Area Resource File. We computed correlations between Medicare and commercial spending and spending growth, as well as Medicare and non-Medicare inpatient days, and examined traits of high- and low-spending HRRs in both sectors. Results We found a positive correlation between inpatient days per capita across counties, but a small inverse correlation between measures of commercial and Medicare spending across HRRs. Spending growth was weakly positively correlated across HRRs. Markets in the upper third of commercial spending had more concentrated hospital markets than markets in the lower third of commercial spending. The reverse was true for Medicare spending. Conclusions The positive correlation in utilization and lack of correlation in spending implies an inverse correlation in prices. This is consistent with evidence that the differences appear to be, at least partially, related to aspects of the market structure. If private markets are to work better to reduce cost, stronger efforts are needed to reduce provider market concentration and promote competitive pricing for healthcare services. PMID:20148618

Geographic correlation between large-firm commercial spending and Medicare spending.

PubMed

Chernew, Michael E; Sabik, Lindsay M; Chandra, Amitabh; Gibson, Teresa B; Newhouse, Joseph P

2010-02-01

To investigate the correlation between geographic variation in inpatient days, total spending, and spending growth in traditional Medicare versus the large-firm commercial sector. Retrospective descriptive analysis. Medicare spending data at the hospital referral region (HRR) level were obtained from the Dartmouth Atlas. Commercial claims data from large employers were obtained from Thomson Reuters MarketScan Database for 1996-2006 and aggregated to the HRR level. County-level data on inpatient days per capita and market characteristics were obtained from the Area Resource File. We computed correlations between Medicare and commercial spending and spending growth, as well as Medicare and non-Medicare inpatient days, and examined traits of high- and low-spending HRRs in both sectors. We found a positive correlation between inpatient days per capita across counties, but a small inverse correlation between measures of commercial and Medicare spending across HRRs. Spending growth was weakly positively correlated across HRRs. Markets in the upper third of commercial spending had more concentrated hospital markets than markets in the lower third of commercial spending. The reverse was true for Medicare spending. The positive correlation in utilization and lack of correlation in spending implies an inverse correlation in prices. This is consistent with evidence that the differences appear to be, at least partially, related to aspects of the market structure. If private markets are to work better to reduce cost, stronger efforts are needed to reduce provider market concentration and promote competitive pricing for healthcare services.

A note on the microeconomics of migration.

PubMed

Stahl, K

1983-11-01

"The purpose of this note is to demonstrate in a simple model that an individual's migration from a small town to a large city may be rationalized purely by a consumption motive, rather than the motive of obtaining a higher income. More specifically, it is shown that in a large city an individual may derive a higher utility from spending a given amount of income than in a small town." A formal model is first developed that includes the principal forces at work and is then illustrated using a graphic example. The theoretical and empirical issues raised are considered in the concluding section. excerpt

Calculating accurate aboveground dry weight biomass of herbaceous vegetation in the Great Plains: A comparison of three calculations to determine the least resource intensive and most accurate method

Treesearch

Ben Butler

2007-01-01

Obtaining accurate biomass measurements is often a resource-intensive task. Data collection crews often spend large amounts of time in the field clipping, drying, and weighing grasses to calculate the biomass of a given vegetation type. Such a problem is currently occurring in the Great Plains region of the Bureau of Indian Affairs. A study looked at six reservations...

13 CFR 119.15 - If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the funds be carried over to the next year? 119.15 Section 119.15 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FOR INVESTMENT IN MICROENTREPRENEURS (âPRIMEâ OR âTHE ACTâ)...

13 CFR 119.15 - If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the funds be carried over to the next year? 119.15 Section 119.15 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FOR INVESTMENT IN MICROENTREPRENEURS (âPRIMEâ OR âTHE ACTâ)...

13 CFR 119.15 - If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the funds be carried over to the next year? 119.15 Section 119.15 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FOR INVESTMENT IN MICROENTREPRENEURS (âPRIMEâ OR âTHE ACTâ)...

13 CFR 119.15 - If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the funds be carried over to the next year? 119.15 Section 119.15 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FOR INVESTMENT IN MICROENTREPRENEURS (âPRIMEâ OR âTHE ACTâ)...

13 CFR 119.15 - If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false If a grantee is unable to spend the entire amount allotted for a single fiscal year, can the funds be carried over to the next year? 119.15 Section 119.15 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FOR INVESTMENT IN MICROENTREPRENEURS (âPRIMEâ OR âTHE ACTâ)...

Time spent by people managing chronic obstructive pulmonary disease indicates biographical disruption

PubMed Central

Jowsey, Tanisha; Yen, Laurann E; Bagheri, Nasser; McRae, Ian S

2014-01-01

Since Bury’s 1982 proposal that chronic illness creates biographical disruption for those who are living with it, there has been no effort to quantitatively measure such disruption. “Biographical disruption” refers to the substantial and directive influence that chronic illness can have over the course of a person’s life. Qualitative research and time use studies have demonstrated that people with chronic illnesses spend considerable amounts of time managing their health, and that these demands may change over time. This study was designed to measure the time that older people with chronic illnesses spend on selected health practices as one indicator of biographical disruption. We look specifically at the time use of people with chronic obstructive pulmonary disease (COPD). As part of a larger time use survey, a recall questionnaire was mailed to 3,100 members of Lung Foundation Australia in 2011. A total of 681 responses were received (22.0% response rate), 611 of which were from people with COPD. Descriptive analyses were undertaken on the amount of time spent on selected health-related activities including personal care, nonclinical health-related care, and activity relating to health services. Almost all people with COPD report spending some time each day on personal or home-based health-related tasks, with a median time of 15 minutes per day spent on these activities. At the median, people also report spending about 30 minutes per day exercising, 2.2 hours per month (the equivalent of 4.4 minutes per day) on nonclinical health-related activities, and 4.1 hours per month (equivalent to 8.2 minutes per day) on clinical activities. Excluding exercise, the median total time spent on health-related activities was 17.8 hours per month (or 35.6 minutes per day). For people in the top 10% of time use, the total amount of time was more than 64.6 hours per month (or 2.2 hours per day) excluding exercise, and 104 hours per month (or 3.5 hours per day) including exercise. The amount of time spent on health-related activity, such as engaging in personal care tasks, may be regular and predictable. The execution of these tasks generally takes relatively small amounts of time, and might be incorporated into daily life (biography) without causing significant disruption. Other activities may require large blocks of time, and they may be disruptive in a practical way that almost inevitably disrupts biography. The amount of time required does not appear to alter in relation to the time since diagnosis. The scale of time needed to manage one’s health could easily be interpreted as disruptive, and for some people, even overwhelming. PMID:24477271

HIV Spending as a Share of Total Health Expenditure: An Analysis of Regional Variation in a Multi-Country Study

PubMed Central

Amico, Peter; Aran, Christian; Avila, Carlos

2010-01-01

Background HIV has devastated numerous countries in sub-Saharan Africa and is a dominant health force in many other parts of the world. Its undeniable importance is reflected in the establishment of Millennium Development Goal No. 6. Unprecedented amounts of funding have been committed and disbursed over the past two decades. Many have argued that this enormous influx of funding has been detrimental to building stronger health systems in recipient countries. This paper examines the funding share for HIV measured against the total funding for health. Methodology/Principal Findings A descriptive analysis of HIV and health expenditures in 2007 from 65 countries was conducted. Comparable data from individual countries was used by applying a consistent definition for HIV expenditures and total health expenditures from NHAs to align them with National AIDS Assessment Reports. In 2007, the total public and international expenditure in LMICs for HIV was 1.6 percent of the total spending on health, while the share in SSA was 19.4 percent. HIV prevalence was six-fold higher in SSA than the next highest region and it is the only region whose share of HIV spending exceeded the burden of HIV DALYs. Conclusions/Significance The share of HIV spending across the 65 countries was quite moderate considering that the estimated share of deaths attributable to HIV stood at 3.8 percent and DALYs at 4.4 percent. Several high spending countries are using a large share of their total health spending for HIV health, but these countries are the exception rather than representative of the average SSA country. There is wide variation between regions, but the burden of disease also varies significantly. The percentage of HIV spending is a useful indicator for better understanding health care resources and their allocation patterns. PMID:20885986

Determinants of hematology-oncology trainees' postfellowship career pathways with a focus on nonmalignant hematology

PubMed Central

Jenkins, Sarah; Mikhael, Joseph; Gitlin, Scott D.

2018-01-01

Nonmalignant hematologic conditions are extremely prevalent and contribute significantly to the global burden of disease. The US health care system may soon face a shortage of specialists in nonmalignant hematology. We sought to identify factors that lead hematology-oncology fellows to pursue (or not to pursue) careers in nonmalignant hematology. Cross-sectional, web-based survey distributed to 149 graduates of a hematology-oncology fellowship program at a large academic medical center between 1998 and 2016. Eighty-six out of 149 graduates responded (57.7%); most (59 [68.6%]) practice at an academic medical center. Respondents spend a mean of 61% of their time in clinical practice, 23.7% conducting research, 5.2% in education, and 5.2% in administration. Those in clinical practice spend a mean of 52.1% of their time in solid tumor oncology, 37.5% in hematologic malignancies, and 10% in nonmalignant hematology; only 1 spent >50% of time practicing nonmalignant hematology. Factors most significantly affecting choice of patient population included clinical experience during fellowship and intellectual stimulation of the patient population/disease type. Factors that could have most significantly influenced a decision to spend more time in nonmalignant hematology included increased exposure/access to role models and mentors and opportunities for better career growth/advancement. Fellowship graduates spend >50% of their time in clinical practice, but almost none spend a significant amount of time practicing nonmalignant hematology. Given the growing number of patients with nonmalignant hematologic conditions and a possible future provider shortage, medical trainees should be encouraged to pursue careers in nonmalignant hematology. PMID:29463548

When Education Expenditure Matters: An Empirical Analysis of Recent International Data

ERIC Educational Resources Information Center

Vegas, Emiliana; Coffin, Chelsea

2015-01-01

We analyze the diminishing correlations between education expenditure and learning outcomes to address two fundamental questions: Do education systems with different levels of education spending have different student achievement levels? If so, at what amount of education spending does the relationship between increased expenditure and student…

Training and the Feds.

ERIC Educational Resources Information Center

Training, 1993

1993-01-01

In a survey of 4,635 training professionals (49% response), 49% were opposed to federally mandated minimum training expenditures; 68% thought tax incentives would increase amount companies spend on training; one-third of companies spend less than 1.5% of payroll on training. Technical assistance and tax credits were most popular roles for…

Analysis of capital spending and capital financing among large US nonprofit health systems.

PubMed

Stewart, Louis J

2012-01-01

This article examines the recent trends (2006 to 2009) in capital spending among 25 of the largest nonprofit health systems in the United States and analyzes the financing sources that these large nonprofit health care systems used to fund their capital spending. Total capital spending for these 25 nonprofit health entities exceeded $41 billion for the four-year period of this study. Less than 3 percent of total capital spending resulted in mergers and acquisition activities. Total annual capital spending grew at an average annual rate of 17.6 percent during the first three year of this study's period of analysis. Annual capital spending for 2009 fell by more than 22 percent over prior year's level due to the impact of widespread disruption in US tax-exempt variable rate debt markets. While cash inflow from long-term debt issues was a significant source of capital financing, this study's primary finding was that operating cash flow was the predominant source of capital spending funding. Key words: nonprofit, mergers and acquisitions (M&A), capital spending, capital financing.

The Overdominance of Computers

ERIC Educational Resources Information Center

Monke, Lowell W.

2006-01-01

Most schools are unwilling to consider decreasing computer use at school because they fear that without screen time, students will not be prepared for the demands of a high-tech 21st century. Monke argues that having young children spend a significant amount of time on computers in school is harmful, particularly when children spend so much…

Problematic Internet Use and Body Mass Index in University Students

ERIC Educational Resources Information Center

Sari, Serkan Volkan; Aydin, Betül

2014-01-01

Problem Statement: Today, immobility and resulting weight gain constitutes one of the greatest problems among young people. The greatest problem for individuals spending a lot of time on the Internet is immobility. The result of this status is spending less energy than the amount required daily. Immobility is considered a cause of being…

Media and Risky Behaviors

ERIC Educational Resources Information Center

Escobar-Chaves, Soledad Liliana; Anderson, Craig A.

2008-01-01

Liliana Escobar-Chaves and Craig Anderson investigate two important trends among American youth and examine the extent to which the two trends might be related. First, the authors note that U.S. youth are spending increasing amounts of time using electronic media, with the average American youngster now spending one-third of each day with some…

Time spent on home food preparation and indicators of healthy eating.

PubMed

Monsivais, Pablo; Aggarwal, Anju; Drewnowski, Adam

2014-12-01

The amount of time spent on food preparation and cooking may have implications for diet quality and health. However, little is known about how food-related time use relates to food consumption and spending, either at restaurants or for food consumed at home. To quantitatively assess the associations among the amount of time habitually spent on food preparation and patterns of self-reported food consumption, food spending, and frequency of restaurant use. This was a cross-sectional study of 1,319 adults in a population-based survey conducted in 2008-2009. The sample was stratified into those who spent <1 hour/day, 1-2 hours/day, and >2 hours/day on food preparation and cleanup. Descriptive statistics and multivariable regression models examined differences between time-use groups. Analyses were conducted in 2011-2013. Individuals who spent the least amount of time on food preparation tended to be working adults who placed a high priority on convenience. Greater amount of time spent on home food preparation was associated with indicators of higher diet quality, including significantly more frequent intake of vegetables, salads, fruits, and fruit juices. Spending <1 hour/day on food preparation was associated with significantly more money spent on food away from home and more frequent use of fast food restaurants compared to those who spent more time on food preparation. The findings indicate that time might be an essential ingredient in the production of healthier eating habits among adults. Further research should investigate the determinants of spending time on food preparation. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Volunteer Work in the Church Among Older Mexican Americans

PubMed Central

Krause, Neal; Hayward, R. David

2012-01-01

The purpose of this study is to identify the factors that influence the amount of volunteer work that older Mexican Americans perform in the place where they worship. The relationship between religion and volunteering is viewed from a social identity perspective. Data from a nationally representative sample of older Mexican Americans suggest that Evangelical/Pentecostal church members spend more time performing volunteer work at church than older Mexican Americans who affiliate with other denominations. Moreover, the findings indicate that the difference in the amount of volunteering between the two groups can largely be explained by differences in the nature of the spiritual support that Evangelical/Pentecostal receive from their fellow church members as well as depth of their commitment to their faith. PMID:22686148

Health Care Spending on Diabetes in the U.S., 1996-2013.

PubMed

Squires, Ellen; Duber, Herbert; Campbell, Madeline; Cao, Jackie; Chapin, Abigail; Horst, Cody; Li, Zhiyin; Matyasz, Taylor; Reynolds, Alex; Hirsch, Irl B; Dieleman, Joseph L

2018-05-10

Health care spending on diabetes in the U.S. has increased dramatically over the past several decades. This research describes health care spending on diabetes to quantify how that spending has changed from 1996 to 2013 and to determine what drivers are increasing spending. Spending estimates were extracted from the Institute for Health Metrics and Evaluation's Disease Expenditure 2013 database. Estimates were produced for each year from 1996 to 2013 for each of 38 age and sex groups and six types of care. Data on disease burden were extracted from the Global Burden of Disease 2016 study. We analyzed the drivers of spending by measuring the impact of population growth and aging and changes in diabetes prevalence, service utilization, and spending per encounter. Spending on diabetes in the U.S. increased from $37 billion (95% uncertainty interval $32-$42 billion) in 1996 to $101 billion ($97-$107 billion) in 2013. The greatest amount of health care spending on diabetes in 2013 occurred in prescribed retail pharmaceuticals (57.6% [53.8-62.1%] of spending growth) followed by ambulatory care (23.5% [21.7-25.7%]). Between 1996 and 2013, pharmaceutical spending increased by 327.0% (222.9-456.6%). This increase can be attributed to changes in demography, increased disease prevalence, increased service utilization, and, especially, increases in spending per encounter, which increased pharmaceutical spending by 144.0% (87.3-197.3%) between 1996 and 2013. Health care spending on diabetes in the U.S. has increased, and spending per encounter has been the biggest driver. This information can help policymakers who are attempting to control future spending on diabetes. © 2018 by the American Diabetes Association.

A Dollars and "Sense" Exploration of Vape Shop Spending and E-cigarette Use.

PubMed

Sears, C; Hart, J; Walker, K; Lee, A; Keith, R; Ridner, S

2016-01-01

Across the US, vape shops have emerged to provide e-cigarette users access to products not usually available at gas stations or retail stores. As vape shop sales have steadily increased, so have questions about the impact of marketing and price on e-cigarette use behaviors. In this exploratory analysis, we aim to characterize spending on e-cigarettes and evaluate the association with customer perceptions and use behaviors. In a cross-sectional survey of vape shop customers (n=78), perceptions and use of e-cigarettes and tobacco products were assessed. Descriptive statistics and multivariate logistic regression were used to evaluate the association between spending and socioeconomic factors, demographics, and use behaviors. Overall, spending amounts ranged from less than $10/month to more than $250/month, with a median around $50-75/month. Males spent more than females (p=0.003), but spending did not significantly differ by age (p=0.13). Customers who spent more than $50/month used lower levels of nicotine (mg/ml) (p=0.003) but a greater quantity of e-liquid (ml/month) (p<0.0001) compared to customers who spent under that amount. Mod use and intention to use e-cigarettes as a cessation device were significantly associated with vape shop spending in the regression model (OR= 17.5; 95% CI= (4.3, 70.2) and OR=0.22; 95% CI= (0.06, 0.75), respectively). Spending appears to be significantly associated with e-cigarette use behaviors. Making "sense" of the potential relationships between the dollars spent at vape shops and consumer use behaviors is important as regulations for e-cigarette sales are proposed.

A Dollars and “Sense” Exploration of Vape Shop Spending and E-cigarette Use

PubMed Central

Sears, C.; Hart, J.; Walker, K.; Lee, A.; Keith, R.; Ridner, S.

2017-01-01

INTRODUCTION Across the US, vape shops have emerged to provide e-cigarette users access to products not usually available at gas stations or retail stores. As vape shop sales have steadily increased, so have questions about the impact of marketing and price on e-cigarette use behaviors. In this exploratory analysis, we aim to characterize spending on e-cigarettes and evaluate the association with customer perceptions and use behaviors. METHODS In a cross-sectional survey of vape shop customers (n=78), perceptions and use of e-cigarettes and tobacco products were assessed. Descriptive statistics and multivariate logistic regression were used to evaluate the association between spending and socioeconomic factors, demographics, and use behaviors. RESULTS Overall, spending amounts ranged from less than $10/month to more than $250/month, with a median around $50–75/month. Males spent more than females (p=0.003), but spending did not significantly differ by age (p=0.13). Customers who spent more than $50/month used lower levels of nicotine (mg/ml) (p=0.003) but a greater quantity of e-liquid (ml/month) (p<0.0001) compared to customers who spent under that amount. Mod use and intention to use e-cigarettes as a cessation device were significantly associated with vape shop spending in the regression model (OR= 17.5; 95% CI= (4.3, 70.2) and OR=0.22; 95% CI= (0.06, 0.75), respectively). CONCLUSIONS Spending appears to be significantly associated with e-cigarette use behaviors. Making “sense” of the potential relationships between the dollars spent at vape shops and consumer use behaviors is important as regulations for e-cigarette sales are proposed. PMID:28758154

Politics and Preschool: The Political Economy of Investment in Pre-Primary Education. Policy Research Working Paper 5647

ERIC Educational Resources Information Center

Kosec, Katrina

2011-01-01

What drives governments with similar revenues to publicly provide very different amounts of goods for which private substitutes are available? Key examples are education and health care. This paper compares spending by Brazilian municipalities on pre-primary education--a good that is also provided privately--with spending on public infrastructure…

Motivation, Engagement, and Social Climate: An International Study of Boarding Schools

ERIC Educational Resources Information Center

Martin, Andrew J.; Papworth, Brad; Ginns, Paul; Malmberg, Lars-Erik

2016-01-01

Most educational climate research is conducted among (day school) students who spend the bulk of their young lives outside of school, potentially limiting the amount of climate variance that can be captured. Boarding school students, on the other hand, spend much of their lives at school and thus offer a potentially unique perspective on…

Understanding the recent growth in Medicaid spending, 2000-2003.

PubMed

Holahan, John; Ghosh, Arunabh

2005-01-01

Growth in Medicaid spending averaged 10.2 percent per year between 2000 and 2003, resulting in a one-third increase in program spending. Spending growth was lower from 2002 to 2003 because of slower growth in enrollment and in spending per enrollee, particularly for acute care services, and declines in disproportionate-share hospital (DSH) payments and upper payment limit (UPL) programs. For the entire 2000-2003 period, Medicaid spending increases were largely driven by enrollment growth, much of which was attributable to the economic downturn. Increases in spending per enrollee over the period were faster than inflation but slower than increases in private insurance spending.

Impact of GDP, spending on R&D, the number of universities and scientific journals on research publications in environmental sciences in the Middle East.

PubMed

Meo, Sultan Ayoub; Al Masri, Abeer A; Usmani, Adnan Mahmood; Halepoto, Dost Muhammad

2013-10-01

This study aimed to assess the impact of the Gross Domestic Product (GDP), spending on Research and Development (R&D), the number of universities and scientific journals on the published research documents, citable documents, citations per document and H-index in environmental sciences in the Middle East countries. All the 16 Middle East countries were included in the study. Information regarding the GDP, spending on R&D, the total number of universities and indexed journals was collected. Total number of research documents (papers), citable documents, citations per document and H-index in environmental sciences during the period 1996-2011 was recorded. The study used the World Bank, SCI-mago/Scopus, Web of Science, Journal Citation Reports (Thomson Reuters) as the main sources of information. The mean GDP per capita of all the Middle East countries amounted to 18 125.49±5386.28 US$, spending on R&D was 0.63±0.28 US$, the number of universities equaled 36.56±11.33 and mean ISI indexed journals amounted to 8.25±3.93. The mean number of research documents published in environmental sciences in the Middle East countries during the period 1996-2011 was 2202.12±883.98; citable documents: 2156.87±865.09; citations per document: 8.74±0.73; and the H-index: 35.37±6.17. There was a positive correlation between the money spent on R&D and citations per documents (r = 0.6, p = 0.01), H-Index (r = 0.6, p = 0.01); the number of universities and a total of research documents (r = 0.65, p = 0.006), citable documents (r = 0.65, p = 0.006), H-Index (r = 0.50, p = 0.04), as well as ISI indexed journals and total research documents (r = 0.94, p = 0.0001), citable documents (r = 0.94, p = 0.0001), H-Index (r = 0.73, p = 0.001). The Middle East countries which spend more on R&D and which have a large number of universities and ISI indexed journals are likely to produce more significant volume of research papers in the field of environmental science.

Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

PubMed

2017-05-20

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3·0%. The largest health spending growth rates were in upper-middle-income (5·9) and lower-middle-income groups (5·0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4·6%, and health spending increased from $51 to $120 per capita. In 2014, 59·2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29·1% and 58·0% of spending was OOP spending and 35·7% and 3·0% of spending was development assistance. Recent growth in development assistance for health has been tepid; between 2010 and 2016, it grew annually at 1·8%, and reached US$37·6 billion in 2016. Nonetheless, there is a great deal of variation revolving around these averages. 29 countries spend at least 50% more than expected per capita, based on their level of economic development alone, whereas 11 countries spend less than 50% their expected amount. Health spending remains disparate, with low-income and lower-middle-income countries increasing spending in absolute terms the least, and relying heavily on OOP spending and development assistance. Moreover, tremendous variation shows that neither time nor economic development guarantee adequate prepaid health resources, which are vital for the pursuit of universal health coverage. The Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Changes In US spending on Mental Health And Substance Abuse Treatment, 1986-2005, and implications for policy.

PubMed

Mark, Tami L; Levit, Katharine R; Vandivort-Warren, Rita; Buck, Jeffrey A; Coffey, Rosanna M

2011-02-01

The United States invests a sizable amount of money on treatments for mental health and substance abuse: $135 billion in 2005, or 1.07 percent of the gross domestic product. We provide treatment spending estimates from the period 1986-2005 to build understanding of past trends and consider future possibilities. We find that the growth rate in spending on mental health medications-a major driver of mental health expenditures in prior years-declined dramatically. As a result, mental health and substance abuse spending grew at a slightly slower rate than gross domestic product in 2004 and 2005, and it continued to shrink as a share of all health spending. Of note, we also find that Medicaid's share of total spending on mental health grew from 17 percent in 1986 to 27 percent in 2002 to 28 percent in 2005. The recent recession, the full implementation of federal parity law, and such health reform-related actions as the planned expansion of Medicaid all have the potential to improve access to mental health and substance abuse treatment and to alter spending patterns further. Our spending estimates provide an important context for evaluating the effect of those policies.

The impact of direct-to-consumer advertised drugs on drug sales in the US and New Zealand.

PubMed

Norey, Edward; Simone, Tessa M; Mousa, Shaker A

2008-01-01

Direct-to-consumer advertising (DTCA) of drugs has been suggested to be a factor in the increased burden of healthcare spending within the US. This review article analyses the pharmaceutical spending differences between the US and New Zealand, two nations that allow DTCA. The pharmaceutical spending burden of New Zealand and the US was compared by assessing the impact of heavily advertised drugs and their position and rank in the pharmaceutical spending of their respective nation. The US spends far more money on pharmaceuticals than New Zealand. It may appear that heavily advertised drugs in the US have a potentially larger impact on what is being prescribed and paid for. It is also probable that the differences in healthcare systems in each nation (free market vs socialized medicine) can have an influence on pharmaceutical spending. The great amount of money being spent on pharmaceuticals per capita in the US is a more complex issue than can be solved solely by targeting DTCA.

The rival wears Prada: luxury consumption as a female competition strategy.

PubMed

Hudders, Liselot; De Backer, Charlotte; Fisher, Maryanne; Vyncke, Patrick

2014-06-04

Previous studies on luxury consumption demonstrated that men spend large sums of money on luxury brands to signal their mate value to women and, thus, increase their reproductive success. Although women also spend copious amounts of money on luxuries, research focusing on women's motives for luxury consumption is rather scarce. Relying on costly signaling and intrasexual competition theory, the goal of the current study was to test whether female intrasexual competition in a mate attraction context triggers women's spending on luxuries. The results of the first experiment reveal that an intrasexual competition context enhances women's preferences for attractiveness enhancing, but not for non-attractiveness related luxuries such as a smartphone. This finding indicates that women may use luxury consumption as a self-promotion strategy during within-sex competitions, as these luxuries improve their advantages against same-sex rivals for mates. A follow-up study shows that compared to women who do not consume luxuries, women who do so are perceived as more attractive, flirty, young, ambitious, sexy, and less loyal, mature and smart by other women. These results suggest that luxury consumption may provide information about a women's willingness to engage in sex, as well as her views about other women, and consequently, her success in intrasexual competitions.

Who uses flexible spending accounts: effects of employee characteristics and employer strategies.

PubMed

Feldman, R; Schultz, J

2001-07-01

Many large employers offer flexible spending accounts (FSAs) to shelter their employees' out-of-pocket medical expenses from taxes and thereby to encourage the purchase of health insurance policies with higher cost sharing. However, very little empirical research has examined the individual employee's decision to contribute to an FSA. To estimate equations for the probability that single employees with no dependents and employees with family health insurance coverage will contribute to FSAs, and the amounts contributed by those with FSAs. An observational study of randomly-selected employees in 15 Minnesota firms matched with information on the strategies those firms use to promote FSAs. Measures of FSA participation were regressed on expected health care spending, employee socio-demographics, and employer strategies. 779 single employees with no dependents and 679 employees with family coverage. Education beyond high school increases the probability that both types of subjects will contribute to FSAs, with marginal effects ranging from 16 to 48 percent. The FSA contribution rate for families doubles when the family's marginal federal income tax rate increases from 15 to 28 percent. Employer strategies to encourage participation are also effective in promoting FSAs. FSAs are used mainly by high-income and highly-educated workers. We question whether this is an equitable use of the income tax code.

The Centaur--Jupiter Family Comet Link

NASA Astrophysics Data System (ADS)

Bailey, Brenae; Malhotra, R.

2008-09-01

The Centaurs’ orbital evolution is characterized by strong chaos and frequent planetary close encounters. We have investigated the transition between the Centaurs and the Jupiter family comets (JFCs), the latter defined as having Tisserand parameter with respect to Jupiter of 2 < TJ < 3. We find that 80% of the known sample of Centaurs spend part of their dynamical lifetimes as JFCs. The amount of time spent as a JFC is typically on the order of a few hundred thousand years, similar to the dynamical lifetimes of JFCs. We also find that the majority of these objects are "handed off” toward the inner solar system from one giant planet to the next before being ejected. In contrast, the orbital evolution of the Centaurs that spend little or no time as JFCs is either dominated by Saturn or consists largely of hopping among mean motion resonances with Uranus and Neptune. This suggests that the JFCs may originate from a dynamically distinct subset of Centaurs.

Is Medicaid sustainable? Spending projections for the program's second forty years.

PubMed

Kronick, Richard; Rousseau, David

2007-01-01

We constructed long-term projections of Medicaid spending and compared projected growth in spending with that of state and federal revenues. Notwithstanding the anticipated decline in employer-sponsored insurance and the long-term care needs of the baby boomers, we project that Medicaid spending as a share of national health spending will average 16.6 percent from 2006 to 2025--roughly unchanged from 16.5 percent in 2005--and then increase slowly to 19.0 percent by 2045. Growth in government revenues is projected to be large enough to sustain both Medicaid spending increases and substantial real growth in spending for other services.

The cost of tax-exempt health benefits in 2004.

PubMed

Sheils, John; Haught, Randall

2004-01-01

The tax expenditure for health benefits is the amount of revenues that the federal government forgoes by exempting health benefits and spending from the federal income and Social Security taxes, including (1) employer health benefit contributions for workers and retirees, (2) health benefit deductions for the self-employed, (3) health spending under flexible spending plans, and (4) the tax deduction for health expenses. We estimate that this expenditure will be dollars 188.5 billion in 2004. Families with incomes of dollars 100,000 or more (14 percent of the population) account for 26.7 percent of all health benefit tax expenditures.

Time Investment and Time Management: An Analysis of Time Students Spend Working at Home for School

ERIC Educational Resources Information Center

Wagner, Petra; Schober, Barbara; Spiel, Christiane

2008-01-01

This paper deals with the time students spend working at home for school. In Study 1, we investigated amount and regulation of time. Study 2 serves to validate the results of Study 1 and, in addition, investigates the duration of the time units students used and their relation to scholastic success. In Study 1, the participants were 332 students…

National study of public spending for mental retardation and developmental disabilities.

PubMed

Braddock, D; Hemp, R; Fujiura, G

1987-09-01

Results of a nationwide study of public mental retardation/developmental disabilities (MR/DD) spending in the states during Fiscal Years 1977 through 1986 were summarized. Trends identified included: (a) continuing growth in spending for community services, (b) contraction of total spending for institutional operations, and (c) predominance of ICF/MR support in large (16+ beds) congregate care settings. Periodic replication of the study was recommended as was additional research to identify the political and economic determinants of state MR/DD spending.

Concentration of Potentially Preventable Spending Among High-Cost Medicare Subpopulations: An Observational Study.

PubMed

Figueroa, Jose F; Joynt Maddox, Karen E; Beaulieu, Nancy; Wild, Robert C; Jha, Ashish K

2017-11-21

Little is known about whether potentially preventable spending is concentrated among a subset of high-cost Medicare beneficiaries. To determine the proportion of total spending that is potentially preventable across distinct subpopulations of high-cost Medicare beneficiaries. Beneficiaries in the highest 10% of total standardized individual spending were defined as "high-cost" patients, using a 20% sample of Medicare fee-for-service claims from 2012. The following 6 subpopulations were defined using a claims-based algorithm: nonelderly disabled, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy. Potentially preventable spending was calculated by summing costs for avoidable emergency department visits using the Billings algorithm plus inpatient and associated 30-day postacute costs for ambulatory care-sensitive conditions (ACSCs). The amount and proportion of potentially preventable spending were then compared across the high-cost subpopulations and by individual ACSCs. Medicare. 6 112 450 Medicare beneficiaries. Proportion of spending deemed potentially preventable. In 2012, 4.8% of Medicare spending was potentially preventable, of which 73.8% was incurred by high-cost patients. Despite making up only 4% of the Medicare population, high-cost frail elderly persons accounted for 43.9% of total potentially preventable spending ($6593 per person). High-cost nonelderly disabled persons accounted for 14.8% of potentially preventable spending ($3421 per person) and the major complex chronic group for 11.2% ($3327 per person). Frail elderly persons accounted for most spending related to admissions for urinary tract infections, dehydration, heart failure, and bacterial pneumonia. Potential misclassification in the identification of preventable spending and lack of detailed clinical data in administrative claims. Potentially preventable spending varied across Medicare subpopulations, with the majority concentrated among frail elderly persons. The Commonwealth Fund.

Healthcare Utilization and Spending for Constipation in Children With Versus Without Complex Chronic Conditions.

PubMed

Stephens, John R; Steiner, Michael J; DeJong, Neal; Rodean, Jonathan; Hall, Matt; Richardson, Troy; Berry, Jay G

2017-01-01

The aim of the study was to examine the prevalence of diagnosis and treatment for constipation among children receiving Medicaid and to compare healthcare utilization and spending for constipation among children based on number of complex chronic conditions (CCCs). Retrospective cohort study of 4.9 million children ages 1 to 17 years enrolled in Medicaid from 2009 to 2011 in 10 states in the Truven Marketscan Database. Constipation was identified using International Classification of Disease, 9th revision codes for constipation (564.0x), intestinal impaction (560.3x), or encopresis (307.7). Outpatient and inpatient utilization and spending for constipation were assessed. CCC status was identified using validated methodology. A total of 267,188 children (5.4%) were diagnosed with constipation. Total constipation spending was $79.5 million. Outpatient constipation spending was $66.8 million (84.1%) during 406,814 visits, mean spending $120/visit. Among children with constipation, 1363 (0.5%) received inpatient treatment, accounting for $12.2 million (15.4%) of constipation spending, mean spending $7815/hospitalization. Of children hospitalized for constipation, 552 (40.5%) did not have an outpatient visit for constipation before admission. Approximately 6.8% of children in the study had ≥1 CCC; these children accounted for 33.5% of total constipation spending, 70.3% of inpatient constipation spending, and 19.8% of emergency department constipation spending. Constipation prevalence was 11.0% for children with 1 CCC, 16.6% with 2 CCCs, and 27.1% with ≥3 CCCs. Although the majority of pediatric constipation treatment occurs in the outpatient setting, inpatient care accounts for a sizable percentage of spending. Children with CCCs have a higher prevalence of constipation and account for a disproportionate amount of constipation healthcare utilization and spending.

Trends in the Cost and Use of Targeted Cancer Therapies for the Privately Insured Nonelderly: 2001 to 2011

PubMed Central

Shih, Ya-Chen Tina; Smieliauskas, Fabrice; Geynisman, Daniel M.; Kelly, Ronan J.; Smith, Thomas J.

2015-01-01

Purpose This study sought to define and identify drivers of trends in cost and use of targeted therapeutics among privately insured nonelderly patients with cancer receiving chemotherapy between 2001 and 2011. Methods We classified oncology drugs as targeted oral anticancer medications, targeted intravenous anticancer medications, and all others. Using the LifeLink Health Plan Claims Database, we studied and disaggregated trends in use and in insurance and out-of-pocket payments per patient per month and during the first year of chemotherapy. Results We found a large increase in the use of targeted intravenous anticancer medications and a gradual increase in targeted oral anticancer medications; targeted therapies accounted for 63% of all chemotherapy expenditures in 2011. Insurance payments per patient per month and in the first year of chemotherapy for targeted oral anticancer medications more than doubled in 10 years, surpassing payments for targeted intravenous anticancer medications, which remained fairly constant throughout. Substitution toward targeted therapies and growth in drug prices both at launch and postlaunch contributed to payer spending growth. Out-of-pocket spending for targeted oral anticancer medications was ≤ half of the amount for targeted intravenous anticancer medications. Conclusion Targeted therapies now dominate anticancer drug spending. More aggressive management of pharmacy benefits for targeted oral anticancer medications and payment reform for injectable drugs hold promise. Restraining the rapid rise in spending will require more than current oral drug parity laws, such as value-based insurance that makes the benefits and costs transparent and involves the patient directly in the choice of treatment. PMID:25987701

Health insurers' financial performance and quality improvement expenditures in the Affordable Care Act's second year.

PubMed

McCue, Michael J; Hall, Mark

2015-02-01

The Affordable Care Act requires health insurers to rebate any amounts less than 80%-85% of their premiums that they fail to spend on medical claims or quality improvement. This study uses the new comprehensive reporting under this law to examine changes in insurers' financial performance and differences in their quality improvement expenditures. In the ACA's second year (2012), insurers' median medical loss ratios continued to increase and their median administrative cost ratios dropped, producing moderate operating margins in the group markets but a small operating loss in the individual market, at the median. For-profit insurers showed larger changes, in general, than did nonprofits. For quality improvement, insurers reported spending a significantly greater amount per member in their government plans than they did on their self-insured members, with spending on commercial insurance being in between these two extremes. The magnitude and source of these differences varied by corporate ownership. © The Author(s) 2014.

Projections of national health expenditures through the year 2000

PubMed Central

Sonnefeld, Sally T.; Waldo, Daniel R.; Lemieux, Jeffrey A.; McKusick, David R.

1991-01-01

In this article, the authors present a scenario for health expenditures during the 1990s. Assuming that current laws and practices remain unchanged, the Nation will spend $1.6 trillion for health care in the year 2000, an amount equal to 16.4 percent of that year's gross national product. Medicare and Medicaid will foot an increasing share of the Nation's health bill, rising to more than one-third of the total. The factors accounting for growth in national health spending are described as well as the effects of those factors on spending by type of service and by source of funds. PMID:10114931

Harnessing naturally occurring data to measure the response of spending to income

PubMed Central

Gelman, Michael; Kariv, Shachar; Shapiro, Matthew D.; Silverman, Dan; Tadelis, Steven

2016-01-01

This paper presents a new data infrastructure for measuring economic activity. The infrastructure records transactions and account balances, yielding measurements with scope and accuracy that have little precedent in economics. The data are drawn from a diverse population that overrepresents males and younger adults but contains large numbers of underrepresented groups. The data infrastructure permits evaluation of a benchmark theory in economics that predicts that individuals should use a combination of cash management, saving, and borrowing to make the timing of income irrelevant for the timing of spending. As in previous studies and in contrast to the predictions of the theory, there is a response of spending to the arrival of anticipated income. The data also show, however, that this apparent excess sensitivity of spending results largely from the coincident timing of regular income and regular spending. The remaining excess sensitivity is concentrated among individuals with less liquidity. PMID:25013075

Assessing child time-activity patterns in relation to indoor cooking fires in developing countries: a methodological comparison.

PubMed

Barnes, Brendon; Mathee, Angela; Moiloa, Kebitsamang

2005-01-01

Indoor air pollution, caused by the indoor burning of biomass fuels, has been associated with an increased risk of child acute respiratory infections in developing countries. The amount of time that children spend in proximity to fires is a crucial determinant of the health impact of indoor air pollution. Researchers are reliant on social scientific methods to assess exposure based on child location patterns in relation to indoor fires. The inappropriate use of methods could lead to misclassification of exposure. The aim of this paper is to compare two methods (observations and questionnaire interview) with video analysis (which is thought to offer a more accurate assessment of exposure) in rural South African villages. Compared to video analysis, results show that observations may underestimate the amount of time that children spend very close (within 1.5 m) to fires. This is possibly due to reactivity caused by the presence of an observer. The questionnaire interview offers a more accurate assessment of the amounts of time that children spend within 1.5 m of fires at the expense of a detailed behavioural analysis. By drawing on the strengths and weaknesses of each, this paper discusses the appropriateness of methods to different research contexts.

Association Between Availability of a Price Transparency Tool and Outpatient Spending.

PubMed

Desai, Sunita; Hatfield, Laura A; Hicks, Andrew L; Chernew, Michael E; Mehrotra, Ateev

2016-05-03

There is increasing interest in using price transparency tools to decrease health care spending. To measure the association between offering a health care price transparency tool and outpatient spending. Two large employers represented in multiple market areas across the United States offered an online health care price transparency tool to their employees. One introduced it on April 1, 2011, and the other on January 1, 2012. The tool provided users information about what they would pay out of pocket for services from different physicians, hospitals, or other clinical sites. Using a matched difference-in-differences design, outpatient spending among employees offered the tool (n=148,655) was compared with that among employees from other companies not offered the tool (n=295,983) in the year before and after it was introduced. Availability of a price transparency tool. Annual outpatient spending, outpatient out-of-pocket spending, use rates of the tool. Mean outpatient spending among employees offered the tool was $2021 in the year before the tool was introduced and $2233 in the year after. In comparison, among controls, mean outpatient spending changed from $1985 to $2138. After adjusting for demographic and health characteristics, being offered the tool was associated with a mean $59 (95% CI, $25-$93) increase in outpatient spending. Mean outpatient out-of-pocket spending among those offered the tool was $507 in the year before introduction of the tool and $555 in the year after. Among the comparison group, mean outpatient out-of-pocket spending changed from $490 to $520. Being offered the price transparency tool was associated with a mean $18 (95% CI, $12-$25) increase in out-of-pocket spending after adjusting for relevant factors. In the first 12 months, 10% of employees who were offered the tool used it at least once. Among employees at 2 large companies, offering a price transparency tool was not associated with lower health care spending. The tool was used by only a small percentage of eligible employees.

29 CFR 541.700 - Primary duty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... other types of duties; the amount of time spent performing exempt work; the employee's relative freedom... employees for the kind of nonexempt work performed by the employee. (b) The amount of time spent performing.... Thus, employees who spend more than 50 percent of their time performing exempt work will generally...

Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five.

PubMed

Wallace, Jacob; Song, Zirui

2016-05-01

To slow the growth of Medicare spending, some policy makers have advocated raising the Medicare eligibility age from the current sixty-five years to sixty-seven years. For the majority of affected adults, this would delay entry into Medicare and increase the time they are covered by private insurance. Despite its policy importance, little is known about how such a change would affect national health care spending, which is the sum of health care spending for all consumers and payers-including governments. We examined how spending differed between Medicare and private insurance using longitudinal data on imaging and procedures for a national cohort of individuals who switched from private insurance to Medicare at age sixty-five. Using a regression discontinuity design, we found that spending fell by $38.56 per beneficiary per quarter-or 32.4 percent-upon entry into Medicare at age sixty-five. In contrast, we found no changes in the volume of services at age sixty-five. For the previously insured, entry into Medicare led to a large drop in spending driven by lower provider prices, which may reflect Medicare's purchasing power as a large insurer. These findings imply that increasing the Medicare eligibility age may raise national health care spending by replacing Medicare coverage with private insurance, which pays higher provider prices than Medicare does. Project HOPE—The People-to-People Health Foundation, Inc.

Traditional Medicare Versus Private Insurance: How Spending, Volume, And Price Change At Age Sixty-Five

PubMed Central

Wallace, Jacob; Song, Zirui

2016-01-01

To slow the growth of Medicare spending, some policy makers have advocated raising the Medicare eligibility age from the current sixty-five years to sixty-seven years. For the majority of affected adults, this would delay entry into Medicare and increase the time they are covered by private insurance. Despite its policy importance, little is known about how such a change would affect national health care spending, which is the sum of health care spending for all consumers and payers—including governments. We examined how spending differed between Medicare and private insurance using longitudinal data on imaging and procedures for a national cohort of individuals who switched from private insurance to Medicare at age sixty-five. Using a regression discontinuity design, we found that spending fell by $38.56 per beneficiary per quarter—or 32.4 percent—upon entry into Medicare at age sixty-five. In contrast, we found no changes in the volume of services at age sixty-five. For the previously insured, entry into Medicare led to a large drop in spending driven by lower provider prices, which may reflect Medicare's purchasing power as a large insurer. These findings imply that increasing the Medicare eligibility age may raise national health care spending by replacing Medicare coverage with private insurance, which pays higher provider prices than Medicare does. PMID:27140993

Retail prescription drug spending in the National Health Accounts.

PubMed

Smith, Cynthia

2004-01-01

Recent rapid spending growth for retail drugs has largely arisen from increased use of new drugs, rather than from increasing prices of existing drugs. A sizable shift in the payment from consumers to third parties has also contributed to faster growth. Strategies such as negotiating for rebates and using tiered copayments have sought to slow spending growth but simultaneously have complicated the estimation of spending in the National Health Accounts (NHA). NHA estimates show that retail pharmaceuticals' share of health spending is not much different than it was in 1960, although its share of gross domestic product (GDP) has tripled.

Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

PubMed

Napier, Patti; Norris, Pauline; Braund, Rhiannon

2018-04-01

Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

PubMed

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L

2015-01-01

Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

Evaluating Existing Strategies to Limit Video Game Playing Time.

PubMed

Davies, Bryan; Blake, Edwin

2016-01-01

Public concern surrounding the effects video games have on players has inspired a large body of research, and policy makers in China and South Korea have even mandated systems that limit the amount of time players spend in game. The authors present an experiment that evaluates the effectiveness of such policies. They show that forcibly removing players from the game environment causes distress, potentially removing some of the benefits that games provide and producing a desire for more game time. They also show that, with an understanding of player psychology, playtime can be manipulated without significantly changing the user experience or negating the positive effects of video games.

Isolation and purification of diastereoisomeric flavonolignans from silymarin by binary-column recycling preparative high-performance liquid chromatography.

PubMed

Zhao, Weiquan; Yang, Guang; Zhong, Fanyi; Yang, Nan; Zhao, Xin; Qi, Yunpeng; Fan, Guorong

2014-09-01

Silymarin extracted from Silybum marianum (L.) Gaertn consists of a large number of flavonolignans, of which diastereoisomeric flavonolignans including silybin A and silybin B, and isosilybin A and isosilybin B are the main bioactive components, whose preparation from the crude extracts is still a difficult task. In this work, binary-column recycling preparative high-performance liquid chromatography systems without sample loop trapping, where two columns were switched alternately via one or two six-port switching valves, were established and successfully applied to the isolation and purification of the four diastereoisomeric flavonolignans from silymarin. The proposed system showed significant advantages over conventional preparative high-performance liquid chromatography with a single column in increasing efficiency and reducing the cost. To obtain the same amounts of products, the proposed system spends only one tenth of the time that the conventional system spends, and needs only one eleventh of the solvent that the conventional system consumes. Using the proposed system, the four diastereoisomers were successfully isolated from silymarin with purities over 98%. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Death, time and the theory of relativity.

PubMed

Chochinov, Harvey Max

2011-09-01

Many people believe that spending large amounts of money on end-of-life care is unjustified and even irrational. This fails to recognize that the value of time, particularly quality time, appears to increase as death draws near. Paying for treatment that merely allows patients and families to avoid confronting the inevitability of death is wrong. However, palliative care, which can bolster the quality of a patient's remaining days, provides benefits that extend to the family and beyond. How can the notion of time gaining value toward the end of life be incorporated into conventional cost-benefit analyses? A standard QALY (Quality Adjusted Life Years) is the product of quality of life and time, without adjusting for any change in the value of time. An additional variable--a Valuation Index (Palliative) (or VIP)--needs to be factored into the equation, providing a rational explanation for what otherwise might be deemed irrational spending. When one recognizes the multitude of important things that happen as people approach the very end of life, the numbers start to add up. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

The U.S. employment effects of military and domestic spending priorities.

PubMed

Pollin, Robert; Garrett-Peltier, Heidi

2009-01-01

This study focuses on the employment effects of military spending versus alternative domestic spending priorities. The authors begin by introducing the basic input-output modeling technique for considering issues such as these in a systematic way. They then present some simple alternative spending scenarios-namely, devoting $1 billion to the military versus the same amount of money spent for five alternatives: tax cuts that produce increased levels of personal consumption; health care; education; mass transit; and construction targeted at home weatherization and infrastructure repair. The first conclusion in assessing such relative employment effects is straightforward: $1 billion spent on personal consumption, health care, education, mass transit, and construction for home weatherization/infrastructure will all create more jobs in the U.S. economy than would the same $1 billion spent on the military. The authors then examine the pay level of jobs created through these alternative spending priorities and assess the overall welfare effects of the alternative employment outcomes. Combining these alternative domestic spending categories in an effective way can also generate a higher level of compensation for working people in the United States and a better average quality ofjobs.

State Medicaid spending and financial burden of families raising children with autism.

PubMed

Parish, Susan L; Thomas, Kathleen C; Rose, Roderick; Kilany, Mona; Shattuck, Paul T

2012-12-01

We examined the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. Child and family data were from the 2005-2006 National Survey of Children with Special Health Care Needs (n  =  2,011 insured children with autism). State characteristics were from public sources. The 4 outcomes included any out-of-pocket health care expenditures during the past year, expenditure amount, expenditures as a proportion of family income, and whether additional income was needed to care for a child. We modeled the association between state per capita Medicaid spending for children with disabilities and families' financial burden, controlling for child, family, and state characteristics. Overall, 78% of families raising children with autism had health care expenditures for their child for the prior 12 months; 42% reported expenditures over $500, with 34% spending over 3% of their income. Families living in states with higher per capita Medicaid spending for children with disabilities were significantly less likely to report financial burden. There is a robust relationship between state Medicaid spending for children with disabilities and the financial burdens incurred by families raising children with autism.

Understanding Trends in Medicare Spending, 2007-2014.

PubMed

Keohane, Laura M; Gambrel, Robert J; Freed, Salama S; Stevenson, David; Buntin, Melinda B

2018-03-06

To analyze the sources of per-beneficiary Medicare spending growth between 2007 and 2014, including the role of demographic characteristics, attributes of Medicare coverage, and chronic conditions. Individual-level Medicare spending and enrollment data. Using an Oaxaca-Blinder decomposition model, we analyzed whether changes in price-standardized, per-beneficiary Medicare Part A and B spending reflected changes in the composition of the Medicare population or changes in relative spending levels per person. We identified a 5 percent sample of fee-for-service Medicare beneficiaries age 65 and above from years 2007 to 2014. Mean payment-adjusted Medicare per-beneficiary spending decreased by $180 between the 2007-2010 and 2011-2014 time periods. This decline was almost entirely attributable to lower spending levels for beneficiaries. Notably, declines in marginal spending levels for beneficiaries with chronic conditions were associated with a $175 reduction in per-beneficiary spending. The decline was partially offset by the increasing prevalence of certain chronic diseases. Still, we are unable to attribute a large share of the decline in spending levels to observable beneficiary characteristics or chronic conditions. Declines in spending levels for Medicare beneficiaries with chronic conditions suggest that changing patterns of care use may be moderating spending growth. © Health Research and Educational Trust.

Caring for the health of the public: cross sectional study of the activities of UK public health departments.

PubMed

Lawlor, D A; Morgan, K; Frankel, S

2002-03-01

The relative time spent in different areas of work in public health departments in the UK was assessed by means of a postal questionnaire. Departments spend one third of their time on population health work, this being similar to the amount of time spent on planning health services. Having a planning department in the health authority did not affect the amount of time spent in any area of work. Having a greater number of consultants in the department was associated with a tendency to spend more time on population health and being involved in training was associated with spending less time on planning. Public health departments in the UK are the only part of the health service with responsibility for the broader aspects of public health. Whilst the tensions between medical care and the wider influences upon population health may represent a false dichotomy, public health professionals must maintain a central focus of their work on the wider influences upon population health if balance is to be maintained within the National Health Service.

The Economics of an Investment in Kaizen

NASA Astrophysics Data System (ADS)

Visuwan, Danupun

2010-10-01

Kaizen has been widely accepted as a continuous process improvement with the gradualist approach. This paper presents the research carried out to explore the pattern of an investment in Kaizen to enhance overall profit. System dynamics-based simulation has been employed with an optimization technique, a Steepest Ascent approach, to improve experimental variables e.g. the amount of spending on prevention and appraisal activities, the time and the amount to reduce the investment which results in maximum Net Present Value (NPV) of profit. The simulation model in this study is based on a Thai automobile manufacturer as a case study company. The result suggests that the investment in Kaizen should spend on activities to eliminate and detect all defects in the early phase and then reduce economically when the process is under controlled. It can be named as the `Hybrid quality improvement', which was proved in this study that it provides greater overall profit than the Stepwise Kaizen and the constant spending. This study also presents the behavior of quality costs and profit against time scale along the different patterns of the investment in Kaizen.

VA Disability Compensation and Money Spent on Substance Use Among Homeless Veterans: A Controversial Association.

PubMed

Tsai, Jack; Rosenheck, Robert A

2015-06-01

There has long been concern that public support payments are used to support addictive behaviors. This study examined the amount of money homeless veterans spend on alcohol and drugs and the association between public support income, including VA disability compensation, and expenditures on alcohol and drugs. Data were from 1,160 veterans from 19 sites on entry into the Housing and Urban Development-Veterans Affairs Supportive Housing program. Descriptive statistics and nonparametric analyses were conducted. About 33% of veterans reported spending money on alcohol and 22% reported spending money on drugs in the past month. No significant association was found between public support income, VA disability compensation, and money spent on alcohol and drugs. A substantial proportion of homeless veterans spend some income on alcohol and drugs, but disability income, including VA compensation, does not seem to be related to substance use or money spent on addictive substances.

Microeconomics. Harnessing naturally occurring data to measure the response of spending to income.

PubMed

Gelman, Michael; Kariv, Shachar; Shapiro, Matthew D; Silverman, Dan; Tadelis, Steven

2014-07-11

This paper presents a new data infrastructure for measuring economic activity. The infrastructure records transactions and account balances, yielding measurements with scope and accuracy that have little precedent in economics. The data are drawn from a diverse population that overrepresents males and younger adults but contains large numbers of underrepresented groups. The data infrastructure permits evaluation of a benchmark theory in economics that predicts that individuals should use a combination of cash management, saving, and borrowing to make the timing of income irrelevant for the timing of spending. As in previous studies and in contrast to the predictions of the theory, there is a response of spending to the arrival of anticipated income. The data also show, however, that this apparent excess sensitivity of spending results largely from the coincident timing of regular income and regular spending. The remaining excess sensitivity is concentrated among individuals with less liquidity. Copyright © 2014, American Association for the Advancement of Science.

Hong Kong's domestic health spending--financial years 1989/90 through 2004/05.

PubMed

Leung, G M; Tin, K Y K; Yeung, G M K; Leung, E S K; Tsui, E L H; Lam, D W S; Tsang, C S H; Fung, A Y K; Lo, S V

2008-04-01

This report presents the latest estimates of Hong Kong's domestic health spending between fiscal years 1989/90 and 2004/05, cross-stratified and categorised by financing source, provider and function on an annual basis. Total expenditure on health was HK$67,807 million in fiscal year 2004/05. In real terms, total expenditure on health showed positive growth averaging 7% per annum throughout the period covered in this report while gross domestic product grew at 4% per annum on average, indicating a growing percentage of health spending relative to gross domestic product, from 3.5% in 1989/90 to 5.2% in 2004/05. This increase was largely driven by the rise in public spending, which rose 9% per annum on average in real terms over the period, compared with 5% for private spending. This represents a growing share of public spending from 40% to 55% of total expenditure on health during the period. While public spending was the dominant source of health financing in 2004/05, private household out-of-pocket expenditure accounted for the second largest share of total health spending (32%). The remaining sources of health finance were employer-provided group medical benefits (8%), privately purchased insurance (5%), and other private sources (1%). Of the $67,807 million total health expenditure in 2004/05, current expenditure comprised $65,429 million (96%) while $2378 million (4%) were capital expenses (ie investment in medical facilities). Services of curative care accounted for the largest share of total health spending (67%) which were made up of ambulatory services (35%), in-patient curative care (28%), day patient hospital services (3%), and home care (1%). The next largest share of total health expenditure was spent on medical goods outside the patient care setting (10%). Analysed by health care provider, hospitals accounted for the largest share (46%) and providers of ambulatory health care the second largest share (30%) of total health spending in 2004/05. We observed a system-wide trend towards service consolidation at institutions (as opposed to free-standing ambulatory clinics, most of which are staffed by solo practitioner). In 2004/05, public expenditure on health amounted to $35,247 million (53.9% of total current expenditure), which was mostly incurred at hospitals (76.5%), whilst private expenditure ($30,182 million) was mostly incurred at providers of ambulatory health care (54.6%). This reflects the mixed health care economy of Hong Kong where public hospitals generally account for about 90% of total bed-days and private doctors (including Western and Chinese medicine practitioners) provide 75% to 80% of out-patient care. While both public and private spending were mostly expended on personal health care services and goods (92.9%), the distributional patterns among functional categories differed. Public expenditure was targeted at in-patient care (54.2%) and substantially less on out-patient care (24.5%), especially low-intensity first-contact care. In comparison, private spending was mostly concentrated on out-patient care (49.6%), whereas medical goods outside the patient care setting (22.6%) and in-patient care (18.8%) comprised the majority of the remaining share. Compared to OECD countries, Hong Kong has devoted a relatively low percentage of gross domestic product to health in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most comparably developed economies, although commensurate with its public revenue collection base.

Differences in Spending in School Districts across Geographic Locales in Minnesota. Summary. Issues & Answers. REL 2012-No. 124

ERIC Educational Resources Information Center

Wan, Yinmei; Norbury, Heather; Molefe, Ayrin C.; Gerdeman, R. Dean; Meyers, Coby V.; Burke, Matthew

2012-01-01

This study examines differences in spending in school districts across geographic locales in Minnesota and factors that might contribute to these differences. The study finds that district spending per student in 2008/09 varied across locale types in Minnesota. These differences are largely accounted for by differences in regional characteristics…

Life under the Spending Caps: The Clinton Fiscal Year 1995 Budget.

ERIC Educational Resources Information Center

Leonard, Paul; Greenstein, Robert

The stage for the introduction of the Clinton Administration's fiscal year 1995 budget was largely set by the passage of the budget reconciliation bill signed into law in August 1993. In developing the budget, the Administration had to come up with enough spending cuts to meet the spending caps--as well as billions of dollars in additional cuts to…

Alaska's Dependence on State Spending. ISER Fiscal Policy Papers, No. 5.

ERIC Educational Resources Information Center

Goldsmith, Scott; And Others

Alaska will face a large fiscal gap and growing budget deficits in the near future. The timing of such fiscal gap open hinges on the joint effect of state budget growth and the oil price change. This paper explains Alaska's dependence on state spending and offers policy options addressing the fiscal gap. State spending: (1) supports nearly one in…

[Colombian Health spending 1993-2003: its composition and trends].

PubMed

Barón-Leguizamón, Gilberto

2007-01-01

Analysing the magnitude, composition, evolution and trends in Colombian national spending on health, forming a proposal and making an important contribution towards knowledge re the reality of social health security. The results obtained respond to an ongoing effort to systematise and standardise the adopted methodology and update calculations and estimates for the eleven-year period during which Law 100/1993 was being reformed. Analysing the above led to identifying changes in the flow of resources and establishing objective comparisons according to current/available international standards. The project began in the Colombian Planning Department (lasting 5 years) and was then passed to the Ministry of Social Protection's Health Reform Support Programme where new institutional scope has been applied during the last four years. Perhaps the work's most important contribution consists of producing annual estimates of total public and private spending on health as a time-series, for a relatively significant period. The results confirm fulfilment of the reform's suppositions in terms of the significant amount of resources channelled to the sector, the important substitution of financing private spending for spending on health insurance, greater dynamism and the importance of public funds in financing total spending and the managing of an important segment of such resources by some of the new agents created by the reform. This contrasts with the little importance paid to spending on promotion and prevention and on public health and basic attention programmes.

Health spending by state of residence, 1991-2009.

PubMed

Cuckler, Gigi; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea; Lassman, Dave; Benson, Joseph

2011-12-06

Provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998-2009), as well as the differential regional and state impacts of the recent recession. State Health Expenditures by State of Residence for 1991-2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average. States with the highest per capita spending tended to have older populations and the highest per capita incomes; states with the lowest per capita spending tended to have younger populations, lower per capita incomes, and higher rates of uninsured. Over the last decade, the New England and Mideast regions exhibited the highest per capita personal health care spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending. Variation in per enrollee Medicaid spending, however, has consistently been greater than that of total per capita personal health care spending or per enrollee Medicare spending from 1998-2009. The Great Lakes, New England, and Far West regions experienced the largest slowdown in per person health spending growth during the recent recession, largely as a result of higher unemployment rates. Public Domain.

Development and Application of Detection Indices for Measuring Guessing Behaviors and Test-Taking Effort in Computerized Adaptive Testing

ERIC Educational Resources Information Center

Chang, Shu-Ren; Plake, Barbara S.; Kramer, Gene A.; Lien, Shu-Mei

2011-01-01

This study examined the amount of time that different ability-level examinees spend on questions they answer correctly or incorrectly across different pretest item blocks presented on a fixed-length, time-restricted computerized adaptive testing (CAT). Results indicate that different ability-level examinees require different amounts of time to…

26 CFR 1.148-7 - Spending exceptions to the rebate requirement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... excluded from the gross proceeds of the prior issue under the special definition of gross proceeds in... treated as gross proceeds of the refunding issue. Thus, for the refunding issue to qualify for the 6-month... those amounts continue to be used in a manner that does not cause those amounts to be gross proceeds...

Supporting voluntary faculty members in departments of psychiatry.

PubMed

Magen, Jed; Ley, Alyse

2011-01-01

Unpaid voluntary faculty members do substantial amounts of teaching in medical schools. This article discusses strategies for recruitment, retention, and development for these individuals. The authors describe a compendium of literature searches and their own experience administering a large medical student education program and residency programs. Voluntary faculty members are internally motivated to teach. Concrete or monetary compensation is much less valued than simple acknowledgment and teaching-excellence awards. Departments should thoughtfully decide how they wish to reward voluntary faculty members for their contributions. Small gestures of gratitude generally are appreciated out of proportion to their intrinsic value. Departments can successfully retain excellent teachers who contribute to the educational mission without spending scarce resources. Copyright © 2011 Academic Psychiatry

Concerns Around Budget Impact Thresholds: Not All Drugs Are the Same.

PubMed

Ciarametaro, Michael; Abedi, Susan; Sohn, Adam; Ge, Colin Fan; Odedara, Neel; Dubois, Robert

2017-02-01

The use of budget thresholds is a recent development in the United States (e.g., the Institute for Clinical and Economic Review drug assessments). Budget thresholds establish limits that require some type of budgetary action if exceeded. This research focused on the advisability of using product-level budget thresholds as fixed spending caps by examining whether they are likely to improve or worsen market efficiency over status quo. The aim of this study was to determine whether fixed product-level spending caps are advisable for biopharmaceuticals. We systematically examined 5-year, postlaunch revenue for drugs that launched in the United States between 2003 and 2014 using the IMS MIDAS database. For products launched between 2011 and 2014, we used historical revenue as the baseline and trended out 60 months postlaunch based on exponential smoothing. Forecasted fifth-year revenue was compared to analyst reports. Fifth-year revenue was compared against a hypothetical $904 million spending cap to determine the amount of annual spending that might require reallocation. Descriptive statistics of 5-year, postlaunch revenue and annual spending requiring reallocation were calculated. Adhering to a $904 million product-level spending cap requires that approximately one-third of new drug spending be reallocated to other goods and services that have the potential to be less cost-effective due to significant barriers. Fixed product-level spending caps have the potential to reduce market efficiency due to their independence from value and the presence of important operational challenges. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Health Spending by State of Residence, 1991–2009

PubMed Central

Cuckler, Gigi; Martin, Anne; Whittle, Lekha; Heffler, Stephen; Sisko, Andrea; Lassman, Dave; Benson, Joseph

2011-01-01

Objective Provide a detailed discussion of baseline health spending by state of residence (per capita personal health care spending, per enrollee Medicare spending, and per enrollee Medicaid spending) in 2009, over the last decade (1998–2009), as well as the differential regional and state impacts of the recent recession. Data Source State Health Expenditures by State of Residence for 1991–2009, produced by the Centers for Medicare & Medicaid Services' Office of the Actuary. Principal Findings In 2009, the 10 states where per capita spending was highest ranged from 13 to 36 percent higher than the national average, and the 10 states where per capita spending was lowest ranged from 8 to 26 percent below the national average. States with the highest per capita spending tended to have older populations and the highest per capita incomes; states with the lowest per capita spending tended to have younger populations, lower per capita incomes, and higher rates of uninsured. Over the last decade, the New England and Mideast regions exhibited the highest per capita personal health care spending, while states in the Southwest and Rocky Mountain regions had the lowest per capita spending. Variation in per enrollee Medicaid spending, however, has consistently been greater than that of total per capita personal health care spending or per enrollee Medicare spending from 1998–2009. The Great Lakes, New England, and Far West regions experienced the largest slowdown in per person health spending growth during the recent recession, largely as a result of higher unemployment rates. PMID:22340779

Building a Stronger System for Tracking Nutrition-Sensitive Spending: A Methodology and Estimate of Global Spending for Nutrition-Sensitive Foreign Aid.

PubMed

Ickes, Scott B; Trichler, Rachel B; Parks, Bradley C

2015-12-01

There is growing awareness that the necessary solutions for improving nutrition outcomes are multisectorial. As such, investments are increasingly directed toward "nutrition-sensitive" approaches that not only address an underlying or basic determinant of nutrition but also seek to achieve an explicit nutrition goal or outcome. Understanding how and where official development assistance (ODA) for nutrition is invested remains an important but complex challenge, as development projects components vary in their application to nutrition outcomes. Currently, no systematic method exists for tracking nutrition-sensitive ODA. To develop a methodology for classifying and tracking nutrition-sensitive ODA and to produce estimates of the amount of nutrition-sensitive aid received by countries with a high burden of undernutrition. We analyzed all financial flows reported to the Organization for Economic Co-Operation and Development's Development Assistance Committee Creditor Reporting Service in 2010 to estimate these investments. We assessed the relationships between national stunting prevalence, stunting burden, under-5 mortality, and the amount of nutrition-specific and nutrition-sensitive ODA. We estimate that, in 2010, a total of $379·4 million (M) US dollars (USD) was committed to nutrition-specific projects and programs of which 25 designated beneficiaries (countries and regions) accounted for nearly 85% ($320 M). A total of $1.79 billion (B) was committed to nutrition-sensitive spending, of which the top 25 countries/regions accounted for $1.4 B (82%). Nine categories of development activities accounted for 75% of nutrition-sensitive spending, led by Reproductive Health Care (30·4%), Food Aid/Food Security Programs (14·1%), Emergency Food Aid (13·2%), and Basic Health Care (5·0%). Multivariate linear regression models indicate that the amount of nutrition-sensitive (P = .001) and total nutrition ODA was significantly predicted by stunting prevalence (P = .001). The size of the total population of stunted children significantly predicted the amount of nutrition-specific ODA (P < .001). The recipient profile of nutrition-specific and nutrition-sensitive ODA is related but distinct. Nutrition indicators are associated with the level of nutrition-related ODA commitments to recipient countries. A reliable estimate of nutrition spending is critical for effective planning by both donors and recipients and key for success, as the global development community recommits to a new round of goals to address the interrelated causes of undernutrition in low-income countries. © The Author(s) 2015.

Future and potential spending on health 2015-40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

PubMed

2017-05-20

The amount of resources, particularly prepaid resources, available for health can affect access to health care and health outcomes. Although health spending tends to increase with economic development, tremendous variation exists among health financing systems. Estimates of future spending can be beneficial for policy makers and planners, and can identify financing gaps. In this study, we estimate future gross domestic product (GDP), all-sector government spending, and health spending disaggregated by source, and we compare expected future spending to potential future spending. We extracted GDP, government spending in 184 countries from 1980-2015, and health spend data from 1995-2014. We used a series of ensemble models to estimate future GDP, all-sector government spending, development assistance for health, and government, out-of-pocket, and prepaid private health spending through 2040. We used frontier analyses to identify patterns exhibited by the countries that dedicate the most funding to health, and used these frontiers to estimate potential health spending for each low-income or middle-income country. All estimates are inflation and purchasing power adjusted. We estimated that global spending on health will increase from US$9·21 trillion in 2014 to $24·24 trillion (uncertainty interval [UI] 20·47-29·72) in 2040. We expect per capita health spending to increase fastest in upper-middle-income countries, at 5·3% (UI 4·1-6·8) per year. This growth is driven by continued growth in GDP, government spending, and government health spending. Lower-middle income countries are expected to grow at 4·2% (3·8-4·9). High-income countries are expected to grow at 2·1% (UI 1·8-2·4) and low-income countries are expected to grow at 1·8% (1·0-2·8). Despite this growth, health spending per capita in low-income countries is expected to remain low, at $154 (UI 133-181) per capita in 2030 and $195 (157-258) per capita in 2040. Increases in national health spending to reach the level of the countries who spend the most on health, relative to their level of economic development, would mean $321 (157-258) per capita was available for health in 2040 in low-income countries. Health spending is associated with economic development but past trends and relationships suggest that spending will remain variable, and low in some low-resource settings. Policy change could lead to increased health spending, although for the poorest countries external support might remain essential. Bill & Melinda Gates Foundation. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Delivery System Integration and Health Care Spending and Quality for Medicare Beneficiaries

PubMed Central

McWilliams, J. Michael; Chernew, Michael E.; Zaslavsky, Alan M.; Hamed, Pasha; Landon, Bruce E.

2013-01-01

Background The Medicare accountable care organization (ACO) programs rely on delivery system integration and provider risk sharing to lower spending while improving quality of care. Methods Using 2009 Medicare claims and linked American Medical Association Group Practice data, we assigned 4.29 million beneficiaries to provider groups based on primary care use. We categorized group size according to eligibility thresholds for the Shared Savings (≥5,000 assigned beneficiaries) and Pioneer (≥15,000) ACO programs and distinguished hospital-based from independent groups. We compared spending and quality of care between larger and smaller provider groups and examined how size-related differences varied by 2 factors considered central to ACO performance: group primary care orientation (measured by the primary care share of large groups’ specialty mix) and provider risk sharing (measured by county health maintenance organization penetration and its relationship to financial risk accepted by different group types for managed care patients). Spending and quality of care measures included total medical spending, spending by type of service, 5 process measures of quality, and 30-day readmissions, all adjusted for sociodemographic and clinical characteristics. Results Compared with smaller groups, larger hospital-based groups had higher total per-beneficiary spending in 2009 (mean difference: +$849), higher 30-day readmission rates (+1.3% percentage points), and similar performance on 4 of 5 process measures of quality. In contrast, larger independent physician groups performed better than smaller groups on all process measures and exhibited significantly lower per-beneficiary spending in counties where risk sharing by these groups was more common (−$426). Among all groups sufficiently large to participate in ACO programs, a strong primary care orientation was associated with lower spending, fewer readmissions, and better quality of diabetes care. Conclusions Spending was lower and quality of care better for Medicare beneficiaries served by larger independent physician groups with strong primary care orientations in environments where providers accepted greater risk. PMID:23780467

Demand for prescription drugs under non-linear pricing in Medicare Part D.

PubMed

Jung, Kyoungrae; Feldman, Roger; McBean, A Marshall

2014-03-01

We estimate the price elasticity of prescription drug use in Medicare Part D, which features a non-linear price schedule due to a coverage gap. We analyze patterns of drug utilization prior to the coverage gap, where the "effective price" is higher than the actual copayment for drugs because consumers anticipate that more spending will make them more likely to reach the gap. We find that enrollees' total pre-gap drug spending is sensitive to their effective prices: the estimated price elasticity of drug spending ranges between [Formula: see text]0.14 and [Formula: see text]0.36. This finding suggests that filling in the coverage gap, as mandated by the health care reform legislation passed in 2010, will influence drug utilization prior to the gap. A simulation analysis indicates that closing the gap could increase Part D spending by a larger amount than projected, with additional pre-gap costs among those who do not hit the gap.

Federal R&D tops $103 billion, but physics stays flat

NASA Astrophysics Data System (ADS)

Dawson, Jim

2002-02-01

Four years of federal budget surpluses are giving way to deficit spending, thanks in large part to terrorits, war, and recession. As the unanticipated spending began late in the budget process, overall science appropriations increased significantly.

Looking Forward: Colorado's Fiscal Prospects Amid a Financial Crisis

ERIC Educational Resources Information Center

Buchanan, Wade, Ed.; Jones, Rich, Ed.; Watt, Joe, Ed

2009-01-01

This report projects the amount Colorado would need to spend to maintain state services at 2007 levels through fiscal year 2012-13 and the amount of revenues that will be generated to pay for them. The costs of services were estimated based on factors that drive the budget, such as the number of students in college, inflation rates and the number…

Apples to Apples: Towards a Pan-Canadian Common University Data Set

ERIC Educational Resources Information Center

Junor, Sean; Kramer, Miriam; Usher, Alex

2006-01-01

Most universities in Canada are spending enormous amounts of effort collecting vast amounts of data, but are still--in some quarters--perceived to be unable to report data effectively. In other countries, this kind of problem has been resolved in two different ways. But in Canada, this hasn't happened. The purpose of this paper is to shed some…

Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.

PubMed

Kokabi, Nima; Junn, Jacqueline C; Xing, Minzhi; Hemingway, Jennifer; Hughes, Danny R; Duszak, Richard

2017-03-01

To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization. Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level. Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08). In 2014, only a small minority of United States radiologists received nonresearch payments from industry. At the state level, medical imaging utilization does not seem to be influenced by such financial relationships. Copyright © 2016. Published by Elsevier Inc.

Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

PubMed Central

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

2015-01-01

Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

The relationship between Nairobi adolescents' media use and their sexual beliefs and attitudes.

PubMed

Miller, Ann Neville; Kinnally, William; Maleche, Hellen; Booker, Nancy Achieng'

2017-07-01

Adolescents in sub-Saharan Africa are at risk for contracting HIV. Although media campaigns have educated the population as a whole, few studies are available about the time sub-Saharan African youth spend listening to and viewing sexual messages via the entertainment and informational media. The goals of this project were: 1) to investigate what programming Nairobi adolescents access; and 2) to investigate the association between frequency of access and level of focus on physical relationships with adolescents' perceptions of descriptive norms of peer sexual behaviour, and their attitudes regarding men as sex driven, women as sex objects, and dating as a sport. A total of 464 students from 6 Nairobi secondary schools were surveyed. When students' favourite musicians had a strong focus on physical relationships in their songs, those students estimated the prevalence of risky sexual behaviours among their peers higher. These students also endorsed gender stereotypical and casual attitudes about sex. Large amounts of time spend on the Internet was predictive of all sexual attitude variables. Students whose favourite TV programmes had a strong focus on physical relationships also estimated prevalence of peer sexual behaviour as high.

Time well spent? Assessing nursing-supply chain activities.

PubMed

Ferenc, Jeff

2010-02-01

The amount of time nurses spend providing direct patient care seems to be continually eroding. So it's little wonder a survey conducted last year of critical care, OR nurses and nurse executives found that half of the 1600 respondents feel they spend too much time on supply chain duties. Most also said their supply chain duties impact patient safe ty and their ability to provide bedside care. Experts interviewed for this report believe it's time for supply chain leaders and nurses to develop a closer working partnership. Included are their recommendations to improve performance.

Hong Kong domestic health spending: financial years 1989/90 to 2005/06.

PubMed

Tin, K Y K; Tsoi, P K O; Leung, E S K; Tsui, E L H; Lam, D W S; Tsang, C S H; Lo, S V

2010-02-01

This report presents the latest estimates of Hong Kong domestic health spending between fiscal years 1989/90 and 2005/06, cross-stratified and categorised by financing source, provider, and function on an annual basis. In fiscal year 2005/06, total health expenditure was HK$71 557 million. In real terms, it grew 6.5% per annum on average throughout the study period, whereas gross domestic product grew 4.1%, indicating a growing percentage of health spending relative to gross domestic product, from 3.5% in 1989/90 to 5.1% in 2005/06. This increase was largely funded by public spending, which rose 8.2% per annum on average in real terms, compared with 5.1% for private spending. This represents a growing share of public spending from 40.2% to 51.6% of total health expenditure during the period. Public spending was the dominant source of health financing in 2005/06, whereas private household out-of-pocket expenditure accounted for the second largest share (34.5%), followed by employer-provided group medical benefits (7.5%), privately purchased insurance (5.1%), and other private sources (1.3%). Of the HK$71 557 million total health expenditure in 2005/06, HK$68 810 million (96.2%) was on current expenditure and HK$2746 million (3.8%) on capital expenses (ie investment in medical facilities). Services of curative care accounted for the largest share (67.3%) and were made up of ambulatory services (35.7%), in-patient services (27.7%), day patient hospital services (3.4%), and home care (0.6%). The second largest share was spending on medical goods outside the patient care setting (10.8%). In terms of health care providers, hospitals (44.0%) accounted for the largest share of total health expenditure in 2005/06, followed by providers of ambulatory health care (31.4%). We observed a system-wide trend towards service consolidation at institutions (as opposed to free-standing ambulatory clinics, most of which are staffed by solo practitioners). Not taking capital expenses (ie investment in medical facilities) into account, public current expenditure on health amounted to HK$34 849 million (50.6% of total current expenditure) in 2005/06, most of which was incurred at hospitals (76.3%), whereas private current expenditure (HK$33 961 million) was mostly incurred at providers of ambulatory health care (55.8%). This reflects the mixed health care economy of Hong Kong, where public hospitals generally account for about 90% of total bed-days and private doctors (including western and Chinese medicine practitioners) provide about 70% of out-patient care. Although both public and private spending were mostly expended on personal health care services and goods (93.0%), the patterns of distribution among functional categories differed. Public expenditure was targeted at in-patient care (53.7%) and substantially less on out-patient care (24.6%), especially low-intensity first-contact care. In comparison, private spending was concentrated on out-patient care (49.9%), followed by medical goods outside the patient care setting (22.0%) and in-patient care (19.0%). Compared to countries of the Organisation for Economic Co-operation and Development, Hong Kong has devoted a relatively low percentage of gross domestic product on health services in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most comparably developed economies, although commensurate with its public revenue collection base.

Roles of prices, poverty, and health in Medicare and private spending in Texas.

PubMed

White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Franzini, Luisa

2015-05-01

To investigate the roles of prices, poverty, and health in divergences between Medicare and private spending in Texas. Retrospective observational design using 2011 Blue Cross Blue Shield of Texas claims data and publicly available Medicare data. We measured market-level spending per enrollee among the privately insured. Variation in Medicare and private spending per person are decomposed into prices and quantities, and their associations with poverty are measured. Markets are divided into 4 groups and are compared based on the ratio of Medicare to private spending: "high-private," "proportional," "high-Medicare," and "extremely high-Medicare." Among the privately insured, poverty appears to have large spillover effects; it is strongly associated with lower prices, quantities, and spending. Among Medicare beneficiaries, health status is a key driver of spending variation. The 2 markets with extremely high Medicare-to-private spending ratios (Harlingen and McAllen) are predominantly Hispanic communities with markedly higher rates of poverty and lack of insurance and also extremely low physician supply. The markets with relatively high private spending stand out for having good health-system performance and health outcomes, and higher than average hospital prices. Variation in private spending appears to reflect the ability of the local population to pay for healthcare, whereas variation in Medicare is more heavily driven by health status, and presumably, by clinical need. These findings highlight the inadvisability of using Medicare spending as a proxy for systemwide spending, and the need for comprehensive market-level spending data that allow comparisons among populations with different sources of insurance coverage.

The Relationship between Commercial Health Care Prices and Medicare Spending and Utilization.

PubMed

Romley, John A; Axeen, Sarah; Lakdawalla, Darius N; Chernew, Michael E; Bhattacharya, Jay; Goldman, Dana P

2015-06-01

To explore the relationship between commercial health care prices and Medicare spending/utilization across U.S. regions. Claims from large employers and Medicare Parts A/B/D over 2007-2009. We compared prices paid by commercial health plans to Medicare spending and utilization, adjusted for beneficiary health and the cost of care, across 301 hospital referral regions. A 10 percent lower commercial price (around the average level) is associated with 3.0 percent higher Medicare spending per member per year, and 4.3 percent more specialist visits (p < .01). Commercial health care prices are negatively associated with Medicare spending across regions. Providers may respond to low commercial prices by shifting service volume into Medicare. Further investigation is needed to establish causality. © Health Research and Educational Trust.

Women Saw Large Decrease In Out-Of-Pocket Spending For Contraceptives After ACA Mandate Removed Cost Sharing.

PubMed

Becker, Nora V; Polsky, Daniel

2015-07-01

The Affordable Care Act mandates that private health insurance plans cover prescription contraceptives with no consumer cost sharing. The positive financial impact of this new provision on consumers who purchase contraceptives could be substantial, but it has not yet been estimated. Using a large administrative claims data set from a national insurer, we estimated out-of-pocket spending before and after the mandate. We found that mean and median per prescription out-of-pocket expenses have decreased for almost all reversible contraceptive methods on the market. The average percentages of out-of-pocket spending for oral contraceptive pill prescriptions and intrauterine device insertions by women using those methods both dropped by 20 percentage points after implementation of the ACA mandate. We estimated average out-of-pocket savings per contraceptive user to be $248 for the intrauterine device and $255 annually for the oral contraceptive pill. Our results suggest that the mandate has led to large reductions in total out-of-pocket spending on contraceptives and that these price changes are likely to be salient for women with private health insurance. Project HOPE—The People-to-People Health Foundation, Inc.

Design and implementation of Bluetooth beacon in mobile payment system

NASA Astrophysics Data System (ADS)

Han, Tiantian; Ding, Lei

2017-08-01

The current line of payment means, mainly in the following ways, cash payment, credit card payment, WeChat Alipay sweep payment. There are many inconvenience in Cash payment, large amounts of cash inconvenience to carry, count the money to spend time and effort, true and false banknotes difficult to distinguish, ticket settlement easy to go wrong. Credit card payment is relatively time-consuming, and WeChat Alipay sweep payment need to sweep. Therefore, the design of a convenient, fast payment to meet the line to pay the demand is particularly important. Based on the characteristics of BLE Bluetooth wireless communication technology, this paper designs a kind of payment method based on Bluetooth beacon. Through the Bluetooth beacon broadcast consumption, consumers only need to open the relevant APP in the Android client, and you can get Bluetooth via mobile phone Bluetooth the amount of consumption of the standard broadcast, in accordance with the corresponding payment platform to complete the payment process, which pay less time to improve the efficiency of payment.

Can we spend our way out of the AIDS epidemic? A world halting AIDS model

PubMed Central

2009-01-01

Background There has been a sudden increase in the amount of money donors are willing to spend on the worldwide HIV/AIDS epidemic. Present plans are to hold most of the money in reserve and spend it slowly. However, rapid spending may be the best strategy for halting this disease. Methods We develop a mathematical model that predicts eradication or persistence of HIV/AIDS on a world scale. Dividing the world into regions (continents, countries etc), we develop a linear differential equation model of infectives which has the same eradication properties as more complex models. Results We show that, even if HIV/AIDS can be eradicated in each region independently, travel/immigration of infectives could still sustain the epidemic. We use a continent-level example to demonstrate that eradication is possible if preventive intervention methods (such as condoms or education) reduced the infection rate to two fifths of what it is currently. We show that, for HIV/AIDS to be eradicated within five years, the total cost would be ≈ $63 billion, which is within the existing $60 billion (plus interest) amount raised by the donor community. However, if this action is spread over a twenty year period, as currently planned, then eradication is no longer possible, due to population growth, and the costs would exceed $90 billion. Conclusion Eradication of AIDS is feasible, using the tools that we have currently to hand, but action needs to occur immediately. If not, then HIV/AIDS will race beyond our ability to afford it. PMID:19922685

Development assistance for health: should policy-makers worry about its macroeconomic impact?

PubMed

Cavagnero, Eleonora; Lane, Christopher; Evans, David B; Carrin, Guy

2008-11-01

Many low-income countries need to substantially increase expenditure to meet universal coverage goals for essential health services but, because they have very low-incomes, most will be unable to raise adequate funds exclusively from domestic sources in the short to medium term. Increased aid for health will be required. However, there has long been a concern that the rapid arrival of large amounts of foreign exchange in a country could lead to an increase in inflation and loss of international competitiveness, with an adverse impact on exports and economic growth, an economic phenomenon termed 'Dutch disease'. We review cross-country and country-level empirical studies and propose a simple framework to gauge the extent of macroeconomic risks. Of the 15 low-income countries that are increasing aid-financed health spending, 7 have high macroeconomic risks that may constrain the sustained expansion of spending. These conditions also apply in one-quarter of the 42 countries not presently increasing spending. Health authorities should be aware of the multiple risk factors at play, including factors that are health-sector specific and others that generally are not. They should also realize that there are effective means for mitigating the risk of Dutch disease associated with increasing development assistance for health. International partners also have an important role to play since more sustainable and predictable flows of donor funding will allow more productivity enhancing investment in physical and human capital, which will also contribute to ensuring there are few harmful macroeconomic effects of increases in aid.

Experiences with Deriva: An Asset Management Platform for Accelerating eScience.

PubMed

Bugacov, Alejandro; Czajkowski, Karl; Kesselman, Carl; Kumar, Anoop; Schuler, Robert E; Tangmunarunkit, Hongsuda

2017-10-01

The pace of discovery in eScience is increasingly dependent on a scientist's ability to acquire, curate, integrate, analyze, and share large and diverse collections of data. It is all too common for investigators to spend inordinate amounts of time developing ad hoc procedures to manage their data. In previous work, we presented Deriva, a Scientific Asset Management System, designed to accelerate data driven discovery. In this paper, we report on the use of Deriva in a number of substantial and diverse eScience applications. We describe the lessons we have learned, both from the perspective of the Deriva technology, as well as the ability and willingness of scientists to incorporate Scientific Asset Management into their daily workflows.

The interplay of couple's shared time, women's intimacy, and intradyadic stress.

PubMed

Milek, Anne; Butler, Emily A; Bodenmann, Guy

2015-12-01

Theoretically, spending time together should be central for couples to build intimacy and should be associated with less relationship stress; however, few empirical studies have examined these links. The present study used 14 days of diary data from 92 women to investigate the interplay between the amount of time they spent with their partner (shared time), intimacy, and daily stress originating inside the relationship (intradyadic stress) on a within- and between-personal level. Multilevel analyses revealed moderation patterns: For example, when women spent more time with their partners than usual on a weekday with low levels of intradyadic stress, they reported higher intimacy. These associations varied substantially between women and were weaker on the weekend or on days with high levels of intradyadic stress. At the between-person level, higher average shared time appeared to buffer the negative association between intradyadic stress and intimacy. Our results suggest that daily fluctuations in intradyadic stress, intimacy, and shared time may have different implications compared with aggregated amounts of those variables. Spending more time together on a weekday with low intimacy might be linked to more intradyadic stress, but aggregated over the long run, spending more time together may provide opportunities for stress resolution and help couples to maintain their intimacy. (c) 2015 APA, all rights reserved).

Changes in Health Care Spending and Quality 4 Years into Global Payment

PubMed Central

Song, Zirui; Rose, Sherri; Safran, Dana G.; Landon, Bruce E.; Day, Matthew P.; Chernew, Michael E.

2014-01-01

BACKGROUND Spending and quality under global budgets remain unknown beyond 2 years. We evaluated spending and quality measures during the first 4 years of the Blue Cross Blue Shield of Massachusetts Alternative Quality Contract (AQC). METHODS We compared spending and quality among enrollees whose physician organizations entered the AQC from 2009 through 2012 with those among persons in control states. We studied spending changes according to year, category of service, site of care, experience managing risk contracts, and price versus utilization. We evaluated process and outcome quality. RESULTS In the 2009 AQC cohort, medical spending on claims grew an average of $62.21 per enrollee per quarter less than it did in the control cohort over the 4-year period (P<0.001). This amount is equivalent to a 6.8% savings when calculated as a proportion of the average post-AQC spending level in the 2009 AQC cohort. Analogously, the 2010, 2011, and 2012 cohorts had average savings of 8.8% (P<0.001), 9.1% (P<0.001), and 5.8% (P = 0.04), respectively, by the end of 2012. Claims savings were concentrated in the outpatient-facility setting and in procedures, imaging, and tests, explained by both reduced prices and reduced utilization. Claims savings were exceeded by incentive payments to providers during the period from 2009 through 2011 but exceeded incentive payments in 2012, generating net savings. Improvements in quality among AQC cohorts generally exceeded those seen elsewhere in New England and nationally. CONCLUSIONS As compared with similar populations in other states, Massachusetts AQC enrollees had lower spending growth and generally greater quality improvements after 4 years. Although other factors in Massachusetts may have contributed, particularly in the later part of the study period, global budget contracts with quality incentives may encourage changes in practice patterns that help reduce spending and improve quality. (Funded by the Commonwealth Fund and others.) PMID:25354104

The economic downturn and its lingering effects reduced medicare spending growth by $4 billion in 2009-12.

PubMed

Dranove, David; Garthwaite, Craig; Ody, Christopher

2015-08-01

Previous work has found a strong connection between the most recent economic recession and reductions in private health spending. However, the effect of economic downturns on Medicare spending is less clear. In contrast to studies involving earlier time periods, our study found that when the macroeconomy slowed during the Great Recession of 2007-09, so did Medicare spending growth. A small (14 percent) but significant share of the decline in Medicare spending growth from 2009 to 2012 relative to growth from 2004 to 2009 can be attributed to lingering effects of the recession. Absent the economic downturn, Medicare spending would have been $4 billion higher in 2009-12. A major reason for the relatively small impact of the macroeconomy is the relative lack of labor-force participation among people ages sixty-five and older. We estimate that if they had been working at the same rate as the nonelderly before the recession, the effect of the downturn on Medicare spending growth would have been twice as large. Project HOPE—The People-to-People Health Foundation, Inc.

Do High Fidelity Wraparound Services for Youth with Serious Emotional Disturbances Save Money in the Long-Term?

PubMed

Snyder, Angela; Marton, James; McLaren, Susan; Feng, Bo; Zhou, Mei

2017-12-01

Treating youth with serious emotional disturbances (SED) is expensive often requiring institutional care. A significant amount of recent federal and state funding has been dedicated to expanding home and community-based services for these youth as an alternative to institutional care. High Fidelity Wraparound (Wrap) is an evolving, evidence-informed practice to help sustain community-based placements for youth with an SED through the use of intensive, customized care coordination among parents, multiple child-serving agencies, and providers. While there is growing evidence on the benefits of Wrap, few studies have examined health care spending associated with Wrap participation and none have examined spending patterns after the completion of Wrap. Merging health care spending data from multiple agencies and programs allows for a more complete picture of the health care costs of treating these youth in a system-of-care framework. (i) To compare overall health care spending for youth who transitioned from institutional care into Wrap (the treatment group) versus youth not receiving Wrap (the control group) and (ii) to compare changes in health care spending, overall and by category, for both groups before (the pre-period) and after (the post-period) Wrap participation. The treatment group (N=161) is matched to the control group (N=324) temporally based on the month the youth entered institutional care. Both total health care spending and spending by category are compared for each group pre- and post-Wrap participation. The post-period includes the time in which the youth was receiving Wrap services and one year afterwards to capture long-term cost impacts. In the year before Wrap participation, the treatment group averaged USD 8,433 in monthly health care spending versus USD 4,599 for the control group. Wrap participation led to an additional reduction of USD 1,130 in monthly health care spending as compared to the control group in the post-period. For youth participating in Wrap, these spending reductions were the result of decreases in mental health inpatient spending and general outpatient spending. Youth participating in Wrap had much higher average monthly costs than youth in the control group for the year prior to entering Wrap, suggesting that the intervention targeted youth with the highest mental health utilization and likely more complex needs. While both groups experienced reductions in spending, the treatment group experienced larger absolute reductions, but smaller relative reductions associated with participation. These differences were driven mainly by reductions in mental health inpatient spending. Larger reductions in general outpatient spending for the treatment group suggest spillover benefits in terms of physical health care spending. Further analysis is needed to assess how these spending changes impacted health outcomes. Wrap or similar programs may lead to reductions in health care spending. This is the first study to find evidence of longer-term spending reductions for up to a year after Wrap participation. Randomized trials or some other source of plausibly exogenous variation in Wrap participation is needed to further assess the causal impact of Wrap on health care spending, outcomes, or broader system-of-care spending.

Evaluation of transportation microenvironments through assessment of cyclists' exposure to traffic related particulate matter.

DOT National Transportation Integrated Search

2011-03-01

Urban residents spend a considerable amount of outdoor time in transportation microenvironments as pedestrians, bicycle commuters, public transit users, residents and workers situated along roadways, and commuters within vehicles. Within these transp...

Walter Cronkite Speaks to Teachers...(and That's the Way It Is).

ERIC Educational Resources Information Center

Cronkite, Walter; Martorelli, Debra

1980-01-01

In this interview with "Instructor" assistant editor Debra Martorelli, respected television journalist Walter Cronkite discusses the amount of time children spend watching television, public concerns with the schools, and the news media's coverage of education. (SJL)

Integrated Pest Management in Schools Program Brochure

EPA Pesticide Factsheets

Our Nation's children spend a considerable amount of their time in schools, as do teachers and school support staff. EPA is working to reduce the risk that both children and employees experience from pests and pesticides in and around schools.

Screen Time, How Much Is Too Much? The Social and Emotional Costs of Technology on the Adolescent Brain

ERIC Educational Resources Information Center

DeWeese, Katherine Lynn

2014-01-01

Screen time no longer means just the amount of time one spends in front of the television. Now it is an aggregate amount of time spent on smartphones, computers as well as multitasking with different devices. How much are the glowing rectangles taking away from adolescent social and emotional health? How is it changing how students learn and how…

On Values, Determinants of Spending, and Civil Rights: Response to Commentaries on Braddock et al.

ERIC Educational Resources Information Center

Braddock, David

1987-01-01

In response to comments on his nationwide study of public mental retardation/developmental disabilities spending in the states, the author considers classification of funds (income maintenance, large private facilities and prisons, nursing homes, and education/vocational rehabilitation), values, determinants, civil rights, and reform. (DB)

After the Blackbird Whistles: Listening to Silence in Classrooms

ERIC Educational Resources Information Center

Schultz, Katherine

2010-01-01

Background/Context: Students spend a large part of their time in schools in silence. However, teachers tend to spend most of their time attending to student talk. Anthropological and linguistic research has contributed to an understanding of silence in particular communities, offering explanations for students' silence in school. This research…

Three large-scale changes to the Medicare program could curb its costs but also reduce enrollment

PubMed Central

Eibner, Christine; Goldman, Dana P.; Sullivan, Jeffrey; Garber, Alan M.

2013-01-01

Medicare spending accounts for a substantial fraction of Federal spending, and significant program changes may be necessary for long-run fiscal balance. We used a microsimulation approach to estimate how benefit changes to Medicare–including Part A, for hospital care, premiums, premium support credits, and changing the eligibility age–affect long-term Medicare spending and enrollment. All policies considered reduce spending, with reductions ranging from 2.4 to 24 percent between 2012 and 2036. However, the policies also reduce coverage among the elderly. To achieve significant costs savings without causing substantial uninsurance among seniors, benefits changes would likely need to occur in combination with other options. PMID:23650322

A comparison of global conservation prioritization models with spatial spending patterns of conservation nongovernmental organizations.

PubMed

Holmes, George; Scholfield, Katherine; Brockington, Dan

2012-08-01

In recent decades, various conservation organizations have developed models to prioritize locations for conservation. Through a survey of the spending patterns of 281 conservation nongovernmental organizations (NGOs), we examined the relation between 2 such models and spatial patterns of spending by conservation NGOs in 44 countries in sub-Saharan Africa. We tested whether, at the country level, the proportion of a country designated as a conservation priority was correlated with where NGOs spent money. For one model (the combination of Conservation International's hotspots and High Biodiversity Wilderness Areas, which are areas of high endemism with high or low levels of vegetation loss respectively), there was no relation between the proportion of a country designated as a priority and levels of NGO spending, including by the NGO associated with the model. In the second model (Global 200), the proportion of a country designated as a priority and the amount of money spent by NGOs were significantly and positively related. Less money was spent in countries in northern and western sub-Saharan Africa than countries in southern and eastern Africa, relative to the proportion of the country designated as a conservation priority. We suggest that on the basis of our results some NGOs consider increasing their spending on the areas designated as of conservation priority which are currently relatively underfunded, although there are economic, political, cultural, historical, biological, and practical reasons why current spending patterns may not align with priority sites. ©2012 Society for Conservation Biology.

2017 National Park visitor spending effects : Economic contributions to local communities, states, and the Nation

USGS Publications Warehouse

Cullinane Thomas, Catherine M.; Koontz, Lynne; Cornachione, Egan

2018-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income. In 2017, the National Park System received an estimated 331 million recreation visits. Visitors to National Parks spent an estimated \\$18.2 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 306 thousand jobs, \\$11.9 billion in labor income, \\$20.3 billion in value added, and \\$35.8 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.5 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with \\$3.7 billion in economic output directly contributed to local gateway economies nationally. Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

2016 National Park visitor spending effects: Economic contributions to local communities, states, and the Nation

USGS Publications Warehouse

Cullinane Thomas, Catherine; Koontz, Lynne

2017-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.In 2016, the National Park System received an estimated 330,971,689 recreation visits. Visitors to National Parks spent an estimated \\$18.4 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 318 thousand jobs, \\$12.0 billion in labor income, \\$19.9 billion in value added, and \\$34.9 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.7 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bars sector, with \\$3.7 billion in economic output directly contributed to local gateway economies nationally.Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at https://www.nps.gov/subjects/socialscience/vse.htm.

2015 National Park visitor spending effects: Economic contributions to local communities, states, and the nation

USGS Publications Warehouse

Cullinane Thomas, Catherine M.; Koontz, Lynne

2016-01-01

The National Park Service (NPS) manages the Nation’s most iconic destinations that attract millions of visitors from across the Nation and around the world. Trip-related spending by NPS visitors generates and supports a considerable amount of economic activity within park gateway communities. This economic effects analysis measures how NPS visitor spending cycles through local economies, generating business sales and supporting jobs and income.In 2015, the National Park System received over 307.2 million recreation visits. NPS visitors spent \\$16.9 billion in local gateway regions (defined as communities within 60 miles of a park). The contribution of this spending to the national economy was 295 thousand jobs, \\$11.1 billion in labor income, \\$18.4 billion in value added, and \\$32.0 billion in economic output. The lodging sector saw the highest direct contributions with \\$5.2 billion in economic output directly contributed to local gateway economies nationally. The sector with the next greatest direct contributions was the restaurants and bar sector, with \\$3.4 billion in economic output directly contributed to local gateway economies nationally.Results from the Visitor Spending Effects report series are available online via an interactive tool. Users can view year-by-year trend data and explore current year visitor spending, jobs, labor income, value added, and economic output effects by sector for national, state, and local economies. This interactive tool is available at http://go.nps.gov/vse.

Retail battle for conservation dollars

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

McCaughey, J.

1981-07-16

Large companies are entering the profitable retail market with conservation equipment and services that will compete for a share of the $10 to $80 billion Americans will spend on energy efficiency this year. Energy centers and clinics are also opening around the country to market products and compete with the utilities for energy audit business. The new retailing efforts are counting on homeowners' willingness to spend money to lower their energy bills. The smaller companies hope to hold their own against competition from large corporations. (DCK)

Feasibility of a new Indiana Coordinate Reference System (INCRS).

DOT National Transportation Integrated Search

2012-10-01

Engineers, Surveyors, and GIS Professionals spend an enormous amount of time correcting field surveys to the classical State Plane : Coordinate System (SPCS). The current mapping corrections are in the order of 1:33,000, or 30 parts per million (ppm)...

What do we know about location affordability in U.S. shrinking cities?

DOT National Transportation Integrated Search

2017-07-01

In late 2013, the Department of Housing and Urban Development (HUD) launched the Location Affordability Index (LAI) portal. Their dataset uses models to estimate typical amount households spend on housing and transportation at the block group level, ...

Unintended consequences of eliminating Medicare payments for consultations1

PubMed Central

Song, Zirui; Ayanian, John Z.; Wallace, Jacob; He, Yulei; Gibson, Teresa B.; Chernew, Michael E.

2013-01-01

Background Prior to 2010, Medicare payments for consultations (commonly billed by specialists) were substantially higher than for office visits of similar complexity (commonly billed by primary care physicians). In January 2010, Medicare eliminated consultation payments from the Part B Physician Fee Schedule and increased fees for office visits. This change was intended to be budget neutral and to decrease payments to specialists while increasing payments to primary care physicians. We assessed the impact of this policy on spending, volume, and complexity for outpatient office encounters in 2010. Methods We examined 2007–2010 outpatient claims for 2,247,810 Medicare beneficiaries with Medicare Supplemental (Medigap) coverage through large employers in the Thomson Reuters MarketScan Database. We used segmented regression analysis to study changes in spending, volume, and complexity of office encounters adjusted for age, sex, health status, secular trends, seasonality, and hospital referral region. Results “New” office visits largely replaced consultations in 2010. An average of $10.20 (6.5 percent) more was spent per beneficiary per quarter on physician encounters after the policy. The total volume of physician encounters did not change significantly. The increase in spending was largely explained by higher office visit fees from the policy and a shift toward higher complexity visits to both specialists and primary care physicians. Conclusions The elimination of consultations led to a net increase in spending on visits to both primary care physicians and specialists. Higher prices, partially due to the subjectivity of codes in the physician fee schedule, explained the spending increase, rather than higher volumes. PMID:23336095

Endowment Spending: Building a Stronger Policy Framework

ERIC Educational Resources Information Center

Sedlacek, Verne O.; Jarvis, William F.

2010-01-01

A large and growing body of work exists on the subject of endowment investing, but the equally important topic of endowment spending is treated less often. While the degree to which endowed institutions depend on their endowment for budgetary support varies widely, the market crisis of 2008-09 demonstrated that failure by the endowment to provide…

Systemic Inequities in Special Education Financing

ERIC Educational Resources Information Center

Conlin, Michael; Jalilevand, Meg

2015-01-01

Since the implementation of IDEA in 1975, as spending on education has continued to grow, a large portion of that spending has been dedicated to students with special needs. This study uses a panel dataset of local and intermediate school districts to examine the complex special education funding and delivery scheme in the State of Michigan. Using…

Getting the Point across

ERIC Educational Resources Information Center

Schuller, Tom

2010-01-01

With an election looming and big cuts to public spending on the way, policy proposals that involve spending large sums of new money are unlikely to be well received by politicians. So what questions for candidates might adult educators have in their pockets and put to prospective parliamentarians as they join the throng in the local school? The…

Consumption patterns and levels among households with HIV positive members and economic impoverishment due to medical spending in Pune city, India.

PubMed

Sharma, Varun; Krishnaswamy, Divya; Mulay, Sanjeevanee

2015-01-01

HIV infection poses a serious threat to the economy of a household. Out of pocket (OOP) health spending can be prohibitive and can drag households below poverty level. Based on the data collected from a cross-sectional survey of 401 households with HIV+ members in Pune city, India, this paper examines the consumption levels and patterns among households, and comments on the economic impoverishment resulting from OOP medical spending. Analysis reveals that households with HIV members spend a major portion of their monthly consumption expenditure on food items. Medical expenditure constitutes a large portion of their total consumption spending. Expenditure on children's education constitutes a minor proportion of total monthly spending. A high proportion of medical expenditure has a bearing on the economic condition of households with HIV members. Poverty increases by 20% among the studied HIV households when OOP health spending is adjusted. It increases 18% among male-headed households and 26% among female-headed households. The results reiterate the need of greater support from the government in terms of accessibility and affordability of health care to save households with HIV members from economic catastrophe.

The Economics of NASA Mission Cost Reserves

NASA Technical Reports Server (NTRS)

Whitley, Sally; Shinn, Stephen

2012-01-01

Increases in NASA mission costs are well-noted but not well-understood, and there is little evidence that they are decreasing in frequency or amount over time. The need to control spending has led to analysis of the causes and magnitude of historical mission overruns, and many program control efforts are being implemented to attempt to prevent or mitigate the problem (NPR 7120). However, cost overruns have not abated, and while some direct causes of increased spending may be obvious (requirements creep, launch delays, directed changes, etc.), the underlying impetus to spend past the original budget may be more subtle. Gaining better insight into the causes of cost overruns will help NASA and its contracting organizations to avoid .them. This paper hypothesizes that one cause of NASA mission cost overruns is that the availability of reserves gives project team members an incentive to make decisions and behave in ways that increase costs. We theorize that the presence of reserves is a contributing factor to cost overruns because it causes organizations to use their funds less efficiently or to control spending less effectively. We draw a comparison to the insurance industry concept of moral hazard, the phenomenon that the presence of insurance causes insureds to have more frequent and higher insurance losses, and we attempt to apply actuarial techniques to quantifY the increase in the expected cost of a mission due to the availability of reserves. We create a theoretical model of reserve spending motivation by defining a variable ReserveSpending as a function of total reserves. This function has a positive slope; for every dollar of reserves available, there is a positive probability of spending it. Finally, the function should be concave down; the probability of spending each incremental dollar of reserves decreases progressively. We test the model against available NASA CADRe data by examining missions with reserve dollars initially available and testing whether they are more likely to spend those dollars, and whether larger levels of reserves lead to higher cost overruns. Finally, we address the question of how to prevent reserves from increasing mission spending without increasing cost risk to projects budgeted without any reserves. Is there a "sweet spot"? How can we derive the maximum benefit associated with risk reduction from reserves while minimizing the effects of reserve spending motivation?

Know how to maximize maintenance spending

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

Carrino, A.J.; Jones, R.B.; Platt, W.E.

Solomon has developed a methodology to determine a large optimum point where availability meets maintenance spending for Powder River Basin (PRB) coal-fired units. Using a database of sufficient size and composition across various operating ranges, Solomon generated an algorithm that predicts the relationship between maintenance spending and availability. Coupling this generalized algorithm with a unit-specific market-loss curve determines the optimum spending for a facility. The article presents the results of the analysis, how this methodology can be applied to develop optimum operating and financial targets for specific units and markets and a process to achieve those targets. It also describesmore » how this methodology can be used for other types of fossil-fired technologies and future enhancements to the analysis. 5 figs.« less

Influence of Solid Noise Barriers on Near-Road and On-Road Air Quality

EPA Science Inventory

Public health concerns regarding adverse health effects for populations spending significant amounts of time near high traffic roadways has increased substantially in recent years. Roadside features, including solid noise barriers, have been investigated as potential methods to ...

5 Ways to Be More Active in Your Everyday Life

Cancer.gov

In addition to meeting the physical activity recommendations, research suggests that getting more activity is better. Another way to increase your physical activity (and decrease the amount of time you spend sitting) is to get moving more in your everyday life.

Enhance "One" Year of Education.

ERIC Educational Resources Information Center

Longhurst, Max L.

2000-01-01

Though substitute teachers spend significant amounts of time with students, they receive little training. The Substitute Teaching Institute at Utah State University has developed training materials that include six content components: being prepared and professional, classroom management skills, legal and first aid issues, teaching and…

Therapy Preferences in Melanoma Treatment - Willingness to Pay and Preference of Quality versus Length of Life of Patients, Physicians and Healthy Controls

PubMed Central

Krammer, Ramona; Heinzerling, Lucie

2014-01-01

Background New melanoma therapies, like e.g. ipilimumab, improve survival. However, only a small subset of patients benefits while 60% encounter side effects. Furthermore, these marginal benefits come at a very high price of €110’000 per treatment. This study examines attitudes towards melanoma therapy options of physicians, healthy individuals and patients, their willingness to pay and preference of quality versus length of life. Methods Based on findings from a focus group questionnaires were developed and pretested. After obtaining ethical approval and informed consent surveys were conducted in a total of 90 participants (n = 30 for each group). Statistical analyses were conducted using R. Findings Attitudes vastly differed between healthy participants, physicians and melanoma patients. Whereas melanoma patients show a high willingness to endure side effects despite very small survival gains (down to 1 extra week) or even only hope with no survival benefit, healthy controls are more critical, while physicians are the most therapy adverse. Consequently, if given €100’000 and the free decision what to spend the money on the willingness to pay for therapy was much higher in the patient group (68%) compared to 28% of healthy controls and only 43% of the physicians, respectively. When lowering the amount of cash that could be received instead of ipilimumab to €50’000 or €10’000 to test price sensitivity 69% (+1%) and 76% (+8%) of melanoma patients, respectively, preferred ipilimumab over cash. When judging on societal spending even melanoma patients opted for spending on ipilimumab in only 21%. Conclusion The judgment about the benefits of new treatment options largely differs between groups, physicians being the most critical against therapy. Price elasticity was low. PMID:25369124

The impact of parent-child interaction on brain structures: cross-sectional and longitudinal analyses.

PubMed

Takeuchi, Hikaru; Taki, Yasuyuki; Hashizume, Hiroshi; Asano, Kohei; Asano, Michiko; Sassa, Yuko; Yokota, Susumu; Kotozaki, Yuka; Nouchi, Rui; Kawashima, Ryuta

2015-02-04

There is a vast amount of evidence from psychological studies that the amount of parent-child interaction affects the development of children's verbal skills and knowledge. However, despite the vast amount of literature, brain structural development associated with the amount of parent-child interaction has never been investigated. In the present human study, we used voxel-based morphometry to measure regional gray matter density (rGMD) and examined cross-sectional correlations between the amount of time spent with parents and rGMD among 127 boys and 135 girls. We also assessed correlations between the amount of time spent with parents and longitudinal changes that occurred a few years later among 106 boys and 102 girls. After correcting for confounding factors, we found negative effects of spending time with parents on rGMD in areas in the bilateral superior temporal gyrus (STG) via cross-sectional analyses as well as in the contingent areas of the right STG. We also confirmed positive effects of spending time with parents on the Verbal Comprehension score in cross-sectional and longitudinal analyses. rGMD in partly overlapping or contingent areas of the right STG was negatively correlated with age and the Verbal Comprehension score in cross-sectional analyses. Subsequent analyses revealed verbal parent-child interactions have similar effects on Verbal Comprehension scores and rGMD in the right STG in both cross-sectional and longitudinal analyses. These findings indicate that parent-child interactions affect the right STG, which may be associated with verbal skills. Copyright © 2015 the authors 0270-6474/15/352233-13$15.00/0.

Determining Financial Capability of SSI/SSDI Beneficiaries with Psychiatric Disabilities: A Case Series

PubMed Central

Lazar, Christina M.; Black, Anne C.; McMahon, Thomas J; O’Shea, Kevin; Rosen, Marc I.

2015-01-01

Objective Social Security beneficiaries’ liberty is constrained if they are judged incapable of managing their disability payments and are assigned a fiduciary to manage benefit payments on their behalf. Conversely, beneficiaries’ well-being may be compromised if they misspend money that they need to survive. Several studies have shown that determinations of financial capability are made inconsistently and capability guidelines appear to be applied inconsistently in practice. This case series describes the ambiguities remaining for a small number of individuals even after published criteria for capability— failing to meet basic needs and/or harmful spending on drugs— are applied. Methods Trained, experienced assessors rated the financial capability of 119 individuals in intensive outpatient or inpatient psychiatric facilities who received SSI or SSDI payments. Ten individuals’ cases were determined difficult to judge. Results Six sources of ambiguity were identified by case review: distinguishing incapability from the challenges of navigating poverty, the amount of nonessential spending needed to be considered incapable, the amount of spending on harmful things needed to be considered incapable, how intermittent periods of capability and incapability should be considered, the relative weighting of past behavior and future plans to change, and discrepancies between different sources of information. Conclusion The cases raise fundamental questions about what financial incapability is, but also illustrate how detailed consideration of beneficiaries’ living situations and decision making can inform the difficult dichotomous decision about capability. PMID:25727116

Un/Paid Labor: Medicaid Home and Community Based Services Waivers That Pay Family as Personal Care Providers.

PubMed

Friedman, Carli; Rizzolo, Mary C

2016-08-01

The United States long-term services and supports system is built on largely unpaid (informal) labor. There are a number of benefits to allowing family caregivers to serve as paid personal care providers including better health and satisfaction outcomes, expanded workforces, and cost effectiveness. The purpose of this study was to examine how Medicaid HCBS Section 1915(c) waivers for people with intellectual and developmental disabilities allocate personal care services to pay family caregivers. Our analysis revealed about two thirds of waivers in fiscal year (FY) 2014 allowed for family caregivers to potentially be paid for personal care services. This amounted to up to $2.71 billion of projected spending, which is slightly more than half of all personal care service expenditures in FY 2014.

Propensity to spending of an average consumer over a brief period

NASA Astrophysics Data System (ADS)

De Luca, Roberto; Di Mauro, Marco; Falzarano, Angelo; Naddeo, Adele

2016-08-01

Understanding consumption dynamics and its impact on the whole economy and welfare within the present economic crisis is not an easy task. Indeed the level of consumer demand for different goods varies with the prices, consumer incomes and demographic factors. Furthermore crisis may trigger different behaviors which result in distortions and amplification effects. In the present work we propose a simple model to quantitatively describe the time evolution over a brief period of the amount of money an average consumer decides to spend, depending on his/her available budget. A simple hydrodynamical analog of the model is discussed. Finally, perspectives of this work are briefly outlined.

Compression of morbidity: a personal, research, and national fiscal solvency perspective.

PubMed

O'Donnell, Michael P

2012-01-01

Soon to be published research shows that people with positive health practices reduced the period of disability at the end of life by an estimated six to nine years. If improved health habits could reduce the period of disability for the entire population of the United States by this amount, spending on Medicare, Medicaid, and Social Security would drop substantially, and state and federal income tax revenues would increase substantially. This is critically important given that the Congressional Budget Office has projected that 100% of federal tax revenues will be consumed by Medicare, Medicaid, and Social Security by the year 2050 if current health and spending trends continue.

RNA sequencing: current and prospective uses in metabolic research.

PubMed

Vikman, Petter; Fadista, Joao; Oskolkov, Nikolay

2014-10-01

Previous global RNA analysis was restricted to known transcripts in species with a defined transcriptome. Next generation sequencing has transformed transcriptomics by making it possible to analyse expressed genes with an exon level resolution from any tissue in any species without any a priori knowledge of which genes that are being expressed, splice patterns or their nucleotide sequence. In addition, RNA sequencing is a more sensitive technique compared with microarrays with a larger dynamic range, and it also allows for investigation of imprinting and allele-specific expression. This can be done for a cost that is able to compete with that of a microarray, making RNA sequencing a technique available to most researchers. Therefore RNA sequencing has recently become the state of the art with regards to large-scale RNA investigations and has to a large extent replaced microarrays. The only drawback is the large data amounts produced, which together with the complexity of the data can make a researcher spend far more time on analysis than performing the actual experiment. © 2014 Society for Endocrinology.

Basic patterns in national health expenditure.

PubMed

Musgrove, Philip; Zeramdini, Riadh; Carrin, Guy

2002-01-01

Analysed in this paper are national health accounts estimates for 191 WHO Member States for 1997, using simple comparisons and linear regressions to describe spending on health and how it is financed. The data cover all sources - out-of-pocket spending, social insurance contributions, financing from government general revenues and voluntary and employment-related private insurance - classified according to their completeness and reliability. Total health spending rises from around 2-3% of gross domestic product (GDP) at low incomes (< 1000 US dollars per capita) to typically 8-9% at high incomes (> 7000 US dollars). Surprisingly, there is as much relative variation in the share for poor countries as for rich ones, and even more relative variation in amounts in US dollars. Poor countries and poor people that most need protection from financial catastrophe are the least protected by any form of prepayment or risk-sharing. At low incomes, out-of-pocket spending is high on average and varies from 20-80% of the total; at high incomes that share drops sharply and the variation narrows. Absolute out-of-pocket expenditure nonetheless increases with income. Public financing increases faster, and as a share of GDP, and converges at high incomes. Health takes an increasing share of total public expenditure as income rises, from 5-6% to around 10%. This is arguably the opposite of the relation between total health needs and need for public spending, for any given combination of services. Within public spending, there is no convergence in the type of finance - general revenue versus social insurance. Private insurance is usually insignificant except in some rich countries.

Basic patterns in national health expenditure.

PubMed Central

Musgrove, Philip; Zeramdini, Riadh; Carrin, Guy

2002-01-01

Analysed in this paper are national health accounts estimates for 191 WHO Member States for 1997, using simple comparisons and linear regressions to describe spending on health and how it is financed. The data cover all sources - out-of-pocket spending, social insurance contributions, financing from government general revenues and voluntary and employment-related private insurance - classified according to their completeness and reliability. Total health spending rises from around 2-3% of gross domestic product (GDP) at low incomes (< 1000 US dollars per capita) to typically 8-9% at high incomes (> 7000 US dollars). Surprisingly, there is as much relative variation in the share for poor countries as for rich ones, and even more relative variation in amounts in US dollars. Poor countries and poor people that most need protection from financial catastrophe are the least protected by any form of prepayment or risk-sharing. At low incomes, out-of-pocket spending is high on average and varies from 20-80% of the total; at high incomes that share drops sharply and the variation narrows. Absolute out-of-pocket expenditure nonetheless increases with income. Public financing increases faster, and as a share of GDP, and converges at high incomes. Health takes an increasing share of total public expenditure as income rises, from 5-6% to around 10%. This is arguably the opposite of the relation between total health needs and need for public spending, for any given combination of services. Within public spending, there is no convergence in the type of finance - general revenue versus social insurance. Private insurance is usually insignificant except in some rich countries. PMID:11953792

Influence of Noise Barriers on Near-Road and On-Road Air Quality: Results from Phoenix

EPA Science Inventory

The presentation describes field study results quantifying the impact of roadside barriers under real-world conditions in Phoenix, Arizona. Public health concerns regarding adverse health effects for populations spending significant amounts of time near high traffic roadways has ...

Units Matter

ERIC Educational Resources Information Center

I, Ji Yeong; Dougherty, Barbara J.; Berkaliev, Zaur

2015-01-01

Young children spend a much greater amount of time on practicing multiplication facts compared to understanding the concept of multiplication. When students have long-term, foundational concepts rather than a series of fragmented algorithms or facts, they are more likely to understand and generalize the mathematics. Using generalized models that…

A winter survey of domestic heating among elderly patients.

PubMed Central

Morgan, R; Blair, A; King, D

1996-01-01

Elderly people have a greater need for domestic heating given the time they spend at home and the decline in the body thermoregulation that occurs with ageing. The use of domestic heating by 200 mentally competent newly admitted elderly in patients was evaluated by means of a questionnaire survey. Most patients (69%) were aware of the addition of value added tax (VAT) to their fuel bill and 31% said they had reduced the amount of heating they use because of this. A third of patients (29.5%) said they had difficulty keeping warm prior to this admission. The majority of patients said they could not manage to keep warm in the winter without financial hardship. In addition, 29% said they had reduced the amount spent on food in order to pay for fuel bills. This study suggests that cold may contribute to hospital admissions in elderly patients. This should have implications for government spending and taxation policy on domestic heating. PMID:8683507

Gender differences in the roles and functions of inpatient psychiatric nurses.

PubMed

Torkelson, Diane J; Seed, Mary S

2011-03-01

This study explored the difference between male and female psychiatric nurses' job performance and job satisfaction levels on an acute care inpatient unit. The amount of time male (n = 28) and female (n = 45) nurses spent on 10 specific functions and roles during a shift were observed and recorded. The nurses also self-rated the amount of time they spent on these specific functions and roles. The observed and self-rated functions were then correlated with job satisfaction. Female nurses were observed and self-rated as spending significantly more time on patient care activities, and these activities were significantly correlated with higher job satisfaction levels. Male nurses who self-rated spending more time on patient care activities had significantly lower job satisfaction scores. Findings confirm the concepts from social role theory that gender identity and expectations influence job performance in psychiatric nursing. The results offer insight for increasing job satisfaction and recruitment/retention efforts. Copyright 2011, SLACK Incorporated.

A winter survey of domestic heating among elderly patients.

PubMed

Morgan, R; Blair, A; King, D

1996-02-01

Elderly people have a greater need for domestic heating given the time they spend at home and the decline in the body thermoregulation that occurs with ageing. The use of domestic heating by 200 mentally competent newly admitted elderly in patients was evaluated by means of a questionnaire survey. Most patients (69%) were aware of the addition of value added tax (VAT) to their fuel bill and 31% said they had reduced the amount of heating they use because of this. A third of patients (29.5%) said they had difficulty keeping warm prior to this admission. The majority of patients said they could not manage to keep warm in the winter without financial hardship. In addition, 29% said they had reduced the amount spent on food in order to pay for fuel bills. This study suggests that cold may contribute to hospital admissions in elderly patients. This should have implications for government spending and taxation policy on domestic heating.

[Nearby nature as a moderator of stress during childhood].

PubMed

Corraliza, José Antonio; Collado, Silvia

2011-04-01

The aim of this investigation is to study the relation between the amount of nature existing in children's daily environments and the way children deal with stressful events. Every day, children are exposed to situations that cause stress. Taking into account previous studies, it is thought that the greener the place where children spend their time, the better they cope with adversities. Thus, when comparing the stress level of children who are exposed to the same amount of adverse situations, the children who have more frequent daily contact with nature will show less stress than those who do not spend time in nature. This effect from nearby nature is called a buffering effect. The present study provides empirical evidence of the buffering effect caused by the existence of Nature in the residential and the school environment. Therefore, our results show that children who have more access to nature increase their resilience, showing a lower stress level than children whose contact with nature is less frequent.

The Determinants of State Spending on Higher Education: How Capital Project Funding Differs from General Fund Appropriations

ERIC Educational Resources Information Center

Ness, Erik C.; Tandberg, David A.

2013-01-01

Our fixed-effects panel data analysis of state spending on higher education fills a near void of studies examining capital expenditures on higher education. In our study, we found that political characteristics (e.g., interest group activity, organizational structure, and formal powers) largely account for differences between general fund and…

Healthy Schools: Lessons for a Clean Educational Environment

ERIC Educational Resources Information Center

US Environmental Protection Agency, 2008

2008-01-01

More than 53 million children and 6 million adults in the United States spend their days in elementary and secondary schools. Reducing environmental risks inside these buildings is critical to maintaining the public health. Almost all of New England's children will spend a large portion of their childhood in school. To help children stay healthy,…

The Physician Payments Sunshine Act: Data Evaluation Regarding Payments to Ophthalmologists

PubMed Central

Chang, Jonathan S.

2014-01-01

Objective/Purpose To review data for ophthalmologists published online from the Physician Payments Sunshine Act. Design Retrospective data review using a publicly available electronic database Methods: Main Outcome Measures A database was downloaded from the Centers for Medicare and Medicaid Services (CMS) Website under Identified General Payments to Physicians and a primary specialty of ophthalmology. Basic statistical analysis was performed including mean, median and range of payments for both single payments and per provider. Data were also summarized by category of payment, geographic region and compared with other surgical subspecialties. Results From August 1, 2013 to December 31, 2013, a total of 55,996 individual payments were reported to 9,855 ophthalmologists for a total of $10,926,447. The mean amount received in a single payment was $195.13 (range $0.04–$193,073). The mean amount received per physician ID was $1,108 (range $1–$397,849) and median amount $112.01. Consulting fees made up the largest percentage of fees. There was not a large difference in payments received by region. The mean payments for the subspecialties of dermatology, neurosurgery, orthopedic surgery and urology ranged from $954–$6,980, and median payments in each field by provider identifier ranged from $88–$173. Conclusions A large amount of data was released by CMS for the Physician Payment Sunshine Act. In ophthalmology, mean and median payments per physician did not vary greatly from other surgical subspecialties. Most single payments were under $100, and most physicians received less than $500 in total payments. Payments for consulting made up the largest category of spending. How this affects patient perception, patient care and medical costs warrants further study. PMID:25578254

Failure to protect: why the individual insurance market is not a viable option for most U.S. families: findings from the Commonwealth Fund Biennial Health Insurance Survey, 2007.

PubMed

Doty, Michelle M; Collins, Sara R; Nicholson, Jennifer L; Rustgi, Sheila D

2009-07-01

Between 2001 and 2007, an increasing share of adults with private insurance--whether employer-based coverage or individual market plans--spent a large amount of their income on premiums and out-of-pocket medical costs, were underinsured, and/or avoided needed health care because of costs. Those with coverage obtained in the individual market were the most affected. Over the last three years, nearly three-quarters of people who tried to buy coverage in this market never actually purchased a plan, either because they could not find one that fit their needs or that they could afford, or because they were turned down due to a preexisting condition. Even people enrolled in employer-based plans are spending larger amounts of their income on health care and curtailing their use of needed services to save money. The findings underscore the need for an expansion of affordable health insurance options, particularly during a time of mounting job losses.

Using Portable Samplers to Determine the Effect of Roadside Vegetation on Near-Road Air Quality

EPA Science Inventory

Growing evidence exists that populations spending significant amounts of time near major roads face increased risks for several adverse health effects.1 These effects may be attributable to increased exposure to particulate matter (PM), gaseous criteria pollutants, and air toxic...

Footprints on Mars

NASA Technical Reports Server (NTRS)

Drake, Bret G.

2013-01-01

The first three human missions to Mars should be to three different geographic sites. Maximize mobility to extend the reach of human exploration beyond the landing site. Maximize the amount of time that the astronauts spend exploring the planet. Provide subsurface access. Return a minimum of 250 kg of samples to Earth.

Academic Researchers Speak

ERIC Educational Resources Information Center

Bergom, Inger; Waltman, Jean; August, Louise; Hollenshead, Carol

2010-01-01

Non-tenure-track (NTT) research faculty are perhaps the most under-recognized group of academic professionals on the campuses today, despite their increasingly important role within the expanding academic research enterprise. The American Association for the Advancement of Science reports that the amount of federal spending on R&D has more than…

Dreams Memories & Photography

ERIC Educational Resources Information Center

Young, Bernard

2012-01-01

Photography students spend a considerable amount of time working on technical issues in shooting, composing, editing, and processing prints. Another aspect of their learning should include the conception and communication of their ideas. A student's memories and dreams can serve as motivation to create images in visual art. Some artists claim that…

Five Star Teacher: In-Service on the Move

ERIC Educational Resources Information Center

Morris, Ronald V.

2017-01-01

Teachers learned knowledge, skills, values, and dispositions through spending significant amounts of time working with heritage sites as they learned more about social studies. Elementary social studies teachers engaged in teacher in-service to increase their abilities to meet geography standards. Teacher professional development that caused…

Swedish technology teachers' attitudes to their subject and its teaching

NASA Astrophysics Data System (ADS)

Nordlöf, Charlotta; Höst, Gunnar E.; Hallström, Jonas

2017-04-01

Background: From previous research among science teachers it is known that teachers' attitudes to their subjects affect important aspects of their teaching, including their confidence and the amount of time they spend teaching the subject. In contrast, less is known about technology teachers' attitudes.

The association between spending on methamphetamine/amphetamine and cannabis for personal use and earnings from acquisitive crime among police detainees in New Zealand.

PubMed

Wilkins, Chris; Sweetsur, Paul

2011-04-01

Few studies have examined the statistical association between methamphetamine/amphetamine use and acquisitive crime. Both methamphetamine/amphetamine and cannabis use have been implicated by New Zealand Police as factors in acquisitive offending among active criminal populations. The aim of our study was to examine the statistical association between spending on methamphetamine/amphetamine and cannabis and earnings from acquisitive crime among police detainees in New Zealand. Four police stations in different regions. A sample of 2125 police detainees were interviewed about their drug use and acquisitive crime. Statistical models were developed to predict involvement in acquisitive crime using spending on methamphetamine/amphetamine and cannabis for personal use, and to examine associations between the level of spending on methamphetamine/amphetamine and cannabis for personal use and level of dollar earnings from acquisitive crime. Self-reported spending on drug use and self-reported earnings from acquisitive crime in the past 30 days. Spending on cannabis and methamphetamine/amphetamine could predict involvement in acquisitive crime. Level of spending on methamphetamine/amphetamine and cannabis was associated positively with the level of earnings from property crime. Level of spending on methamphetamine/amphetamine was also associated positively with level of earnings from drug dealing. There was a largely negative association between level of spending on cannabis and level of earnings from drug dealing. High spending on methamphetamine/amphetamine is associated statistically with higher earnings from acquisitive crime among police detainees. Further research into this association, and in particular the causal nature of the association, is required to obtain clear policy recommendations. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

Three large-scale changes to the Medicare program could curb its costs but also reduce enrollment.

PubMed

Eibner, Christine; Goldman, Dana P; Sullivan, Jeffrey; Garber, Alan M

2013-05-01

With Medicare spending projected to increase to 24 percent of all federal spending and to equal 6 percent of the gross domestic product by 2037, policy makers are again considering ways to curb the program's spending growth. We used a microsimulation approach to estimate three scenarios: imposing a means-tested premium for Part A hospital insurance, introducing a premium support credit to purchase health insurance, and increasing the eligibility age to sixty-seven. We found that the scenarios would lead to reductions in cumulative Medicare spending in 2012-36 of 2.4-24.0 percent. However, the scenarios also would increase out-of-pocket spending for enrollees and, in some cases, cause millions of seniors not to enroll in the program and to be left without coverage. To achieve substantial cost savings without causing substantial lack of coverage among seniors, policy makers should consider benefit changes in combination with other options, such as some of those now being contemplated by the Obama administration and Congress.

R and D: To fund or not to fund

NASA Technical Reports Server (NTRS)

Osterdock, T. N.

1981-01-01

U.S. Government spending to fund the research and development of electronics for a variety of applications is discussed. Commercial enterprises also spend large sums on research and development of electronics and other areas of interest to the U.S. Government and its agencies. The government can take advantage of industrial research programs and thereby maximize the utilization of their own.

Contracting Data Analysis: Assessment of Government-Wide Trends

DTIC Science & Technology

2017-03-01

GAO-17-244SP United States Government Accountability Office (This Page Intentionally Left Blank) United States Government Accountability ...2015, accounting for almost 40 percent of the government’s discretionary spending. Because spending on contracts consumes a large portion of the...year 2015, federal agencies obligated over $430 billion through contracts for goods and services, accounting for almost 40 percent of the

The Budgetary Effects of the United States Participation in the International Monetary Fund

DTIC Science & Technology

2016-06-01

to policymakers and the general public. Proponents of the fair-value approach counter that deci- sions about spending the public’s money should take...member countries, which it must repay, and the amounts owed to members that have lent money to the organiza- tion under the NAB, the GAB, or separate...granted Liberia debt relief in 2010, so it never repaid those new IMF loans in full.1 Because of the relatively small amount of money involved

34 CFR 225.20 - When may a grantee draw down funds?

Code of Federal Regulations, 2010 CFR

2010-07-01

... SECONDARY EDUCATION, DEPARTMENT OF EDUCATION CREDIT ENHANCEMENT FOR CHARTER SCHOOL FACILITIES PROGRAM What... funds after it has signed a performance agreement acceptable to the Department of Education and the... performance agreement provided that the grantee requests to draw down and spend a specific amount of funds and...

Accelerated Reader. What Works Clearinghouse Intervention Report

ERIC Educational Resources Information Center

What Works Clearinghouse, 2009

2009-01-01

"Accelerated Reader" is a computer-based reading management system designed to complement an existing classroom literacy program for grades pre-K-12. It is designed to increase the amount of time students spend reading independently. Students choose reading-level appropriate books or short stories for which Accelerated Reader tests are…

Measuring the Quality of the Website User Experience

ERIC Educational Resources Information Center

Sauro, Jeff

2016-01-01

Consumers spend an increasing amount of time and money online finding information, completing tasks, or making purchases. The quality of the website experience has become a key differentiator for organizations--affecting whether they purchase and their likelihood to return and recommend a website to friends. Two instruments were created to more…

The Payout Method: A Spending Policy That Enhances Return.

ERIC Educational Resources Information Center

Morrell, Louis R.

1991-01-01

College and university business officers are encouraged to implement an endowment distribution method that increases the amount distributed by a fixed annual percentage based on asset mix, inflation, and expected return. Such a payout system provides a predictable, steadily increasing level of endowment income yet maintains the purchasing power of…

Use of a Behavioral Graphic Organizer to Reduce Disruptive Behavior

ERIC Educational Resources Information Center

McDaniel, Sara C.; Flower, Andrea

2015-01-01

Students with challenging behavior spend substantial amounts of time away from instruction due to behavioral problems. Time away from instruction reduces their opportunities for learning, which are critical as these students typically demonstrate academic performance below their same-age peers. After removal from instruction due to behavioral…

Partnering across the Life Course: Sex, Relationships, and Mate Selection

ERIC Educational Resources Information Center

Sassler, Sharon

2010-01-01

Marital delay, relationship dissolution and churning, and high divorce rates have extended the amount of time individuals in search of romantic relationships spend outside of marital unions. The scope of research on intimate partnering now includes studies of "hooking up," Internet dating, visiting relationships, cohabitation, marriage following…

National and community market contributions of Wilderness

Treesearch

Evan Hjerpe; Tom Holmes; Eric White

2017-01-01

Wilderness attracts tourists and generates visitor spending in proximate communities as people enjoy Wilderness for outdoor recreation. Wilderness also attracts amenity migrants and out-of-region investments into surrounding regional economies. To investigate the amount and types of employment and income generated by Wilderness visitation, we conducted an economic...

The Power of Outdoor Play and Play in Natural Environments

ERIC Educational Resources Information Center

Kemple, Kristen M.; Oh, JiHyun; Kenney, Elizabeth; Smith-Bonahue, Tina

2016-01-01

Young children's outdoor play serves important and diverse purposes, including physical exercise and opportunities for growth in all developmental areas. Unfortunately, the amount of time that children spend engaged in unstructured, child-directed outdoor play has diminished significantly in the past generation. In this article, the authors…

Teacher Instruction as a Predictor for Student Engagement and Disruptive Behaviors

ERIC Educational Resources Information Center

Scott, Terrance M.; Hirn, Regina G.; Alter, Peter J.

2014-01-01

Effective instruction is a critical predictor of student achievement. As students with exceptionalities such as emotional and behavioral disorders and learning disabilities, who typically struggle with academic achievement, spend increasing amounts of general education settings, the need for precise instructional behaviors becomes more imperative.…

Paraprofessionals: A Resource for Tomorrow's Teachers.

ERIC Educational Resources Information Center

LeTendre, Mary Jean

There is a need for highly trained professional staff, particularly paraprofessionals, in Title I schools. If paraprofessionals are spending a significant amount of time working with Title I students in a teaching environment, it is crucial that they possess the knowledge and skills sufficient to help the students achieve the same high standards…

Parenting in the New Millennium.

ERIC Educational Resources Information Center

Warnemuende, Carolyn

2002-01-01

Discusses parental guilt, fear, and lack of confidence eroding parents' ability to create a healthy balance between career and family. Maintains that the amount of time employed parents spend with children is not the problem, but that parental fatigue and stress spill into the home environment. Suggests ways parents can improve their confidence…

The Student Assistance Program: Higher Education's Holy Grail

ERIC Educational Resources Information Center

Taylor, Suzan R.; Baker, Sally-Ann

2012-01-01

This paper outlines an exploratory study conducted within the Sport & Exercise Sciences department at a higher education institution in Wales. Prior to the study it was identified that personal tutors were spending an increasing amount of time dealing with pastoral issues. This research sought to investigate the implementation of the Student…

Game-Based Teaching: What Educators Can Learn from Videogames

ERIC Educational Resources Information Center

Jackson, Janna

2009-01-01

Most teachers only dream of their students spending the amount of motivation, attention, passion, and critical thinking on their classes that some students do playing videogames. This investigation examines the success, pitfalls, and lessons learned from incorporating videogame-like components into an educational technology class. For example,…

Alternative Models to Deliver Developmental Math: Issues of Use and Student Access

ERIC Educational Resources Information Center

Kosiewicz, Holly; Ngo, Federick; Fong, Kristen

2016-01-01

Objective: Changing how community colleges deliver developmental education has become a key policy lever to increase student achievement. Alternative development education models reduce the amount of time a student spends in remediation, provide students with supplemental instruction and support, and contextualize content to align with student…

Incentive formularies and changes in prescription drug spending.

PubMed

Landon, Bruce E; Rosenthal, Meredith B; Normand, Sharon-Lise T; Spettell, Claire; Lessler, Adam; Underwood, Howard R; Newhouse, Joseph P

2007-06-01

To examine the impact of incentive formularies on prescription drug spending shifts in formulary compliance, use of generic medications, and mail-order fulfillment in the year after introduction of a new pharmacy benefit strategy. Pre-post comparison study with matched concurrent control group (difference-indifferences analysis). Study subjects were continuously enrolled patients from a single large health plan in the northeastern United States. Health plan administrative data were used to determine the total, health plan, and out-of-pocket spending in the year before and the year after the introduction of 12 different benefit changes, including 1 in which copayments decreased. Overall, changing from a single-tier or 2-tier formulary to a 3-tier formulary was associated with a decrease in total drug spending of about 5% to 15%. Plan spending decreased more dramatically, about 20%, whereas out-of-pocket spending that resulted from higher copayments increased between 20% and >100%. Changing to an incentive formulary with higher copayments was accompanied by a small but inconsistent decrease in use of nonformulary selections and a concomitant increase in both generic and formulary preferred utilization. Mail-order fulfillment doubled, albeit from a low baseline level. Switching to incentive formulary arrangements with higher levels of copayments generally led to overall lower drug costs and vice versa. These effects varied with the degree of change, level of baseline spending, and magnitude of the copayments. Whether these effects are beneficial overall depends on potential health effects and spillover effects on medical spending.

Retiree out-of-pocket healthcare spending: a study of consumer expectations and policy implications.

PubMed

Hoffman, Allison K; Jackson, Howell E

2013-01-01

Even though most American retirees benefit from Medicare coverage, a mounting body of research predicts that many will face large and increasing out-of-pocket expenditures for healthcare costs in retirement and that many already struggle to finance these costs. It is unclear, however, whether the general population understands the likely magnitude of these out-of-pocket expenditures well enough to plan for them effectively. This study is the first comprehensive examination of Americans' expectations regarding their out-of-pocket spending on healthcare in retirement. We surveyed over 1700 near retirees and retirees to assess their expectations regarding their own spending and then compared their responses to experts' estimates. Our main findings are twofold. First, overall expectations of out-of-pocket spending are mixed. While a significant proportion of respondents estimated out-of-pocket costs in retirement at or above expert estimates of what the typical retiree will spend, a disproportionate number estimated their future spending substantially below what experts view as likely. Estimates by members of some demographic subgroups, including women and younger respondents, deviated relatively further from the experts' estimates. Second, respondents consistently misjudged spending uncertainty. In particular, respondents significantly underestimated how much individual health experience and changes in government policy can affect individual out-of-pocket spending. We discuss possible policy responses, including efforts to improve financial planning and ways to reduce unanticipated financial risk through reform of health insurance regulation.

Cost of tax-exempt health benefits in 1998.

PubMed

Sheils, J; Hogan, P

1999-01-01

The tax expenditure for health benefits is the amount of revenues that the federal government forgoes by exempting the following from the federal income and Social Security taxes: (1) employer health benefits contribution, (2) health spending under flexible spending plans, and (3) the tax deduction for health expenses. The health tax expenditure was $111.2 billion in 1998. This figure varied from $2,357 per family among those with annual incomes of $100,000 or more to $71 per family among those with annual incomes of less than $15,000. Families with incomes of $100,000 or more (10 percent of the population) accounted for 23.6 percent of all tax expenditures.

Intended and unintended consequences of the gabapentin off-label marketing lawsuit among patients with bipolar disorder.

PubMed

Chace, Meredith J; Zhang, Fang; Fullerton, Catherine A; Huskamp, Haiden A; Gilden, Daniel; Soumerai, Stephen B

2012-11-01

The number of lawsuits accusing pharmaceutical companies of off-label marketing has risen in recent years. The impact of such lawsuits on drug prescribing and spending has not been examined. We evaluated a nationwide sample to determine whether the $430 million gabapentin off-label marketing lawsuit and accompanying media coverage affected gabapentin market share, substitution of other scientifically substantiated and unsubstantiated anticonvulsants, and anticonvulsant spending of Medicare/Medicaid patients diagnosed with bipolar disorder. Using a national 5% sample of Medicare recipients linked to Medicaid claims, we used an interrupted times series design to evaluate the impact of the lawsuit on monthly market share, utilization, and spending from January 1, 2001, to December 31, 2005. The start of the lawsuit was associated with a 28% relative reduction in gabapentin market share (from ∼ 21% to ∼ 15%) and a reduction in the rate of prescribing from 108 prescriptions per 1,000 patients per month before the start of the lawsuit to 90 by the end of follow-up (P < .001). We also observed increases in market share for 3 other anticonvulsants. Total anticonvulsant use and spending per 1,000 patients increased by 13% and 74%, respectively, after the intervention. The increase in anticonvulsant spending was equivalent to $7,554 per 1,000 patients per year higher than expected compared with the baseline trend (P = .01). We conclude that the lawsuit resulted in a reduction in gabapentin market share, increased market share for other anticonvulsants, and substantially increased total anticonvulsant spending to approximately half of the settlement amount, not counting substitutions of newer drugs for other illnesses affected by the lawsuit. These findings support the need for further study of the effects of current lawsuits regarding off-label drug marketing. © Copyright 2012 Physicians Postgraduate Press, Inc.

Undercontribution bias in health care spending account decisions.

PubMed

Schweitzer, M E; Hershey, J C

1997-01-01

Results from this work describe 239 responses to a mailed survey regarding employee benefits decisions at a large eastern university. The primary objective of this work is to test for an undercontribution bias in health care financing decisions. The results establish the existence of an undercontribution bias in both actual employee decisions and hypothetical flexible spending account contribution decisions. We describe this bias within the context of related biases including loss aversion, mental accounting, status quo and omission biases. Surprisingly, we find a significant order effect in this study and posit that preference construction in this context is an active, reference-dependent process. In addition, results from this work demonstrate the endogenous nature of health care flexible spending account expenditures. The results have important implications both for the descriptive framework of and the normative solution to the flexible spending account contribution decision.

A Framework for the Design of Effective Graphics for Scientific Visualization

NASA Technical Reports Server (NTRS)

Miceli, Kristina D.

1992-01-01

This proposal presents a visualization framework, based on a data model, that supports the production of effective graphics for scientific visualization. Visual representations are effective only if they augment comprehension of the increasing amounts of data being generated by modern computer simulations. These representations are created by taking into account the goals and capabilities of the scientist, the type of data to be displayed, and software and hardware considerations. This framework is embodied in an assistant-based visualization system to guide the scientist in the visualization process. This will improve the quality of the visualizations and decrease the time the scientist is required to spend in generating the visualizations. I intend to prove that such a framework will create a more productive environment for tile analysis and interpretation of large, complex data sets.

Car indoor air pollution - analysis of potential sources

PubMed Central

2011-01-01

The population of industrialized countries such as the United States or of countries from the European Union spends approximately more than one hour each day in vehicles. In this respect, numerous studies have so far addressed outdoor air pollution that arises from traffic. By contrast, only little is known about indoor air quality in vehicles and influences by non-vehicle sources. Therefore the present article aims to summarize recent studies that address i.e. particulate matter exposure. It can be stated that although there is a large amount of data present for outdoor air pollution, research in the area of indoor air quality in vehicles is still limited. Especially, knowledge on non-vehicular sources is missing. In this respect, an understanding of the effects and interactions of i.e. tobacco smoke under realistic automobile conditions should be achieved in future. PMID:22177291

Spending by California’s Department of Developmental Services for Persons with Autism across Demographic and Expenditure Categories

PubMed Central

Leigh, J. Paul; Grosse, Scott D.; Cassady, Diana; Melnikow, Joy; Hertz-Picciotto, Irva

2016-01-01

Background Few autism spectrum disorder (ASD) studies have estimated non-medical costs for treatment or addressed possible differences in provision of services across gender, race-ethnic, age or demographic or expenditure categories, especially among adults. Methods The California Department of Developmental Services (CDDS) provides services to residents with developmental disabilities. CDDS provided aggregate data on primarily non-medical spending for fiscal year 2012–2013 for persons with ASD with or without intellectual disability (ID) (main sample, n = 42,274), and two sub-samples: ASD only (n = 30,164), and ASD+ID (n = 12,110). Demographic variables included sex, age and race-ethnicity. Spending categories included Employment Support, Community Care Facilities, Day Care, Transportation, and in-home and out-of-home Respite. Results Per-person spending for males and females were approximately the same: $10,488 and $10,791 for males and females for ages 3–17 and $26,491 and $26,627 for ages 18+. Among race/ethnicity categories, the ranking from highest to lowest among ages 3–17 was white non-Hispanics ($11,480), Asian non-Hispanics ($11,036), “Others” ($11,031), Hispanics ($9,571), and African-American non-Hispanics ($9,482). For ages 18+, the ranking was whites ($31,008), African-Americans ($26,831), “Others” ($25,395), Asians ($22,993), and Hispanics ($18,083). The ASD+ID sub-sample exerted disproportionate influence on findings from the main sample for persons 18+. Combining all ages, the top two expenditure categories for per-person spending were Community Care Facilities ($43,867) and Day Care ($11,244). For most adult age groups, the percentage of recipients participating were highest for Day Care (44.9% - 62.4%) and Transportation (38.6% - 50.9%). Per-person spending for Day Care, Transportation, and Employment Support was relatively low for children but relatively high for adults. Conclusion White non-Hispanics received the highest per-person spending and Hispanics among the least. Amounts within spending categories varied considerably across age groups. Our estimates may be useful as baseline measures for stakeholders preparing for increasing ASD prevalence, especially among adults. PMID:27015098

Public health and the economy could be served by reallocating medical expenditures to social programs.

PubMed

Tran, Linda Diem; Zimmerman, Frederick J; Fielding, Jonathan E

2017-12-01

As much as 30% of US health care spending in the United States does not improve individual or population health. To a large extent this excess spending results from prices that are too high and from administrative waste. In the public sector, and particularly at the state level, where budget constraints are severe and reluctance to raise taxes high, this spending crowds out social, educational, and public-health investments. Over time, as spending on medical care increases, spending on improvements to the social determinants of health are starved. In California the fraction of General Fund expenditures spent on public health and social programs fell from 34.8% in fiscal year 1990 to 21.4% in fiscal year 2014, while health care increased from 14.1% to 21.3%. In spending more on healthcare and less on other efforts to improve health and health determinants, the state is missing important opportunities for health-promoting interventions with a strong financial return. Reallocating ineffective medical expenditures to proven and cost-effective public health and social programs would not be easy, but recognizing its potential for improving the public's health while saving taxpayers billions of dollars might provide political cover to those willing to engage in genuine reform. National estimates of the percent of medical spending that does not improve health suggest that approximately $5 billion of California's public budget for medical spending has no positive effect on health. Up to 10,500 premature deaths could be prevented annually by reallocating this portion of medical spending to public health. Alternatively, the same expenditure could help an additional 418,000 high school students to graduate.

Music Listening in the Personal and Professional Lives of University Music Majors

ERIC Educational Resources Information Center

Woody, Robert H.

2011-01-01

This exploratory study surveyed 118 music majors to investigate their music listening practices. The questionnaire specifically assessed musical tastes and examined the roles that listening plays in personal and professional activities. With regard to the amount of time spent in their daily lives, these music majors reported spending more than…

Changes to the Intermediate Accounting Course Sequence

ERIC Educational Resources Information Center

Davidson, Lesley H.; Francisco, William H.

2009-01-01

There is an ever-growing amount of information that must be covered in Intermediate Accounting courses. Due to recent accounting standards and the implementation of IFRS this trend is likely to continue. This report incorporates the results of a recent survey to examine the trend of spending more course time to cover this additional material.…

Impact of Policy Environment Characteristics on Physical Activity and Sedentary Behaviors of Children Attending Afterschool Programs

ERIC Educational Resources Information Center

Beets, Michael W.; Huberty, Jennifer; Beighle, Aaron; Moore, Justin B.; Webster, Collin; Ajja, Rahma; Weaver, Glenn

2013-01-01

State and national organizations recently developed policies focused on increasing physical activity (PA) in afterschool programs (ASPs). These policies emphasize "activity friendly" environment characteristics that, when present, should lead to higher levels of PA and reduce the amount of time children spend sedentary during an ASP.…

45 CFR 264.82 - What expenditures qualify for meeting the Matching Grant FAG amount requirement?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true What expenditures qualify for meeting the Matching..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OTHER ACCOUNTABILITY PROVISIONS What Rules Pertain Specifically to the Spending Levels of the Territories? § 264.82 What expenditures qualify for meeting the Matching...

45 CFR 264.82 - What expenditures qualify for meeting the Matching Grant FAG amount requirement?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false What expenditures qualify for meeting the Matching..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OTHER ACCOUNTABILITY PROVISIONS What Rules Pertain Specifically to the Spending Levels of the Territories? § 264.82 What expenditures qualify for meeting the Matching...

45 CFR 264.82 - What expenditures qualify for meeting the Matching Grant FAG amount requirement?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false What expenditures qualify for meeting the Matching..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OTHER ACCOUNTABILITY PROVISIONS What Rules Pertain Specifically to the Spending Levels of the Territories? § 264.82 What expenditures qualify for meeting the Matching...

45 CFR 264.82 - What expenditures qualify for meeting the Matching Grant FAG amount requirement?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false What expenditures qualify for meeting the Matching..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OTHER ACCOUNTABILITY PROVISIONS What Rules Pertain Specifically to the Spending Levels of the Territories? § 264.82 What expenditures qualify for meeting the Matching...

45 CFR 264.82 - What expenditures qualify for meeting the Matching Grant FAG amount requirement?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true What expenditures qualify for meeting the Matching..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OTHER ACCOUNTABILITY PROVISIONS What Rules Pertain Specifically to the Spending Levels of the Territories? § 264.82 What expenditures qualify for meeting the Matching...

Classroom Cut Ups

ERIC Educational Resources Information Center

Lord, Stacy

2011-01-01

Discovering identity can be a lifelong challenge for some people, while others seem to figure it out right away. During the middle school years, finding one's identity can be a daunting task. Most students will spend a considerable amount of time during these middle years looking for it. This lesson on cut-paper self-portraits lets students delve…

Data Systems Linking Resources to Actions and Outcomes: One of the Nation's Most Pressing Education Challenges

ERIC Educational Resources Information Center

Guthrie, James W.

2007-01-01

The inadequacy of present-day public school financial and performance reporting restricts policymakers. With existing spending and activity information now generally available, public officials can determine only overall education resource levels and make allocative decisions only among gross input categories such as relative amounts of labor and…

Creating a Positive School Culture: How Principals and Teachers Can Solve Problems Together

ERIC Educational Resources Information Center

Beaudoin, Marie-Nathalie; Taylor, Maureen E.

2004-01-01

Principals and teachers have very different perspectives, pressures, and struggles. As a result, problems of negativity, isolation, or censure often develop among staff members. This may cause principals and teachers to spend a tremendous amount of energy addressing these issues instead of focusing on their primary goal -- improved student…

Can State Policy Deliver Equitable and Adequate Funding?

ERIC Educational Resources Information Center

Quinn, Rand; Steinberg, Matthew P.

2015-01-01

Sooner or later, talk of closing achievement gaps turns to education finance--specifically, fixing widespread disparities in school funding within individual states. The difference between the resources that a district needs to educate all students and the amount the district actually spends is called an adequacy gap. The availability and use of…

Parents Sharing Books. Annual Report 1991-1992.

ERIC Educational Resources Information Center

Smith, Carl B.; Simic, Marjorie

The amount of time students spend in classrooms is relatively short--"13% of the student's waking hours in the first 18 years of life" (Walberg, Paschal, and Weinstein, 1985). They are developing intellectually, socially, and emotionally all the time, and parents are their models and teachers most of the time. This report describes and…

Modified and improved sleep monitoring display console

NASA Technical Reports Server (NTRS)

Frost, J. D., Jr.

1972-01-01

An outline is given of a sleep monitoring display console capable of simultaneously displaying: (1) the visible current sleep stage of each subject, (2) a cumulative, numerical display (in hours and minutes) of the total amount of time the subject spends in each stage, and (3) a stepwise, graphic recording of subject's sleep stage versus time.

Maternal and Paternal Perceptions of Social Competence in Children and Adolescents

ERIC Educational Resources Information Center

Renk, Kimberly; Phares, Vicky

2007-01-01

We examined maternal and paternal perceptions of social competence in children and adolescents. One hundred forty-seven parents rated scenarios depicting children who varied in age, gender, and social competence. Parents also completed questionnaires assessing the amount of time they spend with their own children, their gender identity, their…

Strategies to Increase Behavior-Specific Teacher Praise in an Inclusive Environment

ERIC Educational Resources Information Center

Musti-Rao, Shobana; Haydon, Todd

2011-01-01

Managing students' disruptive behavior in the classroom can be a time-consuming task and greatly reduces the amount of time teachers spend on instruction. Although there are several research-validated classroom management strategies, teachers are more likely to adopt strategies that are less time-consuming than strategies that take more time or…

Digital Citizenship. Technology Briefing. Number 2

ERIC Educational Resources Information Center

Alberta Education, 2013

2013-01-01

Students are spending an increased amount of time online. During this time, they are communicating with their peers, as well as consuming, sharing, and creating content. In the past, banning the use of personal devices and blocking online content was seen as a way to protect students from harmful content and protect the school's technology…

Visualizing Separations: How Shopping Can Be Useful for Introducing Chromatography

ERIC Educational Resources Information Center

Nagel, Megan L.

2013-01-01

A trip to the mall is used as a classroom demonstration to illustrate the fundamentals of separations without the need for chemicals or any chemistry background. Student volunteers are the "mixture", and depending on the shopping list they have been given, they spend varying amounts of time in the "stores" versus moving through…

Deferred Maintenance and the Americans with Disabilities Act.

ERIC Educational Resources Information Center

Davis, Jerry S.

1997-01-01

A national survey investigated actions taken by 338 colleges and universities on deferred maintenance, amount spent to comply with the Americans with Disabilities Act, spending needed to achieve compliance, how long it will take to achieve that goal, and how many institutions had been identified in a complaint or lawsuit. Results are reported by…

Deferred Maintenance Needs of California Public Higher Education. Fact Sheet 05-05

ERIC Educational Resources Information Center

California Postsecondary Education Commission, 2005

2005-01-01

The California Postsecondary Education Commission estimated in the year 2000 that the State would need to spend approximately $1.5 billion annually to maintain and expand public higher education facilities to meet student demand. This fact sheet updates information about the dollar amount of maintenance projects that are currently backlogged or…

Fathers Caring for Children: Research and Resources.

ERIC Educational Resources Information Center

Seward, Rudy Ray; Yeatts, Dale E.

This paper reviews studies examining the amount of time spent by fathers and mothers in child care activities, characteristics of fathers who spend more time with their children, ways to enhance fathers' child care performance, and the role of parent education in fatherhood. The paper also contains a list of organizations providing resources or…

Banning the Bottle

ERIC Educational Resources Information Center

Palliser, Janna

2010-01-01

Bottled water is ubiquitous, taken for granted, and seemingly benign. Americans are consuming bottled water in massive amounts and spending a lot of money: In 2007, Americans spent $11.7 billion on 8.8 billions gallons of bottled water (Gashler 2008). That same year, two million plastic water bottles were used in the United States every five…

The Tuition Dilemma and the Politics of "Mass" Higher Education

ERIC Educational Resources Information Center

Wellen, Richard

2004-01-01

The prospect of tuition fee increases for public sector universities has attracted an enormous amount of attention in recent years as governments in all industrialized countries have responded to the converging pressures of increased demands for higher education and rising costs of competing areas of social spending. I show that this dilemma is…

Swedish Technology Teachers' Attitudes to Their Subject and Its Teaching

ERIC Educational Resources Information Center

Nordlöf, Charlotta; Höst, Gunnar E.; Hallström, Jonas

2017-01-01

Background: From previous research among science teachers it is known that teachers' attitudes to their subjects affect important aspects of their teaching, including their confidence and the amount of time they spend teaching the subject. In contrast, less is known about technology teachers' attitudes. Purpose: Therefore, the aim of this study is…

Creating an Environment for Safe and Healthy Sleep in Child Care Programs

ERIC Educational Resources Information Center

Rose, Bobbie

2012-01-01

Along with nutrition, physical activity, and secure attachments, sleep is a basic requirement for a child's growth and brain development. Sleep is important for health and wellness, especially for growing infants and young children. Unfortunately, the amount of time children spend sleeping seems to be declining. If only sleep-deprived children…

A State Policymaker's Guide to Expanding Learning Time

ERIC Educational Resources Information Center

Education Commission of the States (NJ3), 2011

2011-01-01

Several decades of research have suggested a meaningful relationship between time and learning, where the amount of time students spend engaged in learning is strongly associated with their level of achievement. Among schools that have expanded the day and/or year, researchers have found that such a strategy can be quite effective, especially with…

Interdependent Group Contingency to Promote Physical Activity in Children

ERIC Educational Resources Information Center

Foote, Catherine; Bray, Melissa A.; Kehle, Thomas J.; VanHeest, Jaci L.; Gelbar, Nicholas W.; Byer-Alcorace, Gabriel; Maykel, Cheryl; DeBiase, Emily

2017-01-01

As the number of children affected by obesity increases in the United States, it is necessary to intervene with preventive and intervention techniques that will enact change. Because children spend a significant amount of their time in school, it is of particular interest to target strategies during the school day. Given the recommendations for…

The Efficiency of Public Spending on Education: An Empirical Comparison of EU Countries

ERIC Educational Resources Information Center

Agasisti, Tommaso

2014-01-01

Recent policy suggestions from the European Community underlined the importance of "efficiency" and "equity" in the provision of education while, at the same time, the European countries are required to provide their educational services by minimizing the amount of public money devoted to them. In this article, an empirical…

Concurrent and Subsequent Associations between Daily Digital Technology Use and High-Risk Adolescents' Mental Health Symptoms

ERIC Educational Resources Information Center

George, Madeleine J.; Russell, Michael A.; Piontak, Joy R.; Odgers, Candice L.

2018-01-01

Adolescents are spending an unprecedented amount of time using digital technologies (especially mobile technologies), and there are concerns that adolescents' constant connectivity is associated with poor mental health, particularly among at-risk adolescents. Participants included 151 adolescents at risk for mental health problems (M[subscript…

Support for Youth: A Profile of Three Communities.

ERIC Educational Resources Information Center

Sipe, Cynthia L.; Ma, Patricia; Gambone, Michelle Alberti

This report provides a detailed picture of how youth aged 12 to 20 in three American neighborhoods--Austin (Texas), St. Petersburg (Florida), and Savannah (Georgia)--spend their nonschool time and the amount and level of the basic "vitamins" of support from adults and institutions that they receive. The three neighborhoods are the…

Colleges Use Field Representatives To Get Close to Potential Applicants.

ERIC Educational Resources Information Center

Gose, Ben

1997-01-01

Increasingly, colleges and universities are using field offices and representatives to recruit applicants at a distance from the institutions. Representatives often spend significant amounts of time with a single student. The practice is particularly popular among colleges wishing to build name recognition and to elevate a narrow market segment in…

Coaching Teaching Assistants to Implement Naturalistic Behavioral Teaching Strategies to Enhance Social Communication Skills during Play in the Preschool Classroom

ERIC Educational Resources Information Center

Frantz, Rebecca Jane

2017-01-01

Naturalistic behavioral interventions increase the acquisition, generalization, and maintenance of child social communication skills among children with developmental delays (DD). Teaching Assistants (TAs) are ideal interventionists for delivering social communication interventions because of the significant amount of time they spend working…

A Closer look on Ineffectiveness in Riau Mainland Expenditure: Local Government Budget Case

NASA Astrophysics Data System (ADS)

Yandra, Alexsander; Roserdevi Nasution, Sri; Harsini; Wardi, Jeni

2018-05-01

this study discussed about the issues on ineffectiveness of expenditure by one Indonesia local Government in Riau. This Provence were amounted Rp. 10.7 trillion through Local Government Budget (APBD) in 2015. According to data from Financial Management Board and Regions Assets (BPKAD) APBD Riau in 2015 stood at approximately 37.58% until October 2015,another data taken from the Ministry of Home Affairs, Riau regional budget, from January to December 2015, it shows the lowest in Indonesia which amounted to 59.6%. The percentage described the lacking implementation of the budget, this can be interpreted that Riau government is less optimal and irrelevant in spending the budget in 2015. Through a theoretical approach to government spending, the implementation of public policies showed the ineffectiveness of the budget that have implicated towards regional development. As regional budget is only the draft in achieving the targets. Budget management in 2015 by the provincial administration through the Local Government Unit (SKPD) shows unsynchronized between the Medium Term Development Plan with the work program from SKPD.

Western Australian students' alcohol consumption and expenditure intentions for Schoolies.

PubMed

Jongenelis, Michelle I; Pettigrew, Simone; Biagioni, Nicole; Hagger, Martin S

2017-07-01

In Australia, the immediate post-school period (known as 'Schoolies') is associated with heavy drinking and high levels of alcohol-related harm. This study investigated students' intended alcohol consumption during Schoolies to inform interventions to reduce alcohol-related harm among this group. An online survey was administered to students in their senior year of schooling. Included items related to intended daily alcohol consumption during Schoolies, amount of money intended to be spent on alcohol over the Schoolies period, and past drinking behaviour. On average, participants (n=187) anticipated that they would consume eight standard drinks per day, which is substantially higher than the recommended maximum of no more than four drinks on a single occasion. Participants intended to spend an average of A$131 on alcohol over the Schoolies period. Although higher than national guidelines, intended alcohol consumption was considerably lower than has been previously documented during Schoolies events. The substantial amounts of money expected to be spent during Schoolies suggest this group has adequate spending power to constitute an attractive target market for those offering alternative activities that are associated with lower levels of alcohol-related harm.

Effects of radiotransmitter necklaces on behaviors of adult male western burrowing owls

USGS Publications Warehouse

Chipman, E.D.; McIntyre, N.E.; Ray, J.D.; Wallace, M.C.; Boal, C.W.

2007-01-01

We studied the behavioral effects of necklace-style radiotransmitters on breeding male western burrowing owls (Athene cunicularia hypugaea) in 2 areas of northwestern Texas, USA, in 2004 and 2005. We tested the hypothesis that transmittered owls would spend time interacting with their necklaces and as a result spend less time in vigilance and resting activities than would nontransmittered owls. Nontransmittered owls (n = 6) spent significantly more time being vigilant (P = 0.007) than did transmittered owls (n = 3) in 2004, who spent significant amounts of time interacting with their necklaces. In 2005, behaviors of transmittered owls (n = 8) were significantly different (P < 0.001) from control individuals (n = 4), but behaviors did not vary consistently by treatment period (prenecklace vs. necklace vs. postnecklace periods). Behavioral activity budgets varied considerably among individuals. Although the owls spent a significant amount of time interacting with their necklaces, they appeared to habituate to the presence of the transmitters within a relatively short period (<1 week), and necklaces did not affect survivorship or fitness in the short-term.

THE RESPONSE OF DRUG EXPENDITURE TO NON-LINEAR CONTRACT DESIGN: EVIDENCE FROM MEDICARE PART D*

PubMed Central

Einav, Liran; Finkelstein, Amy; Schrimpf, Paul

2016-01-01

We study the demand response to non-linear price schedules using data on insurance contracts and prescription drug purchases in Medicare Part D. We exploit the kink in individuals’ budget set created by the famous “donut hole,” where insurance becomes discontinuously much less generous on the margin, to provide descriptive evidence of the drug purchase response to a price increase. We then specify and estimate a simple dynamic model of drug use that allows us to quantify the spending response along the entire non-linear budget set. We use the model for counterfactual analysis of the increase in spending from “filling” the donut hole, as will be required by 2020 under the Affordable Care Act. In our baseline model, which considers spending decisions within a single year, we estimate that “filling” the donut hole will increase annual drug spending by about $150, or about 8 percent. About one-quarter of this spending increase reflects “anticipatory” behavior, coming from beneficiaries whose spending prior to the policy change would leave them short of reaching the donut hole. We also present descriptive evidence of cross-year substitution of spending by individuals who reach the kink, which motivates a simple extension to our baseline model that allows – in a highly stylized way – for individuals to engage in such cross year substitution. Our estimates from this extension suggest that a large share of the $150 drug spending increase could be attributed to cross-year substitution, and the net increase could be as little as $45 per year. PMID:26769984

Geographic Variation in Household and Catastrophic Health Spending in India: Assessing the Relative Importance of Villages, Districts, and States, 2011-2012.

PubMed

Mohanty, Sanjay K; Kim, Rockli; Khan, Pijush Kanti; Subramanian, S V

2018-03-01

Policy Points: Per-capita household health spending was higher in economically developed states and was associated with ability to pay, but catastrophic health spending (CHS) was equally high in both poorer and more developed states in India. Based on multilevel modeling, we found that the largest geographic variation in health spending and CHS was at the state and village levels, reflecting wide inequality in the accessibility to and cost of health care at these levels. Contextual factors at macro and micro political units are important to reduce health spending and CHS in India. In India, health care is a local good, and households are the major source of financing it. Earlier studies have examined diverse determinants of health care spending, but no attempt has been made to understand the geographical variation in household and catastrophic health spending. We used multilevel modeling to assess the relative importance of villages, districts, and states to health spending in India. We used data on the health expenditures of 101,576 households collected in the consumption expenditure schedule (68th round) carried out by the National Sample Survey in 2011-2012. We examined 4 dependent variables: per-capita health spending (PHS), per-capita institutional health spending (PIHS), per-capita noninstitutional health spending (PNHS), and catastrophic health spending (CHS). CHS was defined as household health spending exceeding 40% of its capacity to pay. We used multilevel linear regression and logistic models to decompose the variation in each outcome by state, region, district, village, and household levels. The average PHS was 1,331 Indian rupees (INR), which varied by state-level economic development. About one-fourth of Indian households incurred CHS, which was equally high in both the economically developed and poorer states. After controlling for household level factors, 77.1% of the total variation in PHS was attributable to households, 10.1% to states, 9.5% to villages, 2.6% to districts, and 0.7% to regions. The pattern in variance partitioning was similar for PNHS. The largest interstate variation was found for CHS (15.9%), while the opposite was true for PIHS (3.2%). We observed substantial variations in household health spending at the state and village levels compared with India's districts and regions. The large variation in CHS attributable to states indicates interstate inequality in the accessibility to and cost of health care. Our findings suggest that contextual factors at the macro and micro political units are important to reduce India's household health spending and CHS. © 2018 Milbank Memorial Fund.

WOMEN’S SUFFRAGE, POLITICAL RESPONSIVENESS, AND CHILD SURVIVAL IN AMERICAN HISTORY*

PubMed Central

Miller, Grant

2010-01-01

Women’s choices appear to emphasize child welfare more than those of men. This paper presents new evidence on how suffrage rights for American women helped children to benefit from the scientific breakthroughs of the bacteriological revolution. Consistent with standard models of electoral competition, suffrage laws were followed by immediate shifts in legislative behavior and large, sudden increases in local public health spending. This growth in public health spending fueled large-scale door-to-door hygiene campaigns, and child mortality declined by 8-15% (or 20,000 annual child deaths nationwide) as cause-specific reductions occurred exclusively among infectious childhood killers sensitive to hygienic conditions. PMID:21373369

National Health Expenditures, 19801

PubMed Central

Gibson, Robert M.; Waldo, Daniel R.

1981-01-01

The United States spent an estimated $247 billion for health care in 1980 (Figure 1), an amount equal to 9.4 percent of the Gross National Product (GNP). Highlights of the figures that underlie this estimate include the following: Health care expenditures in 1980 accelerated at a time when the economy as a whole exhibited sluggish growth. The 9.4 percent share of the GNP was a dramatic increase from the 8.9 percent share in 1979.Health care expenditures amounted to $1,067 per person in 1980 (Table 1). Of that amount, $450, or 42.2 percent, came from public funds.Expenditures for health care included $64.9 billion in premiums to private health insurance, $70.9 billion in Federal payments, and $33.3 billion in State and local government funds (Table 2).Hospital care accounted for 40.3 percent of total health care spending in 1980 (Table 3). These expenditures increased 16.2 percent between 1979 and 1980, to a level of $99.6 billion.Spending for the services of physicians increased 14.5 percent to $46.6 billion, 18.9 percent of all health care spending.All third parties combined—private health insurers, governments, philanthropists, and industry—financed 67.6 percent of the $217.9 billion spent for personal health care in 1980 (Table 4), ranging from 90.9 percent of hospital care services to 62.7 percent of physicians' services and 38.5 percent of the remainder (Table 5).Direct payments by consumers reached $70.6 billion in 1980 (Table 6). This accounted for 32.4 percent of all personal health care expenses.Outlays for health care benefits by the Medicare and Medicaid programs totaled $60.6 billion, including $35.8 billion for hospital care. The two programs combined to pay for 27.8 percent of all personal health care in the nation (Table 7). PMID:10309470

National Health Expenditures, 19811

PubMed Central

Gibson, Robert M.; Waldo, Daniel R.

1982-01-01

The United States spent an estimated $287 billion for health care in 1981 (Figure 1), an amount equal to 9.8 percent of the Gross National Product (GNP). Highlights of the figures that underly this estimate include the following: Health care expenditures continued to grow at a rapid rate in 1981, at a time when the economy as a whole exhibited sluggish growth. The 9.8 percent share of the GNP was a dramatic increase from the 8.9 percent share seen just two years earlier.Health care expenditures amounted to $1,225 per person in 1981 (Table 1). Of that amount, $524, or 42.7 percent, came from public funds.Hospital care accounted for 41.2 percent of total health care spending in 1981 (Table 2). These expenditures increased 17.5 percent from 1980, to a level of $118 billion.Spending for the services of physicians increased 16.9 percent to $55 billion—19.1 percent of all health care spending.Public sources provided 42.7 percent of the money spent on health in 1981, including Federal payments of $84 billion and $39 billion in State and local government funds (Table 3).All third parties combined—private health insurers, governments, private charities, and Industry—financed 67.9 percent of the $255 billion in personal health care in 1981 (Table 4), covering 89.2 percent of hospital care services, 62.1 percent of physicians' services, and 41.3 percent of the remainder (Table 5).Direct patient payments for health care reached $82 billion in 1981, accounting for 32.1 percent of all personal health care expenses (Table 6). Consumers and their employers paid another $73 billion in premiums to private health insurers, $67 billion of which was returned in the form of benefits.Outlays for health care benefits by the Medicare and Medicaid programs totaled $73 billion, including $42 billion for hospital care. The two programs combined paid for 28.6 percent of all personal health care in the nation (Table 7). PMID:10309718

National Health Expenditure Projections, 2017-26: Despite Uncertainty, Fundamentals Primarily Drive Spending Growth.

PubMed

Cuckler, Gigi A; Sisko, Andrea M; Poisal, John A; Keehan, Sean P; Smith, Sheila D; Madison, Andrew J; Wolfe, Christian J; Hardesty, James C

2018-03-01

Under current law, national health spending is projected to grow 5.5 percent annually on average in 2017-26 and to represent 19.7 percent of the economy in 2026. Projected national health spending and enrollment growth over the next decade is largely driven by fundamental economic and demographic factors: changes in projected income growth, increases in prices for medical goods and services, and enrollment shifts from private health insurance to Medicare that are related to the aging of the population. The recent enactment of tax legislation that eliminated the individual mandate is expected to result in only a small reduction to insurance coverage trends.

Factors Associated With Increases in US Health Care Spending, 1996-2013

PubMed Central

Squires, Ellen; Bui, Anthony L.; Campbell, Madeline; Chapin, Abigail; Hamavid, Hannah; Horst, Cody; Li, Zhiyin; Matyasz, Taylor; Reynolds, Alex; Sadat, Nafis; Schneider, Matthew T.; Murray, Christopher J. L.

2017-01-01

Importance Health care spending in the United States increased substantially from 1995 to 2015 and comprised 17.8% of the economy in 2015. Understanding the relationship between known factors and spending increases over time could inform policy efforts to contain future spending growth. Objective To quantify changes in spending associated with 5 fundamental factors related to health care spending in the United States: population size, population age structure, disease prevalence or incidence, service utilization, and service price and intensity. Design and Setting Data on the 5 factors from 1996 through 2013 were extracted for 155 health conditions, 36 age and sex groups, and 6 types of care from the Global Burden of Disease 2015 study and the Institute for Health Metrics and Evaluation’s US Disease Expenditure 2013 project. Decomposition analysis was performed to estimate the association between changes in these factors and changes in health care spending and to estimate the variability across health conditions and types of care. Exposures Change in population size, population aging, disease prevalence or incidence, service utilization, or service price and intensity. Main Outcomes and Measures Change in health care spending from 1996 through 2013. Results After adjustments for price inflation, annual health care spending on inpatient, ambulatory, retail pharmaceutical, nursing facility, emergency department, and dental care increased by $933.5 billion between 1996 and 2013, from $1.2 trillion to $2.1 trillion. Increases in US population size were associated with a 23.1% (uncertainty interval [UI], 23.1%-23.1%), or $269.5 (UI, $269.0-$270.0) billion, spending increase; aging of the population was associated with an 11.6% (UI, 11.4%-11.8%), or $135.7 (UI, $133.3-$137.7) billion, spending increase. Changes in disease prevalence or incidence were associated with spending reductions of 2.4% (UI, 0.9%-3.8%), or $28.2 (UI, $10.5-$44.4) billion, whereas changes in service utilization were not associated with a statistically significant change in spending. Changes in service price and intensity were associated with a 50.0% (UI, 45.0%-55.0%), or $583.5 (UI, $525.2-$641.4) billion, spending increase. The influence of these 5 factors varied by health condition and type of care. For example, the increase in annual diabetes spending between 1996 and 2013 was $64.4 (UI, $57.9-$70.6) billion; $44.4 (UI, $38.7-$49.6) billion of this increase was pharmaceutical spending. Conclusions and Relevance Increases in US health care spending from 1996 through 2013 were largely related to increases in health care service price and intensity but were also positively associated with population growth and aging and negatively associated with disease prevalence or incidence. Understanding these factors and their variability across health conditions and types of care may inform policy efforts to contain health care spending. PMID:29114831

Mental health and substance use disorder spending in the Department of Veterans Affairs, fiscal years 2000-2007.

PubMed

Wagner, Todd H; Sinnott, Patricia; Siroka, Andrew M

2011-04-01

This study analyzed spending for treatment of mental health and substance use disorders in the Department of Veterans Affairs (VA) in fiscal years (FYs) 2000 through 2007. VA spending as reported in the VA Decision Support System was linked to patient utilization data as reported in the Patient Treatment Files, the National Patient Care Database, and the VA Fee Basis files. All care and costs from FY 2000 to FY 2007 were analyzed. Over the study period the number of veterans treated at the VA increased from 3.7 million to over 5.1 million (an average increase of 4.9% per year), and costs increased .7% per person per year. For mental health and substance use disorder treatment, the volume of inpatient care decreased markedly, residential care increased, and spending decreased on average 2% per year (from $668 in FY 2000 to $578 per person in FY 2007). FY 2007 saw large increases in mental health spending, bucking the trend from FY 2000 through FY 2006. VA's continued emphasis on outpatient and residential care was evident through 2007. This trend in spending might be unimpressive if VA were enrolling healthier Veterans, but the opposite seems to be true: over this time period the prevalence of most chronic conditions, including depression and posttraumatic stress disorder, increased. VA spending on mental health care grew rapidly in 2007, and given current military activities, this trend is likely to increase.

Delivery system integration and health care spending and quality for Medicare beneficiaries.

PubMed

McWilliams, J Michael; Chernew, Michael E; Zaslavsky, Alan M; Hamed, Pasha; Landon, Bruce E

2013-08-12

The Medicare accountable care organization (ACO) programs rely on delivery system integration and health care provider risk sharing to lower spending while improving quality of care. To compare spending and quality between larger and smaller provider groups and examine how size-related differences vary by 2 factors considered central to ACO performance: group primary care orientation and financial risk sharing by health care providers. Using 2009 Medicare claims and linked American Medical Association Group Practice data, we assigned 4.29 million beneficiaries to health care provider groups based on primary care use. We categorized group size according to eligibility thresholds for the Shared Savings (≥5000 assigned beneficiaries) and Pioneer (≥15,000) ACO programs and distinguished hospital-based from independent groups. We assessed the primary care orientation of larger groups' specialty mix and used health maintenance organization market penetration and data from the Community Tracking Study to measure the extent of financial risk accepted by different types of provider groups in different areas for managed care patients. We estimated linear regression models comparing spending and quality between larger and smaller health care provider groups, allowing size-related differences to vary by measures of group primary care orientation and risk sharing. Spending and quality measures included total medical spending, spending by type of service, 5 process measures of quality, and 30-day readmissions, all adjusted for sociodemographic and clinical characteristics. Compared with smaller groups, larger hospital-based groups had higher total per-beneficiary spending in 2009 (mean difference, +$849), higher 30-day readmission rates (+1.3 percentage points), and similar performance on 4 of 5 process measures of quality. In contrast, larger independent physician groups performed better than smaller groups on all process measures and exhibited significantly lower per-beneficiary spending in counties where risk sharing by these groups was more common (-$426). Among all groups sufficiently large to participate in ACO programs, a strong primary care orientation was associated with lower spending, fewer readmissions, and better quality of diabetes care. Spending was lower and quality of care better for Medicare beneficiaries served by larger independent physician groups with strong primary care orientations in environments where health care providers accepted greater risk.

Could Trends in Time Children Spend with Parents Help Explain the Black-White Gap in Human Capital? Evidence from the American Time Use Survey

ERIC Educational Resources Information Center

Patterson, Richard W.

2017-01-01

It is widely believed that the time children spend with parents significantly impacts human capital formation. If time varies significantly between black and white children, this may help explain the large racial gap in test scores and wages. In this study, I use data from the American Time Use Survey to examine the patterns in the time black and…

Work hard, play hard?: A comparison of male and female lawyers' time in paid and unpaid work and participation in leisure activities.

PubMed

Wallace, Jean E; Young, Marisa C

2010-02-01

There has been a considerable amount of research that documents how women and men spend their time in different work and home tasks. We examine how much time professional women and men spend in paid and unpaid work and how this relates to their participation in different leisure activities. We also explore whether time in paid and unpaid work has gender-specific effects on leisure participation. In examining these issues, we rely on data from lawyers working in different legal settings. Our results show that, as hypothesized, men report more time in paid work and leisure whereas women devote more time to housework and childcare. An unexpected finding is that the time men spend in housework or childcare is either unrelated or positively related to their leisure participation. These results suggest that men's greater overall opportunities for leisure compared with women's appear to stem from the unanticipated relationships between men's involvement in housework and childcare and their leisure activities. We raise several possible explanations for these findings.

Physician pattern of patient notification of test results.

PubMed

Thiedke, Carolyn C; Hoeft, Katherine A; Pearson, William S

2005-01-01

To discover how community-based family physicians notify patients of test results and whether there are differences based on sex, length of time in practice, reimbursement status, employment status,or percentage of practice in managed care. We mailed a survey to 500 randomly selected members of the South Carolina chapter of the American Academy of Family Physicians. All analyses were preformed using SASTM version 8.2. Both descriptive and inferential statistics were used to analyze the collected data. A total of 367 physicians responded (73% response rate). The main outcome variable was the time each physician spent notifying patients of test results: a mean of 20.86 +/- 18.3 minutes per day(range 0-120 minutes/day). Women physicians and those with more than 75% managed care were significantly more likely to spend more than the median time notifying patients of test results. Physicians vary in the amount of time they spend notifying patients of their test results, with female physicians and those with more than 75% of their practice in managed care spending more time than do male physicians and physicians with less managed care.

Improving Transfer of Learning: Relationship to Methods of Using Business Simulation

ERIC Educational Resources Information Center

Mayer, Brad W.; Dale, Kathleen M.; Fraccastoro, Katherine A.; Moss, Gisele

2011-01-01

This study investigates whether the processes associated with the use of business simulations can be structured to improve transfer of learning from the classroom environment to the workplace.The answer to this question is explored by investigating teaching methods used to introduce the simulation, the amount of time students spend on decisions,…

PLCs on Steroids: Moving Teacher Practice to the Center of Data Teams

ERIC Educational Resources Information Center

Wasta, Michael J.

2017-01-01

Research on educators' professional learning communities (PLCs) suggest that while they often help teachers to make sense of student performance data, they tend to spend relatively little time studying what teachers actually do in the classroom. Evidence suggests that, given modest amounts of guidance and support, PLCs can collect useful data on…

Estimating the Economic Impacts of Recreation Response to Resource Management Alternatives

Treesearch

Donald B.K. English; J. Michael Bowker; John C. Bergstrom; H. Ken Cordell

1995-01-01

Managing forest resources involves tradeoffs and making decisions among resource management alternatives. Some alternatives will lead to changes in the level of recreation visitation and the amount of associated visitor spending. Thus, the alternatives can affect local economies. This paper reports a method that can be used to estimate the economic impacts of such...

Maternity Leave in Taiwan

ERIC Educational Resources Information Center

Feng, Joyce Yen; Han, Wen-Jui

2010-01-01

Using the first nationally representative birth cohort study in Taiwan, this paper examines the role that maternity leave policy in Taiwan plays in the timing of mothers returning to work after giving birth, as well as the extent to which this timing is linked to the amount of time mothers spend with their children and their use of breast milk…

Putting the Cart before the Horse: The Role of a Socio-Moral Atmosphere in an Inquiry-Based Curriculum

ERIC Educational Resources Information Center

Geiken, Rosemary; Van Meeteren, Beth Dykstra; Kato, Tsuguhiko

2009-01-01

Research lends support to inquiry-based curriculum demonstrating how social interaction, such as discussion and presentation, positively affects children's learning. As a result, teachers spend an inordinate amount of time and effort in planning investigations to develop skills in inquiry. However, many of them overlook the necessary foundation…

34 CFR 76.655 - Level of expenditures for students enrolled in private schools.

Code of Federal Regulations, 2010 CFR

2010-07-01

... funds on: (1) A student enrolled in a private school who receives benefits under the program; and (2) A student enrolled in a public school who receives benefits under the program. (b) The subgrantee shall spend a different average amount on program benefits for students enrolled in private schools if the...

Success Rates by Software Development Methodology in Information Technology Project Management: A Quantitative Analysis

ERIC Educational Resources Information Center

Wright, Gerald P.

2013-01-01

Despite over half a century of Project Management research, project success rates are still too low. Organizations spend a tremendous amount of valuable resources on Information Technology projects and seek to maximize the utility gained from their efforts. The author investigated the impact of software development methodology choice on ten…

Computer games and prosocial behaviour.

PubMed

Mengel, Friederike

2014-01-01

We relate different self-reported measures of computer use to individuals' propensity to cooperate in the Prisoner's dilemma. The average cooperation rate is positively related to the self-reported amount participants spend playing computer games. None of the other computer time use variables (including time spent on social media, browsing internet, working etc.) are significantly related to cooperation rates.

Role of Educational Investment on Economic Growth and Development in Kenya

ERIC Educational Resources Information Center

Otieno, Ojala Daphen

2016-01-01

The Government of Kenya spends 30% of its budget on education. It is commonly assumed that education has an important positive effect on economic growth, but to date the evidence for this assumption has been surprisingly weak. This study aimed at exploring the relationships between the amount of investments in education and economic growth. It was…

The Impact of Interactive Technology on Children's & Adolescents' Cognitive and Social Skills.

ERIC Educational Resources Information Center

Subrahmanyam, Kaveri

Over the past few years, computer applications such as games and the Internet have increased in popularity and children and teens are spending significant amounts of time interacting with them. In order to understand the growing impact of these interactive technologies on youth, this paper briefly reviews previous research on the impact of…

Elaboration and Organization Strategies Used by Prospective Class Teachers While Studying Social Studies Education Textbooks

ERIC Educational Resources Information Center

Tay, Bayram

2013-01-01

Problem Statement: Students spend a considerable amount of their time studying from textbooks, which play an important role in their learning activities. The strategies students use to learn work as guides, requiring them to mentally process, make sense of and internalize information offered to them during the instructional process. Of these,…

Using Simple Circuits as Thermal Models for Your Home

ERIC Educational Resources Information Center

Poynor, Adele

2014-01-01

In 2009, President Obama proposed an initiative to decrease our country's energy consumption and dependence on fossil fuels. One key to this plan was to decrease the amount of energy used to heat and cool our homes through government incentives. The EPA estimates that the average American household spends over $1000 annually for heating and…

29 CFR 780.136 - Employment in practices on a farm.

Code of Federal Regulations, 2010 CFR

2010-07-01

... activity (§§ 780.104 through 780.144). Even though an employee may work on several farms during a workweek... an employee occurs off the farm will not affect this conclusion. Thus, an employee may spend a small amount of time within the workweek in transporting necessary equipment for work to be done on farms...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2012 CFR

2012-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2014 CFR

2014-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2011 CFR

2011-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

45 CFR 263.13 - Is there a limit on the amount of Federal TANF funds that a State may spend on administrative costs?

Code of Federal Regulations, 2013 CFR

2013-10-01

... Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN...) Expenditures on the information technology and computerization needed for tracking and monitoring required by..., support or operate the portions of information technology or computer systems used for tracking and...

Inking and Thinking: Honors Students and Tattoos

ERIC Educational Resources Information Center

Dundes, Lauren; Francis, Antonia

2016-01-01

This study examines whether academically accelerated students in a college Honors program are as likely as other students to acquire a tattoo and to spend the same amount of time contemplating this decision. A convenience sample of 71 honors students and 135 non-honors students completed a survey at a small mid-Atlantic liberal arts college in…

29 CFR 779.368 - Printing and engraving establishments not recognized as retail.

Code of Federal Regulations, 2014 CFR

2014-07-01

... employees who operate the machines in the printing or engraving department and there may be other employees... establishments these workers spend relatively little time in the work of the printing department. As an... amount of his time (20 percent or less) is allocable to the clerical, messenger, or custodial work of the...

Dual Audio Television; an Experiment in Saturday Morning Broadcast and a Summary Report.

ERIC Educational Resources Information Center

Borton, Terry; And Others

The Philadelphia City Schools engaged in a four-year program to develop and test dual audio television, a way to help children learn more from the massive amounts of time they spend watching commercial television. The format consisted of an instructional radio broadcast which accompanied popular television shows and attempted to clarify and…

A Semiparametric Model for Jointly Analyzing Response Times and Accuracy in Computerized Testing

ERIC Educational Resources Information Center

Wang, Chun; Fan, Zhewen; Chang, Hua-Hua; Douglas, Jeffrey A.

2013-01-01

The item response times (RTs) collected from computerized testing represent an underutilized type of information about items and examinees. In addition to knowing the examinees' responses to each item, we can investigate the amount of time examinees spend on each item. Current models for RTs mainly focus on parametric models, which have the…

Consumer Brand Choice: Money Allocation as a Function of Brand Reinforcing Attributes

ERIC Educational Resources Information Center

Oliveira-Castro, Jorge M.; Foxall, Gordon R.; Wells, Victoria K.

2010-01-01

Previous applications of the matching law to the analysis of consumer brand choice have shown that the amount of money spent purchasing a favorite brand tends to match the quantity bought of the favorite brand divided by the quantity bought of all other brands. Although these results suggest matching between spending and purchased quantity,…

Students' Framing of Language Learning Practices in Social Networking Sites

ERIC Educational Resources Information Center

Lantz-Andersson, Annika; Vigmo, Sylvi; Bowen, Rhonwen

2012-01-01

The amount of time that people, especially young people, spend on communicative activities in social media is rapidly increasing. We are facing new arenas with great potential for learning in general and for language learning in particular, but their impact on learning is not yet acknowledged as such in educational practice (e.g., Conole, 2010;…

A Qualitative Exploration of the Repatriation Experiences of US Third Culture Kids in College

ERIC Educational Resources Information Center

Smith, Virginia J.; Kearney, Kerri S.

2016-01-01

US third culture kids (TCKs), or those who spend a significant amount of their developmental years in other countries, often repatriate for college. However, the TCK population is typically invisible on US campuses, and understanding of their journeys is lacking. Using as lenses Erikson's stages of development (1963, 1968, 1997) and the…

Suspected Child Maltreatment: Recognize and Respond

ERIC Educational Resources Information Center

Kemple, Kristen Mary; Kim, Hae Kyoung

2011-01-01

Early childhood educators spend extensive amounts of time with young children, so they are often the first adults to notice signs that a child may be abused or neglected. All educators are required by law to report suspected maltreatment, and can play an important role in preventing and responding to abuse and neglect of young children. What is…

Media Influence and its Effects on Military Operations

DTIC Science & Technology

1998-01-01

when journalists spend significant amounts of time with Marine units at the company and platoon level. This results in more accurate reporting ...with the reporting process. 7. Under conditions of open coverage, field commanders will permit journalists to ride on military vehicles and...41 Report Documentation Page Form ApprovedOMB No. 0704-0188 Public reporting burden for

The Child and Adult Care Food Program and the Nutrition of Preschoolers

ERIC Educational Resources Information Center

Korenman, Sanders; Abner, Kristin S.; Kaestner, Robert; Gordon, Rachel A.

2013-01-01

Children spend a considerable amount of time in preschools and child care centers. As a result, these settings may have an influence on their diet, weight, and food security, and are potentially important contexts for interventions to address nutritional health. The Child and Adult Care Food Program (CACFP) is one such intervention. No national…

Extracurricular Reading Habits of College Students in Taiwan: Findings from Two National Surveys

ERIC Educational Resources Information Center

Chen, Su-Yen

2007-01-01

The Chinese people have great regard for those who read widely, yet little is known of the extracurricular reading behaviors of Chinese students. This study drew on data from two national surveys to investigate the amount of time Taiwanese college students spend on extracurricular reading. Findings are interpreted in relation to prior research on…

A Proposal of a Color Music Notation System on a Single Melody for Music Beginners

ERIC Educational Resources Information Center

Kuo, Yi-Ting; Chuang, Ming-Chuen

2013-01-01

Music teachers often encounter obstructions in teaching beginners in music reading. Conventional notational symbols require beginners to spend significant amount of time in memorizing, which discourages learning at early stage. This article proposes a newly-developed color music notation system that may improve the recognition of the staff and the…

The Impact of Instructor Attire on College Student Satisfaction

ERIC Educational Resources Information Center

Carr, David L.; Davies, Thomas L.; Lavin, Angeline M.

2010-01-01

Colleges and universities are keenly interested in developing a positive relationship with current students as well as maintaining contact with alumni for a variety of enrollment and financial reasons. Institutions spend a growing amount of time and effort in an attempt to retain their existing student body as tuition and fees are needed to help…

The Media Habits of Infants and Toddlers: Findings from a Parent Survey

ERIC Educational Resources Information Center

Weber, Deborah S.; Singer, Dorothy G.

2004-01-01

The authors summarize previous research and report the results of their study on young children's television and video viewing habits. Previous studies confirm that children under 2 years spend a significant amount of time engaging with television and videos and are highly attentive to them. Attentiveness is contingent on age; for instance, one…

Hillary: The Movie, The History Channel, and the Challenge of the Documentary for Democratic Education

ERIC Educational Resources Information Center

Stoddard, Jeremy

2013-01-01

Background/Context: In "Citizens United vs. Federal Election Commission (2009)," the U.S. Supreme Court cleared the way for corporations to spend unlimited amounts of money to influence citizens' decisions about candidates and issues that will appear on election ballots. More important, however, for democratic educators, the ruling…

The Identification of Filters and Interdependencies for Effective Resource Allocation: Coupling the Mitigation of Natural Hazards to Economic Development.

NASA Astrophysics Data System (ADS)

Agar, S. M.; Kunreuther, H.

2005-12-01

Policy formulation for the mitigation and management of risks posed by natural hazards requires that governments confront difficult decisions for resource allocation and be able to justify their spending. Governments also need to recognize when spending offers little improvement and the circumstances in which relatively small amounts of spending can make substantial differences. Because natural hazards can have detrimental impacts on local and regional economies, patterns of economic development can also be affected by spending decisions for disaster mitigation. This paper argues that by mapping interdependencies among physical, social and economic factors, governments can improve resource allocation to mitigate the risks of natural hazards while improving economic development on local and regional scales. Case studies of natural hazards in Turkey have been used to explore specific "filters" that act to modify short- and long-term outcomes. Pre-event filters can prevent an event from becoming a natural disaster or change a routine event into a disaster. Post-event filters affect both short and long-term recovery and development. Some filters cannot be easily modified by spending (e.g., rural-urban migration) but others (e.g., land-use practices) provide realistic spending targets. Net social benefits derived from spending, however, will also depend on the ways by which filters are linked, or so-called "interdependencies". A single weak link in an interdependent system, such as a power grid, can trigger a cascade of failures. Similarly, weak links in social and commercial networks can send waves of disruption through communities. Conversely, by understanding the positive impacts of interdependencies, spending can be targeted to maximize net social benefits while mitigating risks and improving economic development. Detailed information on public spending was not available for this study but case studies illustrate how networks of interdependent filters can modify social benefits and costs. For example, spending after the 1992 Erzincan earthquake targeted local businesses but limited alternative employment, labor losses and diminished local markets all contributed to economic stagnation. Spending after the 1995 Dinar earthquake provided rent subsidies, supporting a major exodus from the town. Consequently many local people were excluded from reconstruction decisions and benefits offered by reconstruction funds. After the 1999 Marmara earthquakes, a 3-year economic decline in Yalova illustrates the vulnerability of local economic stability to weak regulation enforcement by a few agents. A resource allocation framework indicates that government-community relations, lack of economic diversification, beliefs, and compensation are weak links for effective spending. Stronger positive benefits could be achieved through spending to target land-use regulation enforcement, labor losses, time-critical needs of small businesses, and infrastructure. While the impacts of the Marmara earthquakes were devastating, strong commercial networks and international interests helped to re-establish the regional economy. Interdependencies may have helped to drive a recovery. Smaller events in eastern Turkey, however, can wipe out entire communities and can have long-lasting impacts on economic development. These differences may accelerate rural to urban migration and perpetuate regional economic divergence in the country. 1: Research performed in the Wharton MBA Program, Univ. of Pennsylvania.

The relationship between violent video games, acculturation, and aggression among Latino adolescents.

PubMed

Escobar-Chaves, S Liliana; Kelder, Steve; Orpinas, Pamela

2002-12-01

Multiple factors are involved in the occurrence of aggressive behavior. The purpose of this study was to evaluate the hypotheses that Latino middle school children exposed to higher levels of video game playing will exhibit a higher level of aggression and fighting compared to children exposed to lower levels and that the more acculturated middle school Latino children will play more video games and will prefer more violent video games compared to less acculturated middle school Latino children. This study involved 5,831 students attending eight public schools in Texas. A linear relationship was observed between the time spent playing video games and aggression scores. Higher aggression scores were significantly associated with heavier video playing for boys and girls (p < 0.0001). The more students played video games, the more they fought at school (p < 0.0001). As Latino middle school students were more acculturated, their preference for violent video game playing increased, as well as the amount of time they played video games. Students who reported speaking more Spanish at home and with their friends were less likely to spend large amounts of time playing video games and less likely to prefer violent video games (p < 0.05).

Evaluating the economics of biomass energy production in the Watts Bar region

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

Alexander, R.R.; English, B.C.; Bhat, M.G.

1993-12-31

While the commercial potential of biofuel technology is becoming more feasible, it is not clear whether the supply of biomass feedstock will be available in competitive markets. In order to exploit the potential of biomass crops as a reliable source of biofuels, a significant commitment on the part of farmers to convert large amounts of cropland would be required. Dedicated energy crops have to compete with conventional crops which could result in significant interregional shifts in crop production. Those changes could further affect overall agricultural production, food prices, consumer spending, and government spending on farm programs. Evaluating these economic impactsmore » provides important information for the ongoing debate. This research is a case study incorporating an existing power plant. The objective of this project is to evaluate the potential of short rotation woody crops as a fuel source in the Watts Bar facility located in eastern Tennessee. The appraisal includes estimates of environmental impacts as well as of economic feasibility. This is achieved by estimating the amounts of biomass that would be supplied at a predetermined price. By changing prices of biomass at the plant in an incremental fashion, a regional supply curve for biomass is estimated. The model incorporates current agricultural production possibilities in the region along with the proposed short rotation woody crop production activities. In order to adequately model the landscape, several variables are considered. These variables include soil type, crop production, government policy, land use conversion to crop land, and distance from the plant. Environmental issues including erosion, chemical usage, and potential leaching are also incorporated within the modeling framework; however, only estimates on erosion are available in this analysis. Output from the model provides insight on where and what types of land should shift from current land use to biomass production.« less

Helpers benefit offspring in both the short and long-term in the cooperatively breeding banded mongoose.

PubMed

Hodge, Sarah J

2005-12-07

Helpers in cooperative and communal breeding species are thought to accrue fitness benefits through improving the condition and survival of the offspring that they care for, yet few studies have shown conclusively that helpers benefit the offspring they rear. Using a novel approach to control for potentially confounding group-specific variables, I compare banded mongoose (Mungos mungo) offspring within the same litter that differ in the amount of time they spend with a helper, and hence the amount of care they receive. I show that pups that spend more time in close proximity to a helper are fed more, grow faster and have a higher probability of survival to independence than their littermates. Moreover, high growth rates during development reduce the age at which females breed for the first time, suggesting that helpers can improve the future fecundity of the offspring for which they care. These results provide strong evidence that it is the amount of investment per se that benefits offspring, rather than some correlate such as territory quality, and validate the assumption that helpers improve the reproductive success of breeders, and hence may gain fitness benefits from their actions. Furthermore, the finding that helpers may benefit offspring in the long-term suggests that current studies underestimate the fitness benefits that helpers gain from rearing the offspring of others.

Are sunscreens luxury products?

PubMed

Mahé, Emmanuel; Beauchet, Alain; de Maleissye, Marie-Florence; Saiag, Philippe

2011-09-01

The incidence of skin cancers is rapidly increasing in Western countries. One of the main sun-protection measures advocated is application of sunscreen. Some studies report a failure to comply with sunscreen application guidance. One explanation is their cost. To evaluate the true cost of sunscreen in two situations: a 4-member family spending 1 week at the beach and a transplant patient respecting all the sun protection recommendations. We performed an analysis of prices of sunscreens sold via Internet drugstores in Europe and North America. Standard sunscreen application recommendations were followed. We tested the recommended amount of sunscreen to be applied (ie, 2 mg/cm(2)). Six hundred seven sunscreens from 17 drugstores in 7 countries were evaluated. Median price of sunscreen was $1.7 US per 10 grams. The price decreased with the size of the bottle. The median price for a family varied from $178.2 per week to $238.4 per week. The price decreased by 33% if the family wore UV-protective T-shirts and by 41% if large-volume bottles were used. The median price for a transplant patient varied from $245.3 per year to $292.3 per year. Anti-UVA activity and topical properties were not evaluated. We tested the recommended amount (2 mg/cm(2)) rather than the amount actually used (1 mg/cm(2)). Under acute sun exposure conditions (a week at the beach), the cost of sun protection appears acceptable if sun protective clothing is worn and large-format bottles and low-cost sunscreens are used. Conversely, in a sun-sensitive population requiring year-round protection, the annual budget is relatively high and patients may require financial assistance to be compliant with sun protection guidelines. Copyright © 2010 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Sky-plane discovery rates for Near Earth Object discoveries from Pan-STARRS1 - implications for future search strategies

NASA Astrophysics Data System (ADS)

Wainscoat, Richard J.; Chambers, Kenneth C.; Chastel, Serge; Denneau, Larry; Lilly Schunova, Eva; Micheli, Marco; Weryk, Robert J.

2016-10-01

The Pan-STARRS1 telescope has been spending most of its time for the last 2.5 years searching the sky for Near Earth Objects (NEOs). The surveyed area covers the entire northern sky and extends south to -49 degrees declination. Because Pan-STARRS1 has a large field-of-view, it has been able survey large areas of the sky, and we are now able to examine NEO discovery rates relative to ecliptic latitude.Most contemporary searches, including Pan-STARRS1, have been spending large amounts of their observing time during the dark moon period searching for NEOs close to the ecliptic. The rationale for this is that many objects have low inclination, and all objects in orbit around the Sun must cross the ecliptic. New search capabilities are now available, including Pan-STARRS2, and the upgraded camera in Catalina Sky Survey's G96 telescope. These allow NEO searches to be conducted over wider areas of the sky, and to extend further from the ecliptic.We have examined the discovery rates relative to location on the sky for new NEOs from Pan-STARRS1, and find that the new NEO discoveries are less concentrated on the ecliptic than might be expected. This finding also holds for larger objects. The southern sky has proven to be very productive in new NEO discoveries - this is a direct consequence of the major NEO surveys being located in the northern hemisphere.Our preliminary findings suggest that NEO searches should extend to at least 30 degrees from the ecliptic during the more sensitive dark moon period. At least 6,000 deg2 should therefore be searched each lunation. This is possible with the newly augmented NEO search assets, and repeat coverage will be needed in order to recover most of the NEO candidates found. However, weather challenges will likely make full and repeated coverage of such a large area of sky difficult to achieve. Some simple coordination between observing sites will likely lead to improvement in efficiency.

Issues in health care: interventional pain management at the crossroads.

PubMed

Manchikanti, Laxmaiah; Hirsch, Joshua A

2007-03-01

Emerging strategies in health care are extremely important for interventional pain physicians, as well as with the payors in various categories. While most Americans, including the US Congress and Administration, are looking for ways to provide affordable health care, the process of transformation and emerging health care strategies are troubling for physicians in general, and interventional pain physicians in particular. With the new Congress, only new issues rather than absolute solutions seem to emerge. Interventional pain physicians will continue to face the very same issues in the coming years that they have faced in previous years including increasing national health care spending, physician payment reform, ambulatory surgery center reform, and pay for performance. The national health expenditure data continue to extend the spending pattern that has characterized the 21st century, with US health spending continuing to outpace inflation and accounting for a growing share of the national economy. Health care spending in 2005 was $2.0 trillion or $6,697 per person and represented 16% of the gross domestic product. In 2005, Medicare spending reached $342 billion, while Medicaid spending was $315 billion. Physician and clinical services occupied approximately 21% of all US health care spending in 2005, reaching $421.2 billion. Overall, health spending in the US is expected to double to $4.1 trillion by 2016, then consuming 20% of the nation's gross domestic product, up from the current 16%. It is predicted that by 2016 the government will be paying 48.7% of the nation's health care bill, up from 38% in 1970 and 40% in 1990. The Medicare Physician Payment system based on the Sustainable Growth Rate (SGR) formula continues to be a major issue for physicians. The Congressional Budget Office has projected budget implications of change in the SGR mechanism, with consideration for allowing payment rates to increase by the amount of medical inflation, costing Medicare an estimated $218 billion from 2007 to 2016. Changes in the physician fee schedule in 2006 using the bottom-up methodology have resulted in significant cuts for interventional pain physicians performing procedures in an office setting. Medicaid physician payments and ambulatory surgery center payments for interventional techniques are proposed to be reduced substantially by Medicare and Medicaid, while hospital payments remain at stable levels with increases.

Parents’ time with a partner in a cross-national context: A comparison of the United States, Spain, and France

PubMed Central

Roman, Joan Garcia; Flood, Sarah M.; Genadek, Katie R.

2017-01-01

BACKGROUND Time shared with a partner is an indicator of marital well-being and couples want to spend time together. However, time with a partner depends on work and family arrangements as well as the policies, norms, and values that prevail in society. Contrary to time spent with children, couples’ shared time in cross-national context is relatively unstudied. Previous studies from specific countries show that dual-earner couples spend less time together and that parents spend less time alone together. OBJECTIVE The aim of our study is to investigate partnered parents’ shared time across countries to understand how social conditions, cultural norms, and policy contexts are related to the amount and nature of couples’ shared time. Specifically, we compare time with a partner in the US, France, and Spain. METHODS We use data from national time use surveys conducted in the US, France, and Spain. We leverage information about with whom activities are done to examine three types of time shared with a partner for parents with children under age 10: total time with a partner indicates the minutes per day spent in the presence of a partner; exclusive time corresponds to the minutes per day spent alone with a partner when no one else is present; and family time indicates the minutes per day spent with a partner and a child at the same time. RESULTS Our results show that American couples spend the least time together, and Spanish couples spend the most time together. Parents in France spend the most time alone together. The most striking difference across countries is in time with a partner and children, which is much higher among Spanish families. CONCLUSION Paid work constraints explain a small part of the differences in couples’ shared time that we observe between countries. Differences in couples’ shared time across countries seem to be related to social norms surrounding family and general time use. PMID:29416440

The slowdown in health care spending in 2009-11 reflected factors other than the weak economy and thus may persist.

PubMed

Ryu, Alexander J; Gibson, Teresa B; McKellar, M Richard; Chernew, Michael E

2013-05-01

During and immediately after the recent recession, national health expenditures grew exceptionally slowly. During 2009-11 per capita national health spending grew about 3 percent annually, compared to an average of 5.9 percent annually during the previous ten years. Policy experts disagree about whether the slower health spending growth was temporary or represented a long-term shift. This study examined two factors that might account for the slowdown: job loss and benefit changes that shifted more costs to insured people. Based on an examination of data covering more than ten million enrollees with health care coverage from large firms in 2007-11, we found that these enrollees' out-of-pocket costs increased as the benefit design of their employer-provided coverage became less generous in this period. We conclude that such benefit design changes accounted for about one-fifth of the observed decrease in the rate of growth. However, we also observed a slowdown in spending growth even when we held benefit generosity constant, which suggests that other factors, such as a reduction in the rate of introduction of new technology, were also at work. Our findings suggest cautious optimism that the slowdown in the growth of health spending may persist--a change that, if borne out, could have a major impact on US health spending projections and fiscal challenges facing the country.

Antidepressant use in 27 European countries: associations with sociodemographic, cultural and economic factors.

PubMed

Lewer, Dan; O'Reilly, Claire; Mojtabai, Ramin; Evans-Lacko, Sara

2015-09-01

Prescribing of antidepressants varies widely between European countries despite no evidence of difference in the prevalence of affective disorders. To investigate associations between the use of antidepressants, country-level spending on healthcare and country-level attitudes towards mental health problems. We used Eurobarometer 2010, a large general population survey from 27 European countries, to measure antidepressant use and regularity of use. We then analysed the associations with country-level spending on healthcare and country-level attitudes towards mental health problems. Higher country spending on healthcare was strongly associated with regular use of antidepressants. Beliefs that mentally ill people are 'dangerous' were associated with higher use, and beliefs that they 'never recover' or 'have themselves to blame' were associated with lower and less regular use of antidepressants. Contextual factors, such as healthcare spending and public attitudes towards mental illness, may partly explain variations in antidepressant use and regular use of these medications. © The Royal College of Psychiatrists 2015.

Determinants of states' allocations of the master settlement agreement payments.

PubMed

Sloan, Frank A; Carlisle, Emily Streyer; Rattliff, John R; Trogdon, Justin

2005-08-01

To determine which factors influence states' allocation decisions for the tobacco Master Settlement Agreement and the four individual settlements' annual payments, including the decision to securitize, we analyzed the effects of voter characteristics, political parties, interest groups, prior spending on public tobacco control programs, and state fiscal health on per capita settlement funds allocated to tobacco-control, health, and other programs. Tobacco-producing states and those with high proportions of conservative Democrats or elderly, black, Hispanic, or wealthy people tended to spend less on tobacco control. Education and medical lobbies had strong positive influences on per capita allocations for tobacco-control and health-related programs. State fiscal crises affected amounts spent by states from settlement funds as well as the probability of securitizing future cash flows from the settlements.

National trends in prescription drug expenditures and projections for 2014.

PubMed

Schumock, Glen T; Li, Edward C; Suda, Katie J; Matusiak, Linda M; Hunkler, Robert J; Vermeulen, Lee C; Hoffman, James M

2014-03-15

An analysis of trends in U.S. pharmaceutical spending is presented, including projections for drug expenditures in nonfederal hospital and clinic settings in 2014. Trends in pharmaceutical expenditures and developments likely to influence future spending, including new drug approvals and patent expirations, were analyzed using data from the IMS Health National Sales Perspectives database. Projections were based on a combination of quantitative and qualitative analyses and expert opinion. Total prescription sales for the 12 months ending September 2013 were approximately $326 billion, 0.7% lower than sales during the previous 12 months; pharmaceutical spending by clinics and nonfederal hospitals grew by 4.5% and 1.8%, respectively. Vaccines were among the products driving large sales increases in clinic settings, with alteplase and pegfilgrastim topping the list of fast-growing drugs by hospital expenditures. Few new drug approvals anticipated in 2014 are expected to result in major expenditures by hospitals and clinics. Expansion of access to health care and other changes related to the Patient Protection and Affordable Care Act, as well as continued improvement in the U.S. economy, may drive growth in pharmaceutical spending over the next 12-24 months. Growth in U.S. prescription drug expenditures is expected to rebound in 2014, with a projected 3-5% increase in total drug expenditures across all settings this year, including a 5-7% increase in clinic spending and a 1-3% increase in hospital spending. Health-system pharmacy leaders should carefully examine local drug-utilization patterns to determine their respective organization's anticipated spending in 2014.

Urban/Rural Differences in Therapy Service Use Among Medicaid Children Aged 0-3 With Developmental Conditions in Colorado.

PubMed

McManus, Beth M; Lindrooth, Richard; Richardson, Zachary; Rapport, Mary Jane

2016-01-01

To describe urban/rural differences in physical (PT) and occupational therapy (OT) service utilization and spending among a sample of young Medicaid-enrolled children with developmental conditions. We analyzed Colorado Children's Medicaid administrative claims from 2006 to 2008. The sample included children who were younger than 36 months of age, had a select developmental condition, and were continuously eligible for each study year up to their third birthday. The study outcomes were number of PT/OT claims, type of PT/OT service, and Medicaid PT/OT spending. Multivariable analyses examined urban/rural differences in PT/OT utilization and spending, adjusting for child, family, and health service characteristics. The sample included 20,959 children. In adjusted analyses, urban children had 2-fold higher odds (odds ratio 2.18, 95% confidence interval 1.89, 2.51) of receiving PT/OT compared to their rural peers. Median annual per-child Medicaid PT/OT spending was $99 higher ($98.79 [$3.23, $194.35]) for urban children versus rural children. When place of PT/OT service and PT/OT procedures was included, this spending difference was drastically reduced. Even accounting for child, family, and health service characteristics, Medicaid PT/OT spending is lower for rural children compared to their urban peers. The difference in spending is largely attributable to utilization of services that are less specialized than urban peers, thus suggesting disparities in access to appropriate PT/OT services. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

The value of value-based insurance design: savings from eliminating drug co-payments.

PubMed

Maeng, Daniel D; Pitcavage, James M; Snyder, Susan R; Davis, Duane E

2016-02-01

To estimate the cost impact of a $0 co-pay prescription drug program implemented by a large healthcare employer as a part of its employee wellness program. A $0 co-pay program that included approximately 200 antihypertensive, antidiabetic, and antilipid medications was offered to Geisinger Health System (GHS) employees covered by Geisinger Health Plan (GHP) in 2007. Claims data from GHP for the years 2005 to 2011 were obtained. The sample was restricted to continuously enrolled members with Geisinger primary care providers throughout the study period. The intervention group, defined as 2251 GHS employees receiving any of the drugs eligible for $0 co-pay, was propensity score matched based on 2 years of pre-intervention claims data to a comparison group, which was defined as 3857 non-GHS employees receiving the same eligible drugs at the same time. Generalized linear models were used to estimate differences in terms of per-member-per-month (PMPM) claims amounts related to prescription drugs and medical care. Total healthcare spending (medical plus prescription drug spending) among the GHS employees was lower by $144 PMPM (13%; 95% CI, $38-$250) during the months when they were taking any of the eligible drugs. Considering the drug acquisition cost and the forgone co-pay, the estimated return on investment over a 5-year period was 1.8. This finding suggests that VBID implementation within the context of a wider employee wellness program targeting the appropriate population can potentially lead to positive cost savings.

Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal

PubMed Central

Thakkar, Vidhi; Sullivan, Terrence

2017-01-01

Health services and policy research (HSPR) represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publicly-funded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending. PMID:29179288

Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.

PubMed

Robinson, James C; Whaley, Christopher; Brown, Timothy T

2016-12-01

Fees charged for similar imaging tests often vary dramatically within the same market, leading to wide variation in insurer spending and consumer cost-sharing. Reference pricing is an insurance design that offers good coverage to patients up to a defined contribution limit but requires the patients who select high-priced facilities to pay the remainder out of pocket. To measure the association between implementation of reference pricing and patient choice of facility, test prices, out-of-pocket spending, and insurer spending for advanced imaging (CT and MRI) procedures. Difference-in-differences multivariable analysis of insurance claims data. Study included 4751 employees of a national grocery chain (treatment group) and 23,428 enrollees in the nation's largest private insurance plan (comparison group) that used CT or MRI tests between 2010 and 2013. Patient choice of facility, price paid per test, patient out-of-pocket cost-sharing, and employer spending. Compared with trends in prices paid by insurance enrollees not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 12.5% (95% CI, -25.0%, 2.1%) reduction in average price paid per test by the end of the second full year of the program for CT scans and a 10.5% (95% CI, -16.9%, 3.6%) for MRIs. Out-of-pocket cost-sharing by patients declined by $71,508 (13.8%). The savings accruing to employees amounted to 45.5% of total savings from reference pricing, with the remainder accruing to the employer. Implementation of reference pricing led to reductions in payments by both employer and employees.

Using disease management and market reforms to address the adverse economic effects of drug budgets and price and reimbursement regulations in Germany.

PubMed

Schwermann, Tim; Greiner, Wolfgang; v d Schulenburg, J M Graf

2003-01-01

Germany spends the highest share (10.4%) of its gross domestic product on health care among European Union countries. The majority of this financing comes from an earmarked tax on labor earnings. Drug spending, as a share (12.7%), is relatively low, as is per-capita drug spending. Over the past decade, a number of specific budgeting initiatives were introduced to control drug spending-with some success, at least until the 11% increase in the first 6 months of 2001. This article describes and analyzes these governmental initiatives as well as other market reforms. Germany has had a "drug budget silo mentality" throughout this period. But the focus of the mentality moved rapidly from the central budget to regional budgets and to drug budgets per physician based on historical data. These amounts do not correspond to either medical necessity or economic considerations. An analysis of the health-care system as a whole shows that the efforts to constrain spending with budget in one area can lead to higher total costs. This article also considers the impact of introducing other actual or proposed reforms such as a positive list to replace the negative list, generic substitution, retail price competition among pharmacies, and E-health commerce. There is also a new national institute constructing a database of information on health technology assessments. To overcome the strong segmentation of the health system in physician, drug, and hospital budgets, we recommend using this information from proper cost-effectiveness evaluations to develop clear guidelines for disease management programs, reinforced by appropriate financial incentives.

What Motivates an Ever Increasing Number of Students to Enroll in Part-Time Taught Postgraduate Awards?

ERIC Educational Resources Information Center

Ho, Amaly; Kember, David; Hong, Celina

2012-01-01

There has been a substantial rise in the number of students enrolling in part-time taught postgraduate awards. This study investigates the reasons or motivation for students to spend significant amounts on tutorial fees and find time alongside work, family and social commitments to take a taught postgraduate award. Data were gathered through…

Children's Use of Time; Some Personal and Social Correlations.

ERIC Educational Resources Information Center

Long, Barbara H.; Henderson, Edmund H.

The major interest of this study is the amount of time children spend reading. Data was gathered unobtrusively by having the 150 5th grade subjects keep time records of all their activities for a 2 week period. These were coded into 7 categories and scores were related to those derived from tests of ability, achievement, self-concept and reading…

Clinical Nursing Instructor Perception of the Influence of Engagement in Bedside Nursing Practice on Clinical Teaching

ERIC Educational Resources Information Center

Berndt, Jodi L.

2013-01-01

Clinical experiences are an integral component of nursing education. Because the amount of time that a student spends in clinical experiences can be as many as twelve to sixteen hours per week, the clinical instructor plays a significant role in the nursing student's development of nursing knowledge. Many nurse educators attempt to balance dual…

Working Smarter, Not Working Harder: Revisiting Teacher Feedback in the L2 Writing Classroom

ERIC Educational Resources Information Center

Lee, Icy

2011-01-01

Although second language (L2) teachers spend a significant amount of time marking students' writing, many of them feel that their efforts do not pay off. While students want teachers to give them feedback on their writing and value teacher feedback, they might experience feelings of frustration and confusion once they receive it. What is amiss in…

"Do You Teach Them Anything?" What Really Happens in a Montessori Toddler Class

ERIC Educational Resources Information Center

Dore, Heather S.

2014-01-01

The greatest sign of success for a teacher is to be able to say, "The children are now working as if I did not exist" (Montessori, 1967, p. 283). Montessori Toddler teachers spend a great amount of time preparing and perfecting their environments to allow and to encourage learning to happen. The teachers are constantly adjusting and…

Computer Games Are Fun? On Professional Games and Players' Motivations

ERIC Educational Resources Information Center

Eglesz, Denes; Fekete, Istvan; Kiss, Orhidea Edith; Izso, Lajos

2005-01-01

As computer games are becoming more widespread, there is a tendency for young people to spend a growing amount of time playing games. The first part of this paper will deal with various types of computer games and their characteristic features. In the second part we show the results of our recent surveys. We examined the motivations of young…

An A in Their Social Lives, but an F in School: Adolescent Perceptions of Texting in School

ERIC Educational Resources Information Center

Tulane, Sarah; Vaterlaus, J. Mitchell; Beckert, Troy E.

2017-01-01

Text messaging, used by people of all ages, has become the preferred method of communication for teenagers. Teens spend a significant amount of their daytime hours in school. Schools have not readily accepted the use of cell phone technology for fear of academic dishonesty, distraction, and cyberbullying. The current study examined adolescent (n =…

The Cost of Increasing In-School Time: Evidence from the Massachusetts Expanded Learning Time Initiative

ERIC Educational Resources Information Center

Kolbe, Tammy; O'Reilly, Fran

2017-01-01

A growing number of public schools have adopted reforms that increase the amount of time students spend in school. However, the potential costs of such reforms are not well understood. In this article, we report findings from a resource-cost study conducted in four schools that participated in the Massachusetts Expanded Learning Time Initiative.…

Markers of pregnancy: how early can we detect pregnancies in cattle using pregnancy-associated glycoproteins (PAGs) and microRNAs?

USDA-ARS?s Scientific Manuscript database

Pregnancy detection has evolved over the last few decades and the importance of early pregnancy detection is critical to minimize the amount of time a cow spends not pregnant or open. Embryonic mortality (EM) is generally considered to be the primary factor limiting pregnancy rates in cattle and occ...

Predicting Early Fatherhood and Whether Young Fathers Live with Their Children: Prospective Findings and Policy Recommendations. Discussion Paper.

ERIC Educational Resources Information Center

Jaffee, Sara R.; Caspi, Avshalom; Moffitt, Terrie E.; Taylor, Alan; Dickson, Nigel

This prospective, birth cohort study addressed three questions: Which individual and family-of-origin characteristics predict the age at which young men make the transition to fatherhood? Do these characteristics predict how long young men live with their children? Are individual differences in the amount of time fathers spend living with their…

How Much English Language Arts and Mathematics Instruction Do Students Receive? Investigating Variation in Instructional Time

ERIC Educational Resources Information Center

Phelps, Geoffrey; Corey, Douglas; DeMonte, Jenny; Harrison, Delena; Loewenberg Ball, Deborah

2012-01-01

The amount of instruction students receive has long been viewed as a foundational educational resource. This article presents an analysis of the time students spend in elementary English language arts (ELA) and mathematics instruction. In mathematics, the average student received about 140 hr of instruction, but students in the top sixth of…

Brenna's Story: A Critical Reflection and Analysis of One Mother's Experience of Navigating the Medical System with a Child with Intellectual Disabilities

ERIC Educational Resources Information Center

Bye, Amanda; Aston, Megan

2016-01-01

Children with intellectual disabilities spend more time in the health-care system than mainstream children. Parents have to learn how to navigate the system by coordinating appointments, understanding the referral process, knowing what services are available, and advocating for those services. This places an incredible amount of responsibility on…

Media Madness: With TV and the Internet Available 24/7, Can Libraries Compete?

ERIC Educational Resources Information Center

Jones, Jami

2004-01-01

Today's teens face an endless barrage of media--television, movies, radio, the Internet, magazines, and electronic games, not to mention those advertising slogans that shout out at them from billboards, bumper stickers, and even T-shirts. The sheer amount of time that teens spend with media is mind-boggling. Over the course of a year, young adults…

Relationships between Perceived Parental Involvement in Homework, Student Homework Behaviors, and Academic Achievement: Differences among Elementary, Junior High, and High School Students

ERIC Educational Resources Information Center

Núñez, J. C.; Suárez, N.; Rosário, P.; Vallejo, G.; Valle, A.; Epstein, J. L.

2015-01-01

This study aims to produce a deeper understanding of the relationship between perceived parental homework involvement (i.e., parental homework control and parental homework support), student homework behaviors (i.e., time spend on homework completion, time management, and amount of homework completed), and student academic achievement. Using…

What's Happening in Elementary School Classrooms? Research on Time Use, Classroom Operations, and Activity Management.

ERIC Educational Resources Information Center

Ross, Rhonda P.

A select portion of the educational management literature is reviewed in the three sections of this paper. The first section discusses literature concerning the amount of time students spend in school. Specific attention is given to the quantity of schooling, the allocation of school time, student engagement in academic tasks, and the relationship…

Active Learning and Educated Hope: College and Prison Partnerships in Liberal Education

ERIC Educational Resources Information Center

Inderbitzin, Michelle

2015-01-01

For someone who has never been convicted of a crime, the author spends an unusual amount of time in state prisons and youth correctional facilities. She does not work for these criminal justice agencies; instead, she studies prison culture, and--in small ways-- has become a part of it. The author is a university professor trained in sociology and…

Tailed frogs: distribution, ecology, and association with timber harvest in northeastern Oregon.

Treesearch

Evelyn L. Bull; Bernie E. Carter

1996-01-01

Tailed frogs (Ascaphus truei) were found in 42 of 80 streams surveyed in Union, Umatilla, Wallowa, and Baker Counties in 1992. At least three size classes of larvae were identified in seven of the streams, thereby suggesting that larvae transform after spending 3 or more years in the streams. The amount of cobble and fines in the streambed best...

The Testing Effect on Skills Learning Might Last 6 Months

ERIC Educational Resources Information Center

Kromann, C. B.; Bohnstedt, C.; Jensen, M. L.; Ringsted, C.

2010-01-01

In a recent study we found that testing as a final activity in a skills course increases the learning outcome compared to spending an equal amount of time practicing. Whether this testing effect measured as skills performance can be demonstrated on long-term basis is not known. The research question was: does testing as a final activity in a…

A Necessary Addiction: Student Conceptualizations of Technology and Its Impact on Teaching and Learning

ERIC Educational Resources Information Center

Bauer, Laurie B.

2018-01-01

The near constant use of technology today has led to widespread changes in the way literacy is imagined, used, and theorized. Since college students spend a significant amount of time using and being involved with various acts of technology, there is no doubt that their literate lives are changing and adapting as well. Although most college-aged…

What Kids Don't Get to Do Anymore and Why

ERIC Educational Resources Information Center

Sutterby, John A.

2009-01-01

Since 1981, the amount of time children spend with each other or alone without adult supervision has declined, especially in the area of outdoor free play. Free time for children has declined 16% between 1981 and 1997. A number of researchers have examined societal changes over the last century, especially from the mid-1970s to today. According to…

A Positive Move: 12th Annual College M&O Cost Study

ERIC Educational Resources Information Center

Agron, Joe

2006-01-01

Colleges placed more of an emphasis on maintenance and operations (M&O) this school year by increasing the amount spent on M&O as a percentage of total budget. According to "American School & University's" 12th annual College Maintenance and Operations Cost Study, spending on M&O as a percentage of total college budget increased to 11 percent from…

Applying the Theory of Diffusion of Innovations to Understand Electronic Benefit Transfer Technology Adoption at Mid-West Farmers Markets

ERIC Educational Resources Information Center

Hasin, Afroza

2016-01-01

The Supplemental Nutrition Assistance Program (SNAP, previously "food stamps"), is the nation's largest federal entitlement nutritional assistance program which assists individuals and households living below the federal poverty level in order to reduce the amount of money they spend on food. With the conversion of food stamps coupons to…

When Babies Watch Television: Attention-Getting, Attention-Holding, and the Implications for Learning from Video Material

ERIC Educational Resources Information Center

Courage, Mary L.; Setliff, Alissa E.

2010-01-01

The recent increase in the availability of infant-directed video material (e.g., "Baby Einstein") and the corresponding increase in the amount of time that infants and toddlers spend viewing them have prompted concern among parents and professionals that these media might impede aspects of cognitive and social development. In contrast, supporters…

Health care spending accounts: a flexible solution for Canadian employers.

PubMed

Smithies, R; Steeves, L

1996-01-01

Flexible benefits plans have grown more slowly in Canada than in the United States, largely because of certain legal and regulatory considerations. Health care spending accounts (HCSAs) provide a cost-effective way for Canadian employers to address the health care benefit needs of a diverse workforce. A flexible health care spending account is a versatile and cost-effective instrument that can be used by Canadian employers that wish to provide a full range of health care benefits to employees. The health care alternatives available through an HCSA can provide employees with an opportunity to customize and optimize their benefits program. Regulatory requirements that an HCSA must meet in order to qualify for available tax advantages are discussed, as are the range of health care services that may be covered.

Optimal Investment in HIV Prevention Programs: More Is Not Always Better

PubMed Central

Brandeau, Margaret L.; Zaric, Gregory S.

2008-01-01

This paper develops a mathematical/economic framework to address the following question: Given a particular population, a specific HIV prevention program, and a fixed amount of funds that could be invested in the program, how much money should be invested? We consider the impact of investment in a prevention program on the HIV sufficient contact rate (defined via production functions that describe the change in the sufficient contact rate as a function of expenditure on a prevention program), and the impact of changes in the sufficient contact rate on the spread of HIV (via an epidemic model). In general, the cost per HIV infection averted is not constant as the level of investment changes, so the fact that some investment in a program is cost effective does not mean that more investment in the program is cost effective. Our framework provides a formal means for determining how the cost per infection averted changes with the level of expenditure. We can use this information as follows: When the program has decreasing marginal cost per infection averted (which occurs, for example, with a growing epidemic and a prevention program with increasing returns to scale), it is optimal either to spend nothing on the program or to spend the entire budget. When the program has increasing marginal cost per infection averted (which occurs, for example, with a shrinking epidemic and a prevention program with decreasing returns to scale), it may be optimal to spend some but not all of the budget. The amount that should be spent depends on both the rate of disease spread and the production function for the prevention program. We illustrate our ideas with two examples: that of a needle exchange program, and that of a methadone maintenance program. PMID:19938440

LiFi based automated shopping assistance application in IoT

NASA Astrophysics Data System (ADS)

Akter, Sharmin; Funke Olanrewaju, Rashidah, Dr; Islam, Thouhedul; Salma

2018-05-01

Urban people minimize shopping time in daily life due to time constrain. From that point of view, the concept of supermarket is being popular while consumers can buy different items from same place. However, customer spends hours and hours to find desired items in a large supermarket. In addition, it’s also required to be queued during payment at counter that is also time consuming. As a result, a customer has to spend 2-3 hours for shopping in a large superstore. This paper proposes an Internet of Things and Li-Fi based automated application for smart phone and web to find items easily during shopping that can save consumer’s time as well as reduce man power in supermarket.

Federal Funding Insulated State Budgets From Increased Spending Related To Medicaid Expansion.

PubMed

Sommers, Benjamin D; Gruber, Jonathan

2017-05-01

As states weigh whether to expand Medicaid under the Affordable Care Act (ACA) and Medicaid reform remains a priority for some federal lawmakers, fiscal considerations loom large. As part of the ACA's expansion of eligibility for Medicaid, the federal government paid for 100 percent of the costs for newly eligible Medicaid enrollees for the period 2014-16. In 2017 states will pay some of the costs for new enrollees, with each participating state's share rising to 10 percent by 2020. States continue to pay their traditional Medicaid share (roughly 25-50 percent, depending on the state) for previously eligible enrollees. We used data for fiscal years 2010-15 from the National Association of State Budget Officers and a difference-in-differences framework to assess the effects of the expansion's first two fiscal years. We found that the expansion led to an 11.7 percent increase in overall spending on Medicaid, which was accompanied by a 12.2 percent increase in spending from federal funds. There were no significant increases in spending from state funds as a result of the expansion, nor any significant reductions in spending on education or other programs. States' advance budget projections were also reasonably accurate in the aggregate, with no significant differences between the projected levels of federal, state, and Medicaid spending and the actual expenses as measured at the end of the fiscal year. Project HOPE—The People-to-People Health Foundation, Inc.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Health Care Utilization and Spending Among Carve-In Enrollees.

PubMed

Harwood, Jessica M; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K; Tseng, Chi-Hong; Wells, Kenneth B; Friedman, Sarah; Ettner, Susan L

2017-02-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA's impact on BH expenditures and utilization among "carve-in" enrollees. We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits, medication management, individual and family psychotherapy); intermediate care utilization (structured outpatient, day treatment, residential); and inpatient utilization. MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits [respective immediate increases of: $1.05 (P=0.02); $0.88 (P=0.04); 0.00045 visits (P=0.00)], and individual psychotherapy visits [immediate increase of 0.00578 visits (P=0.00) and additional increases of 0.00017 visits/mo (P=0.03)]. MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; for example, in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act's inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets.

Effects of a consumer driven health plan on pharmaceutical spending and utilization.

PubMed

Parente, Stephen T; Feldman, Roger; Chen, Song

2008-10-01

To compare pharmaceutical spending and utilization in a consumer driven health plan (CDHP) with a three-tier pharmacy benefit design, and to examine whether the CDHP creates incentives to reduce pharmaceutical spending and utilization for chronically ill patients, generic or brand name drugs, and mail-order drugs. Retrospective insurance claims analysis from a large employer that introduced a CDHP in 2001 in addition to a point of service (POS) plan and a preferred provider organization (PPO), both of which used a three-tier pharmacy benefit. Difference-in-differences regression models were estimated for drug spending and utilization. Control variables included the employee's income, age, and gender, number of covered lives per contract, election of flexible spending account, health status, concurrent health shock, cohort, and time trend. Results. CDHP pharmaceutical expenditures were lower than those in the POS cohort in 1 year without differences in the use of brand name drugs. We find limited evidence of less drug consumption by CDHP enrollees with chronic illnesses, and some evidence of less generic drug use and more mail-order drug use among CDHP members. The CDHP is cost-neutral or cost-saving to both the employer and the employee compared with three-tier benefits with no differences in brand name drug use. © Health Research and Educational Trust.

Minding Ps and Qs: The Political and Policy Questions Framing Health Care Spending.

PubMed

Sage, William M

2016-12-01

Tracing the evolution of political conversations about health care spending and their relationship to the formation of policy is a valuable exercise. Health care spending is about science and ethics, markets and government, freedom and community. By the late 1980s the unique upward trajectory of post-Medicare U.S. health care spending had been established, recessions and tax cuts were eroding federal and state budgets, and efforts to harness market forces to serve policy goals were accelerating. From the initial writings on "managed competition," through the failed Clinton health reform effort in the early 1990s, to the passage of the Affordable Care Act in 2010, the policy narrative of health spending acquired a superficial consistency. On closer examination, however, it becomes apparent that the cost problem has been repeatedly reframed in political discourse even during this relatively brief period. The clearest transition has been from a narrative centered on rationing necessary care to one committed to reducing wasteful care - although the role of accumulated law and regulation in perpetuating waste remains largely unrecognized and the recently articulated commitment to population health seems an imperfect proxy for explicitly developing social solidarity with respect to health and health care in the United States.

New analysis reexamines the value of cancer care in the United States compared to Western Europe.

PubMed

Soneji, Samir; Yang, JaeWon

2015-03-01

Despite sharp increases in spending on cancer treatment since 1970 in the United States compared to Western Europe, US cancer mortality rates have decreased only modestly. This has raised questions about the additional value of US cancer care derived from this additional spending. We calculated the number of US cancer deaths averted, compared to the situation in Western Europe, between 1982 and 2010 for twelve cancer types. We also assessed the value of US cancer care, compared to that in Western Europe, by estimating the ratio of additional spending on cancer to the number of quality-adjusted life-years saved. Compared to Western Europe, for three of the four costliest US cancers-breast, colorectal, and prostate-there were approximately 67,000, 265,000, and 60,000 averted US deaths, respectively, and for lung cancer there were roughly 1,120,000 excess deaths in the study period. The ratio of incremental cost to quality-adjusted life-years saved equaled $402,000 for breast cancer, $110,000 for colorectal cancer, and $1,979,000 for prostate cancer-amounts that exceed most accepted thresholds for cost-effective medical care. The United States lost quality-adjusted life-years despite additional spending for lung cancer: -$19,000 per quality-adjusted life-year saved. Our results suggest that cancer care in the United States may provide less value than corresponding cancer care in Western Europe for many leading cancers. Project HOPE—The People-to-People Health Foundation, Inc.

Ways of spending leisure time by the third year-students of the Faculty of Pharmacy, Medical University of Lublin.

PubMed

Czabak-Garbacz, Róza; Skibniewska, Agnieszka; Mazurkiewicz, Piotr; Gdula, Agnieszka

2002-01-01

The aim of the study was the assessment of leisure time among third-year students from the Faculty of Pharmacy of the Medical University of Lublin. It analysed quantity of time devoted to school activity and ways of spending free time. The study involved 114 students (82 women and 32 men). The study revealed that women had less free time than men, who, most probably did not attend some lectures. The most popular activities among the questioned students were: sleeping (average 6.8 hours a day), studying (average 3.6 hours a day), listening to the radio (average 2.9 hours a day), talking with friends (average 1.9 hours a day), personal hygiene (average 1.1 hours a day), watching TV (average 1.1 hours a day), housework. Students devoted the least of their free time on active rest, for example walking (women did it more often than men) or practising sport (more popular among men). Cultural life of the students consisted only of meetings with friends and going to the cinema (women did it more often). The least popular way of spending free time was going to the theatre, opera, concerts and exhibitions. Few students spent their time working. Their number increased significantly during holidays. The way of spending free time by third-year students from the Faculty of Pharmacy (both men and women) during the day was similar, differences related only to the amount of time devoted to each activity.

Hidden burden of non-medical spending associated with inpatient care among the poor in Afghanistan.

PubMed

Mashal, Mohammad Omar; Nakamura, Keiko; Kizuki, Masashi

2016-07-01

To elucidate the household payments required for medical and non-medical spending for inpatient health care and examine the pattern of household payments according to household economic status and the degree of remoteness of the area of residence. The subjects were 5490 individuals included in a nationally representative survey in 2010. Their medical (diagnosis and medicine) and non-medical (accommodation and transportation) expenses for their most recent hospitalization were analyzed. Compared with the richest group, the poorest group paid less for diagnosis and medicine (AOR = 0.37, P < 0.001; AOR = 0.78, P = 0.009, respectively), paid similar amounts for accommodation (AOR = 1.19, P = 0.164), and more for transportation (AOR = 2.09, P < 0.001). Residents in urban areas paid less than residents in rural areas for accommodation and transportation (AOR = 0.73, P < 0.001; AOR = 0.58, P < 0.001, respectively). Poor households paid less for diagnosis and medicine, but more for transportation related to inpatient care. Non-medical spending for inpatient care among the poor should be considered for affordable and accessible health-care utilization.

The Economic Impact of Medicaid Expansion on Pennsylvania.

PubMed

Price, Carter C; Donohue, Julie M; Saltzman, Evan; Woods, Dulani; Eibner, Christine

2013-01-01

The Affordable Care Act is a substantial reform of the U.S. health care insurance system. Using the RAND COMPARE model, researchers assessed the act's potential economic effects on Pennsylvania, factoring in an optional expansion of Medicaid, and found the state would enjoy significant net benefits. With or without the expansion of Medicaid, the act will increase insurance coverage to hundreds of thousands of Pennsylvanians, but the COMPARE model estimates that the expansion of Medicaid eligibility would cover an additional 350,000 people and bring more than $2 billion in federal spending into the state annually than if the state did not expand. Should the state expand Medicaid, the additional spending will add more than $3 billion a year to the state's GDP and support 35,000 jobs. But Medicaid expansion is not without cost for the state; the estimated cumulative effect on Pennsylvania's Medicaid spending will be $180 million higher with the expansion than without between 2014 and 2020. Substantial reductions in uncompensated care costs for hospitals are possible even without expansion, but savings to hospitals for uncompensated care funding are even larger with the Medicaid expansion, amounting to $550 million or more each year.

IS/IT the prescription to enable medical group practices attain their goals.

PubMed

Wickramasinghe, Nilmini; Silvers, J B

2003-05-01

The US spends significantly more money as a percentage of GDP on health care than any other OECD country and more importantly, this amount is anticipated to increase exponentially. In this high cost environment, two important trends have occurred: (1) the movement to managed care, and (2) large investments in Information Systems/Information Technology (IS/IT). Managed care has emerged as an attempt to provide good quality yet cost effective health care treatment. Its implications are not well discussed in the literature while, its impact on different types of medical group practices is even less well understood. The repercussions of the large investments in IS/IT on the health care sector in general and on the medical group practice in particular, although clearly of importance, are also largely ignored by the literature. This study attempts to address this significant void in the literature. By analyzing three different types of group practices; an Independent Practice Association (IPA), a Faculty Practice and a Multi Specialty Group Practice in a managed care environment during their implementation of practice management/billing systems, we are able to draw some conclusions regarding the impacts of these two central trends on health care in general as well as on the medical group practice in particular.

Financial protection from health spending in the Philippines: policies and progress.

PubMed

Bredenkamp, Caryn; Buisman, Leander R

2016-09-01

The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years. The main driver of health spending is medicines, accounting for almost two-thirds of total health spending, and as much as three-quarters among the poor. The incidence of catastrophic payments has tripled since 2000, from 2.5% to 7.7%. The percentage of people impoverished by health spending has also increased and, in 2012, out-of-pocket spending on health added 1.5 percentage points to the poverty rate, pushing more than 1.5 million people into poverty. In light of these findings, recent policies to enhance financial risk protection-such as the expansion of government-subsidized health insurance from the poor to the near-poor, a policy of zero copayments for the poor, a deepening of the benefit package and provider payment reform aimed at cost-containment-are to be commended. Indeed, between 2008 and 2013, self-reported health insurance coverage increased across all quintiles and its distribution became more pro-poor. To speed progress toward financial protection goals, quick wins could include issuing health insurance cards to the poor to increase awareness of coverage and limiting out-of-pocket spending by clearly defining a clear copayment structure for non-poor members. An in-depth analysis of the pharmaceutical sector would help to shed light on why medicines impose such a large financial burden on households. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests.

PubMed

Robinson, James C; Whaley, Christopher; Brown, Timothy T

2016-09-01

Prices for laboratory and other clinical services vary widely. Employers and insurers increasingly are adopting "reference pricing" policies to create incentives for patients to select lower-priced facilities. To measure the association between implementation of reference pricing and patient choice of laboratory, test prices, patient out-of-pocket spending, and insurer spending. We conducted an observational study of changes in laboratory pricing and selection by employees of a large national grocery firm (n = 30 415) before and after the firm implemented a reference pricing policy for laboratory services and compared the findings with changes over the same period for policy holders of a large national insurer that did not implement reference pricing (n = 181 831). The grocery firm established a maximum payment limit at the 60th percentile of the distribution of prices for each laboratory test in each region. Employees were provided with data on prices at all laboratories through a mobile digital platform. Patients selecting a laboratory that charged more than the payment limit were required to pay the full difference themselves. A total of 2.13 million claims were analyzed for 285 types of in vitro diagnostic tests between 2010 and 2013. Patient choice of laboratory, price paid per test, patient out-of-pocket costs, and employer spending. Compared with trends in prices paid by insurance policy holders not subject to reference pricing, and after adjusting for characteristics of tests and patients, implementation of reference pricing was associated with a 31.9% reduction (95% CI, 20.6%-41.6%) in average price paid per test by the third year of the program. In these 3 years, total spending on laboratory tests declined by $2.57 million (95% CI, $1.59-$3.35 million). Out-of-pocket costs by patients declined by $1.05 million (95% CI, $0.73-$1.37 million). Spending by the employer declined by $1.70 million (95% CI, $0.92-$2.48 million). When combined with access to price information, reference pricing was associated with patient choice of lower-cost laboratories and reductions in prices and payments by both employer and employees.

Telecommuting in the Federal Workforce

DTIC Science & Technology

2001-12-01

annually per teleworker as a result of reduced employee absenteeism because personal and medical errands are typically geographically proximal to the...that employee absenteeism can be reduced by up to 45% under telecommuting arrangements, SWDIV could realistically assume that it would achieve similar...in reduced absenteeism for each teleworker . Although I do not know the amount SWDIV spends on leased office space, 100% of those expenses could be

The Role of Mental Health Professionals Contributes to Mental Health Promotion and Prevention: Innovative Programmes in Serbia

ERIC Educational Resources Information Center

Milovancevic, Milica Pejovic; Jovicic, Milica

2013-01-01

It has been estimated that 9 to 13% of children and adolescents have a mental disorder that causes significant functioning impairment and that only one fifth of those who need mental health services actually receive them. The majority of children and adolescents are enrolled in schools, where they spend a considerable amount of time, and this is…

U.S. and Chilean College Students' Reading Practices: A Cross-Cultural Perspective

ERIC Educational Resources Information Center

Huang, Suhua; Orellana, Pelusa; Capps, Matthew

2016-01-01

The purpose of this study was to investigate the differences between the amounts of time that U.S. and Chilean students spend on conventional academic reading, extracurricular reading, and Facebook and also to report the types of materials they prefer to read. The study surveyed students in the United States (n = 1,265) and Chile (n = 2,076)…

Need Satisfaction, Work-School Interference and School Dropout: An Application of Self-Determination Theory

ERIC Educational Resources Information Center

Taylor, Genevieve; Lekes, Natasha; Gagnon, Hugo; Kwan, Lisa; Koestner, Richard

2012-01-01

Background: In many parts of the world, it is common for secondary school students to be involved in part-time employment. Research shows that working can have a negative impact on school engagement. However, the majority of studies have focused on the amount of time that students spend working rather than on the "quality" of work experience and…

Envisioning a Modern Federal-State Partnership in the Reauthorization of the HEA as an Engine to Increase Social Mobility

ERIC Educational Resources Information Center

Alexander, F. King; Arceneaux, Ashley

2015-01-01

Financial aid makes up the bulk of federal higher education spending, but do those dollars make a difference to needy students? A look at Federal Work-Study and Federal Supplemental Educational Opportunity Grant allocations show that a disproportionate amount of funding goes to private universities with high tuition and low Federal Pell Grant…

A Nation at Rest: The American Way of Homework

ERIC Educational Resources Information Center

Gill, Brian P.; Schlossman, Steven L.

2003-01-01

We use several national surveys to provide a 50-year perspective on time spent on homework. The great majority of American children at all grade levels now spend less than one hour studying on a typical day--an amount that has not changed substantially in at least 20 years. Moreover, high school students in the late 1940s and early 1950s studied…

SunWise: A Program that Radiates Good Ideas. Policy Information

ERIC Educational Resources Information Center

US Environmental Protection Agency, 2010

2010-01-01

The school day makes up a major part of a child's everyday life. The time children spend outside of the classroom, including recess, lunch, physical education classes, field trips, and after-school activities, can result in a significant amount of sun exposure, especially if it occurs during the hours of peak sun intensity from 10 a.m. to 4 p.m.…

Revisiting Risk in the 21st Century. Forum Focus. Volume 3, Issue 1, January-February 2005

ERIC Educational Resources Information Center

Forum for Youth Investment, 2005

2005-01-01

Over the past year, dozens of articles have been published about excessive youth borrowing and spending (leading to high amounts of debt), new reactions to negative body image (such as plastic surgery), as well as more familiar risks like premarital sex and smoking. In Forum Focus: Revisiting Risk in the 21st Century, we explore these challenges…

Deferred and Income-Contingent Tuition Fees: An Empirical Assessment Using Belgian, German and UK Data

ERIC Educational Resources Information Center

Vandenberghe, V.; Debande, O.

2007-01-01

This paper is a numerical exploration of the following. Assume, in the European Union context, that decision-makers want to spend more on higher education via higher tuition fees, but also want payments to be deferred and income-contingent. There are several possible ways to achieve this. First, ask graduates to repay a fixed amount each year if…

Social-Emotional Needs: A School-Based Approach to Preventing Suicide among Students with Gifts and Talents

ERIC Educational Resources Information Center

Cross, Tracy L.

2012-01-01

This article provides a succinct primer on some of the basic constructs that adults need to know to help keep students with gifts and talents from completing suicide. It focuses on the school as the primary context to look out for potentially suicidal gifted students. This makes sense, as students spend a considerable amount of time in school,…

Returning to Reading: An Online Course in French Offers a Snapshot of L2 Reading Habits and Trends

ERIC Educational Resources Information Center

Gascoigne, Carolyn; Parnell, Juliette

2016-01-01

With todays' students spending increasing amounts of time involved in online activities, there is a growing need to study their online reading habits. Indeed, it is not only students' out-of-class engagement with electronic media that calls for increased attention to the reading skill, in general, and online reading, in particular, but it is also…

Schooling and Factors Affecting Decisions on Schooling by Household Members in the Rural Areas of Turkey

ERIC Educational Resources Information Center

Olgun, Akin; Gumus, Sevtap Guler; Adanacioglu, Hakan

2010-01-01

Despite the fact that rural education has always been one of the most important means of rural development, it has been ignored in many developing countries, with the result that rural development has not achieved great success. The problems of education in rural areas are not only related to the amount the country spends on education or to the…

Is More Time in Head Start Always Better for Children? The Moderating Role of Classroom Quality

ERIC Educational Resources Information Center

Friedman-Krauss, Allison H.; Connors, Maia C.; Morris, Pamela A.

2014-01-01

The 1998 reauthorization of Head Start called for a national evaluation of the Head Start program. The goal of Head Start is to improve the school readiness skills of low-income children. Yet characteristics of Head Start programs, such as their quality and the amount of time children spend in them may influence their effectiveness at achieving…

Young people, money, and access to tobacco.

PubMed

Wong, Grace; Glover, Marewa; Nosa, Vili; Freeman, Becky; Paynter, Janine; Scragg, Robert

2007-12-14

The social and family processes involved in children's sources and use of money in relation to buying cigarettes are not well understood. Hence this study investigated how Maori, Pacific Island, European, and Asian school students access cigarettes, with a special focus on their disposable income. Students aged 11-15 years, recruited through schools, participated in 12 focus groups run by ethnically matched senior student facilitators and researchers. Topics discussed included sources of student money, parental monitoring of the use of money and student access to cigarettes. Students reported that young people can easily buy cigarettes from tobacco retailers. They could also be bought cheaply (50 cents for a roll-your-own) and/or on an "I owe you" basis from friends and social suppliers. Students used money from family, and money that was earned, "scabbed", and borrowed from friends. Cigarettes were also obtained freely from family members or from adults on the street. Whilst parents monitored students' use of large amounts of money, participants experienced relative freedom to spend small amounts which they saved out of money provided by parents for lunches and other purposes. Students were open to parental advice on how to use money but felt they should have the final say. Cigarettes continue to be accessible to children free or at affordable prices. Adults and family members must be discouraged from supplying cigarettes to children. Parents should be made aware of the way children use small amounts of money and advised to monitor, educate, and guide them to discourage cigarette purchase.

[Invested time in private care: estimated by people in need of help and care and their private caregivers].

PubMed

Heinemann-Knoch, M; Knoch, T; Korte, E

2006-12-01

The amount of time that ought to be invested for private care is regulated by the German Care Assurance (SGB XI). Whether this reflects the actual amount of help given to the people cornered is not certain. In our qualitative study, which was part of the project "Potentials and Limits of Independent Living in Private Households in Germany" [1] funded by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, we had the chance to document the amount of time people themselves think they spend or vice versa receive for help and care with a timetable. Even if the amount of time alone does not yet lead to a conclusion about the quality of the given effort, it is one indicator for an adequate care that allows living at home as long as possible.

PathText: a text mining integrator for biological pathway visualizations

PubMed Central

Kemper, Brian; Matsuzaki, Takuya; Matsuoka, Yukiko; Tsuruoka, Yoshimasa; Kitano, Hiroaki; Ananiadou, Sophia; Tsujii, Jun'ichi

2010-01-01

Motivation: Metabolic and signaling pathways are an increasingly important part of organizing knowledge in systems biology. They serve to integrate collective interpretations of facts scattered throughout literature. Biologists construct a pathway by reading a large number of articles and interpreting them as a consistent network, but most of the models constructed currently lack direct links to those articles. Biologists who want to check the original articles have to spend substantial amounts of time to collect relevant articles and identify the sections relevant to the pathway. Furthermore, with the scientific literature expanding by several thousand papers per week, keeping a model relevant requires a continuous curation effort. In this article, we present a system designed to integrate a pathway visualizer, text mining systems and annotation tools into a seamless environment. This will enable biologists to freely move between parts of a pathway and relevant sections of articles, as well as identify relevant papers from large text bases. The system, PathText, is developed by Systems Biology Institute, Okinawa Institute of Science and Technology, National Centre for Text Mining (University of Manchester) and the University of Tokyo, and is being used by groups of biologists from these locations. Contact: brian@monrovian.com. PMID:20529930

Automated Slide Scanning and Segmentation in Fluorescently-labeled Tissues Using a Widefield High-content Analysis System.

PubMed

Poon, Candice C; Ebacher, Vincent; Liu, Katherine; Yong, Voon Wee; Kelly, John James Patrick

2018-05-03

Automated slide scanning and segmentation of fluorescently-labeled tissues is the most efficient way to analyze whole slides or large tissue sections. Unfortunately, many researchers spend large amounts of time and resources developing and optimizing workflows that are only relevant to their own experiments. In this article, we describe a protocol that can be used by those with access to a widefield high-content analysis system (WHCAS) to image any slide-mounted tissue, with options for customization within pre-built modules found in the associated software. Not originally intended for slide scanning, the steps detailed in this article make it possible to acquire slide scanning images in the WHCAS which can be imported into the associated software. In this example, the automated segmentation of brain tumor slides is demonstrated, but the automated segmentation of any fluorescently-labeled nuclear or cytoplasmic marker is possible. Furthermore, there are a variety of other quantitative software modules including assays for protein localization/translocation, cellular proliferation/viability/apoptosis, and angiogenesis that can be run. This technique will save researchers time and effort and create an automated protocol for slide analysis.

Effects of classroom organization on letter-word reading in first grade.

PubMed

Cameron, Claire E; Connor, Carol McDonald; Morrison, Frederick J; Jewkes, Abigail M

2008-04-01

Teacher organization is a crucial part of classroom functioning; however, its relation to student achievement has not been investigated as extensively as that of instruction. In this study, organization is defined as the amount of time teachers spend explaining the purpose and procedures of learning activities and daily routines. Data from first-grade classrooms (N=44) observed three times during the school year (fall, winter, and spring) are analyzed, along with students' (N=108) literacy skills at fall and spring. Hierarchical Linear Modeling reveals that, controlling for students' fall word reading and vocabulary skills, as well as amount of language arts instruction they receive, both amount and change in amount over time in classroom organization significantly predicts spring word reading skills. Specifically, children in classrooms observed in higher amounts of classroom time in organization at the beginning of the school year, followed by sharp decreases over the school year, demonstrated stronger letter and word reading skills by spring, and this was a main effect (p<.05). Practical and research implications are discussed.

How to Get Cost-Effectiveness Analysis Right? The Case of Vaccine Economics in Latin America.

PubMed

Glassman, Amanda; Cañón, Oscar; Silverman, Rachel

2016-12-01

In middle-income countries, vaccines against pneumococcal disease, rotavirus, and human papilloma virus are in general more costly, not necessarily cost saving, and less consistently cost-effective than earlier generation vaccines against measles, diphtheria, tetanus, and pertussis. Budget impact is also substantial; public spending on vaccines in countries adopting new vaccines is, on average, double the amount of countries that have not adopted. Policymakers must weigh the costs and benefits of the adoption decision carefully, given the low coverage of other kinds of cost-effective health and nonhealth interventions in these same settings and relatively flat overall public spending on health as a share of gross domestic product (GDP) over time. This paper considers lessons learned from recent vaccine cost-effectiveness analyses and subsequent adoption decisions in Latin America a, largely under the auspices of the Pro Vac Initiative. The paper illustrates how small methodological choices and seemingly minor technical limitations of cost-effectiveness models can have major implications for the studies' conclusions, potentially influencing countries' subsequent vaccine adoption decisions. We evaluate the ProVac models and technical outputs against the standards and framework set out by the International Decision Support Initiative Reference Case for economic evaluation and consider the practical effects of deviations from those standards. Lessons learned are discussed, including issues of appropriate comparators, GDP-based thresholds, and use of average versus incremental cost-effectiveness ratios as a convention are assessed. The article ends with recommendations for the future. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Beyond Ignorance: Using the Cultural Stereotypes of Americans Studying in the UK as a Resource for Learning and Teaching about British Culture

ERIC Educational Resources Information Center

Janes, Dominic

2011-01-01

A course introducing British culture is a standard component of many study abroad programmes running in this country that are aimed at international students who will be spending a limited amount of time in the United Kingdom. However, it is not often acknowledged that such students possess a range of strong pre-conceptions about British culture…

LANDSAT-4 Science Characterization Early Results. Volume 4: Applications. [agriculture, soils land use, geology, hydrology, wetlands, water quality, biomass identification, and snow mapping

NASA Technical Reports Server (NTRS)

Barker, J. L. (Editor)

1985-01-01

The excellent quality of TM data allows researchers to proceed directly with applications analyses, without spending a significant amount of time applying various corrections to the data. The early results derived of TM data are discussed for the following applications: agriculture, land cover/land use, soils, geology, hydrology, wetlands biomass, water quality, and snow.

A Study on the Rationale of Social Media Use by the Students of King Khalid University

ERIC Educational Resources Information Center

Ahmed, Sayed Salahuddin; Hassan, Abdulkhaleq Q. A.

2017-01-01

Is not it deplorable that in a country that tops in the entire world in using several social media sites does not utilize the same media in acquiring knowledge and skills? In Saudi Arabia, undergraduate students spend a significant amount of time on social media every day, but they are reluctant (or not motivated enough) to use the same media for…

Adolescent Overscheduling: The Relationship between Levels of Participation in Scheduled Activities and Self-Reported Clinical Symptomology

ERIC Educational Resources Information Center

Melman, Shari; Little, Steven G.; Akin-Little, K. Angeleque

2007-01-01

The past 20 to 30 years has seen an increase in the time children and adolescents spend in structured activities outside of the regular school day. This has resulted in a significant reduction in the amount of free time children and youth have for leisure time activities. While much discussion has been given to this topic in the popular press,…

Personal and organizational influences to the use of fire and fuels research by federal agency managers

Treesearch

Vita Wright

2008-01-01

The Joint Fire Science Program (JFSP) and the National Fire Plan (NFP) spend considerable amounts of money on fire and fuels research. From Fiscal Year 1998-2006, the JFSP spent approximately $145 million, and from Fiscal Year 2001-2005, the NFP spent approximately $104 million on research. For the costs of research to be fully realized, it is critical that science...

Text Processing: The Role of Reader Expectations and Background Knowledge.

DTIC Science & Technology

1987-08-01

essay test were expected, but spend more time processing lower-- level information than if a recognition test were expected. Furthermore, processing ...shifts ii tle amount of time devoted to reading information at various levels in a t.x, structure, rather than dramatic differences in processing patt...structures ( Craik & Lockhart , 1972; Goetz, Schallert, Reynolds, & Radin, 1983). If new information is compatible with existing memory structures, it is

Problematic usage among highly-engaged players of massively multiplayer online role playing games.

PubMed

Peters, Christopher S; Malesky, L Alvin

2008-08-01

One popular facet of Internet gaming is the massively multiplayer online role playing game (MMORPG). Some individuals spend so much time playing these games that it creates problems in their lives. This study focused on players of World of Warcraft. Factor analysis revealed one factor related to problematic usage, which was correlated with amount of time played, and personality characteristics of agreeableness, conscientiousness, neuroticism, and extraversion.

Iran: Politics, Gulf Security, and U.S. Policy

DTIC Science & Technology

2016-08-19

nuclear weapon if it decided to do so. President Obama has asserted that the JCPOA has the potential to produce the added benefit of improving U.S... benefits , and can spend significant amounts of unbudgeted funds on arms, technology, and support to pro-Iranian movements. Society of Militant...international isolation, continues to back state intervention in the economy to benefit workers and lower classes. Appeared at some of the 2009 protests

Iran: Politics, Gulf Security, and U.S. Policy

DTIC Science & Technology

2016-03-30

to produce the added benefit of improving U.S.-Iran relations. However, since the deal was finalized, Iran, Iran has tested ballistic missiles and...political and social freedoms and reducing Iran’s international isolation, continues to back state intervention in the economy to benefit workers and lower...is able to generate profits from its business affiliates, which enjoy vast tax and regulatory benefits , and can spend significant amounts of

Reforming the Ukrainian Armed Forces on a Budget

DTIC Science & Technology

2017-05-25

Free Europe, October 13, 2014, accessed October 27, 2016, http://www.rferl.org/a/ukraine-revolving-door-defense-ministers/26635213.html. 27 Evgen...provide money to implement NATO’s policies and activities. There are two principles of funding. The first is national, also called indirect, when a...2 percent guideline. Another important agreement was reached about the amount of money the members spend on the procurement of new equipment and

Digital Game-Based Textbook vs. Traditional Print-Based Textbook: The Effect of Textbook Format on College Students' Engagement with Textbook Content outside of the Classroom

ERIC Educational Resources Information Center

Thomas, Antonio Lamar

2017-01-01

The relatively little amount of time that some college students spend reading their textbooks outside of the classroom presents a significant threat to their academic success. Using Prenksy's (2001) digital game-based learning (DGBL) principles and Astin's student involvement theory as frameworks, the purpose of this true experiment was to…

Mexican Tax Reform: Look to the Russian Example

DTIC Science & Technology

2011-10-31

GDP approximately 787% in nominal terms. Also, real wages doubled. Hours worked by primary breadwinners increased 5% to 7% and unemployment dropped...doubled. Hours worked by primary breadwinners increased 5% to 7% and unemployment dropped from 11.9% to 7.6%. By adopting such tax reforms, the...itself, a further tax burden. Businesses and individuals have to spend excessive amounts of their time and effort just complying with complicated tax

Does Spending Money on Education Help? A Reaction to the Heritage Foundation and the "Wall Street Journal."

ERIC Educational Resources Information Center

Wainer, Howard

In June 1993 the "Wall Street Journal" carried a table of data prepared by the Heritage Foundation that listed the states in order of the average amount they expend on each public school student. The table also contained each state's rank on the average score on the Scholastic Aptitude Test (SAT) and the rank of each state in the average…

Information Technology in a Developing Country: An Exploration of the Factors Associated with Attitudes of Decision Makers in Jordanian Government Institutions toward the Utilization of Computer-Based Technology

ERIC Educational Resources Information Center

Khasawneh, Saleh

2010-01-01

In this era of rapidly advancing technologies, many governments around the globe are spending a great amount of money on these technologies, in order to increase their work performance. Therefore, the Jordanian government decided to implement IT in its public organizations. However, the picture is unclear about users' attitudes toward this…

Capping the tax exclusion for employment-based health coverage: implications for employers and workers.

PubMed

Fronstin, Paul

2009-01-01

HEALTH CARE TAX CAP: With health reform a major priority of the new 111th Congress and President Barack Obama, this Issue Briefexamines the administrative and implementation issues that arise from one of the major reform proposals: Capping the exclusion of employment-based health coverage from workers' taxable income. The amount that employers contribute toward workers' health coverage is generally excluded, without limit, from workers' taxable income. In addition, workers whose employers sponsor flexible spending accounts are able to pay out-of-pocket expenses with pretax dollars. Employers can also make available a premium conversion arrangement, which allows workers to pay their share of the premium for employment-based coverage with pretax dollars. In 2005, a presidential advisory board concluded that limiting the amount of tax-preferred health coverage could lower overall private-sector health spending. The panel recommended a cap on the amount of employment-based health coverage individuals can exclude from their income tax, as a way to reduce health spending. In his 2008 "Call to Action" for health care reform, Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, states that "Congress should explore ways to restructure the current tax incentives to encourage more efficient spending on health and to target our tax dollars more effectively and fairly." While a tax cap on health coverage sounds simple, for many employers, it could be difficult to administer and results would vary by employer based on the type of health benefit plan, the size and demographics of their work force, and even where the workers live. The change would be especially difficult for self-insured employers that do not pay insurance premiums, since they would have to set the "premium equivalent" for each worker. This would not only be costly for employers, depending upon the requirements set out by law, but could also create fairness and tax issues for many affected workers. For self-insured employers, calculating insurance premium costs under a tax cap could be done fairly easily using the COBRA premium. However, whether self-insured employers would be able to use the least costly method to determine the value of coverage would have to be determined by law and/or regulations. THE SEC. 89 EXPERIENCE: Sec. 89 of the Tax Reform Act of 1986, which attempted to make employee benefits more standard and fair, became so controversial that it was repealed by Congress in 1989--in part because the regulations created regulatory burdens that were so complicated and costly as to be unworkable. Similarly, valuation calculations under a health coverage tax cap could become overly burdensome if the lessons from Sec. 89 are not heeded.

Relationships between electronic game play, obesity, and psychosocial functioning in young men.

PubMed

Wack, Elizabeth; Tantleff-Dunn, Stacey

2009-04-01

Most estimates suggest that American youth are spending a large amount of time playing video and computer games, spurring researchers to examine the impact this media has on various aspects of health and psychosocial functioning. The current study investigated relationships between frequency of electronic game play and obesity, the social/emotional context of electronic game play, and academic performance among 219 college-aged males. Current game players reported a weekly average of 9.73 hours of game play, with almost 10% of current players reporting an average of 35 hours of play per week. Results indicated that frequency of play was not significantly related to body mass index or grade point average. However, there was a significant positive correlation between frequency of play and self-reported frequency of playing when bored, lonely, or stressed. As opposed to the general conception of electronic gaming as detrimental to functioning, the results suggest that gaming among college-aged men may provide a healthy source of socialization, relaxation, and coping.

Whale shark economics: a valuation of wildlife tourism in South Ari Atoll, Maldives.

PubMed

Cagua, Edgar Fernando; Collins, Neal; Hancock, James; Rees, Richard

2014-01-01

Whale sharks attract large numbers of tourists, divers and snorkelers each year to South Ari Atoll in the Republic of Maldives. Yet without information regarding the use and economic extent of the attraction, it is difficult to prioritize conservation or implement effective management plans. We used empirical recreational data and generalized mixed statistical models to conduct the first economic valuation (with direct spend as the primary proxy) of whale shark tourism in Maldives. We estimated that direct expenditures for whale shark focused tourism in the South Ari Marine Protected Area for 2012 and 2013 accounted for US$7.6 and $9.4 million respectively. These expenditures are based on an estimate of 72,000-78,000 tourists who are involved in whale shark excursions annually. That substantial amount of income to resort owners and operators, and tourism businesses in a relatively small area highlights the need to implement regulations and management that safeguard the sustainability of the industry through ensuring guest satisfaction and whale shark conservation.

Sweet sixteen: changing time preferences in the transition from middle school to high school, for different scenarios.

PubMed

Lahav, Eyal; Shavit, Tal; Benzion, Uri

2015-01-01

Teenagers earn, save and spend large amounts of money. Therefore, understanding teenagers' time preference and how it affects their economic behavior is very important. The current study investigates time preferences of high school and middle school students, and the effect of different intertemporal choice scenarios on teenagers' subjective discount rate. One scenario used a standard intertemporal choice question while the other was a wage scenario. We found higher future orientation (lower subjective discount rate) among high school students than among middle school students when using a standard scenario but found no difference between groups in the wage scenario. For both groups, we found the subjective discount rates increased when the teenagers are asked to delay receipt of wages they earned by working (wage scenario). Other variables, like participation in sports and an allowance given by parents, were found to affect teenagers' time preferences. © Society for the Experimental Analysis of Behavior.

HIV/AIDS and time allocation in rural Malawi

PubMed Central

Bignami-Van Assche, Simona; Van Assche, Ari; Anglewicz, Philip; Fleming, Peter; van de Ruit, Catherine

2012-01-01

AIDS-related morbidity and mortality are expected to have a large economic impact in rural Malawi, because they reduce the time that adults can spend on production for subsistence and on income-generating activities. However, households may compensate for production losses by reallocating tasks among household members. The data demands for measuring these effects are high, limiting the amount of empirical evidence. In this paper, we utilize a unique combination of qualitative and quantitative data, including biomarkers for HIV, collected by the 2004 Malawi Diffusion and Ideational Change Project, to analyze the association between AIDS-related morbidity and mortality, and time allocation decisions in rural Malawian households. We find that AIDS-related morbidity and mortality have important economic effects on women’s time, whereas men’s time is unresponsive to the same shocks. Most notably, AIDS is shown to induce diversification of income sources, with women (but not men) reallocating their time, generally from work-intensive (typically farming and heavy chores) to cash-generating tasks (such as casual labor). PMID:22639544

Whale shark economics: a valuation of wildlife tourism in South Ari Atoll, Maldives

PubMed Central

Collins, Neal; Hancock, James; Rees, Richard

2014-01-01

Whale sharks attract large numbers of tourists, divers and snorkelers each year to South Ari Atoll in the Republic of Maldives. Yet without information regarding the use and economic extent of the attraction, it is difficult to prioritize conservation or implement effective management plans. We used empirical recreational data and generalized mixed statistical models to conduct the first economic valuation (with direct spend as the primary proxy) of whale shark tourism in Maldives. We estimated that direct expenditures for whale shark focused tourism in the South Ari Marine Protected Area for 2012 and 2013 accounted for US$7.6 and $9.4 million respectively. These expenditures are based on an estimate of 72,000–78,000 tourists who are involved in whale shark excursions annually. That substantial amount of income to resort owners and operators, and tourism businesses in a relatively small area highlights the need to implement regulations and management that safeguard the sustainability of the industry through ensuring guest satisfaction and whale shark conservation. PMID:25165629

Coalmine: an experience in building a system for social media analytics

NASA Astrophysics Data System (ADS)

White, Joshua S.; Matthews, Jeanna N.; Stacy, John L.

2012-06-01

Social media networks make up a large percentage of the content available on the Internet and most of the time users spend online today is in interacting with them. All of the seemingly small pieces of information added by billions of people result in a enormous rapidly changing dataset. Searching, correlating, and understanding billions of individual posts is a significant technical problem; even the data from a single site such as Twitter can be difficult to manage. In this paper, we present Coalmine a social network data-mining system. We describe the overall architecture of Coalmine including the capture, storage and search components. We also describe our experience with pulling 150-350 GB of Twitter data per day through their REST API. Specifically, we discuss our experience with the evolution of the Twitter data APIs from 2011 to 2012 and present strategies for maximizing the amount of data collected. Finally, we describe our experiences looking for evidence of botnet command and control channels and examining patterns of SPAM in the Twitter dataset.

Global Budgets and Technology-Intensive Medical Services.

PubMed

Song, Zirui; Fendrick, A Mark; Safran, Dana Gelb; Landon, Bruce; Chernew, Michael E

2013-06-01

In 2009-2010, Blue Cross Blue Shield of Massachusetts entered into global payment contracts (the Alternative Quality contract, AQC) with 11 provider organizations. We evaluated the impact of the AQC on spending and utilization of several categories of medical technologies, including one considered high value (colonoscopies) and three that include services that may be overused in some situations (cardiovascular, imaging, and orthopedic services). Approximately 420,000 unique enrollees in 2009 and 180,000 in 2010 were linked to primary care physicians whose organizations joined the AQC. Using three years of pre-intervention data and a large control group, we analyzed changes in utilization and spending associated with the AQC with a propensity-weighted difference-in-differences approach adjusting for enrollee demographics, health status, secular trends, and cost-sharing. In the 2009 AQC cohort, total volume of colonoscopies increased 5.2 percent (p=0.04) in the first two years of the contract relative to control. The contract was associated with varied changes in volume for cardiovascular and imaging services, but total spending on cardiovascular services in the first two years decreased by 7.4% (p=0.02) while total spending on imaging services decreased by 6.1% (p<0.001) relative to control. In addition to lower utilization of higher-priced services, these decreases were also attributable to shifting care to lower-priced providers. No effect was found in orthopedics. As one example of a large-scale global payment initiative, the AQC was associated with higher use of colonoscopies. Among several categories of services whose value may be controversial, the contract generally shifted volume to lower-priced facilities or services.

Current and future funding sources for specialty mental health and substance abuse treatment providers.

PubMed

Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

2013-06-01

Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

HIV/AIDS case management tasks and activities: the results of a functional analysis study.

PubMed

Grube, B; Chernesky, R H

2001-01-01

Functional analysis, a variation of the time study technique, was used to examine how HIV/AIDS case managers in the tri-county region of New York State spend their time-the actual tasks and activities they choose to perform relative to the total universe of activities and tasks subsumed in the general category of case management. The picture developed was of a system operating primarily in a crisis mode, spending relatively brief amounts of time completing a range of activities and providing an extensive scope of services for or on behalf of clients. The bulk of the work was client centered, not administrative, and involved providing disease management and essential services (e.g., family and mental health). The implications of these findings are discussed, with particular attention paid to the potential influence of client profiles and worker demographics.

Patient cost sharing and medical expenditures for the Elderly.

PubMed

Fukushima, Kazuya; Mizuoka, Sou; Yamamoto, Shunsuke; Iizuka, Toshiaki

2016-01-01

Despite the rapidly aging population, relatively little is known about how cost sharing affects the elderly's medical spending. Exploiting longitudinal claims data and the drastic reduction of coinsurance from 30% to 10% at age 70 in Japan, we find that the elderly's demand responses are heterogeneous in ways that have not been previously reported. Outpatient services by orthopedic and eye specialties, which will continue to increase in an aging society, are particularly price responsive and account for a large share of the spending increase. Lower cost sharing increases demand for brand-name drugs but not for generics. These high price elasticities may call for different cost-sharing rules for these services. Patient health status also matters: receiving medical services appears more discretionary for the healthy than the sick in the outpatient setting. Finally, we found no evidence that additional medical spending improved short-term health outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

Don't tell on me: Experimental evidence of asymmetric information in transnational households*

PubMed Central

Ambler, Kate

2014-01-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information. PMID:25558123

Working at the Weekend: Fathers' Time with Family in the United Kingdom.

PubMed

Hook, Jennifer L

2012-08-01

Whereas most resident fathers are able to spend more time with their children on weekends than on weekdays, many fathers work on the weekends spending less time with their children on these days. There are conflicting findings about whether fathers are able to make up for lost weekend time on weekdays. Using unique features of the United Kingdom's National Survey of Time Use 2000 (UKTUS) I examine the impact of fathers' weekend work on the time fathers spend with their children, family, and partners (N = 595 fathers). I find that weekend work is common among fathers and is associated with less time with children, families, and partners. Fathers do not recover lost time with children on weekdays, largely because weekend work is a symptom of overwork. Findings also reveal that even if fathers had compensatory time, they are unlikely to recover lost time spent as a family or couple.

Working at the Weekend: Fathers’ Time with Family in the United Kingdom

PubMed Central

Hook, Jennifer L.

2012-01-01

Whereas most resident fathers are able to spend more time with their children on weekends than on weekdays, many fathers work on the weekends spending less time with their children on these days. There are conflicting findings about whether fathers are able to make up for lost weekend time on weekdays. Using unique features of the United Kingdom’s National Survey of Time Use 2000 (UKTUS) I examine the impact of fathers’ weekend work on the time fathers spend with their children, family, and partners (N = 595 fathers). I find that weekend work is common among fathers and is associated with less time with children, families, and partners. Fathers do not recover lost time with children on weekdays, largely because weekend work is a symptom of overwork. Findings also reveal that even if fathers had compensatory time, they are unlikely to recover lost time spent as a family or couple. PMID:22844157

Don't tell on me: Experimental evidence of asymmetric information in transnational households.

PubMed

Ambler, Kate

2015-03-01

Although most theoretical models of household decision making assume perfect information, empirical studies suggest that information asymmetries can have large impacts on resource allocation. I demonstrate the importance of these asymmetries in transnational households, where physical distance between family members can make information barriers especially acute. I implement an experiment among migrants in Washington, DC, and their families in El Salvador that examines how information asymmetries can have strategic and inadvertent impacts on remittance decisions. Migrants make an incentivized decision over how much of a cash windfall to remit, and recipients decide how they will spend a remittance. Migrants strategically send home less when their choice is not revealed to recipients. Recipients make spending choices closer to migrants' preferences when the migrants' preferences are shared, regardless of whether or not the spending choices are revealed to the migrants, suggesting that recipients' choices are inadvertently affected by imperfect information.

Reducing children's television-viewing time: a qualitative study of parents and their children.

PubMed

Jordan, Amy B; Hersey, James C; McDivitt, Judith A; Heitzler, Carrie D

2006-11-01

The American Academy of Pediatrics recommends that children over age 2 years spend < or = 2 hours per day with screen media, because excessive viewing has been linked to a plethora of physical, academic, and behavioral problems. The primary goal of this study was to qualitatively explore how a recommendation to limit television viewing might be received and responded to by a diverse sample of parents and their school-age children. The study collected background data about media use, gathered a household media inventory, and conducted in-depth individual and small group interviews with 180 parents and children ages 6 to 13 years old. Most of the children reported spending approximately 3 hours per day watching television. The average home in this sample had 4 television sets; nearly two thirds had a television in the child's bedroom, and nearly half had a television set in the kitchen or dining room. Although virtually all of the parents reported having guidelines for children's television viewing, few had rules restricting the time children spend watching television. Data from this exploratory study suggest several potential barriers to implementing a 2-hour limit, including: parents' need to use television as a safe and affordable distraction, parents' own heavy television viewing patterns, the role that television plays in the family's day-to-day routine, and a belief that children should spend their weekend leisure time as they wish. Interviews revealed that for many of these families there is a lack of concern that television viewing is a problem for their child, and there remains confusion about the boundaries of the recommendation of the American Academy of Pediatrics. Parents in this study expressed interest in taking steps toward reducing children's television time but also uncertainty about how to go about doing so. Results suggest possible strategies to reduce the amount of time children spend in front of the screen.

Public Spending on Health Service and Policy Research in Canada, the United Kingdom, and the United States: A Modest Proposal.

PubMed

Thakkar, Vidhi; Sullivan, Terrence

2017-04-10

Health services and policy research (HSPR) represent a multidisciplinary field which integrates knowledge from health economics, health policy, health technology assessment, epidemiology, political science among other fields, to evaluate decisions in health service delivery. Health service decisions are informed by evidence at the clinical, organizational, and policy level, levels with distinct, managerial drivers. HSPR has an evolving discourse spanning knowledge translation, linkage and exchange between research and decision-maker partners and more recently, implementation science and learning health systems. Local context is important for HSPR and is important in advancing health reform practice. The amounts and configuration of national investment in this field remain important considerations which reflect priority investment areas. The priorities set within this field or research may have greater or lesser effects and promise with respect to modernizing health services in pursuit of better value and better population outcomes. Within Canada an asset map for HSPR was published by the national HSPR research institute. Having estimated publicly-funded research spending in Canada, we sought identify best available comparable estimates from the United States and the United Kingdom. Investments from industry and charitable organizations were not included in these numbers. This commentary explores spending by the United States, Canada, and the United Kingdom on HSPR as a fraction of total public spending on health and the importance of these respective investments in advancing health service performance. Proposals are offered on the merits of common nomenclature and accounting for areas of investigation in pursuit of some comparable way of assessing priority HSPR investments and suggestions for earmarking such investments to total investment in health services spending. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Strategies for Engaging FCS Learners in a Large-Format Classroom: Embedded Videos

ERIC Educational Resources Information Center

Leslie, Catherine Amoroso

2014-01-01

This article presents a method for utilizing technology to increase student engagement in large classroom formats. In their lives outside the classroom, students spend considerable time interfacing with media, and they are receptive to information conveyed in electronic formats. Research has shown that multimedia is an effective learning resource;…

Use of the computer and Internet among Italian families: first national study.

PubMed

Bricolo, Francesco; Gentile, Douglas A; Smelser, Rachel L; Serpelloni, Giovanni

2007-12-01

Although home Internet access has continued to increase, little is known about actual usage patterns in homes. This nationally representative study of over 4,700 Italian households with children measured computer and Internet use of each family member across 3 months. Data on actual computer and Internet usage were collected by Nielsen//NetRatings service and provide national baseline information on several variables for several age groups separately, including children, adolescents, and adult men and women. National averages are shown for the average amount of time spent using computers and on the Web, the percentage of each age group online, and the types of Web sites viewed. Overall, about one-third of children ages 2 to 11, three-fourths of adolescents and adult women, and over four-fifths of adult men access the Internet each month. Children spend an average of 22 hours/month on the computer, with a jump to 87 hours/month for adolescents. Adult women spend less time (about 60 hours/month), and adult men spend more (over 100). The types of Web sites visited are reported, including the top five for each age group. In general, search engines and Web portals are the top sites visited, regardless of age group. These data provide a baseline for comparisons across time and cultures.

Revisiting the concept of severe mental illness: severity indicators and healthcare spending in psychotic, depressive and dissociative disorders.

PubMed

Gonzalez Vazquez, Ana Isabel; Seijo Ameneiros, Natalia; Díaz Del Valle, Juan Carlos; Lopez Fernandez, Ester; Santed Germán, Miguel Angel

2017-08-10

The concept of severe mental illness (SMI) has been related to bipolar or psychotic diagnosis, or to some cases of depressive disorders. Other mental health problems such as personality disorders or posttraumatic dissociative conditions, which can sometimes lead to relevant functional impairments, remain separate from the SMI construct. This study aimed to evaluate the clinical severity as well as healthcare spending on dissociative disorders (DDs). This diagnostic group was compared with two other groups usually considered as causing severe impairment and high healthcare spending: bipolar and psychotic disorders, and unipolar depression. From a random sample of 200 psychiatric outpatients, 108 with unipolar depression (N = 45), psychotic/bipolar (N = 31) or DDs (N = 32) were selected for this study. The three groups were compared by the severity of their disorder and healthcare indicators. Of the three groups, those with a DD were more prone to and showed higher indices of suicide, self-injury, emergency consultations, as well as psychotropic drug use. This group ranked just below psychotic/bipolar patients in the amount of psychiatric hospitalisations. Despite a certain intra-professional stigma regarding DDs, these data supported the severity of these posttraumatic conditions, and their inclusion in the construct of SMI.

Hospital Advertising, Competition, and HCAHPS: Does It Pay to Advertise?

PubMed

Huppertz, John W; Bowman, R Alan; Bizer, George Y; Sidhu, Mandeep S; McVeigh, Colleen

2017-08-01

To test whether hospital advertising expenditures predict HCAHPS global ratings. We examined media advertising expenditures by 2,142 acute care hospitals in 209 markets in the United States. Data on hospital characteristics, location, and revenue came from CMS reports; system ownership was obtained from the American Hospital Association. Advertising data came from Kantar Media. HCAHPS data were obtained from HospitalCompare. Regression models examined whether hospitals' advertising spending predicts HCAHPS global measures and whether market concentration moderated this association. Hospital advertising spending was calculated by adding each individual hospital's expenditures to the amount spent by its parent health system, proportionally allocated by hospital revenue. Health system market share was used to estimate market concentration. These data were compared to hospitals' HCAHPS measures. In competitive markets (HHI below 1,000), hospital advertising predicted HCAHPS global measures. A 1-percent increase in advertising was associated with a 1.173-percent increase in patients rating the hospital a "9" or "10" on the HCAHPS survey and a 1.540-percent increase in patients who "definitely" would recommend the hospital. In concentrated markets, this association was not significant. In competitive markets, hospitals that spend more on advertising earn higher HCAHPS ratings on global measures. © Health Research and Educational Trust.

Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India.

PubMed

Mohanty, Sanjay K; Agrawal, Nand Kishor; Mahapatra, Bidhubhusan; Choudhury, Dhrupad; Tuladhar, Sabarnee; Holmgren, E Valdemar

2017-01-18

Economic burden to households due to out-of-pocket expenditure (OOPE) is large in many Asian countries. Though studies suggest increasing household poverty due to high OOPE in developing countries, studies on association of multidimensional poverty and household health spending is limited. This paper tests the hypothesis that the multidimensionally poor are more likely to incur catastrophic health spending cutting across countries. Data from the Poverty and Vulnerability Assessment (PVA) Survey carried out by the International Center for Integrated Mountain Development (ICIMOD) has been used in the analyses. The PVA survey was a comprehensive household survey that covered the mountainous regions of India, Nepal and Myanmar. A total of 2647 households from India, 2310 households in Nepal and 4290 households in Myanmar covered under the PVA survey. Poverty is measured in a multidimensional framework by including the dimensions of education, income and energy, water and sanitation using the Alkire and Foster method. Health shock is measured using the frequency of illness, family sickness and death of any family member in a reference period of one year. Catastrophic health expenditure is defined as 40% above the household's capacity to pay. Results suggest that about three-fifths of the population in Myanmar, two-fifths of the population in Nepal and one-third of the population in India are multidimensionally poor. About 47% of the multidimensionally poor in India had incurred catastrophic health spending compared to 35% of the multidimensionally non-poor and the pattern was similar in both Nepal and Myanmar. The odds of incurring catastrophic health spending was 56% more among the multidimensionally poor than among the multidimensionally non-poor [95% CI: 1.35-1.76]. While health shocks to households are consistently significant predictors of catastrophic health spending cutting across country of residence, the educational attainment of the head of the household is not significant. The multidimensionally poor in the poorer regions are more likely to face health shocks and are less likely to afford professional health services. Increasing government spending on health and increasing households' access to health insurance can reduce catastrophic health spending and multidimensional poverty.

Health Care Spending and Quality in Year 1 of the Alternative Quality Contract

PubMed Central

Song, Zirui; Safran, Dana Gelb; Landon, Bruce E.; He, Yulei; Ellis, Randall P.; Mechanic, Robert E.; Day, Matthew P.; Chernew, Michael E.

2012-01-01

Background In 2009, Blue Cross Blue Shield of Massachusetts (BCBS) implemented a global payment system called the Alternative Quality Contract (AQC). Provider groups in the AQC system assume accountability for spending, similar to accountable care organizations that bear financial risk. Moreover, groups are eligible to receive bonuses for quality. Methods Seven provider organizations began 5-year contracts as part of the AQC system in 2009. We analyzed 2006–2009 claims for 380,142 enrollees whose primary care physicians (PCPs) were in the AQC system (intervention group) and for 1,351,446 enrollees whose PCPs were not in the system (control group). We used a propensity-weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the AQC in comparisons of spending and quality between the intervention group and the control group. Results Average spending increased for enrollees in both the intervention and control groups in 2009, but the increase was smaller for enrollees in the intervention group — $15.51 (1.9%) less per quarter (P = 0.007). Savings derived largely from shifts in outpatient care toward facilities with lower fees; from lower expenditures for procedures, imaging, and testing; and from a reduction in spending for enrollees with the highest expected spending. The AQC system was associated with an improvement in performance on measures of the quality of the management of chronic conditions in adults (P<0.001) and of pediatric care (P = 0.001), but not of adult preventive care. All AQC groups met 2009 budget targets and earned surpluses. Total BCBS payments to AQC groups, including bonuses for quality, are likely to have exceeded the estimated savings in year 1. Conclusions The AQC system was associated with a modest slowing of spending growth and improved quality of care in 2009. Savings were achieved through changes in referral patterns rather than through changes in utilization. The long-term effect of the AQC system on spending growth depends on future budget targets and providers’ ability to further improve efficiencies in practice. (Funded by the Commonwealth Fund and others.) PMID:21751900

Health care spending and quality in year 1 of the alternative quality contract.

PubMed

Song, Zirui; Safran, Dana Gelb; Landon, Bruce E; He, Yulei; Ellis, Randall P; Mechanic, Robert E; Day, Matthew P; Chernew, Michael E

2011-09-08

In 2009, Blue Cross Blue Shield of Massachusetts (BCBS) implemented a global payment system called the Alternative Quality Contract (AQC). Provider groups in the AQC system assume accountability for spending, similar to accountable care organizations that bear financial risk. Moreover, groups are eligible to receive bonuses for quality. Seven provider organizations began 5-year contracts as part of the AQC system in 2009. We analyzed 2006-2009 claims for 380,142 enrollees whose primary care physicians (PCPs) were in the AQC system (intervention group) and for 1,351,446 enrollees whose PCPs were not in the system (control group). We used a propensity-weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the AQC in comparisons of spending and quality between the intervention group and the control group. Average spending increased for enrollees in both the intervention and control groups in 2009, but the increase was smaller for enrollees in the intervention group--$15.51 (1.9%) less per quarter (P=0.007). Savings derived largely from shifts in outpatient care toward facilities with lower fees; from lower expenditures for procedures, imaging, and testing; and from a reduction in spending for enrollees with the highest expected spending. The AQC system was associated with an improvement in performance on measures of the quality of the management of chronic conditions in adults (P<0.001) and of pediatric care (P=0.001), but not of adult preventive care. All AQC groups met 2009 budget targets and earned surpluses. Total BCBS payments to AQC groups, including bonuses for quality, are likely to have exceeded the estimated savings in year 1. The AQC system was associated with a modest slowing of spending growth and improved quality of care in 2009. Savings were achieved through changes in referral patterns rather than through changes in utilization. The long-term effect of the AQC system on spending growth depends on future budget targets and providers' ability to further improve efficiencies in practice. (Funded by the Commonwealth Fund and others.).

The Role of Policy and Institutions on Health Spending.

PubMed

de la Maisonneuve, Christine; Moreno-Serra, Rodrigo; Murtin, Fabrice; Oliveira Martins, Joaquim

2017-07-01

This paper investigates the impact of policies and institutions on health expenditures for a large panel of Organisation for Economic Co-operation and Development countries for the period of 2000-2010. A set of 20 policy and institutional indicators developed by the Organisation for Economic Co-operation and Development are integrated into a theoretically motivated econometric framework, alongside control variables related to demographic (dependency ratio) and non-demographic (income, prices and technology) drivers of health expenditures per capita. Although a large share of cross-country differences in public health expenditures can be explained by demographic and economic factors (around 71%), cross-country variations in policies and institutions also have a significant influence, explaining most of the remaining difference in public health spending (23%). Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Carve-In Enrollees

PubMed Central

Harwood, Jessica M.; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K.; Tseng, Chi-Hong; Wells, Kenneth B.; Friedman, Sarah; Ettner, Susan L.

2016-01-01

Objective The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA’s impact on BH expenditures and utilization among “carve-in” enrollees. Method We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008–2009), during (2010), and after (2011–2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual and family psychotherapy); intermediate care utilization (structured outpatient; day treatment; residential); and inpatient utilization. Results MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits (respective immediate increases of: $1.05 [p=0.02]; $0.88 [p=0.04]; 0.00045 visits [p=0.00]), and individual psychotherapy visits (immediate increase of 0.00578 visits [p=0.00] and additional increases of 0.00017 visits/month [p=0.03]). Conclusions MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; e.g., in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act’s inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets. PMID:27632769

Offering A Price Transparency Tool Did Not Reduce Overall Spending Among California Public Employees And Retirees.

PubMed

Desai, Sunita; Hatfield, Laura A; Hicks, Andrew L; Sinaiko, Anna D; Chernew, Michael E; Cowling, David; Gautam, Santosh; Wu, Sze-Jung; Mehrotra, Ateev

2017-08-01

Insurers, employers, and states increasingly encourage price transparency so that patients can compare health care prices across providers. However, the evidence on whether price transparency tools encourage patients to receive lower-cost care and reduce overall spending remains limited and mixed. We examined the experience of a large insured population that was offered a price transparency tool, focusing on a set of "shoppable" services (lab tests, office visits, and advanced imaging services). Overall, offering the tool was not associated with lower shoppable services spending. Only 12 percent of employees who were offered the tool used it in the first fifteen months after it was introduced, and use of the tool was not associated with lower prices for lab tests or office visits. The average price paid for imaging services preceded by a price search was 14 percent lower than that paid for imaging services not preceded by a price search. However, only 1 percent of those who received advanced imaging conducted a price search. Simply offering a price transparency tool is not sufficient to meaningfully decrease health care prices or spending. Project HOPE—The People-to-People Health Foundation, Inc.

Spending to save? State health expenditure and infant mortality in India.

PubMed

Bhalotra, Sonia

2007-09-01

There are severe inequalities in health in the world, poor health being concentrated amongst poor people in poor countries. Poor countries spend a much smaller share of national income on health expenditure than do richer countries. What potential lies in political or growth processes that raise this share? This depends upon how effective government health spending in developing countries is. Existing research presents little evidence of an impact on childhood mortality. Using specifications similar to those in the existing literature, this paper finds a similar result for India, which is that state health spending saves no lives. However, upon allowing lagged effects, controlling in a flexible way for trended unobservables and restricting the sample to rural households, a significant effect of health expenditure on infant mortality emerges, the long run elasticity being about -0.24. There are striking differences in the impact by social group. Slicing the data by gender, birth order, religion, maternal and paternal education and maternal age at birth, I find the weakest effects in the most vulnerable groups (with the exception of a large effect for scheduled tribes). Copyright (c) 2007 John Wiley & Sons, Ltd.

US Spending On Complementary And Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System

PubMed Central

Davis, Matthew A.; Martin, Brook I.; Coulter, Ian D.; Weeks, William B.

2013-01-01

Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending. PMID:23297270

Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services.

PubMed

Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N

2015-06-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

PubMed Central

Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.

2015-01-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

Effective Time Management in the Project Office. Executive Summary.

DTIC Science & Technology

1976-11-05

manager. It can be concluded from the study that project managers have difficulty in managing their time and that although neglected, time management should...be taught to project managers so as to preclude spending an inordinate amount of time to accomplish their job. An understanding and use of the time ... management principles delineated in the study should allow the manager to make much more effective use of his available time. (Author)

Air & Space Power Journal Summer 2006

DTIC Science & Technology

2006-01-01

spending a great deal of time and money developing and fielding a system that may not provide the capabilities expected of it, the use of near ...magnetic fields , or infrared radiation against the cold background of space. 28 Merge-Page.indd 29 5/1/06 10:37:10 AM If the correct...cialized field . During the 1960s through 1980s, our workforce gained an immense amount of knowledge and experience from the Apollo, shuttle, and

[The need for education and regulation regarding the use of digital media].

PubMed

Gautellier, Christian

2015-01-01

Children and teenagers spend vast amounts of time in front of screens. Faced with this reality, it is essential that they receive media education to help them get a proper grasp of information and image cultures. It is designed to offer global support for their cognitive, emotional and social construction and requires the participation all those who play a role in their education: their family, teachers and extracurricular activity leaders.

Quit for My Finances | Smokefree 60+

Cancer.gov

You can save money by quitting smoking. Why should you quit now? The cost of smoking adds up quickly. If you smoke a pack a day, you're spending at least $43 per week. Use the calculator to find out how much you could save if you quit today. These amounts are based on a 2015 national average price of about $6.25 per pack. Depending on where you live, the cost of cigarettes could be more.

Time to Work or Time to Play: The Effect of Student Employment on Homework, Housework, Screen Time, and Sleep. Working Paper 423

ERIC Educational Resources Information Center

Kalenkoski, Charlene Marie; Pabilonia, Sabrina Wulff

2009-01-01

Recent research suggests that working while in high school reduces the amount of time students spend doing homework. However, an additional hour of work leads to a reduction in homework by much less than one hour, suggesting a reduction in other activities. This paper uses data from the 2003-2007 American Time Use Surveys (ATUS) to investigate the…

An Examination of Binder Systems and Their Influences on Burn Rates of High-Nitrogen Containing Formulations

DTIC Science & Technology

2011-01-01

sought-after to advance existing HHS technology. Currently existing HHS candle formulations contain significant amounts of potassium perchlorate...Defense spends tens of billions of dollars annually on per- chlorate remediation efforts. Therefore, efforts to elimi- nate perchlorate from military...develop per- chlorate -free formulations of the M126A1 red star para- chute. To maximize the performance of these formula- tions, KClO4 was replaced

Quit for My Finances | Smokefree 60+

Cancer.gov

You can save money by quitting smoking. Why should you quit now? The cost of smoking adds up quickly. If you smoke a pack a day, you're spending at least $45 per week. Use the calculator to find out how much you could save if you quit today. These amounts are based on a 2018 national average price of about $6.35 per pack. Depending on where you live, the cost of cigarettes could be more.

Association between quality domains and health care spending across physician networks

PubMed Central

Rahman, Farah; Guan, Jun; Glazier, Richard H.; Brown, Adalsteinn; Bierman, Arlene S.; Croxford, Ruth; Stukel, Therese A.

2018-01-01

One of the more fundamental health policy questions is the relationship between health care quality and spending. A better understanding of these relationships is needed to inform health systems interventions aimed at increasing quality and efficiency of care. We measured 65 validated quality indicators (QI) across Ontario physician networks. QIs were aggregated into domains representing six dimensions of care: screening and prevention, evidence-based medications, hospital-community transitions (7-day post-discharge visit with a primary care physician; 30-day post-discharge visit with a primary care physician and specialist), potentially avoidable hospitalizations and emergency department (ED) visits, potentially avoidable readmissions and unplanned returns to the ED, and poor cancer end of life care. Each domain rate was computed as a weighted average of QI rates, weighting by network population at risk. We also measured overall and sector-specific per capita healthcare network spending. We evaluated the associations between domain rates, and between domain rates and spending using weighted correlations, weighting by network population at risk, using an ecological design. All indicators were measured using Ontario health administrative databases. Large variations were seen in timely hospital-community transitions and potentially avoidable hospitalizations. Networks with timely hospital-community transitions had lower rates of avoidable admissions and readmissions (r = -0.89, -0.58, respectively). Higher physician spending, especially outpatient primary care spending, was associated with lower rates of avoidable hospitalizations (r = -0.83) and higher rates of timely hospital-community transitions (r = 0.81) and moderately associated with lower readmission rates (r = -0.46). Investment in effective primary care services may help reduce burden on the acute care sector and associated expenditures. PMID:29614131

Perlite

USGS Publications Warehouse

Bolen, W.P.

2010-01-01

Consumption, imports and domestic production of perlite in the United States continued to be severely affected by the multi-year downturn in construction activity and decreased consumer spending. The estimated amount of processed perlite sold or used from U.S. mines in 2009 fell to 380 kt (418,000 st), the lowest amount of domestic perlite sold or used since 1967.The U.S. consumption of crude processed perlite in 2009 was estimated to have decreased to 480 kt (530,000 st), the lowest level of consumption since 1984 when consumption was 474 kt (522,000 st). Preliminary reports indicate that perlite imports decreased for the third consecutive year and have fallen about 45 percent since peaking in 2006.

Engagement in health and wellness: An online incentive-based program.

PubMed

Gibson, Teresa B; Maclean, J Ross; Carls, Ginger S; Moore, Brian J; Ehrlich, Emily D; Fener, Victoria; Goldberg, Jordan; Mechanic, Elaine; Baigel, Colin

2017-09-01

Increasingly, corporate health promotion programs are implementing wellness programs integrating principles of behavioral economics. Employees of a large firm were provided a customized online incentive program to design their own commitments to meet health goals. This study examines patterns of program participation and engagement in health promotion activities. Subjects were US-based employees of a large, nondurable goods manufacturing firm who were enrolled in corporate health benefits in 2010 and 2011. We assessed measures of engagement with the workplace health promotion program (e.g., incentive points earned, weight loss). To further examine behaviors indicating engagement in health promotion activities, we constructed an aggregate, employee-level engagement index. Regression models were employed to assess the association between employee characteristics and the engagement index, and the engagement index and spending. 4220 employees utilized the online program and made 25,716 commitments. Male employees age 18-34 had the highest level of engagement, and male employees age 55-64 had the lowest level of engagement overall. Prior year health status and prior year spending did not show a significant association with the level of engagement with the program ( p  > 0.05). Flexible, incentive-based behavioral health and lifestyle programs may reach the broader workforce including those with chronic conditions and higher levels of health spending.

Spending patterns in region of residency training and subsequent expenditures for care provided by practicing physicians for Medicare beneficiaries.

PubMed

Chen, Candice; Petterson, Stephen; Phillips, Robert; Bazemore, Andrew; Mullan, Fitzhugh

2014-12-10

Graduate medical education training may imprint young physicians with skills and experiences, but few studies have evaluated imprinting on physician spending patterns. To examine the relationship between spending patterns in the region of a physician's graduate medical education training and subsequent mean Medicare spending per beneficiary. Secondary multilevel multivariable analysis of 2011 Medicare claims data (Part A hospital and Part B physician) for a random, nationally representative sample of family medicine and internal medicine physicians completing residency between 1992 and 2010 with Medicare patient panels of 40 or more patients (2851 physicians providing care to 491,948 Medicare beneficiaries). Locations of practice and residency training were matched with Dartmouth Atlas Hospital Referral Region (HRR) files. Training and practice HRRs were categorized into low-, average-, and high-spending groups, with approximately equal distribution of beneficiary numbers. There were 674 physicians in low-spending training and low-spending practice HRRs, 180 in average-spending training/low-spending practice, 178 in high-spending training/low-spending practice, 253 in low-spending training/average-spending practice, 417 in average-spending training/average-spending practice, 210 in high-spending training/average-spending practice, 97 in low-spending training/high-spending practice, 275 in average-spending training/high-spending practice, and 567 in high-spending training/high-spending practice. Mean physician spending per Medicare beneficiary. For physicians practicing in high-spending regions, those trained in high-spending regions had a mean spending per beneficiary per year $1926 higher (95% CI, $889-$2963) than those trained in low-spending regions. For practice in average-spending HRRs, mean spending was $897 higher (95% CI, $71-$1723) for physicians trained in high- vs low-spending regions. For practice in low-spending HRRs, the difference across training HRR levels was not significant ($533; 95% CI, -$46 to $1112). After controlling for patient, community, and physician characteristics, there was a 7% difference (95% CI, 2%-12%) in patient expenditures between low- and high-spending training HRRs. Across all practice HRRs, this corresponded to an estimated $522 difference (95% CI, $146-$919) between low- and high-spending training regions. For physicians 1 to 7 years in practice, there was a 29% difference ($2434; 95% CI, $1004-$4111) in spending between those trained in low- and high-spending regions; however, after 16 to 19 years, there was no significant difference. Among general internists and family physicians who completed residency training between 1992 and 2010, the spending patterns in the HRR in which their residency program was located were associated with expenditures for subsequent care they provided as practicing physicians for Medicare beneficiaries. Interventions during residency training may have the potential to help control future health care spending.

Are Alcohol Taxation and Pricing Policies Regressive? Product-Level Effects of a Specific Tax and a Minimum Unit Price for Alcohol.

PubMed

Vandenberg, Brian; Sharma, Anurag

2016-07-01

To compare estimated effects of two policy alternatives, (i) a minimum unit price (MUP) for alcohol and (ii) specific (per-unit) taxation, upon current product prices, per capita spending (A$), and per capita consumption by income quintile, consumption quintile and product type. Estimation of baseline spending and consumption, and modelling policy-to-price and price-to-consumption effects of policy changes using scanner data from a panel of demographically representative Australian households that includes product-level details of their off-trade alcohol spending (n = 885; total observations = 12,505). Robustness checks include alternative price elasticities, tax rates, minimum price thresholds and tax pass-through rates. Current alcohol taxes and alternative taxation and pricing policies are not highly regressive. Any regressive effects are small and concentrated among heavy consumers. The lowest-income consumers currently spend a larger proportion of income (2.3%) on alcohol taxes than the highest-income consumers (0.3%), but the mean amount is small in magnitude [A$5.50 per week (95%CI: 5.18-5.88)]. Both a MUP and specific taxation will have some regressive effects, but the effects are limited, as they are greatest for the heaviest consumers, irrespective of income. Among the policy alternatives, a MUP is more effective in reducing consumption than specific taxation, especially for consumers in the lowest-income quintile: an estimated mean per capita reduction of 11.9 standard drinks per week (95%CI: 11.3-12.6). Policies that increase the cost of the cheapest alcohol can be effective in reducing alcohol consumption, without having highly regressive effects. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

The Budget and Economic Outlook: Fiscal Years 2008 to 2018

DTIC Science & Technology

2008-01-01

the same impact on the probability of a downturn. If high short-term rates are more important, then the degree of mone - tary restraint normally...55,000 jobs added per 13. A significant amount of uncertainty exists about how much spending changes when wealth changes (known as the marginal ...capacity utilization in the manufactur- ing sector stayed below the level that suggests a high level of demand for goods that in turn can lead to

An Analysis of the President’s February Budgetary Proposals

DTIC Science & Technology

1993-03-01

recent trends in corporate income tax collections explain more than half of this difference. Second, both the amount and timing of spending for deposit...percent of the increase in revenue in 1994 through 1998 comes from increases in individual and corporate income tax rates, repeal of the wage cap on the...federal unemployment insurance payroll taxes, and the corporate income tax . For purposes of ranking by adjusted family income (API), income for each family

Private dental insurance expenditure in Brazil

PubMed Central

Cascaes, Andreia Morales; de Camargo, Maria Beatriz Junqueira; de Castilhos, Eduardo Dickie; Silva, lexandre Emídio Ribeiro; Barros, Aluísio J D

2018-01-01

ABSTRACT OBJECTIVE To quantify the household expenditure per capita and to estimate the percentage of Brazilian households that have spent with dental insurance. METHODS We analyzed data from 55,970 households that participated in the research Pesquisa de Orçamentos Familiares in 2008–2009. We have analyzed the annual household expenditure per capita with dental insurance (business and private) according to the Brazilian states and the socioeconomic and demographic characteristics of the households (sex, age, race, and educational level of the head of the household, family income, and presence of an older adult in the household). RESULTS Only 2.5% of Brazilian households have reported spending on dental insurance. The amount spent per capita amounted to R$5.10 on average, most of which consisted of private dental insurance (R$4.70). Among the characteristics of the household, higher educational level and income were associated with higher spending. São Paulo was the state with the highest household expenditure per capita (R$10.90) and with the highest prevalence of households with expenditures (4.6%), while Amazonas and Tocantins had the lowest values, in which both spent less than R$1.00 and had a prevalence of less than 0.1% of households, respectively. CONCLUSIONS Only a small portion of the Brazilian households has dental insurance expenditure. The market for supplementary dentistry in oral health care covers a restricted portion of the Brazilian population. PMID:29489995

Ambiguity in determining financial capability of SSI and SSDI beneficiaries with psychiatric disabilities.

PubMed

Lazar, Christina M; Black, Anne C; McMahon, Thomas J; O'Shea, Kevin; Rosen, Marc I

2015-03-01

The liberty of individuals who receive Social Security disability payments is constrained if they are judged incapable of managing their payments and are assigned a payee or conservator to manage benefit payments on their behalf. Conversely, beneficiaries' well-being may be compromised if they misspend money that they need to survive. Several studies have shown that determinations of financial capability are made inconsistently and that capability guidelines appear to be applied inconsistently. This article describes ambiguities that remained for individuals even after a comprehensive assessment of financial capability was conducted by independent assessors. Trained, experienced assessors rated the financial capability of 118 individuals in intensive outpatient or inpatient psychiatric facilities who received Social Security Disability Insurance or Supplemental Security Income. Ten individuals' cases were determined to be difficult to judge. Six sources of ambiguity were identified by case review: distinguishing incapability from the challenges of navigating poverty, the amount of nonessential spending that indicates incapability, the amount of spending on harmful things that indicates incapability, how to consider intermittent periods of capability and incapability, the relative weighting of past behavior and future plans to change, and discrepancies between different sources of information. The cases raise fundamental questions about how to define and identify financial incapability, but they also illustrate how detailed consideration of beneficiaries' living situations and decision making can inform the difficult dichotomous decision about capability.

Time providing care outside visits in a home-based primary care program

PubMed Central

Pedowitz, Elizabeth J.; Ornstein, Katherine A.; Farber, Jeffrey; DeCherrie, Linda V.

2016-01-01

Background/Objectives Homebound elderly patients with chronic medical illnesses face multiple barriers to care. Primary care physicians (PCPs) devote a significant amount of time to care apart from actual office visits, but there is little quantification of such time by physicians who provide primary care in the home. This article assesses exactly how much time physicians in a large home based primary care (HBPC) program spend providing care outside of home visits. Unreimbursed time, as well as patient and provider-related factors that may contribute to that increased time, are considered. Design Mount Sinai Visiting Doctors (MSVD) providers filled out research forms for every interaction involving care provision outside of home visits. Data collected included: length of interaction, mode, nature, and whom the interaction was with for 3 weeks. Setting/Participants MSVD is an academic home-visit program in Manhattan, NY. All PCPs in MSVD (n=14) agreed to participate. Measurements Time data were analyzed using a comprehensive estimate and conservative estimates to quantify unbillable time. Results Data on 1151 interactions for 537 patients were collected. An average 8.2 hours/week were spent providing non-home visit care for a full-time provider. Using the most conservative estimates, 3.6 hours/week was estimated to be unreimbursed per full-time provider. No significant differences in interaction times were found among dementia vs. non-dementia patients, new vs. non-new patients, and primary-panel vs. covered patients. Conclusion Findings suggest that HBPC providers spend substantial time providing care outside home visits, much of which goes unrecognized in the current reimbursement system. These findings may help guide practice development and creation of new payment systems for HBPC and similar models of care. PMID:24802078

Limitations of outsourcing on-the-ground biodiversity conservation.

PubMed

Iacona, Gwenllian D; Bode, Michael; Armsworth, Paul R

2016-12-01

To counteract global species decline, modern biodiversity conservation engages in large projects, spends billions of dollars, and includes many organizations working simultaneously within regions. To add to this complexity, the conservation sector has hierarchical structure, where conservation actions are often outsourced by funders (foundations, government, etc.) to local organizations that work on-the-ground. In contrast, conservation science usually assumes that a single organization makes resource allocation decisions. This discrepancy calls for theory to understand how the expected biodiversity outcomes change when interactions between organizations are accounted for. Here, we used a game theoretic model to explore how biodiversity outcomes are affected by vertical and horizontal interactions between 3 conservation organizations: a funder that outsourced its actions and 2 local conservation organizations that work on-the-ground. Interactions between the organizations changed the spending decisions made by individual organizations, and thereby the magnitude and direction of the conservation benefits. We showed that funders would struggle to incentivize recipient organizations with set priorities to perform desired actions, even when they control substantial amounts of the funding and employ common contracting approaches to enhance outcomes. Instead, biodiversity outcomes depended on priority alignment across the organizations. Conservation outcomes for the funder were improved by strategic interactions when organizational priorities were well aligned, but decreased when priorities were misaligned. Meanwhile, local organizations had improved outcomes regardless of alignment due to additional funding in the system. Given that conservation often involves the aggregate actions of multiple organizations with different objectives, strategic interactions between organizations need to be considered if we are to predict possible outcomes of conservation programs or costs of achieving conservation targets. © 2016 Society for Conservation Biology.

Assessment of the Impact of Teaching Demands on Research Productivity Among Doctoral Nursing Program Faculty.

PubMed

Smeltzer, Suzanne C; Cantrell, Mary Ann; Sharts-Hopko, Nancy C; Heverly, Mary Ann; Jenkinson, Amanda; Nthenge, Serah

2016-01-01

This article reports the findings of a study that examined the research and scholarship productivity of doctorally prepared nursing faculty teaching and mentoring doctoral students and the conflicting demands on them to maintain programs of research and scholarship. The specific aims were to (a) examine the research productivity and scholarship of faculty members teaching in doctoral programs and mentoring doctoral students to examine the perceived effectiveness of existing institutional mechanisms to support scholarship, (b) explore institutional features and personal practices used by doctoral program faculty to develop and maintain research and scholarship productivity, and (c) analyze predictors of scholarship productivity. Data were collected via an on-line researcher-developed survey that examined doctoral faculty roles/responsibilities and their relationship to their scholarly productivity, overall research productivity, and institutional features and personal practices to support research/scholarship activities. Survey respondents reported spending a large amount of time engaged in research-related activities with 58.9% (n = 326) spending anywhere from 6 to 20 hours per week conducting research, writing research-based papers, giving presentations, grant writing, or conducting evidence-based improvement projects. Scholar productivity among the respondents was robust. Personal practices that most strongly supported faculty members' scholarship productivity were the belief that engaging in scholarship made them better teachers and the personal gratification in experiencing doctoral students' successes. A multiple regression analysis conducted to determine predictors of productivity indicated that the strongest predictor was the average number of hours spent on research/scholarship-related activities, followed by time bought out from teaching and other responsibilities of the faculty role for research. Copyright © 2016 Elsevier Inc. All rights reserved.

Application Level Processing for Long-Lived and Information Rich Wireless Sensor Networks

NASA Astrophysics Data System (ADS)

Wilkins, R.; Gaura, E.; Brusey, J.

2013-12-01

A primary design goal in Wireless Sensor Networks (WSNs) is to ensure the longest possible node lifetime with the available power budget while still meeting application requirements. Since radio transmissions often consume the most power in WSN devices, it follows that a node should aim to maximise its lifetime by transmitting only the data or information required to enable the motivating application. Full raw data streams are often not required since summaries of data are sufficient to meet application needs summaries are often performed at a central point after collection). When raw data is not a requirement, it makes sense to perform as much application-specific processing on-node as possible to minimise the amount of transmissions a node must make. For example, in home environment monitoring, the amount of time a room spends within an acceptable temperature range is more important than the raw stream of temperature measurements. The work presents Bare Necessities (BN) which implements the calculation of application-specific summaries on-node. In the case of knowing the amount time a room spends within an acceptable temperature range, BN encodes the raw signal as a distribution over bins (e.g. a bin might comprise temperatures between 18 °C and 22 °C). BN conserves power by only transmitting when changes to the distribution occur only sending the bare necessities of information the end user is interested in (thus the algorithm name). In the case of home monitoring it has been shown that BN can lead to a packet transmission reduction of 99.98%, increasing a nodes lifetime by a factor of 14 when compared to sense-and-send nodes. A summary of the Bare Necessities process at the node.

Physiotherapists systematically overestimate the amount of time stroke survivors spend engaged in active therapy rehabilitation: an observational study.

PubMed

Kaur, Gurpreet; English, Coralie; Hillier, Susan

2013-03-01

How accurately do physiotherapists estimate how long stroke survivors spend in physiotherapy sessions and the amount of time stroke survivors are engaged in physical activity during physiotherapy sessions? Does the mode of therapy (individual sessions or group circuit classes) affect the accuracy of therapists' estimates? Observational study embedded within a randomised trial. People who participated in the CIRCIT trial after having a stroke. 47 therapy sessions scheduled and supervised by physiotherapists (n = 8) and physiotherapy assistants (n = 4) for trial participants were video-recorded. Therapists' estimations of therapy time were compared to the video-recorded times. The agreement between therapist-estimated and video-recorded data for total therapy time and active time was excellent, with intraclass correlation coefficients (ICC) of 0.90 (95% CI 0.83 to 0.95) and 0.83 (95% CI 0.73 to 0.93) respectively. Agreement between therapist-estimated and video-recorded data for inactive time was good (ICC score 0.62, 95% CI 0.40 to 0.77). The mean (SD) difference between therapist-estimated and video-recorded total therapy time, active time, and inactive time for all sessions was 7.7 (10.5), 14.1 (10.3) and -6.9 (9.5) minutes respectively. Bland-Altman analyses revealed a systematic bias of overestimation of total therapy time and total active time, and underestimation of inactive time by therapists. Compared to individual therapy sessions, therapists estimated total circuit class therapy duration more accurately, but estimated active time within circuit classes less accurately. Therapists are inaccurate in their estimation of the amount of time stroke survivors are active during therapy sessions. When accurate therapy data are required, use of objective measures is recommended. Copyright © 2013 Australian Physiotherapy Association. Published by .. All rights reserved.

How Much Is Too Much to Pay for Internet Access? A Behavioral Economic Analysis of Internet Use.

PubMed

Broadbent, Julie; Dakki, Michelle A

2015-08-01

The popularity of online recreational activities, such as social networking, has dramatically increased the amount of time spent on the Internet. Excessive or inappropriate use of the Internet can result in serious adverse consequences. The current study used a behavioral economic task to determine if the amount of time spent online by problematic and nonproblematic users can be modified by price. The Internet Purchase Task was used to determine how much time undergraduate students (N=233) would spend online at 13 different prices. Despite high demand for Internet access when access was free, time spent online by both problematic and nonproblematic users decreased dramatically, even at low prices. These results suggest that the amount of time spent online may be modified by having a tangible cost associated with use, whereas having free access to the Internet may encourage excessive, problematic use.

The effect of hospital acquisitions of physician practices on prices and spending.

PubMed

Capps, Cory; Dranove, David; Ody, Christopher

2018-05-01

During the past decade, U.S. hospitals have acquired a large number of physician practices. For example, from 2007 to 2013, hospitals acquired nearly 10% of the practices in our sample. We find that the prices for the services provided by acquired physicians increase by an average of 14.1% post-acquisition. Nearly half of this increase is attributable to the exploitation of payment rules. Price increases are larger when the acquiring hospital has a larger share of its inpatient market. We find that integration of primary care physicians increases enrollee spending by 4.9%. Copyright © 2018 Elsevier B.V. All rights reserved.

Land revenues, schools and literacy: a historical examination of public and private funding of education.

PubMed

Chaudhary, Latika

2010-01-01

Despite the centralised nature of the fiscal system in colonial India, public education expenditures varied dramatically across regions with the western and southern provinces spending three to four times as much as the eastern provinces. A significant portion of the inter-regional difference was due to historical differences in land taxes, an important source of provincial revenues in the nineteenth and early twentieth century. The large differences in public spending, however, did not produce comparable differences in enrollment rates or literacy in the colonial period. Nonetheless, public investments influenced the direction of school development and perhaps the long run trajectory of rural literacy.

GeneView: a comprehensive semantic search engine for PubMed.

PubMed

Thomas, Philippe; Starlinger, Johannes; Vowinkel, Alexander; Arzt, Sebastian; Leser, Ulf

2012-07-01

Research results are primarily published in scientific literature and curation efforts cannot keep up with the rapid growth of published literature. The plethora of knowledge remains hidden in large text repositories like MEDLINE. Consequently, life scientists have to spend a great amount of time searching for specific information. The enormous ambiguity among most names of biomedical objects such as genes, chemicals and diseases often produces too large and unspecific search results. We present GeneView, a semantic search engine for biomedical knowledge. GeneView is built upon a comprehensively annotated version of PubMed abstracts and openly available PubMed Central full texts. This semi-structured representation of biomedical texts enables a number of features extending classical search engines. For instance, users may search for entities using unique database identifiers or they may rank documents by the number of specific mentions they contain. Annotation is performed by a multitude of state-of-the-art text-mining tools for recognizing mentions from 10 entity classes and for identifying protein-protein interactions. GeneView currently contains annotations for >194 million entities from 10 classes for ∼21 million citations with 271,000 full text bodies. GeneView can be searched at http://bc3.informatik.hu-berlin.de/.

Weapons to widgets: Organic systems and public policy for tech transfer

NASA Technical Reports Server (NTRS)

Cargo, Russell A.

1994-01-01

Large cuts in defense spending cause serious repercussions throughout the American economy. One means to counter the negative effects of defense reductions is to redirect federal dollars to temporarily prop up defense industries and, over the longer-term, stimulate growth of new nondefense industries. The creation of non-defense products and industries by channeling ideas from public laboratories into the private sector manufacturing facilities, known as technology transfer, is being undertaken in a massive program that has high visibility, large amounts of money, and broad federal agency involvement. How effectively federal money can be directed toward stimulating the creation of non-defense products will define the strength of the economy, (i.e., tax base, employment level, trade balance, capital investments, etc.), over the next decade. Key functions of the tech transfer process are technology and market assessment, capital formation, manufacturing feasibility, sales and distribution, and business organization creation. Those, however, are not functions typically associated with the federal government. Is the government prepared to provide leadership in those areas? This paper suggests organic systems theory as a means to structure the public sector's actions to provide leadership in functional areas normally outside their scope of expertise. By applying new ideas in organization theory, can we design government action to efficiently and effectively transfer technologies?

Congressional cuts threaten family planning programs.

PubMed

Van Hoogstraat, A

1996-01-01

In the spring of 1996, the US government's omnibus spending bill reduced support for international family planning (FP) programs by 35%. The bill also prohibited the US Agency for International Development (USAID) from spending any of the money allocated until July 1 and limited USAID allocations to 6.7% per month for 15 months, which meant that only $72 million could be spent in fiscal year 1996, as compared to $547 in fiscal year 1995. While some observers attributed the cut in spending to anti-abortion forces, Senator Mark Hatfield, an opponent of abortion, campaigned hard to keep the appropriations as a means of reducing the need for abortion. In 1995, the US spent less than 1% of its budget on foreign aid, and most Americans support foreign aid assistance for FP programs. The ability of opponents of international FP programs to continue to restrict the program for fiscal year 1997 will depend in large measure on the results of the November 1996 elections.

Occupational Therapy in Medicaid Home and Community-Based Services Waivers.

PubMed

Friedman, Carli; VanPuymbrouck, Laura

Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. Comparisons across states strengthen the profession's ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. Copyright © 2018 by the American Occupational Therapy Association, Inc.

Occupational Therapy in Medicaid Home and Community-Based Services Waivers

PubMed Central

VanPuymbrouck, Laura

2018-01-01

OBJECTIVE. Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. METHOD. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. RESULTS. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. CONCLUSION. Comparisons across states strengthen the profession’s ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. PMID:29426389

Measuring the cost implications of the Collaborative Accountable Care initiative in Texas.

PubMed

Ho, Vivian; Allen, Timothy K; Kim, Urie; Keenan, William P; Ku-Goto, Meei-Hsiang; Sanderson, Mark

2016-09-01

We analyzed changes in healthcare spending associated with the implementation of Cigna's Collaborative Accountable Care (CAC) initiative in a large multi-clinic physician practice. We compared claims from 2009, prior to the CAC initiative, against claims for 2010 to 2011, contrasting the patients covered by Cigna's CAC initiative with patients in other practices in the same geographic area covered by Cigna's medical plan. We used a propensity weighted difference-in-differences approach, adjusting for age, sex, health status, and secular trends to isolate the treatment effect of the CAC. The CAC initiative resulted in a 5.7% reduction in net spending per patient for 2010 to 2011, relative to what spending would have been without the initiative. This reduced spending was evident in multiple service categories: evaluation and management, procedures, imaging, tests, and durable medical equipment. Professional payments, inpatient facility, and outpatient facility payments for Medical Clinic of North Texas enrollees all experienced significant cost savings relative to the control group. About half of the savings resulted from using lower-priced sources. The CAC initiative, which includes an embedded care coordinator and a list of recommended providers, was associated with cost savings similar to those reported by other initiatives, such as global budgets and risk-based contracts.

Estimating financial resources for universal access to sexual reproductive health care: Evidence from two states in India.

PubMed

Rout, Sarit Kumar; Pradhan, Jalandhar; Choudhury, Sarmistha

2016-10-01

India has made insignificant progress towards achieving universal access to sexual and reproductive health (SRH). One of the key inputs for achieving universal access to SRH is financial resources. Given this, many international agencies including the UN are emphasising on monitoring the financial progress towards achieving SRH. To generate evidence on spending on SRH from various sources - (government, household, international donors and NGOs) to improve the accountability of the government towards SRH goal. Adapting a sub account framework of the NHA, this paper investigated the SRH expenditure of the two divergent states of India. The data were collected from government, households (NSSO), and foreign donors and were classified as per the International Classification of Health Accounts (ICHA). Total SRH expenditure is less than one percent of SGDP from all sources in each state. Among the sources, government's spending on SRH is more than household. A large part of household spending is on curative care which has implications for accessing services by the poor. In spite of data constraints, this paper presents a comprehensive analysis on SRH spending, which is critical for monitoring the commitment towards universal access to SRH. This evidence can be used for further improving data quality for RCH account in LMICs. Copyright © 2016 Elsevier B.V. All rights reserved.

EPA Stops Sales of WellPlant's Mold Manager

EPA Pesticide Factsheets

U.S. DOJ and EPA announce settlement with ASARCO requiring the company to spend $150 million to install new equipment and pollution control technology to reduce emissions of toxic heavy metals at a large smelter located in Hayden, Ariz.

Responsive Education Applied to Engineering Mechanics.

ERIC Educational Resources Information Center

Brillhart, Lia V.

1981-01-01

With less time to spend with individual students, teachers of large classes may need course materials that augment texts and lectures. The author discusses what criteria such materials must meet and gives examples from a course in statics. (Author/DS)

Oregon hydrologic landscape regions

EPA Science Inventory

Individuals who spend time working with streams intuitively come to understand that stream hydrologic and ecological characteristics are related to the attributes of the watersheds in which they occur. This is easy to see in Oregon with its large climatic and geologic variations ...

Sedentary behavior as a mediator of type 2 diabetes

PubMed Central

Hamilton, Marc T.; Hamilton, Deborah G.; Zderic, Theodore W.

2015-01-01

Over the past 5 years, the fastest growing new area of physical activity research centered around the concept that the large amount of time people spend sitting inactive may have significant physiological consequences hazardous to human health, including risk for type 2 diabetes and poor metabolism of lipids and glucose. Meta-analysis (10 studies) suggest there is a 112% greater relative risk associated with a large duration of sedentary behavior for type 2 diabetes. Meta-analysis also indicates significantly greater odds for metabolic syndrome. We also summarize results for 7 studies using objective measures of total sedentary time and focusing on cardiometabolic risks in persons at high risk for type 2 diabetes or already diagnosed with type 2 diabetes. The underlying hypothesis introduced in 2004 by the inactivity physiology paradigm, has been that frequent and abundant contractile activity by certain types of skeletal muscle can have a potent influence on key physiological processes, even when the intensity is below that achieved through exercise. We explain some of the mechanisms for why the metabolism in slow-twitch oxidative skeletal muscle is key for understanding the healthy responses to low intensity physical activity (LIPA). Findings from objective measures from inclinometry indicated that the quartile range for weekly sedentary time is ~29 hours/week. The total daily time that people sit, stand, and accumulate non-exercise steps is independent of traditionally recommended moderate-vigorous physical activity (MVPA). The large amount of sedentary time associated with risk for disease can only be reduced significantly with safe and non-fatiguing LIPA, especially in the most at risk proportion of the population. Importantly, experimental studies are starting to indicate that it will be especially insightful to understand the acute dose-response effects of LIPA in order to understand why reducing sedentary time can improve lipid and glucose metabolism for the prevention and treatment of chronic disorders related to type 2 diabetes. PMID:25226797

Economic Impact of Pacific Northwest National Laboratory on the State of Washington in Fiscal Year 2013

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

Scott, Michael J.; Niemeyer, Jackie M.

Pacific Northwest National Laboratory (PNNL) is a large economic entity, with $1.06 billion in annual funding, $936 million in total spending, and 4,344 employees in fiscal year (FY) 2013. Four thousand, one hundred and one (4,101) employees live in Washington State. The Laboratory directly and indirectly supports almost $1.31 billion in economic output, 6,802 jobs, and $514 million in Washington State wage income from current operations. The state also gains more than $1.21 billion in output, more than 6,400 jobs, and $459 million in income through closely related economic activities, such as visitors, health care spending, spending by resident retirees,more » and spinoff companies. PNNL affects Washington’s economy through commonly recognized economic channels, including spending on payrolls and other goods and services that support Laboratory operations. Less-commonly recognized channels also have their own impacts and include company-supported spending on health care for its staff members and retirees, spending of its resident retirees, Laboratory visitor spending, and the economic activities in a growing constellation of “spinoff” companies founded on PNNL research, technology, and managerial expertise. PNNL also has a significant impact on science and technology education and community nonprofit organizations. PNNL is an active participant in the future scientific enterprise in Washington with the state’s K-12 schools, colleges, and universities. The Laboratory sends staff members to the classroom and brings hundreds of students to the PNNL campus to help train the next generation of scientists, engineers, mathematicians, and technicians. This investment in human capital, though difficult to measure in terms of current dollars of economic output, is among the important lasting legacies of the Laboratory. Finally, PNNL contributes to the local community with millions of dollars’ worth of cash and in-kind corporate and staff contributions, all of which strengthen the economy. This report quantifies these effects, providing detailed information on PNNL’s revenues and expenditures, as well as the impacts of its activities on the rest of the Washington State economy. This report also describes the impacts of the four closely related activities: health care spending, spinoff companies with roots in PNNL, visitors to the Laboratory, and PNNL retirees.« less

Inequity in costs of seeking sexual and reproductive health services in India and Kenya.

PubMed

Haghparast-Bidgoli, Hassan; Pulkki-Brännström, Anni-Maria; Lafort, Yves; Beksinska, Mags; Rambally, Letitia; Roy, Anuradha; Reza-Paul, Sushena; Ombidi, Wilkister; Gichangi, Peter; Skordis-Worrall, Jolene

2015-09-15

This study aims to assess inequity in expenditure on sexual and reproductive health (SRH) services in India and Kenya. In addition, this analysis aims to measure the extent to which payments are catastrophic and to explore coping mechanisms used to finance health spending. Data for this study were collected as a part of the situational analysis for the "Diagonal Interventions to Fast Forward Enhanced Reproductive Health" (DIFFER) project, a multi-country project with fieldwork sites in three African sites; Mombasa (Kenya), Durban (South Africa) and Tete (Mozambique), and Mysore in India. Information on access to SRH services, the direct costs of seeking care and a range of socio-economic variables were obtained through structured exit interviews with female SRH service users in Mysore (India) and Mombasa (Kenya) (n = 250). The costs of seeking care were analysed by household income quintile (as a measure of socio-economic status). The Kakwani index and quintile ratios are used as measures of inequitable spending. Catastrophic spending on SRH services was calculated using the threshold of 10% of total household income. The results showed that spending on SRH services was highly regressive in both sites, with lower income households spending a higher percentage of their income on seeking care, compared to households with a higher income. Spending on SRH as a percentage of household income ranged from 0.02 to 6.2% and 0.03-7.5% in India and Kenya, respectively. There was a statistically significant difference in the proportion of spending on SRH services across income quintiles in both settings. In India, the poorest households spent two times, and in Kenya ten times, more on seeking care than the least poor households. The most common coping mechanisms in India and Kenya were "receiving [money] from partner or household members" (69%) and "using own savings or regular income" (44%), respectively. Highly regressive spending on SRH services highlights the heavier burden borne by the poorest when seeking care in resource-constrained settings such as India and Kenya. The large proportion of service users, particularly in India, relying on money received from family members to finance care seeking suggests that access would be more difficult for those with weak social ties, small social networks or weak bargaining positions within the family - although this requires further study.

Parents' Knowledge and Beliefs about the Impact of Exposure to Media Violence on Children's Aggression.

PubMed

Al-Ali, Nahla Mansour; Yaghy, Hadeel Said; Shattnawi, Khulood K; Al-Shdayfat, Noha M

2018-02-15

The current study aimed to assess Jordanian parents' knowledge and beliefs about the effects of violent media on children's aggressive behavior. A sample of 262 parents of children aged 6-11 years completed a Media Quotient questionnaire about children's media habits, media effects, and children's aggressive behavior. Parents reported that their children spend an average of 4.83 h (SD = 2.12) watching TV, 3.20 h (SD = 2.29) playing video games, 1.07 h (SD = 0.88) listening to music, and only 0.52 min (SD = 0.67) reading for pleasure per day. Parents have a moderate level of knowledge about the media effect (M = 15.49, SD = 3.439). Children of parents who have adequate knowledge about the media effect, spend less time watching TV (r = -.355, p < .001), playing video games (r = -.265, p < .001), and listening to music (r = -.347, p < .001). Ninety-two percent (n = 241) of parents were concerned about the amount of sexual and of violent content their children see in movies or on TV. Children who spend more time playing video games (r = -.201, p = .004) show aggressive relational behavior. This study suggests that increasing parents' knowledge of media of evidence-based programs may have a protective effect on children's behavior.

Marketing in the HMO industry: an analysis of spending patterns and enrollment growth results.

PubMed

Menges, J J

1988-01-01

The purpose of this paper is to assess the level of marketing spending in the HMO industry and the enrollment growth HMOs have achieved in return for their marketing dollars. This study identifies industry norms that are designed to assist HMOs in the evaluation of their marketing performance. The study is based on data from 1985 to 1986 covering approximately half the HMOs in the country and comprising a substantial proportion of industry-wide enrollment (Table 1). The analyses are designed to allow operational HMOs to compare their marketing efforts, enrollment growth, and marketing costs per new member with industry norms within similar age, model type, enrollment level, and geographic categories. The marketing expenses provided by each HMO are an aggregate figure including sales staff salaries, benefits and commissions, advertising, costs for the production and printing of marketing materials, and all other expenses directly related to the marketing effort. Components of the aggregate marketing expenses, such as the amount spent on advertising versus sales staff compensation, were not available.

New Directions: Ozone-initiated reaction products indoors may be more harmful than ozone itself

NASA Astrophysics Data System (ADS)

Weschler, Charles J.

2004-10-01

Epidemiological studies have found associations between ozone concentrations measured at outdoor monitoring stations and certain adverse health outcomes. As a recent example, Gent et al. (2003, Journal of the American Medical Association 290, 1859-1867) have observed an association between ozone levels and respiratory symptoms as well as the use of maintenance medication by 271 asthmatic children living in Connecticut and the Springfield area of Massachusetts. In another example, Gilliland et al. (2001, Epidemiology 12, 43-54) detected an association between short-term increases in ozone levels and increased absences among 4th grade students from 12 southern California communities during the period from January to June 1996. Although children may spend a significant amount of time outdoors, especially during periods when ozone levels are elevated, they spend a much larger fraction of their time indoors. I hypothesize that exposure to the products of ozone-initiated indoor chemistry is more directly responsible for the health effects observed in the cited epidemiological studies than is exposure to outdoor ozone itself.

How Physically Active Are People with Stroke in Physiotherapy Sessions Aimed at Improving Motor Function? A Systematic Review

PubMed Central

Kaur, Gurpreet; English, Coralie; Hillier, Susan

2012-01-01

Background. Targeted physical activity drives functional recovery after stroke. This review aimed to determine the amount of time stroke survivors spend physically active during physiotherapy sessions. Summary of Review. A systematic search was conducted to identify published studies that investigated the use of time by people with stroke during physiotherapy sessions. Seven studies were included; six observational and one randomised controlled trial. People with stroke were found to be physically active for an average of 60 percent of their physiotherapy session duration. The most common activities practiced in a physiotherapy session were walking, sitting, and standing with a mean (SD) practice time of 8.7 (4.3), 4.5 (4.0), and 8.3 (2.6) minutes, respectively. Conclusion. People with stroke were found to spend less than two-thirds of their physiotherapy sessions duration engaged in physical activity. In light of dosage studies, practice time may be insufficient to drive optimal motor recovery. PMID:22567542

Place of death among older Americans: does state spending on home- and community-based services promote home death?

PubMed

Muramatsu, Naoko; Hoyem, Ruby L; Yin, Hongjun; Campbell, Richard T

2008-08-01

The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them. To examine whether states' spending on home- and community-based services (HCBS) affects place of death, taking into consideration county health care resources and individuals' family, sociodemographic, and health factors. Using exit interview data from respondents in the Health and Retirement Study born in 1923 or earlier who died between 1993 and 2002 (N = 3362), we conducted discrete-time survival analysis of the risk of end-of-life nursing home relocation to examine whether states' HCBS spending would delay or prevent end-of-life nursing home admission. Then we ran logistic regression analysis to investigate the HCBS effects on place of death separately for those who relocated to a nursing home and those who remained in the community. Living in a state with higher HCBS spending was associated with lower risk of end-of-life nursing home relocation, especially among people who had Medicaid. However, state HCBS support was not directly associated with place of death. States' generosity for HCBS increases the chance of dying at home via lowering the risk of end-of-life nursing home relocation. State-to-state variation in HCBS spending may partly explain variation in home deaths. Our findings add to the emerging encouraging evidence for continued efforts to enhance support for HCBS.

Public Expenditures for Mental Health Services in Canadian Provinces: Dépenses publiques pour les services de santé mentale dans les provinces canadiennes.

PubMed

Wang, Jian; Jacobs, Philip; Ohinmaa, Arto; Dezetter, Anne; Lesage, Alain

2018-04-01

The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications. Total public expenditures were inflation adjusted and expressed per capita and as a percentage of the total provincial health spending. Total public spending for mental health and addiction programs/services was estimated to be $6.75 billion for FY 2013. The largest component of the expenditures was hospital inpatient services ($4.02 billion, 59.6%), followed by clinical payments to physicians or psychologists ($1.69 billion, 25%), and then publicly funded prescribed psychotherapeutic medications ($1.04 billion, 15.4%). Nationally, the portion of total public spending on health that was spent on mental health decreased from FY 2003 to FY 2013 from 5.4% to 4.9%. Our results reveal that mental health spending, as a proportion of public health care expenditures, decreased in the decade from FY 2003 to FY 2013. Due to large differences in how the provinces report community mental health services, we still lack a comprehensive picture of the mental health system.

Hong Kong domestic health spending: financial years 1989/90 to 2009/10.

PubMed

Tin, K Y K; Tsoi, P K O; Lee, Y H; Tsui, E L H; Lam, D W S; Chui, A W M; Lo, S V

2013-04-01

This report presents the latest estimates of Hong Kong domestic health spending for financial years 1989/90 to 2009/10, cross-stratified and categorised by financing source, provider and function. Total expenditure on health (TEH) was HK$88,721 million in financial year 2009/10, which represents an increase of HK$5031 million or 6.0% over the preceding year. As a result of a slow revival in the economy from the financial tsunami in 2008, TEH grew faster relative to gross domestic product (GDP) leading to a marked increase in TEH as a percentage of GDP from 5.0% in 2008/09 to 5.2% in 2009/10. During the period 1989/90 to 2009/10, total health spending per capita (at constant 2010 prices) grew at an average annual rate of 4.9%, which was faster than the average annual growth rate of per capita GDP by 2.0 percentage points. In 2009/10, public and private expenditure on health increased by 6.2% and 5.8% when compared with 2008/09, reaching HK$43,823 million and HK$44,898 million, respectively. Consequently, public and private shares of total health expenditure stayed at similar levels (49% and 51% respectively) in the 2 years. With respect to private spending, the most important source of health financing was out-of-pocket payments by households (34.9% of TEH), followed by employer-provided group medical benefits (7.4%) and private insurance (6.8%). During the period, a growing number of households (mostly in middle to high income groups) have taken out pre-payment plans to finance health care. As such, private insurance has taken on an increasingly important role in financing private spending. Of the HK$88,721 million total health expenditure in 2009/10, current expenditure comprised HK$84,874 million (95.7%), whereas HK$3847 million (4.3%) was for capital expenses (ie investment in medical facilities). Analysed by health care function, services for curative care accounted for the largest share (66.2%), which was made up of ambulatory services (33.5%), in-patient curative care (27.3%), day patient hospital services (4.9%) and home care (0.5%). Notwithstanding the small share of total spending for day patient hospital services, there was an increasing trend over the period 1989/90 to 2009/10, likely as a result of policy directives to shift the emphasis from in-patient to day patient care. Hospitals accounted for an increasing share of total spending, from 28.2% in 1989/90 to 46.8% in 2002/03 and then dropped steadily to 43% to 44% during the period 2005/06 to 2009/10. This trend was primarily driven by reduced expenditure by the Hospital Authority. As a result of epidemics that were of public health importance (eg avian flu, SARS, swine flu) and expansion of the private health insurance market in the last 2 decades, spending on provision and administration of public health programmes, and general health administration and insurance accounted for increasing, though less significant, shares of total health spending over the period. Without taking into account capital expenses (ie investment in medical facilities), public current expenditure on health amounted to HK$40,951 million (48.2% of total current expenditure) in 2009/10. The remaining HK$43,923 expenditure was mostly incurred at hospitals (74.1%), whereas private current expenditure was mostly incurred at providers of ambulatory health care (50.9%). Although both public and private spending were mostly expended on personal health care services and goods (91.0% of total current spending), the distribution patterns among functional categories differed. Public expenditure was targeted at in-patient care (48.9%) and substantially less on out-patient care (26.0%). In comparison, private spending was mostly concentrated on out-patient care (43.4%), whereas in-patient care (23.3%) and medical goods outside the patient care setting (19.5%) accounted for the majority of the remaining share. Compared to the Organisation for Economic Cooperation and Development countries, Hong Kong has devoted a relatively low percentage of GDP to health care in the last decade. As a share of total spending, public funding (either general government revenue or social security funds) was also lower than in most economies with comparable economic development and public revenue collection base.

Report of the Aircraft Systems/Flight Test Workshop Held at East Point, Georgia on 8-17 November 1977.

DTIC Science & Technology

1977-11-01

prior knowledge to decrease the amount of manpower and time required to evaluate the second package, but in principle, each STC package must be...techniques. Our knowledge of the problems, hazards, and pitfalls in the use of these techniques is very limited. Background: We do not have sufficient...prediction techniques, and what recommendations we would like to make, based on the limited knowledge we currently have. I would really like to spend another

Office managers' perception of stress, control, and satisfaction: a comparison between primary care and specialty practices.

PubMed

Chang, Jyh-Hann; Whittier, Nathan; DeFries, Erin; Garfinkle, Amanda

2006-01-01

Perception of stress, control, and satisfaction was measured by office managers in medical practices. Office managers spend enormous amounts of time each day handling difficult interpersonal issues among staff physicians, and patients. As a group, physician disruptions were the most prevalent per day. Other staff members were considered the most stressful by rank order. Significant differences were discovered between primary care practices versus specialty practices in the areas of interactions with physicians.

Fraud prevention in paying portal

NASA Astrophysics Data System (ADS)

Sandhu, P. S.; Senthilkumar, N. C.

2017-11-01

The purpose of presenting this paper is to give the idea to prevent the fraud in finance paying portals as fraud is increasing on daily basis and mostly in financial sector. So through this paper we are trying to prevent the fraud. This paper will give you the working algorithm through which you can able to prevent the fraud. Algorithm will work according to the spending amount of the user, which means that use will get categories into one of the low, medium, high or very high category.

Skin-to-skin contact. Part one: just an hour of your time...

PubMed

Vincent, Sarah

2011-05-01

A growing body of evidence suggests that extended skin-to-skin contact between mother and baby immediately after birth provides numerous and significant benefits including regulating heartbeat and temperature for the baby, protecting against infections, and promoting feelings of calm and wellbeing in both mother and baby. As a result the Baby Friendly Initiative has increased the amount of time that mothers and babies should spend in skin contact to one hour minimum, and much more where possible.

Budgetary and Economic Outcomes Under Paths for Federal Revenues and Noninterest Spending Specified in the Conference Report on the 2016 Budget Resolution

DTIC Science & Technology

2015-04-01

excluding interest savings and macroeconomic effects, would be roughly $5 trillion lower than in CBO’s current-law baseline, as adjusted to...and spending—and the resulting amount of federal borrow- ing—under those paths would affect the economy and how those macroeconomic effects (or...baseline projections. With interest savings included and the resulting macroeconomic effects incorpo- rated, the cumulative deficit over the 2016–2025

Generational Differences In U.S. Public Spending, 1980–2000

PubMed Central

Pati, Susmita; Keren, Ron; Alessandrini, Evaline A.; Schwarz, Donald F.

2013-01-01

The balance between spending on children and spending on the elderly is important in evaluating the allocation of public welfare spending. We examine trends in public spending on social welfare programs for children and the elderly during 1980–2000. For both groups, social welfare spending as a percentage of gross domestic product changed little, even during the economic expansions of the 1990s. In constant dollars, the gap in per capita social welfare spending between children and the elderly grew 20 percent. Unlike spending for programs for the elderly, spending for children’s programs suffered during recessions. Public discussion about the current imbalance in public spending is needed. PMID:15371377

Financial Incentives, Workplace Wellness Program Participation, and Utilization of Health Care Services and Spending.

PubMed

Fronstin, Paul; Roebuck, M Christopher

2015-08-01

This paper analyzes data from a large employer that enhanced financial incentives to encourage participation in its workplace wellness programs. It examines, first, the effect of financial incentives on wellness program participation, and second, it estimates the impact of wellness program participation on utilization of health care services and spending. The Patient Protection and Affordable Care Act of 2010 (PPACA) allows employers to provide financial incentives of as much as 30 percent of the total cost of coverage when tied to participation in a wellness program. Participation in health risk assessments (HRAs) increased by 50 percentage points among members of unions that bargained in the incentive, and increased 22 percentage points among non-union employees. Participation in the biometric screening program increased 55 percentage points when financial incentives were provided. Biometric screenings led to an average increase of 0.31 annual prescription drug fills, with related spending higher by $56 per member per year. Otherwise, no significant effects of participation in HRAs or biometric screenings on utilization of health care services and spending were found. The largest increase in medication utilization as a result of biometric screening was for statins, which are widely used to treat high cholesterol. This therapeutic class accounted for one-sixth of the overall increase in prescription drug utilization. Second were antidepressants, followed by ACE inhibitors (for hypertension), and thyroid hormones (for hypothyroidism). Biometric screening also led to significantly higher utilization of biologic response modifiers and immunosuppressants. These specialty medications are used to treat autoimmune diseases, such as rheumatoid arthritis and multiple sclerosis, and are relatively expensive compared with non-specialty medications. The added spending associated with the combined increase in fills of 0.02 was $27 per member per year--about one-half of the overall increase in prescription drug spending from those who participated in biometric screenings.

Impact of GDP, spending on R&D, number of universities and scientific journals on research publications among Asian countries.

PubMed

Meo, Sultan Ayoub; Al Masri, Abeer A; Usmani, Adnan Mahmood; Memon, Almas Naeem; Zaidi, Syed Ziauddin

2013-01-01

This study aimed to compare the impact of Gross Domestic Product (GDP) per capita, spending on Research and Development (R&D), number of universities, and Indexed Scientific Journals on total number of research documents (papers), citations per document and Hirsch index (H-index) in various science and social science subjects among Asian countries. In this study, 40 Asian countries were included. The information regarding Asian countries, their GDP per capita, spending on R&D, total number of universities and indexed scientific journals were collected. We recorded the bibliometric indicators, including total number of research documents, citations per document and H-index in various science and social sciences subjects during the period 1996-2011. The main sources for information were World Bank, SCI-mago/Scopus and Web of Science; Thomson Reuters. The mean per capita GDP for all the Asian countries is 14448.31±2854.40 US$, yearly per capita spending on R&D 0.64±0.16 US$, number of universities 72.37±18.32 and mean number of ISI indexed journal per country is 17.97±7.35. The mean of research documents published in various science and social science subjects among all the Asian countries during the period 1996-2011 is 158086.92±69204.09; citations per document 8.67±0.48; and H-index 122.8±19.21. Spending on R&D, number of universities and indexed journals have a positive correlation with number of published documents, citations per document and H-index in various science and social science subjects. However, there was no association between the per capita GDP and research outcomes. The Asian countries who spend more on R&D have a large number of universities and scientific indexed journals produced more in research outcomes including total number of research publication, citations per documents and H-index in various science and social science subjects.

Colony attendance and population monitoring of Black-legged Kittiwakes on the Semidi Islands, Alaska

USGS Publications Warehouse

Hatch, Scott A.; Hatch, Martha A.

1988-01-01

Patterns of colony attendance in Black-legged Kittiwakes (Rissa tridactyla) were studied over 5 years on the Semidi Islands, western Gulf of Alaska. A census period of 50 days, extending from first egg laying through final hatching, was appropriate because counts made then were subject to the least amount of daily variation. Five counts during that period were sufficient to detect a 25% change in numbers between years; counts made on all 50 days of the census period would detect a 5 to 7% change. There was little evidence for seasonal trends or serial correlation of counts during the census period, but attendance was negatively correlated with wind speed. Half of an apparent 17% increase in population between 1980 and 1981 was due to birds spending more time at their nest sites in the latter year, thereby increasing the mean of attendance counts. Despite such difficulties in the interpretation of attendance counts, birds were considered to be better counting units for population monitoring than nests, because nest densities were subject to large annual fluctuations in breeding effort.

Petrology and isotopic composition of Quaternary basanites dredged from the Bering Sea continental margin near Navarin Basin

USGS Publications Warehouse

Davis, A.S.; Gunn, S.H.; Gray, L.-B.; Marlow, M. S.; Wong, F.L.

1993-01-01

Quaternary basanites were recovered from the continental margin of the Bering Sea near Navarin Basin. The basanites are highly vesicular flow rock and hyaloclastites similar to other alkalic volcanic rocks erupted repeatedly during the last Cenozoic on islands in the Bering Sea region and in mainland Alaska. K-Ar ages for the basanites indicate at least two episodes of volcanism at about 1.1 and 0.4 Ma. Trace-element data indicate these alkalic lavas have been generated by small, but variable, amounts of partial melting of a metasomatized lherzolite source. The relativley primitive compositions (MgO >9%), presence of mantle-derived xenoliths in some alkalic lavas, and presence of forsteritic olivine with low CaO and high NiO suggest that magma rose rapidly from great depth without spending time in large, long-lived magma chambers. Alkalic volcanism apparently resulted from upwelling and decompressional melting of small isolated mantle diapirs in response to local lithospheric attenuation associated with jostling of blocks during adjustment to regional stresses. -from Authors

[Control of scabies in the district of Ytre Nordhordland. An experiment within community medicine in the 1860's].

PubMed

Sandvik, H

1993-01-10

19th century Norway may be likened to the developing countries of today. Scabies was very prevalent, and traditional approaches to treatment were in vain. The poor peasant population would not spend money on such. Thomas Collett (1835-98), the local doctor in a rural district of western Norway, initiated a programme for community control of scabies. The local Board of Health agreed to purchase a large amount of sulphur ointment. 1/8 of a barrel of ointment was placed at the disposal of local teachers. The teachers were instructed to initiate treatment of school-children who were found to be infected with scabies. The household to which the child belonged was also to be treated, as well as the other children at the school. Gradually, the prevalence of scabies declined. Self-care increased, and eventually, the peasants ended up making their own sulphur ointment. Experiences and recommendations from developing countries of today agree with the strategy adopted by Collett. Individual medical treatment of cases and their contacts is too costly, and fails to reduce the total prevalence of scabies.

Federal R and D Reductions, Market Share, and Aerospace Information Usage

NASA Technical Reports Server (NTRS)

Rocker, JoAnne; Roncaglia, George

2000-01-01

Reductions in federally funded research have a rippling effect over the entire aerospace industry. The decline in federal R&D spending in aerospace in recent years coincides with declines in U.S. aerospace market share, One of the lesser-understood factors in the declining U.S. market share may be the differing ways and intensity with which the U.S. and its competitors approach another trend, the increasing availability of large amounts of aerospace research information on the World Wide Web. The U.S. has been a pioneer in making research information available in electronic form, and the international community has long been a heavy consumer of that information. In essence, the U.S. contributes to the research efforts of its competitors, thus contributing to foreign aerospace consortiums efforts to gain market share in the aerospace industry, This may be a cautionary note to the U.S. aerospace industry to consider the use of R&D output in its own development and strategy because the foreign competition is using the U.S. scientific and technical literature.

National Health Care Spending In 2016: Spending And Enrollment Growth Slow After Initial Coverage Expansions.

PubMed

Hartman, Micah; Martin, Anne B; Espinosa, Nathan; Catlin, Aaron; The National Health Expenditure Accounts Team

2018-01-01

Total nominal US health care spending increased 4.3 percent and reached $3.3 trillion in 2016. Per capita spending on health care increased by $354, reaching $10,348. The share of gross domestic product devoted to health care spending was 17.9 percent in 2016, up from 17.7 percent in 2015. Health spending growth decelerated in 2016 following faster growth in 2014 and 2015 associated with coverage expansions under the Affordable Care Act (ACA) and strong retail prescription drug spending growth. In 2016 the slowdown was broadly based, as spending for the largest categories by payer and by service decelerated. Enrollment trends drove the slowdown in Medicaid and private health insurance spending growth in 2016, while slower per enrollee spending growth influenced Medicare spending. Furthermore, spending for retail prescription drugs slowed, partly as a result of lower spending for drugs used to treat hepatitis C, while slower use and intensity of services drove the slowdown in hospital care and physician and clinical services.

Impacts of Solid Noise Barriers and Roadside Vegetation on Near-Road Air Quality

EPA Science Inventory

Public health concerns for populations spending time near high traffic roadways has increased substantially in recent years. Air quality measurements indicate high pollutant concentrations near these large roads. However, roadside features have been shown to substantially affec...

National health expenditures, 1991

PubMed Central

Letsch, Suzanne W.; Lazenby, Helen C.; Levit, Katharine R.; Cowan, Cathy A.

1992-01-01

Spending for health care rose to $751.8 billion in 1991, an increase of 11.4 percent from the 1990 level. National health expenditures as a share of gross domestic product increased to 13.2 percent, up from 12.2 percent in 1990. The health care sector exhibited strong growth, despite slow growth in the overall economy. This combination resulted in the largest increase in the share of the Nation's output consumed by health care in the past three decades. In this article, the authors present estimates of health spending in the United States for 1991. The authors also examine reasons for the unusually large growth in Medicaid expenditures and highlight recent trends in the hospital sector. PMID:10127445

Buying time promotes happiness.

PubMed

Whillans, Ashley V; Dunn, Elizabeth W; Smeets, Paul; Bekkers, Rene; Norton, Michael I

2017-08-08

Around the world, increases in wealth have produced an unintended consequence: a rising sense of time scarcity. We provide evidence that using money to buy time can provide a buffer against this time famine, thereby promoting happiness. Using large, diverse samples from the United States, Canada, Denmark, and The Netherlands ( n = 6,271), we show that individuals who spend money on time-saving services report greater life satisfaction. A field experiment provides causal evidence that working adults report greater happiness after spending money on a time-saving purchase than on a material purchase. Together, these results suggest that using money to buy time can protect people from the detrimental effects of time pressure on life satisfaction.

Dot-gov: market failure and the creation of a national health information technology system.

PubMed

Kleinke, J D

2005-01-01

The U.S. health care marketplace's continuing failure to adopt information technology (IT) is the result of economic problems unique to health care, business strategy problems typical of fragmented industries, and technology standardization problems common to infrastructure development in free-market economies. Given the information intensity of medicine, the quality problems associated with inadequate IT, the magnitude of U.S. health spending, and the large federal share of that spending, this market failure requires aggressive governmental intervention. Federal policies to compel the creation of a national health IT system would reduce aggregate health care costs and improve quality, goals that cannot be attained in the health care marketplace.

Buying time promotes happiness

PubMed Central

Whillans, Ashley V.; Dunn, Elizabeth W.; Smeets, Paul; Bekkers, Rene; Norton, Michael I.

2017-01-01

Around the world, increases in wealth have produced an unintended consequence: a rising sense of time scarcity. We provide evidence that using money to buy time can provide a buffer against this time famine, thereby promoting happiness. Using large, diverse samples from the United States, Canada, Denmark, and The Netherlands (n = 6,271), we show that individuals who spend money on time-saving services report greater life satisfaction. A field experiment provides causal evidence that working adults report greater happiness after spending money on a time-saving purchase than on a material purchase. Together, these results suggest that using money to buy time can protect people from the detrimental effects of time pressure on life satisfaction. PMID:28739889

Measured sedentary time and physical activity during the school day of European 10- to 12-year-old children: the ENERGY project.

PubMed

van Stralen, Maartje M; Yıldırım, Mine; Wulp, Anouk; te Velde, Saskia J; Verloigne, Maïté; Doessegger, Alain; Androutsos, Odysseas; Kovács, Éva; Brug, Johannes; Chinapaw, Mai J M

2014-03-01

This study aims to describe the time devoted to sedentary and physical activities at school in five European countries and to examine differences according to country, sex, ethnicity, parental education and weight status. cross-European cross-sectional survey. Primary schoolchildren (n=1025) aged 10-12 years in Belgium, Greece, Hungary, the Netherlands, and Switzerland wore accelerometers for at least six consecutive days. Only weekdays were used for this study to calculate the percentages of school-time spent in sedentary activities and moderate to vigorous intensity activity. Trained research assistants measured height and weight. Sex and date of birth were self-reported by the child and parental education and ethnicity were parent-reported. European schoolchildren spent on average 65% of their time at school in sedentary activities and 5% on moderate to vigorous intensity activities, with small differences between countries. Girls spent a significant larger amount of school-time in sedentary activities (67%) than boys (63%; p<0.0001), and spent less time in moderate to vigorous intensity activities (4% versus 5%; p<0.001). Overweight children spent significantly less time in moderate to vigorous intensity activities (4%) than normal weight children (5%,p < 0.01) [corrected]. Parental education or ethnicity were not associated with time spent in sedentary or physical activities. European schoolchildren spend a small amount of their school-time in moderate to vigorous intensity activities and a large amount in sedentary activities, with small but significant differences across countries. Future interventions should target more physical activities and less sedentary time at school particularly in girls. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Patterns of Healthcare Spending in the Last Year of Life

PubMed Central

Davis, Matthew A.; Nallamothu, Brahmajee K.; Banerjee, Mousumi; Bynum, Julie P.W.

2016-01-01

The underlying assumption that healthcare spending skyrockets at the end-of-life may suggest that policymakers should target the last few months of life to control costs. However, spending patterns leading up to death have not been fully examined. We applied a new methodology to administrative claims data for older Medicare beneficiaries who died in 2012 to characterize trajectories of healthcare spending in the last year of life. After adjustment, we identified four unique spending trajectories among decedents: 48.7 percent had High Persistent spending, 29.0 percent had Moderate Persistent spending, 10.2 percent had Progressive spending, and only 12.1 percent had Late Rise spending. High spending throughout the full year before death (approximately half of all decedents) was associated with having multiple chronic conditions but not any specific diseases. These findings suggest that spending at the end-of-life is a marker of general spending patterns often set in motion long before death. PMID:27307350

Stereotypical modulations in dynamic functional connectivity explained by changes in BOLD variance.

PubMed

Glomb, Katharina; Ponce-Alvarez, Adrián; Gilson, Matthieu; Ritter, Petra; Deco, Gustavo

2018-05-01

Spontaneous activity measured in human subject under the absence of any task exhibits complex patterns of correlation that largely correspond to large-scale functional topographies obtained with a wide variety of cognitive and perceptual tasks. These "resting state networks" (RSNs) fluctuate over time, forming and dissolving on the scale of seconds to minutes. While these fluctuations, most prominently those of the default mode network, have been linked to cognitive function, it remains unclear whether they result from random noise or whether they index a nonstationary process which could be described as state switching. In this study, we use a sliding windows-approach to relate temporal dynamics of RSNs to global modulations in correlation and BOLD variance. We compare empirical data, phase-randomized surrogate data, and data simulated with a stationary model. We find that RSN time courses exhibit a large amount of coactivation in all three cases, and that the modulations in their activity are closely linked to global dynamics of the underlying BOLD signal. We find that many properties of the observed fluctuations in FC and BOLD, including their ranges and their correlations amongst each other, are explained by fluctuations around the average FC structure. However, we also report some interesting characteristics that clearly support nonstationary features in the data. In particular, we find that the brain spends more time in the troughs of modulations than can be expected from stationary dynamics. Copyright © 2018 Elsevier Inc. All rights reserved.

Non-equilibrium thermodynamics theory of econometric source discovery for large data analysis

NASA Astrophysics Data System (ADS)

van Bergem, Rutger; Jenkins, Jeffrey; Benachenhou, Dalila; Szu, Harold

2014-05-01

Almost all consumer and firm transactions are achieved using computers and as a result gives rise to increasingly large amounts of data available for analysts. The gold standard in Economic data manipulation techniques matured during a period of limited data access, and the new Large Data Analysis (LDA) paradigm we all face may quickly obfuscate most tools used by Economists. When coupled with an increased availability of numerous unstructured, multi-modal data sets, the impending 'data tsunami' could have serious detrimental effects for Economic forecasting, analysis, and research in general. Given this reality we propose a decision-aid framework for Augmented-LDA (A-LDA) - a synergistic approach to LDA which combines traditional supervised, rule-based Machine Learning (ML) strategies to iteratively uncover hidden sources in large data, the artificial neural network (ANN) Unsupervised Learning (USL) at the minimum Helmholtz free energy for isothermal dynamic equilibrium strategies, and the Economic intuitions required to handle problems encountered when interpreting large amounts of Financial or Economic data. To make the ANN USL framework applicable to economics we define the temperature, entropy, and energy concepts in Economics from non-equilibrium molecular thermodynamics of Boltzmann viewpoint, as well as defining an information geometry, on which the ANN can operate using USL to reduce information saturation. An exemplar of such a system representation is given for firm industry equilibrium. We demonstrate the traditional ML methodology in the economics context and leverage firm financial data to explore a frontier concept known as behavioral heterogeneity. Behavioral heterogeneity on the firm level can be imagined as a firm's interactions with different types of Economic entities over time. These interactions could impose varying degrees of institutional constraints on a firm's business behavior. We specifically look at behavioral heterogeneity for firms that are operating with the label of `Going-Concern' and firms labeled according to institutional influence they may be experiencing, such as constraints on firm hiring/spending while in a Bankruptcy or a Merger procedure. Uncovering invariant features, or behavioral data metrics from observable firm data in an economy can greatly benefit the FED, World Bank, etc. We find that the ML/LDA communities can benefit from Economic intuitions just as much as Economists can benefit from generic data exploration tools. The future of successful Economic data understanding, modeling, simulation, and visualization can be amplified by new A-LDA models and approaches for new and analogous models of Economic system dynamics. The potential benefits of improved economic data analysis and real time decision aid tools are numerous for researchers, analysts, and federal agencies who all deal with increasingly large amounts of complex data to support their decision making.

Using behavioral economics to predict opioid use during prescription opioid dependence treatment.

PubMed

Worley, Matthew J; Shoptaw, Steven J; Bickel, Warren K; Ling, Walter

2015-03-01

Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Secondary analyses examined participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (N=353). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use. Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount (OR=1.30, p<.001) and a greater proportion of their income on drugs (OR=1.31, p<.001) were more likely to use opioids during treatment. Individual differences in drug reinforcement value, as indicated by pre-treatment allocation of economic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Using behavioral economics to predict opioid use during prescription opioid dependence treatment

PubMed Central

Worley, Matthew J.; Shoptaw, Steven J.; Bickel, Warren K.; Ling, Walter

2015-01-01

Background Research grounded in behavioral economics has previously linked addictive behavior to disrupted decision-making and reward-processing, but these principles have not been examined in prescription opioid addiction, which is currently a major public health problem. This study examined whether pre-treatment drug reinforcement value predicted opioid use during outpatient treatment of prescription opioid addiction. Methods Secondary analyses examined participants with prescription opioid dependence who received 12 weeks of buprenorphine-naloxone and counseling in a multi-site clinical trial (N = 353). Baseline measures assessed opioid source and indices of drug reinforcement value, including the total amount and proportion of income spent on drugs. Weekly urine drug screens measured opioid use. Results Obtaining opioids from doctors was associated with lower pre-treatment drug spending, while obtaining opioids from dealers/patients was associated with greater spending. Controlling for demographics, opioid use history, and opioid source frequency, patients who spent a greater total amount (OR = 1.30, p < .001) and a greater proportion of their income on drugs (OR = 1.31, p < .001) were more likely to use opioids during treatment. Conclusions Individual differences in drug reinforcement value, as indicated by pre-treatment allocation of economic resources to drugs, reflects propensity for continued opioid use during treatment among individuals with prescription opioid addiction. Future studies should examine disrupted decision-making and reward-processing in prescription opioid users more directly and test whether reinforcer pathology can be remediated in this population. PMID:25622776

Academic Goals, Student Homework Engagement, and Academic Achievement in Elementary School.

PubMed

Valle, Antonio; Regueiro, Bibiana; Núñez, José C; Rodríguez, Susana; Piñeiro, Isabel; Rosário, Pedro

2016-01-01

There seems to be a general consensus in the literature that doing homework is beneficial for students. Thus, the current challenge is to examine the process of doing homework to find which variables may help students to complete the homework assigned. To address this goal, a path analysis model was fit. The model hypothesized that the way students engage in homework is explained by the type of academic goals set, and it explains the amount of time spend on homework, the homework time management, and the amount of homework done. Lastly, the amount of homework done is positively related to academic achievement. The model was fit using a sample of 535 Spanish students from the last three courses of elementary school (aged 9 to 13). Findings show that: (a) academic achievement was positively associated with the amount of homework completed, (b) the amount of homework completed was related to the homework time management, (c) homework time management was associated with the approach to homework, (d) and the approach to homework, like the rest of the variables of the model (except for the time spent on homework), was related to the student's academic motivation (i.e., academic goals).

Academic Goals, Student Homework Engagement, and Academic Achievement in Elementary School

PubMed Central

Valle, Antonio; Regueiro, Bibiana; Núñez, José C.; Rodríguez, Susana; Piñeiro, Isabel; Rosário, Pedro

2016-01-01

There seems to be a general consensus in the literature that doing homework is beneficial for students. Thus, the current challenge is to examine the process of doing homework to find which variables may help students to complete the homework assigned. To address this goal, a path analysis model was fit. The model hypothesized that the way students engage in homework is explained by the type of academic goals set, and it explains the amount of time spend on homework, the homework time management, and the amount of homework done. Lastly, the amount of homework done is positively related to academic achievement. The model was fit using a sample of 535 Spanish students from the last three courses of elementary school (aged 9 to 13). Findings show that: (a) academic achievement was positively associated with the amount of homework completed, (b) the amount of homework completed was related to the homework time management, (c) homework time management was associated with the approach to homework, (d) and the approach to homework, like the rest of the variables of the model (except for the time spent on homework), was related to the student's academic motivation (i.e., academic goals). PMID:27065928

Personal Health Care Expenditures by State, Selected Years 1966-1978

PubMed Central

Levit, Katharine R.

1982-01-01

In 1966, spending for personal health care in the U.S. was $39 billion. By 1978, these expenditures had grown to $166 billion. Among regions and states, different patterns and levels of spending emerged, along with different rates of growth. Some of the highlights from the accompanying report which pinpoint personal health care spending differences among regions and states are listed below. In 1978, $745 per person was spent for personal health care services within the U.S. Massachusetts led the nation in spending with $935 per person. The lowest spending for personal health—$521 per capita—occurred in South Carolina.Expenditures for hospital care ranged from a high of $490 per capita in Massachusetts to a low of $197 per capita in Idaho, with the U.S. expenditure level at $337 per person.Spending for physician services in 1978 was $161 per person nationwide. The highest level of spending—$238—was in California, and the lowest—$90—was in Vermont. Florida, with the largest proportion of aged residents in the U.S., registered expenditure levels of $208 per person for physician services. Despite a 29.5 percent increase nationwide in the number of physicians from 1969 to 1978, little change has occurred in the rank of states and regions in their physician-to-population concentrations.Minnesota led the nation in nursing home care expenditures, spending $126 per person for this service in 1978. Minnesota's high per capita spending for nursing home care correlates with its large number of nursing home beds per 65 years of age and over population. In 1978, the 96 beds per 1000 elderly residents which were maintained in Minnesota contrasted sharply with the 56 beds maintained per 1000 elderly residents nationwide.Personal health care expenditures per capita grew an average of 11.6 percent per year between 1966 and 1978. Growth was most dramatic in the Southeast, where expenditures per capita more than quadrupled, growing 12.6 percent per year. Mississippi registered an average annual growth rate of 14.0 percent to lead the region and the nation in rate of increase in per capita personal health care spending growth. The region with the smallest rate of increase in personal health expenditures per capita was the Rocky Mountain Region with an average annual growth of 10.4 percent between 1966 and 1978. Wyoming registered the slowest growth in personal health care expenditures per capita in that region and the nation, with 8.9 percent average annual growth.Expenditures for personal health care in states and regions have grown at different rates. However, when the effects of population and the changing age structure of a geographic area are removed, much of the variation disappears. PMID:10309908

Father involvement moderates the effect of maternal depression during a child's infancy on child behavior problems in kindergarten.

PubMed

Mezulis, Amy H; Hyde, Janet Shibley; Clark, Roseanne

2004-12-01

This research investigated whether father involvement in infancy may reduce or exacerbate the well-established adverse effect of maternal depression during a child's infancy on behavior problems in childhood. In a community sample (N = 350), the authors found that fathers' self-reported parenting styles interacted with the amount of time fathers spent caring for their infants to moderate the longitudinal effect of maternal depression during the child's infancy on children's internalizing, but not externalizing, behaviors. Low to medium amounts of high-warmth father involvement and high amounts of medium- or high-control father involvement at this time were associated with lower child internalizing behaviors. Paternal depression during a child's infancy exacerbated the effect of maternal depression, but this moderating effect was limited to depressed fathers spending medium to high amounts of time caring for their infants. Results emphasize the moderating role fathers may play in reducing or exacerbating the adverse long-term effects of maternal depression during a child's infancy on later child behavior problems. ((c) 2004 APA, all rights reserved).

EPA Requires ASARCO to Cut Toxic Emissions at 103-Year-Old Arizona Copper Smelter

EPA Pesticide Factsheets

U.S. DOJ and EPA announce settlement with ASARCO requiring the company to spend $150 million to install new equipment and pollution control technology to reduce emissions of toxic heavy metals at a large smelter located in Hayden, Ariz.

Who is bearing the financial burden of non-communicable diseases in Mongolia?

PubMed Central

Dugee, Otgontuya; Palam, Enkhtuya; Dorjsuren, Bayarsaikhan; Mahal, Ajay

2018-01-01

Background Non-communicable diseases (NCDs) pose a formidable health and development challenge for low- and middle-income countries (LMICs). However, translating this challenge into resource allocation is seriously constrained by a lack of country specific evidence on NCD financing and its distributional implications. This study estimated expenditures associated with NCDs in Mongolia and their distributions across socioeconomic groups, focusing especially on private out-of-pocket (OOP) spending on the major NCDs. Methods Secondary data analysis of multiple data sources on NCD related health service use and expenditures including detailed administrative data, World Health Organization STEPwise approach to Surveillance (STEPs) survey for Mongolia, and household surveys. Sample-weighted estimates of OOP expenditures for NCDs were constructed using STEPs data. OOP payments per discharge and per outpatient visit were estimated by condition and type of service provider, and survey data on utilization, after adjusting for utilization in administrative records. Results NCDs in Mongolia accounted for more than one-third of total health expenditures in 2013. A significant fraction of this expenditure was borne by households in the form of OOP spending. CVD-related health spending is the major driver of NCD-spending in Mongolia, accounting for about 24.2% of total health expenditure. OOP health payments, largely driven by outpatient diagnostics and drugs, were incurred disproportionately by the better-off, seeking more specialist services and better quality private care. Conclusion A high share of OOP spending for NCDs in Mongolia, which ostensibly enjoys universal health coverage, provides a cautionary tale for LMICs in a similar situation. Improvement in the quality of services at the primary care level and rural health care facilities, where the poor mainly attend, is desirable together with an effective exemption policy for user fees at higher level hospitals. PMID:29564086

Machine-Learning Algorithms to Code Public Health Spending Accounts

PubMed Central

Leider, Jonathon P.; Resnick, Beth A.; Alfonso, Y. Natalia; Bishai, David

2017-01-01

Objectives: Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. Methods: We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Results: Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Conclusions: Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation. PMID:28363034

Machine-Learning Algorithms to Code Public Health Spending Accounts.

PubMed

Brady, Eoghan S; Leider, Jonathon P; Resnick, Beth A; Alfonso, Y Natalia; Bishai, David

Government public health expenditure data sets require time- and labor-intensive manipulation to summarize results that public health policy makers can use. Our objective was to compare the performances of machine-learning algorithms with manual classification of public health expenditures to determine if machines could provide a faster, cheaper alternative to manual classification. We used machine-learning algorithms to replicate the process of manually classifying state public health expenditures, using the standardized public health spending categories from the Foundational Public Health Services model and a large data set from the US Census Bureau. We obtained a data set of 1.9 million individual expenditure items from 2000 to 2013. We collapsed these data into 147 280 summary expenditure records, and we followed a standardized method of manually classifying each expenditure record as public health, maybe public health, or not public health. We then trained 9 machine-learning algorithms to replicate the manual process. We calculated recall, precision, and coverage rates to measure the performance of individual and ensembled algorithms. Compared with manual classification, the machine-learning random forests algorithm produced 84% recall and 91% precision. With algorithm ensembling, we achieved our target criterion of 90% recall by using a consensus ensemble of ≥6 algorithms while still retaining 93% coverage, leaving only 7% of the summary expenditure records unclassified. Machine learning can be a time- and cost-saving tool for estimating public health spending in the United States. It can be used with standardized public health spending categories based on the Foundational Public Health Services model to help parse public health expenditure information from other types of health-related spending, provide data that are more comparable across public health organizations, and evaluate the impact of evidence-based public health resource allocation.

Acute Hospital Care Is The Chief Driver of Regional Spending Variation in Medicare Patients with Advanced Cancer

PubMed Central

Brooks, Gabriel A.; Li, Ling; Uno, Hajime; Hassett, Michael J.; Landon, Bruce E.; Schrag, Deborah

2014-01-01

The root causes of regional variation in medical spending are poorly understood and vary by clinical condition. To identify drivers of regional spending variation for Medicare patients with advanced cancer, we used linked Surveillance, Epidemiology, and End Results (SEER) program–Medicare data from 2004–10. We broke down Medicare spending into thirteen cancer-relevant service categories. We then calculated the contribution of each category to spending and regional spending variation. Acute hospital care was the largest component of spending and the chief driver of regional spending variation, accounting for 48 percent of spending and 67 percent of variation. In contrast, chemotherapy accounted for 16 percent of spending and 10 percent of variation. Hospice care comprised 5 percent of spending; however variation in hospice spending was fully offset by opposing variation in other categories. Our analysis suggests that the strategy with the greatest potential to improve the value of care for patients with advanced cancer is to reduce reliance on acute hospital care for this patient population. PMID:25288424

Changes in Post-acute Care in the Medicare Shared Savings Program

PubMed Central

McWilliams, J. Michael; Gilstrap, Lauren G.; Stevenson, David G.; Chernew, Michael E.; Huskamp, Haiden A.; Grabowski, David C.

2017-01-01

Importance Post-acute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit post-acute spending has implications for the importance and design of other payment models that include post-acute care. Objective To assess changes in post-acute spending and utilization associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred. Design and Setting Using fee-for-service Medicare claims from 2009–2014, we conducted difference-in-difference comparisons of beneficiaries served by ACOs with beneficiaries served by local non-ACO providers (control group) before vs. after entry into the MSSP. We estimated differential changes separately for cohorts of ACOs entering the MSSP in 2012, 2013, and 2014. Participants Random 20% sample of beneficiaries with 25,544,650 patient-years, 8,395,426 hospital admissions, and 1,595,352 SNF stays from 2009–2014. Exposure Patient attribution to an ACO in the MSSP. Main Outcomes and Measures Post-acute spending, discharge to a facility, length of SNF stays, readmissions, use of highly-rated SNFs, and mortality, adjusted for patient characteristics. Results For the 2012 cohort of ACOs, MSSP participation was associated with an overall reduction in post-acute spending (differential change in 2014 for ACOs vs. control group: −$106/beneficiary or −9.0%; P=0.003) that was driven by differential reductions in inpatient utilization, discharges to facilities rather than home (−0.6 percentage points or −2.7%; P=0.03), and length of SNF stays (−0.60 days/stay or −2.2%; P=0.002). Reductions in SNF use and length of stay were due largely to within-hospital or within-SNF changes in care specifically for ACO patients. MSSP participation was associated with smaller significant reductions in SNF spending in 2014 for the 2013 ACO cohort but not in the 2013 or 2014 cohort’s first year of participation. Estimates were similar for ACOs with and without financial ties to hospitals. MSSP participation was not associated with significant changes in 30-day readmissions, use of highly-rated SNFs, or mortality. Conclusion and Relevance Participation in the MSSP has been associated with significant reductions in post-acute spending without ostensible deterioration in quality. Spending reductions were more consistent with clinicians working within hospitals and SNFs to influence care for ACO patients than with hospital-wide initiatives by ACOs or use of preferred SNFs. PMID:28192556

Explaining public support for space exploration funding in America: A multivariate analysis

NASA Astrophysics Data System (ADS)

Nadeau, François

2013-05-01

Recent studies have identified the need to understand what shapes public attitudes toward space policy. I address this gap in the literature by developing a multivariate regression model explaining why many Americans support government spending on space exploration. Using pooled data from the 2006 and 2008 General Social Surveys, the study reveals that spending preferences on space exploration are largely apolitical and associated instead with knowledge and opinions about science. In particular, the odds of wanting to increase funding for space exploration are significantly higher for white, male Babyboomers with a higher socio-economic status, a fondness for organized science, and a post-secondary science education. As such, I argue that public support for NASA's spending epitomizes what Launius termed "Apollo Nostalgia" in American culture. That is, Americans benefitting most from the old social order of the 1960s developed a greater fondness for science that makes them more likely to lament the glory days of space exploration. The article concludes with suggestions for how to elaborate on these findings in future studies.

Targeting global conservation funding to limit immediate biodiversity declines

PubMed Central

Waldron, Anthony; Mooers, Arne O.; Miller, Daniel C.; Nibbelink, Nate; Redding, David; Kuhn, Tyler S.; Roberts, J. Timmons; Gittleman, John L.

2013-01-01

Inadequate funding levels are a major impediment to effective global biodiversity conservation and are likely associated with recent failures to meet United Nations biodiversity targets. Some countries are more severely underfunded than others and therefore represent urgent financial priorities. However, attempts to identify these highly underfunded countries have been hampered for decades by poor and incomplete data on actual spending, coupled with uncertainty and lack of consensus over the relative size of spending gaps. Here, we assemble a global database of annual conservation spending. We then develop a statistical model that explains 86% of variation in conservation expenditures, and use this to identify countries where funding is robustly below expected levels. The 40 most severely underfunded countries contain 32% of all threatened mammalian diversity and include neighbors in some of the world’s most biodiversity-rich areas (Sundaland, Wallacea, and Near Oceania). However, very modest increases in international assistance would achieve a large improvement in the relative adequacy of global conservation finance. Our results could therefore be quickly applied to limit immediate biodiversity losses at relatively little cost. PMID:23818619

Targeting global conservation funding to limit immediate biodiversity declines.

PubMed

Waldron, Anthony; Mooers, Arne O; Miller, Daniel C; Nibbelink, Nate; Redding, David; Kuhn, Tyler S; Roberts, J Timmons; Gittleman, John L

2013-07-16

Inadequate funding levels are a major impediment to effective global biodiversity conservation and are likely associated with recent failures to meet United Nations biodiversity targets. Some countries are more severely underfunded than others and therefore represent urgent financial priorities. However, attempts to identify these highly underfunded countries have been hampered for decades by poor and incomplete data on actual spending, coupled with uncertainty and lack of consensus over the relative size of spending gaps. Here, we assemble a global database of annual conservation spending. We then develop a statistical model that explains 86% of variation in conservation expenditures, and use this to identify countries where funding is robustly below expected levels. The 40 most severely underfunded countries contain 32% of all threatened mammalian diversity and include neighbors in some of the world's most biodiversity-rich areas (Sundaland, Wallacea, and Near Oceania). However, very modest increases in international assistance would achieve a large improvement in the relative adequacy of global conservation finance. Our results could therefore be quickly applied to limit immediate biodiversity losses at relatively little cost.

How registered nurses, licensed practical nurses and resident aides spend time in nursing homes: An observational study.

PubMed

McCloskey, Rose; Donovan, Cindy; Stewart, Connie; Donovan, Alicia

2015-09-01

Calls for improved conditions in nursing homes have pointed to the importance of optimizing the levels and skills of care providers. Understanding the work of care providers will help to determine if staff are being used to their full potential and if opportunities exist for improved efficiencies. To explore the activities of care providers in different nursing homes and to identify if variations exist within and across homes and shifts. A multi-centre cross-sectional observational work flow study was conducted in seven different nursing homes sites in one Canadian province. Data were collected by a research assistant who conducted 368 h of observation. The research assistant collected data by following an identical route in each site and recording observations on staff activities. Findings indicate staff activities vary across roles, sites and shifts. Licensed practical nurses (nursing assistants) have the greatest variation in their role while registered nurses have the least amount of variability. In some sites both registered nurses and licensed practical nurses perform activities that may be safely delegated to others. Care providers spend as much as 53.7% of their time engaged in non-value added activities. There may be opportunities for registered nurses and licensed practical nurses to delegate some of their activities to non-regulated workers. The time care providers spend in non-value activities suggest there may be opportunities to improve efficiencies within the nursing home setting. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Great Recession and Health Spending among Uninsured U.S. Immigrants: Implications for the Affordable Care Act Implementation

PubMed Central

Bustamante, Arturo Vargas; Chen, Jie

2014-01-01

Objective We study the association between the timing of the Great Recession (GR) and health spending among uninsured adults distinguishing by citizenship/nativity status and time of U.S. residence. Data Source Uninsured U.S. citizens and noncitizens from the 2005–2006 and 2008–2009 Medical Expenditure Panel Survey. Study Design The probability of reporting any health spending and the natural logarithm of health spending are our main dependent variables. We compare health spending across population categories before/during the GR. Subsequently, we implement two-part regression analyses of total and specific health-spending measures. We predict average health spending before/during the GR with a smearing estimation. Principal Findings The probability of reporting any spending diminished for recent immigrants compared to citizens during the GR. For those with any spending, recent immigrants reported higher spending during the GR (27 percent). Average reductions in total spending were driven by the decline in the share of the population reporting any spending among citizens and noncitizens. Conclusions Our study findings suggest that recent immigrants could be forgoing essential care, which later translates into higher spending. It portrays the vulnerability of a population that would remain exposed to income shocks, even after the Affordable Care Act (ACA) implementation. PMID:24962550

Heterogeneity in spending change at retirement

PubMed Central

Hurd, Michael D.; Rohwedder, Susann

2014-01-01

The simple one-good model of life-cycle consumption requires that consumption be continuous over retirement; yet prior research based on partial measures of consumption or on synthetic panels indicates that spending drops at retirement, a result that has been called the retirement-consumption puzzle. Using panel data on total spending, nondurable spending and food spending, we find that spending declines at small rates at retirement, rates that could be explained by mechanisms such as the cessation of work-related expenses, unexpected retirement due to a health shock or by the substitution of time for spending. We find substantial heterogeneity in spending change at retirement: in the upper half of the wealth distribution spending increased. In the low-wealth population where spending did decline at higher rates, the main explanation for the decline appears to be early retirement due to poor health, possibly augmented by a short planning horizon by a minority of the population. PMID:24524026

The role, costs and value for money of external consultancies in the health sector: A study of New Zealand's District Health Boards.

PubMed

Penno, Erin; Gauld, Robin

2017-04-01

Public spending on external consultancies, particularly within the health sector, is highly controversial in many countries. Yet, despite the apparently large sums of money involved, there is little international analysis surrounding the scope of activities of consultants, meaning there is little understanding of how much is spent, for what purpose and with what result. This paper examines spending on external consultancies in each of New Zealand's 20 District Health Boards (DHB). Using evidence obtained from DHBs, it provides an insight into the cost and activities of consultants within the New Zealand health sector, the policies behind their engagement and the processes in place to ensure value for money. It finds that DHB spending on external consultants is substantial, at $NZ10-60 million annually. However, few DHBs had policies governing when consultants should be engaged and many were unable to easily identify the extent or purpose of consultancies within their organisation, making it difficult to derive an accurate picture of consultant activity throughout the DHB sector. Policies surrounding value for money were uncommon and, where present, were rarely applied. Given the large sums being spent by New Zealand's DHBs, and assuming expenditure is similar in other health systems, our findings point to the need for greater accountability for expenditure and better evidence of value for money of consultancies within publicly funded health systems. Copyright © 2017 Elsevier B.V. All rights reserved.

TRIGA Mark II nuclear reactor facility. Final report, 1 July 1980--30 June 1995

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

Ryan, B.C.

1997-05-01

This report is a final culmination of activities funded through the Department of Energy`s (DOE) University Reactor Sharing Program, Grant DE-FG02-80ER10273, during the period 1 July 1980 through 30 June 1995. Progress reports have been periodically issued to the DOE, namely the Reactor Facility Annual Reports C00-2082/2219-7 through C00-2082/10723-21, which are contained as an appendix to this report. Due to the extent of time covered by this grant, summary tables are presented. Table 1 lists the fiscal year financial obligations of the grant. As listed in the original grant proposals, the DOE grant financed 70% of project costs, namely themore » total amount spent of these projects minus materials costs and technical support. Thus the bulk of funds was spent directly on reactor operations. With the exception of a few years, spending was in excess of the grant amount. As shown in Tables 2 and 3, the Reactor Sharing grant funded a immense number of research projects in nuclear engineering, geology, animal science, chemistry, anthropology, veterinary medicine, and many other fields. A list of these users is provided. Out of the average 3000 visitors per year, some groups participated in classes involving the reactor such as Boy Scout Merit Badge classes, teacher`s workshops, and summer internships. A large number of these projects met the requirements for the Reactor Sharing grant, but were funded by the University instead.« less

Implementation of a national near-road NO2 monitoring network--conference

EPA Science Inventory

In recent years, a large number of health studies have identified increased risks of adverse health effects for populations spending significant time near major roads. These studies indicate that populations living, working or going to school near major roads may be subjected to ...

Hazy Outlook, Time to Regroup.

ERIC Educational Resources Information Center

Florio, David H.

1980-01-01

Legislative concerns for years to come will include: (1) limitations of uncontrolled spending which could affect educational programs; (2) a possible curtailment of cost-effective research and training programs; and (3) the possibility of replacing some of the large federally supported educational programs with tax credits or vouchers. (JN)

Why Colleges Can't Shake the Feds

ERIC Educational Resources Information Center

Fain, Paul

2008-01-01

This article reports that Congress is cranky about how colleges spend money. Over the last three years, regulation-minded lawmakers have investigated university endowments, intercollegiate athletics, and presidential pay, but that grilling has largely ceased. A presidential election has dulled legislative ambitions, and Congress has its hands full…

The financial burden of out-of-pocket expenses in the United States and Canada: How different is the United States?

PubMed Central

Baird, Katherine E

2016-01-01

Background: This article compares the burden that medical cost-sharing requirements place on households in the United States and Canada. It estimates the probability that individuals with similar demographic features in the two countries have large medical expenses relative to income. Method: The study uses 2010 nationally representative household survey data harmonized for cross-national comparisons to identify individuals with high medical expenses relative to income. Using logistic regression, it estimates the probability of high expenses occurring among 10 different demographic groups in the two countries. Results: The results show the risk of large medical expenses in the United States is 1.5–4 times higher than it is in Canada, depending on the demographic group and spending threshold used. The United States compares least favorably when evaluating poorer citizens and when using a higher spending threshold. Conclusion: Recent health care reforms can be expected to reduce Americans’ catastrophic health expenses, but it will take very large reductions in out-of-pocket expenditures—larger than can be expected—if poorer and middle-class families are to have the financial protection from high health care costs that their counterparts in Canada have. PMID:26985389

Role of Grooming in Reducing Tick Load in Wild Baboons (Papio cynocephalus)

PubMed Central

Akinyi, Mercy Y.; Tung, Jenny; Jeneby, Maamun; Patel, Nilesh B.; Altmann, Jeanne; Alberts, Susan C.

2013-01-01

Nonhuman primate species spend a conspicuous amount of time grooming during social interactions, a behavior that probably serves both social and health-related functions. While the social implications of grooming have been relatively well studied, less attention has been paid to the health benefits, especially the removal of ectoparasites, which may act as vectors in disease transmission. In this study, we examined the relationship between grooming behavior, tick load (number of ticks), and haemoprotozoan infection status in a population of wild free-ranging baboons (Papio cynocephalus). We found that the amount of grooming received was influenced by an individual’s age, sex and dominance rank. The amount of grooming received, in turn, affected the tick load of an individual. Baboons with higher tick loads had lower packed red cell volume (PCV or haematocrit), one general measure of health status. We detected a tick-borne haemoprotozoan, Babesia microti, but its low prevalence in the population precluded identifying sources of variance in infection. PMID:24659824