[Comparison of the factors influencing young adolescents' aggression according to family structure].

PubMed

Yun, Eun Kyoung; Shin, Sung Hee

2013-06-01

This cross-sectional study was done to compare factors influencing young adolescents' aggression according to family structure. Participants were 680 young adolescents aged 11 to 15 years (113 in single father families, 136 in single mother families, 49 in grandparent families, and 382 in both-parent families). All measures were self-administered. Data were analyzed using SPSS 18.0 program and factors affecting young adolescents' aggression were analyzed by stepwise multiple regression. Levels of young adolescents' aggression and all variables were significantly different among the four family structure groups. Factors influencing young adolescents' aggression were also different according to these 4 groups. For single father families, depression-anxiety and family hardiness significantly predicted the level of young adolescents' aggression (adjusted R square=.37, p<.001). For single mother families, depression-anxiety, gender, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For grandparent families, depression-anxiety and family support significantly predicted the level of young adolescents' aggression (adjusted R square=.58, p<.001). For both-parent families, depression-anxiety, family hardiness, and friends' support significantly predicted the level of young adolescents' aggression (adjusted R square=.48, p<.001). Nurses working with young adolescents should consider family structure-specific factors influencing aggression in this population.

Strategic Defense Initiative Organization adaptive structures program overview

NASA Astrophysics Data System (ADS)

Obal, Michael; Sater, Janet M.

In the currently envisioned architecture none of the Strategic Defense System (SDS) elements to be deployed will receive scheduled maintenance. Assessments of performance capability due to changes caused by the uncertain effects of environments will be difficult, at best. In addition, the system will have limited ability to adjust in order to maintain its required performance levels. The Materials and Structures Office of the Strategic Defense Initiative Organization (SDIO) has begun to address solutions to these potential difficulties via an adaptive structures technology program that combines health and environment monitoring with static and dynamic structural control. Conceivable system benefits include improved target tracking and hit-to-kill performance, on-orbit system health monitoring and reporting, and threat attack warning and assessment.

Functional design specification: NASA form 1510

NASA Technical Reports Server (NTRS)

1979-01-01

The 1510 worksheet used to calculate approved facility project cost estimates is explained. Topics covered include data base considerations, program structure, relationship of the 1510 form to the 1509 form, and functions which the application must perform: WHATIF, TENENTER, TENTYPE, and data base utilities. A sample NASA form 1510 printout and a 1510 data dictionary are presented in the appendices along with the cost adjustment table, the floppy disk index, and methods for generating the calculated values (TENCALC) and for calculating cost adjustment (CONSTADJ). Storage requirements are given.

[Development of methods and instruments for external quality assurance in inpatient parent-child rehabilitation and prevention].

PubMed

Neuderth, S; Lukasczik, M; Musekamp, G; Gerlich, C; Saupe-Heide, M; Löbmann, R; Vogel, H

2013-02-01

There so far is no standardized program for external quality assurance in inpatient parent-child prevention and rehabilitation in Germany. Therefore, instruments and methods of external quality assurance were developed and evaluated on behalf of the federal-level health insurance institutions. On the level of structure quality, a modular questionnaire for assessing structural features of rehabilitation/prevention centers, basic and allocation criteria as well as a checklist for visitations were developed. Structural data were collected in a nationwide survey of parent-child prevention and rehabilitation centers. Process and outcome quality data were collected in n=38 centers. Process quality was assessed using multiple methods (process-related structural features, case-related routine documentation, and incident-related patient questionnaires). Outcome quality was measured via patient questionnaires (n=1 799 patients). We used a multi-level modelling approach by adjusting relevant confounders on institutional and patient levels. The methods, instruments and analyzing procedures developed for measuring quality on the level of structure, processes and outcomes were adjusted in cooperation with all relevant stakeholders. Results are exemplarily presented for all quality assurance tools. For most of the risk-adjusted outcome parameters, we found no significant differences between institutions. For the first time, a comprehensive, standardized and generally applicable set of methods and instruments for routine use in comparative quality measurement of inpatient parent-child prevention and rehabilitation is available. However, it should be considered that the very heterogeneous field of family-oriented measures can not be covered entirely by an external quality assurance program. Therefore, methods and instruments have to be adapted continuously to the specifics of this area of health care and to new developments. © Georg Thieme Verlag KG Stuttgart · New York.

The Experience of Risk-Adjusted Capitation Payment for Family Physicians in Iran: A Qualitative Study.

PubMed

Esmaeili, Reza; Hadian, Mohammad; Rashidian, Arash; Shariati, Mohammad; Ghaderi, Hossien

2016-04-01

When a country's health system is faced with fundamental flaws that require the redesign of financing and service delivery, primary healthcare payment systems are often reformed. This study was conducted with the purpose of exploring the experiences of risk-adjusted capitation payment of urban family physicians in Iran when it comes to providing primary health care (PHC). This is a qualitative study using the framework method. Data were collected via digitally audio-recorded semi-structured interviews with 24 family physicians and 5 executive directors in two provinces of Iran running the urban family physician pilot program. The participants were selected using purposive and snowball sampling. The codes were extracted using inductive and deductive methods. Regarding the effects of risk-adjusted capitation on the primary healthcare setting, five themes with 11 subthemes emerged, including service delivery, institutional structure, financing, people's behavior, and the challenges ahead. Our findings indicated that the health system is enjoying some major changes in the primary healthcare setting through the implementation of risk-adjusted capitation payment. With regard to the current challenges in Iran's health system, using risk-adjusted capitation as a primary healthcare payment system can lead to useful changes in the health system's features. However, future research should focus on the development of the risk-adjusted capitation model.

20 CFR 664.460 - What are work experiences for youth?

Code of Federal Regulations, 2010 CFR

2010-04-01

....460 What are work experiences for youth? (a) Work experiences are planned, structured learning... adjustment, and other transition activities; (7) Entrepreneurship; (8) Service learning; (9) Paid and unpaid... age 18. Local program operators may choose, however, to use this service strategy for eligible youth...

20 CFR 664.460 - What are work experiences for youth?

Code of Federal Regulations, 2011 CFR

2011-04-01

....460 What are work experiences for youth? (a) Work experiences are planned, structured learning... adjustment, and other transition activities; (7) Entrepreneurship; (8) Service learning; (9) Paid and unpaid... age 18. Local program operators may choose, however, to use this service strategy for eligible youth...

The impact of structural adjustment policies on women's and children's health in Tanzania.

PubMed

Lugalla, J L

1995-03-01

Since 1981, the government of Tanzania has adopted a variety of policy measures including the National Economic Survival Plan (NESP), Structural Adjustment Program (SAP), Economic Recovery Program (ERP) I, ERP II, Economic and Social Action Plan (ESAP), and Priority Social Action Plan (PSAP) to deal with the country's present social and economic crisis dating back to the late 1970s. The main objective of the these adjustment measures has been to attain macroeconomic balance by bringing national expenditure into line with national income to reduce inflation and to increase exports. Other objectives have been to maintain egalitarian income distribution and the provision of basic social services to the majority of the population. To realize these objectives, the government has been controlling credit and removed subsidies on certain food items and agricultural inputs, introduced a system of progressive devaluation, liberalized trade, and has been trying to reduce government expenditure by introducing cost sharing measures in the education and health sector. The author concludes that the erosion of real incomes and increased poverty have had a devastating effect upon women and children. Rural women have heavier workloads as males migrate to urban areas in search of work, there is increased maternal mortality, and chronic malnutrition and poverty make it difficult to implement HIV/AIDS intervention strategies.

Locating Environmental Education between Modern Capitalism and Postmodern Socialism: A Reply to Lucie Sauve.

ERIC Educational Resources Information Center

Huckle, John

1999-01-01

Claims that structural-adjustment programs, deregulation, and opening of markets may be good for international capital, but such processes increase inequalities, encourage people and countries to over-exploit natural resources, and contribute to reductions in spending on social and environmental welfare. (Author/CCM)

45 CFR 800.204 - Reinsurance, risk corridors, and risk adjustment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 3 2013-10-01 2013-10-01 false Reinsurance, risk corridors, and risk adjustment... Adjustment § 800.204 Reinsurance, risk corridors, and risk adjustment. (a) Transitional reinsurance program... transitional reinsurance program for the individual market. (b) Temporary risk corridors program. An MSPP...

45 CFR 800.204 - Reinsurance, risk corridors, and risk adjustment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Reinsurance, risk corridors, and risk adjustment... Adjustment § 800.204 Reinsurance, risk corridors, and risk adjustment. (a) Transitional reinsurance program... transitional reinsurance program for the individual market. (b) Temporary risk corridors program. An MSPP...

Profiles of dyadic adjustment for advanced prostate cancer to inform couple-based intervention.

PubMed

Elliott, Kate-Ellen J; Scott, Jennifer L; Monsour, Michael; Nuwayhid, Fadi

2015-01-01

The purpose of the study is to describe from a relational perspective, partners' psychological adjustment, coping and support needs for advanced prostate cancer. A mixed methods design was adopted, employing triangulation of qualitative and quantitative data, to produce dyadic profiles of adjustment for six couples recruited from the urology clinics of local hospitals in Tasmania, Australia. Dyads completed a video-taped communication task, semi-structured interview and standardised self-report questionnaires. Themes identified were associated with the dyadic challenges of the disease experience (e.g. relationship intimacy, disease progression and carer burden). Couples with poor psychological adjustment profiles had both clinical and global locus of distress, treatment side-effects, carer burden and poor general health. Resilient couples demonstrated relationship closeness and adaptive cognitive and behavioural coping strategies. The themes informed the adaption of an effective program for couples coping with women's cancers (CanCOPE, to create a program for couples facing advanced prostate cancer (ProCOPE-Adv). Mixed method results inform the development of psychological therapy components for couples coping with advanced prostate cancer. The concomitance of co-morbid health problems may have implications for access and engagement for older adult populations in face-to-face intervention.

45 CFR 153.365 - General oversight requirements for State-operated risk adjustment programs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... risk adjustment programs. 153.365 Section 153.365 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS STANDARDS RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT State Standards Related to the Risk Adjustment Program...

Impact of International Monetary Fund programs on child health

PubMed Central

Nosrati, Elias; Reinsberg, Bernhard; Kentikelenis, Alexander E.; Stubbs, Thomas H.; King, Lawrence P.

2017-01-01

Parental education is located at the center of global efforts to improve child health. In a developing-country context, the International Monetary Fund (IMF) plays a crucial role in determining how governments allocate scarce resources to education and public health interventions. Under reforms mandated by IMF structural adjustment programs, it may become harder for parents to reap the benefits of their education due to wage contraction, welfare retrenchment, and generalized social insecurity. This study assesses how the protective effect of education changes under IMF programs, and thus how parents’ ability to guard their children’s health is affected by structural adjustment. We combine cross-sectional stratified data (countries, 67; children, 1,941,734) from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys. The sample represents ∼2.8 billion (about 50%) of the world’s population in year 2000. Based on multilevel models, our findings reveal that programs reduce the protective effect of parental education on child health, especially in rural areas. For instance, in the absence of IMF programs, living in an household with educated parents reduces the odds of child malnourishment by 38% [odds ratio (OR), 0.62; 95% CI, 0.66–0.58]; in the presence of programs, this drops to 21% (OR, 0.79; 95% CI, 0.86–0.74). In other words, the presence of IMF conditionality decreases the protective effect of parents’ education on child malnourishment by no less than 17%. We observe similar adverse effects in sanitation, shelter, and health care access (including immunization), but a beneficial effect in countering water deprivation. PMID:28507158

Impact of International Monetary Fund programs on child health.

PubMed

Daoud, Adel; Nosrati, Elias; Reinsberg, Bernhard; Kentikelenis, Alexander E; Stubbs, Thomas H; King, Lawrence P

2017-06-20

Parental education is located at the center of global efforts to improve child health. In a developing-country context, the International Monetary Fund (IMF) plays a crucial role in determining how governments allocate scarce resources to education and public health interventions. Under reforms mandated by IMF structural adjustment programs, it may become harder for parents to reap the benefits of their education due to wage contraction, welfare retrenchment, and generalized social insecurity. This study assesses how the protective effect of education changes under IMF programs, and thus how parents' ability to guard their children's health is affected by structural adjustment. We combine cross-sectional stratified data (countries, 67; children, 1,941,734) from the Demographic and Health Surveys and the Multiple Indicator Cluster Surveys. The sample represents ∼2.8 billion (about 50%) of the world's population in year 2000. Based on multilevel models, our findings reveal that programs reduce the protective effect of parental education on child health, especially in rural areas. For instance, in the absence of IMF programs, living in an household with educated parents reduces the odds of child malnourishment by 38% [odds ratio (OR), 0.62; 95% CI, 0.66-0.58]; in the presence of programs, this drops to 21% (OR, 0.79; 95% CI, 0.86-0.74). In other words, the presence of IMF conditionality decreases the protective effect of parents' education on child malnourishment by no less than 17%. We observe similar adverse effects in sanitation, shelter, and health care access (including immunization), but a beneficial effect in countering water deprivation.

Exploring Post-Program Psychological Adjustment for Adult Staff Facilitating a Wilderness Adventure Program

ERIC Educational Resources Information Center

Lawrence-Wood, Ellie; Raymond, Ivan

2011-01-01

This paper outlines a pilot study of the post-program psychological adjustment outcomes of adult staff facilitating an Australian-based wilderness adventure program for youth at risk. The descriptive and correlational survey study (N = 62) examined the psychological adjustment processes staff underwent following program completion, and the factors…

Highlights from the First World Congress of Education International.

ERIC Educational Resources Information Center

Education International, Brussels (Belgium).

The papers in this volume reflect the general theme of the congress, "Educators United, Ready for Change." A theme that emerged during the conference concerned the need to fight structural adjustment programs, imposed by the World Bank or the International Monetary Fund, which were destroying the educational and social infrastructure of…

Economic Liberalization and Women's Education: Prospects for Post-Apartheid South Africa.

ERIC Educational Resources Information Center

Abdi, Ali A.

1998-01-01

Examines women's education and related issues in South Africa in light of restrictions on educational spending imposed by Structural Adjustment Programs stipulated by the World Bank and International Monetary Fund. Argues that the contraction of educational resources will have a strong negative effect on women's education, particularly for black…

Rescore protein-protein docked ensembles with an interface contact statistics.

PubMed

Mezei, Mihaly

2017-02-01

The recently developed statistical measure for the type of residue-residue contact at protein complex interfaces, based on a parameter-free definition of contact, has been used to define a contact score that is correlated with the likelihood of correctness of a proposed complex structure. Comparing the proposed contact scores on the native structure and on a set of model structures the proposed measure was shown to generally favor the native structure but in itself was not able to reliably score the native structure to be the best. Adjusting the scores of redocking experiments with the contact score showed that the adjusted score was able to move up the ranking of the native-like structure among the proposed complexes when the native-like was not ranked the best by the respective program. Tests on docking of unbound proteins compared the contact scores of the complexes with the contact score of the crystal structure again showing the tendency of the contact score to favor native-like conformations. The possibility of using the contact score to improve the determination of biological dimers in a crystal structure was also explored. Proteins 2017; 85:235-241. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Computerisation of general practice in the Republic of Croatia: experience gained in general practice use.

PubMed

Bergman-Marković, Biserka; Katić, Milica; Kern, Josipa

2007-01-01

Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.

Two-Component Structure of the Radio Source 0014+813 from VLBI Observations within the CONT14 Program

NASA Astrophysics Data System (ADS)

Titov, O. A.; Lopez, Yu. R.

2018-03-01

We consider a method of reconstructing the structure delay of extended radio sources without constructing their radio images. The residuals derived after the adjustment of geodetic VLBI observations are used for this purpose. We show that the simplest model of a radio source consisting of two point components can be represented by four parameters (the angular separation of the components, the mutual orientation relative to the poleward direction, the flux-density ratio, and the spectral index difference) that are determined for each baseline of a multi-baseline VLBI network. The efficiency of this approach is demonstrated by estimating the coordinates of the radio source 0014+813 observed during the two-week CONT14 program organized by the International VLBI Service (IVS) in May 2014. Large systematic deviations have been detected in the residuals of the observations for the radio source 0014+813. The averaged characteristics of the radio structure of 0014+813 at a frequency of 8.4 GHz can be calculated from these deviations. Our modeling using four parameters has confirmed that the source consists of two components at an angular separation of 0.5 mas in the north-south direction. Using the structure delay when adjusting the CONT14 observations leads to a correction of the average declination estimate for the radio source 0014+813 by 0.070 mas.

25 CFR 170.220 - What is the Population Adjustment Factor?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What is the Population Adjustment Factor? 170.220 Section... ROADS PROGRAM Indian Reservation Roads Program Funding Population Adjustment Factor § 170.220 What is the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the...

25 CFR 170.220 - What is the Population Adjustment Factor?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false What is the Population Adjustment Factor? 170.220 Section... ROADS PROGRAM Indian Reservation Roads Program Funding Population Adjustment Factor § 170.220 What is the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the...

25 CFR 170.220 - What is the Population Adjustment Factor?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is the Population Adjustment Factor? 170.220 Section... ROADS PROGRAM Indian Reservation Roads Program Funding Population Adjustment Factor § 170.220 What is the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the...

25 CFR 170.220 - What is the Population Adjustment Factor?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false What is the Population Adjustment Factor? 170.220 Section... ROADS PROGRAM Indian Reservation Roads Program Funding Population Adjustment Factor § 170.220 What is the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the...

25 CFR 170.220 - What is the Population Adjustment Factor?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true What is the Population Adjustment Factor? 170.220 Section... ROADS PROGRAM Indian Reservation Roads Program Funding Population Adjustment Factor § 170.220 What is the Population Adjustment Factor? The Population Adjustment Factor (PAF) is a special portion of the...

Psychological health of military children: Longitudinal evaluation of a family-centered prevention program to enhance family resilience

PubMed Central

Lester, Patricia; Stein, Judith A.; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W.; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2014-01-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include: 1) Understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level, and 2) Determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with de-identified service delivery data from 280 families (505 children ages 3-17) in two follow-up assessments. Standardized measures included Service Member and Civilian parental distress (Brief Symptom Inventory, PTSD Checklist – Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families, and suggest areas for future research. PMID:23929043

Adjusting to the Growing Impact of Latinos on Indiana Public Schools

ERIC Educational Resources Information Center

Strietelmeier, Curtiss A.

2010-01-01

Over the last 15 years, the Latino population has expanded at a rapid pace in the United States. This national trend has been mirrored in Indiana. As a result, school districts within the state have developed structures and supports for the growing number of Latino students arriving in their schools. This study highlights some programs developed…

Education and Development: The Issues and the Evidence. Education Research. Serial No. 6.

ERIC Educational Resources Information Center

Lewin, Keith M.

This literature review is divided into two main sections. The first part identifies key dimensions of the policy debate that will condition future patterns of investment in education. The themes chosen are the impact of recession, the effects of debt and structural adjustment programs on the resources available for education; the implications of…

Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

PubMed Central

Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

2004-01-01

This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

Medicaid Managed Care Structures and Care Coordination.

PubMed

Gilchrist-Scott, Douglas H; Feinstein, James A; Agrawal, Rishi

2017-09-01

Child enrollment in Medicaid managed care (MMC) has expanded dramatically, primarily through state mandates. Care coordination is a key metric in MMC evaluation because it drives much of the proposed cost savings and may be associated with improved health outcomes and utilization. We evaluated the relationships between enrollment in 2 MMC structures, primary care case management (PCCM) and health maintenance organization (HMO) and access to and receipt of care coordination by children. Using data from the 2011/2012 National Survey of Children's Health and the Medicaid Statistical Information System state data mart, we conducted a retrospective, cross-sectional analysis of the relationships between fee-for-service, PCCM or HMO enrollment, and access to and receipt of care coordination. State-level univariate analyses and individual and state multilevel multivariable analyses evaluated correlations between MMC enrollment and care coordination, controlling for demographic characteristics and state financing levels. In univariate and multilevel multivariable analyses, the PCCM penetration rate was significantly associated with increased access to care coordination (adjusted odds ratio: 1.23, P = .034) and receipt of care coordination (adjusted odds ratio: 1.37, P = .02). The HMO penetration rate was significantly associated with lower access to care coordination (adjusted odds ratio: 0.85, P = .05) and receipt of care coordination (adjusted odds ratio: 0.71, P < .001). Fee-for-service served as the referent. State utilization of MMC varied widely. These data suggest that care coordination may be more effective in PCCM than HMO structures. States should consider care coordination outcomes when structuring their Medicaid programs. Copyright © 2017 by the American Academy of Pediatrics.

7 CFR 4279.279 - Domestic lamb industry adjustment assistance program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Domestic lamb industry adjustment assistance program. 4279.279 Section 4279.279 Agriculture Regulations of the Department of Agriculture (Continued) RURAL... Biorefinery Assistance Loans § 4279.279 Domestic lamb industry adjustment assistance program. The provisions...

7 CFR 4279.279 - Domestic lamb industry adjustment assistance program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Domestic lamb industry adjustment assistance program. 4279.279 Section 4279.279 Agriculture Regulations of the Department of Agriculture (Continued) RURAL... Biorefinery Assistance Loans § 4279.279 Domestic lamb industry adjustment assistance program. The provisions...

7 CFR 4279.279 - Domestic lamb industry adjustment assistance program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Domestic lamb industry adjustment assistance program. 4279.279 Section 4279.279 Agriculture Regulations of the Department of Agriculture (Continued) RURAL... Biorefinery Assistance Loans § 4279.279 Domestic lamb industry adjustment assistance program. The provisions...

Solving Component Structural Dynamic Failures Due to Extremely High Frequency Structural Response on the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Frady, Greg; Nesman, Thomas; Zoladz, Thomas; Szabo, Roland

2010-01-01

For many years, the capabilities to determine the root-cause failure of component failures have been limited to the analytical tools and the state of the art data acquisition systems. With this limited capability, many anomalies have been resolved by adding material to the design to increase robustness without the ability to determine if the design solution was satisfactory until after a series of expensive test programs were complete. The risk of failure and multiple design, test, and redesign cycles were high. During the Space Shuttle Program, many crack investigations in high energy density turbomachines, like the SSME turbopumps and high energy flows in the main propulsion system, have led to the discovery of numerous root-cause failures and anomalies due to the coexistences of acoustic forcing functions, structural natural modes, and a high energy excitation, such as an edge tone or shedding flow, leading the technical community to understand many of the primary contributors to extremely high frequency high cycle fatique fluid-structure interaction anomalies. These contributors have been identified using advanced analysis tools and verified using component and system tests during component ground tests, systems tests, and flight. The structural dynamics and fluid dynamics communities have developed a special sensitivity to the fluid-structure interaction problems and have been able to adjust and solve these problems in a time effective manner to meet budget and schedule deadlines of operational vehicle programs, such as the Space Shuttle Program over the years.

The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

PubMed

Englesbe, Michael J; Grenda, Dane R; Sullivan, June A; Derstine, Brian A; Kenney, Brooke N; Sheetz, Kyle H; Palazzolo, William C; Wang, Nicholas C; Goulson, Rebecca L; Lee, Jay S; Wang, Stewart C

2017-06-01

The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015. Propensity score matching was used to match program participants to a control group who underwent operative care prior to program implementation. Primary outcome measures were hospital duration of stay and payer costs. Multivariate regression was used to determine the covariate-adjusted effect of program participation. A total of 641 patients participated in the program; 82% were actively engaged in the program, recording physical activity at least 3 times per week for the majority of the program; 182 patients were propensity matched to patients who underwent operative care prior to program implementation. Multivariate analysis demonstrated that participation in the Michigan Surgical Home and Optimization Program was associated with a 31% reduction in hospital duration of stay (P < .001) and 28% lower total costs (P < .001) after adjusting for covariates. A home-based, preoperative training program decreased hospital duration of stay, lowered costs of care, and was well accepted by patients. Further efforts will focus on broader implementation and linking participation to postoperative complications and rigorous patient-reported outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

24 CFR 880.609 - Adjustment of contract rents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.609 Adjustment of contract rents. (a) Automatic annual adjustment of Contract Rents. Upon...

24 CFR 880.609 - Adjustment of contract rents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.609 Adjustment of contract rents. (a) Automatic annual adjustment of Contract Rents. Upon...

24 CFR 880.609 - Adjustment of contract rents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.609 Adjustment of contract rents. (a) Automatic annual adjustment of Contract Rents. Upon...

24 CFR 880.609 - Adjustment of contract rents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.609 Adjustment of contract rents. (a) Automatic annual adjustment of Contract Rents. Upon...

24 CFR 880.609 - Adjustment of contract rents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.609 Adjustment of contract rents. (a) Automatic annual adjustment of Contract Rents. Upon...

An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study.

PubMed

Silva, Daniel Dutra Romualdo; Bosco, Adriana Aparecida

2015-01-01

Self-monitoring of blood glucose (SMBG) has been recommended as a useful tool for improving glycemic control, but is still an underutilized strategy and most diabetic patients are not aware of the actions that must be taken in response to its results and do not adjust their treatment. The purpose of this study was to evaluate the effectiveness and safety of an educational program for insulin self-adjustment based on SMBG in poorly controlled patients with type 2 diabetes (T2DM). A prospective, randomized, controlled 12-week intervention study was conducted on poorly controlled insulin-requiring patients with T2DM. Twenty-three subjects were randomized to two educational programs: a 2-week basic program with guidance about SMBG and types and techniques of insulin administration (group A, n = 12) and a 6-week program including the basic one and additional instructions about self-titration of insulin doses according to a specific protocol (group B, n = 11). Patients were reviewed after 12 weeks and baseline to endpoint changes in glycated hemoglobin (A1C), insulin doses, body weight and incidence of hypoglycemia were compared by paired and independent Student t-tests. After 12 weeks, there was a significant reduction in A1C only in group B, but group comparison showed no significant difference (p = 0.051). A higher percentage of subjects in group B achieved an A1C near the treatment target (<7.5%) than in group A. Daily insulin dose increased non-significantly in the two groups and there was no significant difference in the incidence of hypoglycemia or body weight changes between groups. Training for self-titrating insulin doses combined with structured SMBG can safely improve glycemic control in poorly controlled insulin-treated T2DM patients. This strategy may facilitate effective insulin therapy in routine medical practice, compensating for any reluctance on the part of physicians to optimize insulin therapy and thus to improve the achievement of recommended targets of diabetes care.

76 FR 71559 - Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9494-6] Acid Rain Program: Notice of Annual Adjustment... annual adjustment factors for excess emissions penalty. SUMMARY: The Acid Rain Program under title IV of... emissions for sources that do not meet their annual Acid Rain emissions limitations. This notice states the...

78 FR 64496 - Acid Rain Program: Notice of Annual Adjustment Factors for Excess Emissions Penalty

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9902-14-OAR] Acid Rain Program: Notice of Annual Adjustment... annual adjustment factors for excess emissions penalty. SUMMARY: The Acid Rain Program under title IV of... emissions for sources that do not meet their annual Acid Rain emissions limitations. This notice states the...

13 CFR 313.3 - Overview of Community Trade Adjustment Assistance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Overview of Community Trade..., DEPARTMENT OF COMMERCE COMMUNITY TRADE ADJUSTMENT ASSISTANCE Participation in the Community Trade Adjustment Assistance Program § 313.3 Overview of Community Trade Adjustment Assistance. The Community TAA Program is...

13 CFR 313.3 - Overview of Community Trade Adjustment Assistance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Overview of Community Trade..., DEPARTMENT OF COMMERCE COMMUNITY TRADE ADJUSTMENT ASSISTANCE Participation in the Community Trade Adjustment Assistance Program § 313.3 Overview of Community Trade Adjustment Assistance. The Community TAA Program is...

Generalized adjustment by least squares ( GALS).

USGS Publications Warehouse

Elassal, A.A.

1983-01-01

The least-squares principle is universally accepted as the basis for adjustment procedures in the allied fields of geodesy, photogrammetry and surveying. A prototype software package for Generalized Adjustment by Least Squares (GALS) is described. The package is designed to perform all least-squares-related functions in a typical adjustment program. GALS is capable of supporting development of adjustment programs of any size or degree of complexity. -Author

Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

PubMed

Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

2013-08-01

Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

Optimization of carbon mitigation paths in the power sector of Shenzhen, China

NASA Astrophysics Data System (ADS)

Li, Xin; Hu, Guangxiao; Duan, Ying; Ji, Junping

2017-08-01

This paper studied the carbon mitigation paths of the power sector in Shenzhen, China from a supply-side perspective. We investigated the carbon mitigation potentials and investments of seventeen mitigation technologies in the power sector, and employed a linear programming method to optimize the mitigation paths. The results show that: 1) The total carbon mitigation potential is 5.95 MtCO2 in 2020 in which the adjustment of power supply structure, technical improvements of existing coal- and gas-fired power plant account for 87.5%,6.5% and 6.0%, respectively. 2) In the optimal path, the avoided carbon dioxide to meet the local government’s mitigation goal in power sector is 1.26 MtCO2.The adjustment of power supply structure and technical improvement of the coal-fired power plants are the driving factors of carbon mitigation, with contributions to total carbon mitigation are 72.6% and 27.4%, respectively.

Study on Web-Based Tool for Regional Agriculture Industry Structure Optimization Using Ajax

NASA Astrophysics Data System (ADS)

Huang, Xiaodong; Zhu, Yeping

According to the research status of regional agriculture industry structure adjustment information system and the current development of information technology, this paper takes web-based regional agriculture industry structure optimization tool as research target. This paper introduces Ajax technology and related application frameworks to build an auxiliary toolkit of decision support system for agricultural policy maker and economy researcher. The toolkit includes a “one page” style component of regional agriculture industry structure optimization which provides agile arguments setting method that enables applying sensitivity analysis and usage of data and comparative advantage analysis result, and a component that can solve the linear programming model and its dual problem by simplex method.

Smoke Alarm Giveaway and Installation Programs

PubMed Central

Liu, Ying; Mack, Karin A.; Diekman, Shane T.

2015-01-01

Background The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. Purpose To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Methods Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Results Cost-effectiveness analysis (CEA) resulted in anaverage cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost–benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit–cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Conclusions Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventionsto reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. PMID:22992356

Eastern Europe: Status of U.S. Assistance Efforts

DTIC Science & Technology

1991-02-26

110 United States e= General Accounting OfficeWashington, D.C. 20548 Accesion For National Security and NTIS CRA&M International Affairs Division DTIC...the international donor community or the East European governments, (2) Hungarian government officials have not clearly identified the type and...through the International Red Cross and $250,000 for medical supplies. The five principal SEED program elements were: " Structural adjustment assistance

Synchronous Control Method and Realization of Automated Pharmacy Elevator

NASA Astrophysics Data System (ADS)

Liu, Xiang-Quan

Firstly, the control method of elevator's synchronous motion is provided, the synchronous control structure of double servo motor based on PMAC is accomplished. Secondly, synchronous control program of elevator is implemented by using PMAC linear interpolation motion model and position error compensation method. Finally, the PID parameters of servo motor were adjusted. The experiment proves the control method has high stability and reliability.

Reducing readmissions to detoxification: an interorganizational network perspective.

PubMed

Spear, Suzanne E

2014-04-01

The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance use disorder treatment systems. This study examined the extent to which the structure of local networks available to detox programs affects patients' odds of readmission to detox within 1 year. Administrative data from 32 counties in California in 2008-2009 were used to map network ties between programs based on patient transfers. Social network analysis was employed to measure structural features of detox program networks. Contextual predictors included efficiency (proportion of ties within a network that are non-redundant) and out-degree (number of outgoing ties to other programs). A binary mixed model was used to predict the odds of readmission among detox patients in residential (non-hospital) facilities (N=18,278). After adjusting for patient-level covariates and continuity of service from detox to outpatient or residential treatment, network efficiency was associated with lower odds of readmission. The impact of network structure on detox readmissions suggests that the interorganizational context in which detox programs operate may be important for improving continuity of service within substance use disorder treatment systems. Implications for future research are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Reducing Readmissions to Detoxification: An Interorganizational Network Perspective

PubMed Central

Spear, Suzanne E.

2014-01-01

Background The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance use disorder treatment systems. This study examined the extent to which the structure of local networks available to detox programs affects patients’ odds of readmission to detox within 1 year. Methods Administrative data from 32 counties in California in 2008–2009 were used to map network ties between programs based on patient transfers. Social network analysis was employed to measure structural features of detox program networks. Contextual predictors included efficiency (proportion of ties within a network that are non-redundant) and out-degree (number of outgoing ties to other programs). A binary mixed model was used to predict the odds of readmission among detox patients in residential (non-hospital) facilities (N =18,278). Results After adjusting for patient-level covariates and continuity of service from detox to outpatient or residential treatment, network efficiency was associated with lower odds of readmission. Conclusion The impact of network structure on detox readmissions suggests that the interorganizational context in which detox programs operate may be important for improving continuity of service within substance use disorder treatment systems. Implications for future research are discussed. PMID:24529966

Five features of value-based insurance design plans were associated with higher rates of medication adherence.

PubMed

Choudhry, Niteesh K; Fischer, Michael A; Smith, Benjamin F; Brill, Gregory; Girdish, Charmaine; Matlin, Olga S; Brennan, Troyen A; Avorn, Jerry; Shrank, William H

2014-03-01

Value-based insurance design (VBID) plans selectively lower cost sharing to increase medication adherence. Existing plans have been structured in a variety of ways, and these variations could influence the effectiveness of VBID plans. We evaluated seventy-six plans introduced by a large pharmacy benefit manager during 2007-10. We found that after we adjusted for the other features and baseline trends, VBID plans that were more generous, targeted high-risk patients, offered wellness programs, did not offer disease management programs, and made the benefit available only for medication ordered by mail had a significantly greater impact on adherence than plans without these features. The effects were as large as 4-5 percentage points. These findings can provide guidance for the structure of future VBID plans.

chemf: A purely functional chemistry toolkit.

PubMed

Höck, Stefan; Riedl, Rainer

2012-12-20

Although programming in a type-safe and referentially transparent style offers several advantages over working with mutable data structures and side effects, this style of programming has not seen much use in chemistry-related software. Since functional programming languages were designed with referential transparency in mind, these languages offer a lot of support when writing immutable data structures and side-effects free code. We therefore started implementing our own toolkit based on the above programming paradigms in a modern, versatile programming language. We present our initial results with functional programming in chemistry by first describing an immutable data structure for molecular graphs together with a couple of simple algorithms to calculate basic molecular properties before writing a complete SMILES parser in accordance with the OpenSMILES specification. Along the way we show how to deal with input validation, error handling, bulk operations, and parallelization in a purely functional way. At the end we also analyze and improve our algorithms and data structures in terms of performance and compare it to existing toolkits both object-oriented and purely functional. All code was written in Scala, a modern multi-paradigm programming language with a strong support for functional programming and a highly sophisticated type system. We have successfully made the first important steps towards a purely functional chemistry toolkit. The data structures and algorithms presented in this article perform well while at the same time they can be safely used in parallelized applications, such as computer aided drug design experiments, without further adjustments. This stands in contrast to existing object-oriented toolkits where thread safety of data structures and algorithms is a deliberate design decision that can be hard to implement. Finally, the level of type-safety achieved by Scala highly increased the reliability of our code as well as the productivity of the programmers involved in this project.

chemf: A purely functional chemistry toolkit

PubMed Central

2012-01-01

Background Although programming in a type-safe and referentially transparent style offers several advantages over working with mutable data structures and side effects, this style of programming has not seen much use in chemistry-related software. Since functional programming languages were designed with referential transparency in mind, these languages offer a lot of support when writing immutable data structures and side-effects free code. We therefore started implementing our own toolkit based on the above programming paradigms in a modern, versatile programming language. Results We present our initial results with functional programming in chemistry by first describing an immutable data structure for molecular graphs together with a couple of simple algorithms to calculate basic molecular properties before writing a complete SMILES parser in accordance with the OpenSMILES specification. Along the way we show how to deal with input validation, error handling, bulk operations, and parallelization in a purely functional way. At the end we also analyze and improve our algorithms and data structures in terms of performance and compare it to existing toolkits both object-oriented and purely functional. All code was written in Scala, a modern multi-paradigm programming language with a strong support for functional programming and a highly sophisticated type system. Conclusions We have successfully made the first important steps towards a purely functional chemistry toolkit. The data structures and algorithms presented in this article perform well while at the same time they can be safely used in parallelized applications, such as computer aided drug design experiments, without further adjustments. This stands in contrast to existing object-oriented toolkits where thread safety of data structures and algorithms is a deliberate design decision that can be hard to implement. Finally, the level of type-safety achieved by Scala highly increased the reliability of our code as well as the productivity of the programmers involved in this project. PMID:23253942

Community Based Psychosocial Education Can Improve Mood Disturbance in Breast Cancer Survivors at Various Stages of Their Recovery.

PubMed

Kokavec, Anna

2016-11-01

Psychosocial distress can contribute to avoidance, refusal, or discontinuation of cancer treatment, which could impact recovery and survival. The aim of the present study was to evaluate the effectiveness of a community based psychosocial program on alleviating mood disturbance in breast cancer survivors at different stages of their breast cancer journey. A total of 37 women participated in an 8-week psychosocial program at their local community centre. The weekly 3-hour program was delivered in a small group format. Program components included health education, behavioural training, cognitive behavioural therapy, art therapy and stress-management. Questionnaires aimed at assessing psychiatric morbidity and mood adjustment were administered at the beginning of the program (Pre) and at the completion of the program (Post). Group data revealed a significant reduction in psychiatric morbidity and improved psychological adjustment. When participants were divided into degree of psychiatric morbidity (mild, moderate, severe, very severe) a significant reduction in the reporting of anxiety symptoms in the mild, moderate, severe and very severe groups was reported; depression symptoms in the severe and very severe groups were noted, and anger, confusion and somatic symptoms in the mild group were noted. The level of activity was also significantly improved in the very severe group. A structured community based psychosocial program is beneficial to women struggling to come to terms with the emotional consequences of breast cancer at all stages of recovery.

House Calls: California Program For Homebound Patients Reduces Monthly Spending, Delivers Meaningful Care.

PubMed

Melnick, Glenn A; Green, Lois; Rich, Jeremy

2016-01-01

In 2009 HealthCare Partners Affiliates Medical Group, based in Southern California, launched House Calls, an in-home program that provides, coordinates, and manages care primarily for recently discharged high-risk, frail, and psychosocially compromised patients. Its purpose is to reduce preventable emergency department visits and hospital readmissions. We present data over time from this well-established program to provide an example for other new programs that are being established across the United States to serve this population with complex needs. The findings show that the initial House Calls structure, staffing patterns, and processes differed across the geographic areas that it served, and that they also evolved over time in different ways. In the same time period, all areas experienced a reduction in operating costs per patient and showed substantial reductions in monthly per patient health care spending and hospital utilization after enrollment in the House Calls program, compared to the period before enrollment. Despite more than five years of experience, the program structure continues to evolve and adjust staffing and other features to accommodate the dynamic nature of this complex patient population. Project HOPE—The People-to-People Health Foundation, Inc.

7 CFR 2201.30 - Adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Adjustments. 2201.30 Section 2201.30 Agriculture Regulations of the Department of Agriculture (Continued) LOCAL TELEVISION LOAN GUARANTEE BOARD LOCAL TELEVISION LOAN GUARANTEE PROGRAM-PROGRAM REGULATIONS Loan Guarantees § 2201.30 Adjustments. (a) The Board...

Risk Selection, Risk Adjustment and Choice: Concepts and Lessons from the Americas

PubMed Central

Ellis, Randall P.; Fernandez, Juan Gabriel

2013-01-01

Interest has grown worldwide in risk adjustment and risk sharing due to their potential to contain costs, improve fairness, and reduce selection problems in health care markets. Significant steps have been made in the empirical development of risk adjustment models, and in the theoretical foundations of risk adjustment and risk sharing. This literature has often modeled the effects of risk adjustment without highlighting the institutional setting, regulations, and diverse selection problems that risk adjustment is intended to fix. Perhaps because of this, the existing literature and their recommendations for optimal risk adjustment or optimal payment systems are sometimes confusing. In this paper, we present a unified way of thinking about the organizational structure of health care systems, which enables us to focus on two key dimensions of markets that have received less attention: what choices are available that may lead to selection problems, and what financial or regulatory tools other than risk adjustment are used to influence these choices. We specifically examine the health care systems, choices, and problems in four countries: the US, Canada, Chile, and Colombia, and examine the relationship between selection-related efficiency and fairness problems and the choices that are allowed in each country, and discuss recent regulatory reforms that affect choices and selection problems. In this sample, countries and insurance programs with more choices have more selection problems. PMID:24284351

24 CFR 880.610 - Adjustment of utility allowances.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.610 Adjustment of utility allowances. In connection with annual and special adjustments of... the housing assistance payment for the unit. (Approved by the Office of Management and Budget under...

24 CFR 880.610 - Adjustment of utility allowances.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.610 Adjustment of utility allowances. In connection with annual and special adjustments of... the housing assistance payment for the unit. (Approved by the Office of Management and Budget under...

24 CFR 880.610 - Adjustment of utility allowances.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.610 Adjustment of utility allowances. In connection with annual and special adjustments of... the housing assistance payment for the unit. (Approved by the Office of Management and Budget under...

24 CFR 880.610 - Adjustment of utility allowances.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.610 Adjustment of utility allowances. In connection with annual and special adjustments of... the housing assistance payment for the unit. (Approved by the Office of Management and Budget under...

24 CFR 880.610 - Adjustment of utility allowances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM FOR NEW CONSTRUCTION Management § 880.610 Adjustment of utility allowances. In connection with annual and special adjustments of... the housing assistance payment for the unit. (Approved by the Office of Management and Budget under...

75 FR 59682 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied petitions (No.'s 2011006-2011011, 2011028) for trade adjustment assistance for..., Farm Service Agency, Agricultural Marketing Service, and FAS. After a review, the Administrator... Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA; or by phone at (202...

75 FR 62759 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... Service (FAS), denied a petition (No. 2011019) for trade adjustment assistance (TAA) for Tilapia filed..., and FAS. After a review, the Administrator determined that the petition was unable to demonstrate the... INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS...

Socio-emotional regulation in children with intellectual disability and typically developing children, and teachers' perceptions of their social adjustment.

PubMed

Baurain, Céline; Nader-Grosbois, Nathalie; Dionne, Carmen

2013-09-01

This study examined the extent to which socio-emotional regulation displayed in three dyadic interactive play contexts (neutral, competitive or cooperative) by 45 children with intellectual disability compared with 45 typically developing children (matched on developmental age, ranging from 3 to 6 years) is linked with the teachers' perceptions of their social adjustment. A Coding Grid of Socio-Emotional Regulation by Sequences (Baurain & Nader-Grosbois, 2011b, 2011c) focusing on Emotional Expression, Social Behavior and Behavior toward Social Rules in children was applied. The Social Adjustment for Children Scale (EASE, Hugues, Soares-Boucaud, Hochman, & Frith, 1997) and the Assessment, Evaluation and Intervention Program System (AEPS, Bricker, 2002) were completed by teachers. Regression analyses emphasized, in children with intellectual disability only, a positive significant link between their Behavior toward Social Rules in interactive contexts and the teachers' perceptions of their social adjustment. Children with intellectual disabilities who listen to and follow instructions, who are patient in waiting for their turn, and who moderate their externalized behavior are perceived by their teachers as socially adapted in their daily social relationships. The between-groups dissimilarity in the relational patterns between abilities in socio-emotional regulation and social adjustment supports the "structural difference hypothesis" with regard to the group with intellectual disability, compared with the typically developing group. Hierarchical cluster cases analyses identified distinct subgroups showing variable structural patterns between the three specific categories of abilities in socio-emotional regulation and their levels of social adjustment perceived by teachers. In both groups, several abilities in socio-emotional regulation and teachers' perceptions of social adjustment vary depending on children's developmental age. Chronological age in children with intellectual disability had no impact on their socio-emotional regulation and social adjustment. Copyright © 2013 Elsevier Ltd. All rights reserved.

75 FR 32182 - Medicaid Program: Proposed Implementation of Section 614 of the Children's Health Insurance...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-07

... of the Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal... subject to adjustment pursuant to section 614 of the Children's Health Insurance Program Reauthorization... assistance expenditures under the Children's Health Insurance Program under title XXI of the Social Security...

75 FR 59682 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied petitions (Nos. 2011023-2011027) for trade adjustment assistance for wool filed... Economist, Farm Service Agency, Agricultural Marketing Service, and FAS. After a review, the Administrator... Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA; or by phone at (202...

Foreign Students and Internationalization of Higher Education. Proceedings of OECD/Japan Seminar on Higher Education and the Flow of Foreign Students (Hiroshima, Japan, November 8-10, 1988).

ERIC Educational Resources Information Center

Ebuchi, Kazuhiro, Ed.

This volume reports on a seminar structured around three themes: institutional policies toward the flow of foreign students in member countries of the Organization for Economic Cooperation and Development (OECD); specific measures and programs for foreign students; and social and cultural adjustment by foreign students. The volume contains seminar…

45 CFR 153.10 - Basis and scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT General... program for individual market in each State. (3) Section 1342. Establishment of risk corridors for plans... risk corridors program, and a permanent risk adjustment program. ...

45 CFR 153.10 - Basis and scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT General... program for individual market in each State. (3) Section 1342. Establishment of risk corridors for plans... risk corridors program, and a permanent risk adjustment program. ...

45 CFR 153.10 - Basis and scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... RELATED TO REINSURANCE, RISK CORRIDORS, AND RISK ADJUSTMENT UNDER THE AFFORDABLE CARE ACT General... program for individual market in each State. (3) Section 1342. Establishment of risk corridors for plans... risk corridors program, and a permanent risk adjustment program. ...

A Comparative Analysis of the Financial Incentives of Two Distinct Experience-Rating Programs.

PubMed

Tompa, Emile; McLeod, Chris; Mustard, Cam

2016-07-01

The aim of this study was to compare the association between insurance premium incentives and claim outcomes in two different workers' compensation programs. Regression models were run for claim outcomes using data from two Canadian jurisdictions with different experience-rating programs-one with prospective (British Columbia) and another with retrospective (Ontario) adjustment of premiums. Key explanatory variables were past premium adjustments. For both programs, past premium adjustments were significantly associated with claim outcomes, suggesting adjustments provided incentives for claims reduction. The magnitudes of effects in the prospective program were smaller than the retrospective one, though relative persistence of effects over time was larger. Having large and immediate employer responses to incentives may appear desirable, but insurers should consider the time required for employers to improve and sustain good practices, and create incentives that parallel such time lines.

Medicare program; additional extension of the payment adjustment for low-volume hospitals and the Medicare-dependent hospital (MDH) program under the hospital Inpatient Prospective Payment Systems (IPPS) for acute care hospitals for fiscal year 2014. Extension of a payment adjustment and a program.

PubMed

2014-06-17

This document announces changes to the payment adjustment for low-volume hospitals and to the Medicare-dependent hospital (MDH) program under the hospital inpatient prospective payment systems (IPPS) for the second half of FY 2014 (April 1, 2014 through September 30, 2014) in accordance with sections 105 and 106, respectively, of the Protecting Access to Medicare Act of 2014 (PAMA).

7 CFR 1400.500 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.500 Applicability... program payments or benefits described in § 1400.1 if the average adjusted gross income of the person or... average adjusted gross nonfarm income as defined in § 1400.3 that exceeds $500,000 will not be eligible to...

7 CFR 1400.500 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.500 Applicability... program payments or benefits described in § 1400.1 if the average adjusted gross income of the person or... average adjusted gross nonfarm income as defined in § 1400.3 that exceeds $500,000 will not be eligible to...

75 FR 59684 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied a petition (No. 2011001) for trade adjustment assistance for coffee filed under... of the Chief Economist, Farm Service Agency, Agricultural Marketing Service, and FAS. After a review... Adjustment Assistance for Farmers Program Staff, Office of Trade Programs, FAS, USDA; or by phone at (202...

7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Domestic lamb industry adjustment assistance program set aside. 4279.175 Section 4279.175 Agriculture Regulations of the Department of Agriculture... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance...

7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Domestic lamb industry adjustment assistance program set aside. 4279.175 Section 4279.175 Agriculture Regulations of the Department of Agriculture... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance...

7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Domestic lamb industry adjustment assistance program set aside. 4279.175 Section 4279.175 Agriculture Regulations of the Department of Agriculture... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance...

7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Domestic lamb industry adjustment assistance program set aside. 4279.175 Section 4279.175 Agriculture Regulations of the Department of Agriculture... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance...

7 CFR 4279.175 - Domestic lamb industry adjustment assistance program set aside.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Domestic lamb industry adjustment assistance program... GUARANTEED LOANMAKING Business and Industry Loans § 4279.175 Domestic lamb industry adjustment assistance... National Office to fund loans to lamb processors for real estate purchases and improvements; working...

Smoke alarm giveaway and installation programs: an economic evaluation.

PubMed

Liu, Ying; Mack, Karin A; Diekman, Shane T

2012-10-01

The burden of residential fire injury and death is substantial. Targeted smoke alarm giveaway and installation programs are popular interventions used to reduce residential fire mortality and morbidity. To evaluate the cost effectiveness and cost benefit of implementing a giveaway or installation program in a small hypothetic community with a high risk of fire death and injury through a decision-analysis model. Model inputs included program costs; program effectiveness (life-years and quality-adjusted life-years saved); and monetized program benefits (medical cost, productivity, property loss and quality-of-life losses averted) and were identified through structured reviews of existing literature (done in 2011) and supplemented by expert opinion. Future costs and effectiveness were discounted at a rate of 3% per year. All costs were expressed in 2011 U.S. dollars. Cost-effectiveness analysis (CEA) resulted in an average cost-effectiveness ratio (ACER) of $51,404 per quality-adjusted life-years (QALYs) saved and $45,630 per QALY for the giveaway and installation programs, respectively. Cost-benefit analysis (CBA) showed that both programs were associated with a positive net benefit with a benefit-cost ratio of 2.1 and 2.3, respectively. Smoke alarm functional rate, baseline prevalence of functional alarms, and baseline home fire death rate were among the most influential factors for the CEA and CBA results. Both giveaway and installation programs have an average cost-effectiveness ratio similar to or lower than the median cost-effectiveness ratio reported for other interventions to reduce fatal injuries in homes. Although more effort is required, installation programs result in lower cost per outcome achieved compared with giveaways. Published by Elsevier Inc.

Deployable reflector antenna performance optimization using automated surface correction and array-feed compensation

NASA Technical Reports Server (NTRS)

Schroeder, Lyle C.; Bailey, M. C.; Mitchell, John L.

1992-01-01

Methods for increasing the electromagnetic (EM) performance of reflectors with rough surfaces were tested and evaluated. First, one quadrant of the 15-meter hoop-column antenna was retrofitted with computer-driven and controlled motors to allow automated adjustment of the reflector surface. The surface errors, measured with metric photogrammetry, were used in a previously verified computer code to calculate control motor adjustments. With this system, a rough antenna surface (rms of approximately 0.180 inch) was corrected in two iterations to approximately the structural surface smoothness limit of 0.060 inch rms. The antenna pattern and gain improved significantly as a result of these surface adjustments. The EM performance was evaluated with a computer program for distorted reflector antennas which had been previously verified with experimental data. Next, the effects of the surface distortions were compensated for in computer simulations by superimposing excitation from an array feed to maximize antenna performance relative to an undistorted reflector. Results showed that a 61-element array could produce EM performance improvements equal to surface adjustments. When both mechanical surface adjustment and feed compensation techniques were applied, the equivalent operating frequency increased from approximately 6 to 18 GHz.

DCS-Neural-Network Program for Aircraft Control and Testing

NASA Technical Reports Server (NTRS)

Jorgensen, Charles C.

2006-01-01

A computer program implements a dynamic-cell-structure (DCS) artificial neural network that can perform such tasks as learning selected aerodynamic characteristics of an airplane from wind-tunnel test data and computing real-time stability and control derivatives of the airplane for use in feedback linearized control. A DCS neural network is one of several types of neural networks that can incorporate additional nodes in order to rapidly learn increasingly complex relationships between inputs and outputs. In the DCS neural network implemented by the present program, the insertion of nodes is based on accumulated error. A competitive Hebbian learning rule (a supervised-learning rule in which connection weights are adjusted to minimize differences between actual and desired outputs for training examples) is used. A Kohonen-style learning rule (derived from a relatively simple training algorithm, implements a Delaunay triangulation layout of neurons) is used to adjust node positions during training. Neighborhood topology determines which nodes are used to estimate new values. The network learns, starting with two nodes, and adds new nodes sequentially in locations chosen to maximize reductions in global error. At any given time during learning, the error becomes homogeneously distributed over all nodes.

45 CFR 153.340 - Data collection under risk adjustment.

Code of Federal Regulations, 2012 CFR

2012-10-01

... program, the State may vary the amount and type of data collected, but the State must collect or calculate... 45 Public Welfare 1 2012-10-01 2012-10-01 false Data collection under risk adjustment. 153.340... CARE ACT State Standards Related to the Risk Adjustment Program § 153.340 Data collection under risk...

Outcomes for youth residential treatment programs using administrative data from the child welfare system: a risk-adjustment application.

PubMed

McMillen, J Curtis; Lee, Bethany R; Jonson-Reid, Melissa

2008-05-01

This study assessed whether administrative data from the public child welfare system could be used to develop risk-adjusted performance reports for residential mental health programs for adolescents. Regression methods were used with 3,759 residential treatment spells for 2,784 children and youth to determine which outcomes could be adequately risk adjusted for case mix. Expected outcomes were created for each residential program given its case mix; then, expected and achieved outcomes were compared. For most programs, achieved results did not differ significantly from expected results for individual outcomes. Overall, outcomes achieved were not impressive. Only one quarter of spells resulted in a youth being maintained in a single less restrictive setting in the year following discharge. Methodological implications of this study suggest further refinements are needed for child welfare administrative data in order to develop risk-adjusted report cards of program performance.

Interparental violence and children's long-term psychosocial adjustment: the mediating role of parenting practices.

PubMed

Gámez-Guadix, Manuel; Almendros, Carmen; Carrobles, José Antonio; Muñoz-Rivas, Marina

2012-03-01

The objectives of this study were: (a) to examine the direct and indirect relationships among witnessing interparental violence, parenting practices, and children's long-term psychosocial adjustment; (b) to analyze the possible gender differences in the relationships specified. The sample consisted of 1295 Spanish university students (M age = 21.21, SD = 4.04). We performed statistical analyses using structural equation modeling. The results showed that witnessing parental violence as a child is related to poor long-term psychosocial adjustment during the child's adult years. Furthermore, we found that parenting practices fully mediated the relation between witnessing interparental violence and the child's long-term adjustment. The multigroup analyses showed that most of the relations among the variables did not differ significantly by gender. However, the relation between harsh discipline and antisocial behavior was stronger for males, whereas the relation between harsh discipline and depressive symptoms was stronger for females. Finally, we discuss the implications of these findings for the clinicians and specialists who plan and develop intervention programs for populations at risk.

The Effects of School-Based Maum Meditation Program on the Self-Esteem and School Adjustment in Primary School Students

PubMed Central

Yoo, Yang Gyeong; Lee, In Soo

2013-01-01

Self-esteem and school adjustment of children in the lower grades of primary school, the beginning stage of school life, have a close relationship with development of personality, mental health and characters of children. Therefore, the present study aimed to verify the effect of school-based Maum Meditation program on children in the lower grades of primary school, as a personality education program. The result showed that the experimental group with application of Maum Meditation program had significant improvements in self-esteem and school adjustment, compared to the control group without the application. In conclusion, since the study provides significant evidence that the intervention of Maum Meditation program had positive effects on self-esteem and school adjustment of children in the early stage of primary school, it is suggested to actively employ Maum Meditation as a school-based meditation program for mental health promotion of children in the early school ages, the stage of formation of personalities and habits. PMID:23777717

Atrioventricular and ventricular-to-ventricular programming in patients with cardiac resynchronization therapy: results from ALTITUDE.

PubMed

Steinberg, Benjamin A; Wehrenberg, Scott; Jackson, Kevin P; Hayes, David L; Varma, Niraj; Powell, Brian D; Day, John D; Frazier-Mills, Camille G; Stein, Kenneth M; Jones, Paul W; Piccini, Jonathan P

2015-12-01

Cardiac resynchronization therapy (CRT) improves outcomes in patients with heart failure, yet response rates are variable. We sought to determine whether physician-specified CRT programming was associated with improved outcomes. Using data from the ALTITUDE remote follow-up cohort, we examined sensed atrioventricular (AV) and ventricular-to-ventricular (VV) programming and their associated outcomes in patients with de novo CRT from 2009-2010. Outcomes included arrhythmia burden, left ventricular (LV) pacing, and all-cause mortality at 4 years. We identified 5709 patients with de novo CRT devices; at the time of implant, 34% (n = 1959) had entirely nominal settings programmed, 40% (n = 2294) had only AV timing adjusted, 11% (n = 604) had only VV timing adjusted, and 15% (n = 852) had both AV and VV adjusted from nominal programming. Suboptimal LV pacing (<95%) during follow-up was similar across groups; however, the proportion with atrial fibrillation (AF) burden >5% was lowest in the AV-only adjusted group (17.9%) and highest in the nominal (27.7%) and VV-only adjusted (28.3%) groups. Adjusted all-cause mortality was significantly higher among patients with non-nominal AV delay >120 vs. <120 ms (adjusted heart rate (HR) 1.28, p = 0.008) but similar when using the 180-ms cutoff (adjusted HR 1.13 for >180 vs. ≤180 ms, p = 0.4). Nominal settings for de novo CRT implants are frequently altered, most commonly the AV delay. There is wide variability in reprogramming. Patients with nominal or AV-only adjustments appear to have favorable pacing and arrhythmia outcomes. Sensed AV delays less than 120 ms are associated with improved survival.

A wirelessly programmable actuation and sensing system for structural health monitoring

NASA Astrophysics Data System (ADS)

Long, James; Büyüköztürk, Oral

2016-04-01

Wireless sensor networks promise to deliver low cost, low power and massively distributed systems for structural health monitoring. A key component of these systems, particularly when sampling rates are high, is the capability to process data within the network. Although progress has been made towards this vision, it remains a difficult task to develop and program 'smart' wireless sensing applications. In this paper we present a system which allows data acquisition and computational tasks to be specified in Python, a high level programming language, and executed within the sensor network. Key features of this system include the ability to execute custom application code without firmware updates, to run multiple users' requests concurrently and to conserve power through adjustable sleep settings. Specific examples of sensor node tasks are given to demonstrate the features of this system in the context of structural health monitoring. The system comprises of individual firmware for nodes in the wireless sensor network, and a gateway server and web application through which users can remotely submit their requests.

STS-92 Mission Specialist Chiao has his launch and entry suit adjusted

NASA Technical Reports Server (NTRS)

2000-01-01

In the Operations and Checkout Building, STS-92 Mission Specialist Leroy Chiao has his launch and entry suit adjusted during fit check. Chiao and the rest of the crew are at KSC for Terminal Countdown Demonstration Test activities. The TCDT provides emergency egress training, simulated countdown exercises and opportunities to inspect the mission payload. This mission will be Chiao's third Shuttle flight. STS-92 is scheduled to launch Oct. 5 at 9:38 p.m. EDT from Launch Pad 39A on the fifth flight to the International Space Station. It will carry two elements of the Space Station, the Integrated Truss Structure Z1 and the third Pressurized Mating Adapter. The mission is also the 100th flight in the Shuttle program.

On performing of interference technique based on self-adjusting Zernike filters (SA-AVT method) to investigate flows and validate 3D flow numerical simulations

NASA Astrophysics Data System (ADS)

Pavlov, Al. A.; Shevchenko, A. M.; Khotyanovsky, D. V.; Pavlov, A. A.; Shmakov, A. S.; Golubev, M. P.

2017-10-01

We present a method for and results of determination of the field of integral density in the structure of flow corresponding to the Mach interaction of shock waves at Mach number M = 3. The optical diagnostics of flow was performed using an interference technique based on self-adjusting Zernike filters (SA-AVT method). Numerical simulations were carried out using the CFS3D program package for solving the Euler and Navier-Stokes equations. Quantitative data on the distribution of integral density on the path of probing radiation in one direction of 3D flow transillumination in the region of Mach interaction of shock waves were obtained for the first time.

Resource and cost adjustment in the design of allocation funding formulas in public health programs.

PubMed

Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

2012-01-01

Multiple federal public health programs use funding formulas to allocate funds to states. To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk. Fifty US states and the District of Columbia. Formula-based funding allocations to states for 4 representative federal public health programs were adjusted using indicators of cost (average salaries), potential within-state revenues (per-capita income, the Federal Medical Assistance Percentage, per-capita aggregate home values), and income disparities (Theil index). Percentage of allocation shifted by adjustment, the number of states and the percentage of US population living in states with a more than 20% increase or decrease in funding, maximum percentage increase or decrease in funding. Each adjustor had a comparable impact on allocations across the 4 program allocations examined. Approximately 2% to 8% of total allocations were shifted, with adjustments for variations in income disparity and housing values having the least and greatest effects, respectively. The salary cost and per-capita income adjustors were inversely correlated and had offsetting effects on allocations. With the exception of the housing values adjustment, fewer than 10 states had more than 20% increases or decreases in allocations, and less than 10% of the US population lived in such states. Selection of adjustors for formula-based funding allocations should consider the impacts of different adjustments, correlations between adjustors and other data elements in funding formulas, and the relationship of formula inputs to program objectives.

Near Field Antenna Measurement System.

DTIC Science & Technology

1982-03-01

is 2" in diameter, the others are 1". The shafts are mounted to the structure with specially- designed adjusters which provide two axes of control for...program when a supplier was found who provided an entire motor and controller system designed for direct computer interfacing. These units, Control ...distribution unlimited. "The findings in this report are not to be construed as an official Department of the Army position unless so designated by other

Organizational Attributes Associated With Medicare ACO Quality Performance.

PubMed

Zhu, Xi; Mueller, Keith; Huang, Huang; Ullrich, Fred; Vaughn, Thomas; MacKinney, A Clinton

2018-05-08

To evaluate associations between geographic, structural, and service-provision attributes of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) and the ACOs' quality performance. We conducted cross-sectional and longitudinal analyses of ACO quality performance using data from the Centers for Medicare and Medicaid Services and additional sources. The sample included 322 and 385 MSSP ACOs that had successfully reported quality measures in 2014 and 2015, respectively. Results show that after adjusting for other organizational factors, rural ACOs' average quality score was comparable to that of ACOs serving other geographic categories. ACOs with hospital-system sponsorship, larger beneficiary panels, and higher posthospitalization follow-up rates achieved better quality performance. There is no significant difference in average quality performance between rural ACOs and other ACOs after adjusting for structural and service-provision factors. MSSP ACO quality performance is positively associated with hospital-system sponsorship, beneficiary panel size, and posthospitalization follow-up rate. © 2018 National Rural Health Association.

The AstroPAL Starter Pack: How to Create a Grad Mentoring Program That Fosters Equity and Inclusion in Your Department

NASA Astrophysics Data System (ADS)

Cabrera, Nicole

2017-01-01

The Astronomy Peer Advising Leaders program (AstroPAL) at Georgia State University is a grassroots effort initiated by one PhD student with no budget, yet has quickly become a successful program that especially impacts students of marginalized identities. AstroPAL provides guidance for incoming grad students and helps them adjust to the workload, stress, and other difficulties that can come with grad school. This talk will cover the AstroPAL goals and accomplishments, its logistical structure, and its longterm sustainability. We will discuss how the program has helped create a bridge between faculty and students as well as the positive effect it has had on our community. I will also provide tools that anyone can use to launch AstroPAL at their home institution.

Interactive grid generation for turbomachinery flow field simulations

NASA Technical Reports Server (NTRS)

Choo, Yung K.; Eiseman, Peter R.; Reno, Charles

1988-01-01

The control point form of algebraic grid generation presented provides the means that are needed to generate well structured grids for turbomachinery flow simulations. It uses a sparse collection of control points distributed over the flow domain. The shape and position of coordinate curves can be adjusted from these control points while the grid conforms precisely to all boundaries. An interactive program called TURBO, which uses the control point form, is being developed. Basic features of the code are discussed and sample grids are presented. A finite volume LU implicit scheme is used to simulate flow in a turbine cascade on the grid generated by the program.

Interactive grid generation for turbomachinery flow field simulations

NASA Technical Reports Server (NTRS)

Choo, Yung K.; Reno, Charles; Eiseman, Peter R.

1988-01-01

The control point form of algebraic grid generation presented provides the means that are needed to generate well structured grids of turbomachinery flow simulations. It uses a sparse collection of control points distributed over the flow domain. The shape and position of coordinate curves can be adjusted from these control points while the grid conforms precisely to all boundaries. An interactive program called TURBO, which uses the control point form, is being developed. Basic features of the code are discussed and sample grids are presented. A finite volume LU implicit scheme is used to simulate flow in a turbine cascade on the grid generated by the program.

Learning polynomial feedforward neural networks by genetic programming and backpropagation.

PubMed

Nikolaev, N Y; Iba, H

2003-01-01

This paper presents an approach to learning polynomial feedforward neural networks (PFNNs). The approach suggests, first, finding the polynomial network structure by means of a population-based search technique relying on the genetic programming paradigm, and second, further adjustment of the best discovered network weights by an especially derived backpropagation algorithm for higher order networks with polynomial activation functions. These two stages of the PFNN learning process enable us to identify networks with good training as well as generalization performance. Empirical results show that this approach finds PFNN which outperform considerably some previous constructive polynomial network algorithms on processing benchmark time series.

Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals.

PubMed

Turner, Jason S; Broom, Kevin D; Counte, Michael A

2015-01-01

Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program.

Reducing Aggressive Behavior and Increasing Motivation in School: The Evolution of an Intervention to Strengthen School Adjustment

ERIC Educational Resources Information Center

Hudley, Cynthia; Graham, Sandra; Taylor, April

2007-01-01

The pervasive links between problem behaviors and school adjustment suggest that effective intervention programs to enhance school adjustment must focus both on decreasing the motivation to aggress and increasing the motivation to achieve. We describe a program of intervention research to improve social behavior and academic motivation in…

A Statewide Collaboration: Ohio Level III Trauma Centers' Approach to the Development of a Benchmarking System.

PubMed

Lang, Carrie L; Simon, Diane; Kilgore, Jane

The American College of Surgeons Committee on Trauma revised the Resources for Optimal Care of the Injured Patient to include the criteria for trauma centers to participate in a risk-adjusted benchmarking system. Trauma Quality Improvement Program is currently the risk-adjusted benchmarking program sponsored by the American College of Surgeons, which will be required of all trauma centers to participate in early 2017. Prior to this, there were no risk-adjusted programs for Level III verified trauma centers. The Ohio Society of Trauma Nurse Leaders is a collaborative group made up of trauma program managers, coordinators, and other trauma leaders who meet 6 times a year. Within this group, a Level III Subcommittee was formed initially to provide a place for the Level III centers to discuss issues specific to the Level III centers. When the new requirement regarding risk-adjustment became official, the subcommittee agreed to begin reporting simple data points with the idea to risk adjust in the future.

48 CFR 552.216-71 - Economic Price Adjustment-Special Order Program Contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Economic Price Adjustment... Provisions and Clauses 552.216-71 Economic Price Adjustment—Special Order Program Contracts. As prescribed in 516.203-4(a), insert the following clause: Economic Price Adjustment—Special Order Program Contracts...

48 CFR 552.216-71 - Economic Price Adjustment-Special Order Program Contracts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Economic Price Adjustment... Provisions and Clauses 552.216-71 Economic Price Adjustment—Special Order Program Contracts. As prescribed in 516.203-4(a), insert the following clause: Economic Price Adjustment—Special Order Program Contracts...

48 CFR 552.216-71 - Economic Price Adjustment-Special Order Program Contracts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 4 2014-10-01 2014-10-01 false Economic Price Adjustment... Provisions and Clauses 552.216-71 Economic Price Adjustment—Special Order Program Contracts. As prescribed in 516.203-4(a), insert the following clause: Economic Price Adjustment—Special Order Program Contracts...

48 CFR 552.216-71 - Economic Price Adjustment-Special Order Program Contracts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 4 2013-10-01 2013-10-01 false Economic Price Adjustment... Provisions and Clauses 552.216-71 Economic Price Adjustment—Special Order Program Contracts. As prescribed in 516.203-4(a), insert the following clause: Economic Price Adjustment—Special Order Program Contracts...

48 CFR 552.216-71 - Economic Price Adjustment-Special Order Program Contracts.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 4 2012-10-01 2012-10-01 false Economic Price Adjustment... Provisions and Clauses 552.216-71 Economic Price Adjustment—Special Order Program Contracts. As prescribed in 516.203-4(a), insert the following clause: Economic Price Adjustment—Special Order Program Contracts...

75 FR 63147 - Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

...] Solicitation of Applications for the Public Works, Economic Adjustment Assistance, and Global Climate Change... Program; and (iii) Global Climate Change Mitigation Incentive Fund (GCCMIF) Program. To enhance the...; and (iii) Global Climate Change Mitigation Incentive Fund (GCCMIF) Program. EDA will publish separate...

Identifying the contents of a type 1 diabetes outpatient care program based on the self-adjustment of insulin using the Delphi method.

PubMed

Kubota, Mutsuko; Shindo, Yukari; Kawaharada, Mariko

2014-10-01

The objective of this study is to identify the items necessary for an outpatient care program based on the self-adjustment of insulin for type 1 diabetes patients. Two surveys based on the Delphi method were conducted. The survey participants were 41 certified diabetes nurses in Japan. An outpatient care program based on the self-adjustment of insulin was developed based on pertinent published work and expert opinions. There were a total of 87 survey items in the questionnaire, which was developed based on the care program mentioned earlier, covering matters such as the establishment of prerequisites and a cooperative relationship, the basics of blood glucose pattern management, learning and practice sessions for the self-adjustment of insulin, the implementation of the self-adjustment of insulin, and feedback. The participants' approval on items in the questionnaires was defined at 70%. Participants agreed on all of the items in the first survey. Four new parameters were added to make a total of 91 items for the second survey and participants agreed on the inclusion of 84 of them. Items necessary for a type 1 diabetes outpatient care program based on self-adjustment of insulin were subsequently selected. It is believed that this care program received a fairly strong approval from certified diabetes nurses; however, it will be necessary to have the program further evaluated in conjunction with intervention studies in the future. © 2014 The Authors. Japan Journal of Nursing Science © 2014 Japan Academy of Nursing Science.

44 CFR 62.21 - Claims adjustment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program SALE OF INSURANCE AND ADJUSTMENT OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.21 Claims adjustment. (a) In...

Computer programs for adjusting the mechanical properties of 2-inch dimension lumber for changes in moisture content

Treesearch

James W. Evans; Jane K. Evans; David W. Green

1990-01-01

This paper presents computer programs for adjusting the mechanical properties of 2-in. dimension lumber for changes in moisture content. Mechanical properties adjusted are modulus of rupture, ultimate tensile stress parallel to the grain, ultimate compressive stress parallel to the gain, and flexural modulus of elasticity. The models are valid for moisture contents...

Operators manual for the magnetograph program (section 2)

NASA Technical Reports Server (NTRS)

November, L.; Title, A. M.

1974-01-01

This manual for use of the magnetograph program describes: (1) black box use of the programs; (2) the magtape data formats used; (3) the adjustable control parameters in the program; and (4) the algorithms. With no adjustments on the control parameters this program may be used purely as a black box. For optimal use, however, the control parameters may be varied. The magtape data formats are of use in adopting other programs to look at raw data or final magnetograph data.

75 FR 50847 - Cotton Program Changes for Upland Cotton, Adjusted World Price, and Active Shipping Orders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-18

... Cotton Program Changes for Upland Cotton, Adjusted World Price, and Active Shipping Orders AGENCY... previous final rule that implemented the 2008 Farm Bill provisions for the cotton program. The correction removes definitions that are no longer used concerning Northern Europe prices for cotton. CCC is also...

Development of a Mentoring Program for Chinese Immigrant Adolescents' Cultural Adjustment

ERIC Educational Resources Information Center

Yeh, Christine J.; Ching, Alison M.; Okubo, Yuki; Luthar, Suniya S.

2007-01-01

The development and evaluation of a peer mentoring program for Chinese immigrant adolescents' cultural adjustment is described. Twenty-three high school students who recently immigrated from Mainland China participated in the year-long program and 4 high school students served as their peer mentors. Data analyses revealed that the students who…

The Rapid Adjustment Farm Program's Influence on Other Farms in the Community.

ERIC Educational Resources Information Center

Simeral, Kenneth D.

The study investigated the diffusion of innovative farming practices from Rapid Adjustment Farms (RAF) to other farms in southeast Ohio. The RAF program, begun in 1968, introduced new technology and management practices to its participant farmers. After reviewing literature of farming programs' information diffusion, a descriptive survey was made…

Is There a Relationship Between Value-Based Purchasing and Hospital Profitability? An Exploratory Study of Missouri Hospitals

PubMed Central

Broom, Kevin D.; Counte, Michael A.

2015-01-01

Recent US legislation is attempting to transition inpatient Medicare payments to a value-based purchasing (VBP) program. The VBP program is a pay-for-performance (P4P) system that incentivizes hospitals to improve patient satisfaction, health outcomes, and adherence to clinical protocols while simultaneously holding down costs. Our study evaluates (1) the impact of financial performance on the VBP adjustments and (2) whether there is a correlation between the VBP adjustment and the financial performance of Missouri hospitals that opted into the program. While upward and downward adjustments to the inpatient base rate may be related to hospital financial performance, prior financial performance may also be related to the adjustments. Financial health may allow facilities to invest and position the hospital for favorable future P4P adjustments. The results of our analysis indicate the VBP adjustment to the inpatient base rate is very small (±0.18%), clustered around zero, and is not correlated with financial performance. We also find that financial performance and improvement in the years prior to the adjustment are not related to the VBP adjustment or its respective components. This suggests that CMS is avoiding penalizing less profitable facilities, but the adjustment is also so small and tightly clustered around zero that it is failing to provide an adequate incentive to hospitals. The costs of improving patient satisfaction, clinical process adherence, health care outcomes, and efficiency above that of peers coupled with the growing number of metrics being used to calculate the VBP adjustments call into question the financial incentives of the hospital VBP program. PMID:28462265

User preferences for a text message-based smoking cessation intervention.

PubMed

Bock, Beth C; Heron, Kristin E; Jennings, Ernestine G; Magee, Joshua C; Morrow, Kathleen M

2013-04-01

Younger adults are more likely to smoke and less likely to seek treatment than older smokers. They are also frequent users of communication technology. In the current study, we conducted focus groups to obtain feedback about preferences for a text message-based smoking cessation program from potential users. Participants (N = 21, M age = 25.6 years, age range = 20-33 years) were current or recently quit smokers (M cigarettes/day = 12.8) who used text messaging. Participants completed questionnaires and participated in a 2-hour focus group. Focus groups were conducted using an a priori semistructured interview guide to promote discussion of the content and functionality of the intervention. Major themes from analysis of the focus groups included support for the acceptability of a text-based cessation program, suggestions for a more technologically broad-based program, and adjustments to the program structure. Participants recommended including social networking functions, user control of program output through an online profile, and text message features to promote interaction with the system. Interestingly, many participants suggested the program should begin on individuals' identified quit day, challenging the procedures used in most cessation programs, which begin by preparing participants for a future quit date. Overall, younger adult smokers appear to be interested in participating in a smoking cessation program that uses text messages and web-based elements. Qualitative feedback regarding the perceived optimal features and structure of a technology-based intervention challenged traditional methods of implementing smoking cessation interventions and will inform the development of future programs.

Using evaluation methods to guide the development of a tobacco-use prevention curriculum for youth: a case study.

PubMed

Bridge, P D; Gallagher, R E; Berry-Bobovski, L C

2000-01-01

Fundamental to the development of educational programs and curricula is the evaluation of processes and outcomes. Unfortunately, many otherwise well-designed programs do not incorporate stringent evaluation methods and are limited in measuring program development and effectiveness. Using an advertising lesson in a school-based tobacco-use prevention curriculum as a case study, the authors examine the role of evaluation in the development, implementation, and enhancement of the curricular lesson. A four-phase formative and summative evaluation design was developed to divide the program-evaluation continuum into a structured process that would aid in the management of the evaluation, as well as assess curricular components. Formative and summative evaluation can provide important guidance in the development, implementation, and enhancement of educational curricula. Evaluation strategies identified unexpected barriers and allowed the project team to make necessary "time-relevant" curricular adjustments during each stage of the process.

Study of the ammonia ice cloud layer in the north tropical zone of Jupiter from the infrared interferometric experiment on Voyager

NASA Technical Reports Server (NTRS)

Shaffer, William A.; Samuelson, Robert E.; Conrath, Barney J.

1986-01-01

An average of 51 Voyager 1 IRIS spectra of Jupiter's North Tropical Zone was analyzed to infer the abundance, vertical extent, and size distribution of the particles making up the ammonia cloud in this region. It is assumed that the cloud base coincides with the level at which 100% saturation of ammonia vapor occurs. The vertical distribution of particulates above this level is determined by assuming a constant total ammonia mixing ratio and adjusting the two phases so that the vapor is saturated throughout the cloud. A constant scaling factor then adjusts the base number density. A radiative transfer program is used that includes the effects of absorption and emission of all relevant gases as well as anisotropic scattering by cloud particles. Mie scattering from a gaussian particle size distribution is assumed. The vertical thermal structure is inferred from a temperature retrieval program that utilizes the collision induced S(0) and S(1) molecular hydrogen lines between 300 and 700.cm, and the 1304.cm methane band.

STS-92 Mission Specialist Wakata has his launch and entry suit adjusted

NASA Technical Reports Server (NTRS)

2000-01-01

During pre-pack and fit check in the Operations and Checkout Building, STS-92 Mission Specialist Koichi Wakata of Japan gets an adjustment on his launch and entry suit. This mission is Wakata's second Shuttle flight. He and the rest of the crew are at KSC for Terminal Countdown Demonstration Test activities. The TCDT provides emergency egress training, simulated countdown exercises and opportunities to inspect the mission payload. STS- 92 is scheduled to launch Oct. 5 at 9:38 p.m. EDT from Launch Pad 39A on the fifth flight to the International Space Station. It will carry two elements of the Space Station, the Integrated Truss Structure Z1 and the third Pressurized Mating Adapter. The mission is also the 100th flight in the Shuttle program.

Limitations for a Successful Army Leader Development Strategy

DTIC Science & Technology

2013-05-23

the Army, the programs for managing officers to be adjusted to support the strategy, and the policies that constrain the programs to be adjusted...officer management programs exposes a number of policies that detrimentally limit the accomplishment of the objectives. The effectiveness of the ALDS...system. Commanders would fight to get their best officers to school as early as possible as a reward and would develop aggressive development programs

Transition from early intervention program to primary school in children with autism spectrum disorder

PubMed Central

Eapen, Valsamma; Grove, Rachel; Aylward, Elizabeth; Joosten, Annette V; Miller, Scott I; Van Der Watt, Gerdamari; Fordyce, Kathryn; Dissanayake, Cheryl; Maya, Jacqueline; Tucker, Madonna; DeBlasio, Antonia

2017-01-01

AIM To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism. METHODS Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child’s school adjustment. The relationship between child characteristics and school outcomes was evaluated. RESULTS Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement. CONCLUSION Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential. PMID:29259892

Transition from early intervention program to primary school in children with autism spectrum disorder.

PubMed

Eapen, Valsamma; Grove, Rachel; Aylward, Elizabeth; Joosten, Annette V; Miller, Scott I; Van Der Watt, Gerdamari; Fordyce, Kathryn; Dissanayake, Cheryl; Maya, Jacqueline; Tucker, Madonna; DeBlasio, Antonia

2017-11-08

To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism. Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child's school adjustment. The relationship between child characteristics and school outcomes was evaluated. Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement. Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential.

Structure and work process in primary care and hospitalizations for sensitive conditions

PubMed Central

Araujo, Waleska Regina Machado; Queiroz, Rejane Christine de Sousa; Rocha, Thiago Augusto Hernandes; da Silva, Núbia Cristina; Thumé, Elaine; Tomasi, Elaine; Facchini, Luiz Augusto; Thomaz, Erika Barbara Abreu Fonseca

2017-01-01

ABSTRACT OBJECTIVE The objective of this study is to investigate whether the characteristics of the structure of primary health units and the work process of primary care teams are associated with the number of hospitalizations for primary care sensitive conditions. METHODS In this ecological study, we have analyzed data of Brazilian municipalities related to sociodemographic characteristics, coverage of care programs, structure of primary health units, and work process of primary care teams. We have obtained the data from the first cycle of the Brazilian Program for Improving Access and Quality of the Primary Care, of the Department of Information Technology of the Brazilian Unified Health System, the Brazilian Institute of Geography and Statistics, and the United Nations Development Programme. The associations have been estimated using negative binomial regression coefficients (β) and respective 95% confidence intervals, with a hierarchical approach in three levels (alpha = 5%). RESULTS In the adjusted analysis for the outcome in 2013, in the distal level, the coverage of the Bolsa Família Program (β = -0.001) and private insurance (β = -0.01) had a negative association, and the human development index (β = 1.13), the proportion of older adults (β = 0.05) and children under the age of five (β = 0.05), and the coverage of the Community Health Agent Strategy (β = 0.002) showed positive association with hospitalizations for primary care sensitive conditions. In the intermediate level, minimum hours (β = -0.14) and availability of vaccines (β = -0.16) showed a negative association, and availability of medications showed a positive association (β = 0.16). In the proximal level, only the variable of matrix support (β = 0.10) showed a positive association. The variables in the adjusted analysis of the number of hospitalizations for primary care sensitive conditions in 2014 presented the same association as in 2013. CONCLUSIONS The characteristics of the structure of primary health units and the work process of the primary care teams impact the number of hospitalizations for primary care sensitive conditions in Brazilian municipalities. PMID:28832757

Psychosocial Adjustment to Illness Scale: Factor structure, reliability, and validity assessment in a sample of Greek breast cancer patients.

PubMed

Kolokotroni, Philippa; Anagnostopoulos, Fotios; Missitzis, Ioannis

2017-07-01

The study and measurement of psychosocial adjustment is important for evaluating patients' well-being, and assessing the illness's course, treatment's success, and patients' recovery. In this study, internal consistency reliability and construct validity of the Greek version of the Psychosocial Adjustment to Illness Scale-Self-Report (PAIS-SR) were examined. Demographic and psychosocial data were collected from a sample of 243 women with breast cancer, recruited from September 2011 to December 2012. With some exceptions in specific items, the original conceptually-derived PAIS-SR subscales emerged in a seven-factor solution. Social Environment, Job and Household Duties, and Psychological Distress accounted for more of the total variance than other subscales. PAIS-SR showed good internal consistency reliability, with Cronbach's alpha coefficients >0.62. Correlations of PAIS-SR domains with measures of quality of life and posttraumatic stress symptoms supported the convergent validity of the PAIS-SR and its significance for cancer research. The Greek version of the PAIS-SR has acceptable internal consistency reliability and construct validity, as well as satisfactory convergent validity. Results provide some suggestions for the development of programs to evaluate adjustment status and implement psychosocial interventions among breast cancer survivors.

25 CFR 39.144 - What is the small high school adjustment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false What is the small high school adjustment? 39.144 Section... EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.144 What is the small high school adjustment? (a) The small high school adjustment is a WSU adjustment given to a small high school...

25 CFR 39.144 - What is the small high school adjustment?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 1 2012-04-01 2011-04-01 true What is the small high school adjustment? 39.144 Section... EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.144 What is the small high school adjustment? (a) The small high school adjustment is a WSU adjustment given to a small high school...

25 CFR 39.144 - What is the small high school adjustment?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false What is the small high school adjustment? 39.144 Section... EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.144 What is the small high school adjustment? (a) The small high school adjustment is a WSU adjustment given to a small high school...

25 CFR 39.144 - What is the small high school adjustment?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false What is the small high school adjustment? 39.144 Section... EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.144 What is the small high school adjustment? (a) The small high school adjustment is a WSU adjustment given to a small high school...

25 CFR 39.144 - What is the small high school adjustment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false What is the small high school adjustment? 39.144 Section... EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.144 What is the small high school adjustment? (a) The small high school adjustment is a WSU adjustment given to a small high school...

Linearly Adjustable International Portfolios

NASA Astrophysics Data System (ADS)

Fonseca, R. J.; Kuhn, D.; Rustem, B.

2010-09-01

We present an approach to multi-stage international portfolio optimization based on the imposition of a linear structure on the recourse decisions. Multiperiod decision problems are traditionally formulated as stochastic programs. Scenario tree based solutions however can become intractable as the number of stages increases. By restricting the space of decision policies to linear rules, we obtain a conservative tractable approximation to the original problem. Local asset prices and foreign exchange rates are modelled separately, which allows for a direct measure of their impact on the final portfolio value.

Trainable Mentally Retarded; A Guide to Programming.

ERIC Educational Resources Information Center

Georgia State Dept. of Education, Atlanta. Div. of Special Education.

Development of the following aspects in programing for the trainable is discussed: communication skills, motor coordination, emotional adjustment, self concept, self care and health, social adjustment, recreational activities, safety, moral and spiritual values, and aesthetic appreciation and economic usefulness. Curriculum activities presented…

How the Avahan HIV prevention program transitioned from the Gates Foundation to the government of India.

PubMed

Sgaier, Sema K; Ramakrishnan, Aparajita; Dhingra, Neeraj; Wadhwani, Alkesh; Alexander, Ashok; Bennett, Sara; Bhalla, Aparajita; Kumta, Sameer; Jayaram, Matangi; Gupta, Pankaj; Piot, Peter K; Bertozzi, Stefano M; Anthony, John

2013-07-01

Developing countries face diminishing development aid and time-limited donor commitments that challenge the long-term sustainability of donor-funded programs to improve the health of local populations. Increasing country ownership of the programs is one solution. Transitioning managerial and financial responsibility for donor-funded programs to governments and local stakeholders represents a highly advanced form of country ownership, but there are few successful examples among large-scale programs. We present a transition framework and describe how it was used to transfer the Bill & Melinda Gates Foundation's HIV/AIDS prevention program, the Avahan program, to the Government of India. Essential features recommended for the transition of donor-funded programs to governments include early planning with the government, aligning donor program components with government structures and funding models prior to transition, building government capacity through active technical and management support, budgeting for adequate support during and after the transition, and dividing the transition into phases to allow time for adjustments and corrections. The transition of programs to governments is an important sustainability strategy for efforts to scale up HIV prevention programs to reach the populations most at risk.

Getting Real Performance Out of Pay-for-Performance

PubMed Central

Nicholson, Sean; Pauly, Mark V; Wu, Anita Ya Jung; Murray, James F; Teutsch, Steven M; Berger, Marc L

2008-01-01

Context Most private and public health insurers are implementing pay-for-performance (P4P) programs in an effort to improve the quality of medical care. This article offers a paradigm for evaluating how P4P programs should be structured and how effective they are likely to be. Methods This article assesses the current comprehensiveness of evidence-based medicine by estimating the percentage of outpatient medical spending for eighteen medical processes recommended by the Institute of Medicine. Findings Three conditions must be in place for outcomes-based P4P programs to improve the quality of care: (1) health insurers must not fully understand what medical processes improve health (i.e., the health production function); (2) providers must know more about the health production function than insurers do; and (3) health insurers must be able to measure a patient's risk-adjusted health. Only two of these conditions currently exist. Payers appear to have incomplete knowledge of the health production function, and providers appear to know more about the health production function than payers do, but accurate methods of adjusting the risk of a patient's health status are still being developed. Conclusions This article concludes that in three general situations, P4P will have a different impact on quality and costs and so should be structured differently. When information about patients’ health and the health production function is incomplete, as is currently the case, P4P payments should be kept small, should be based on outcomes rather than processes, and should target physicians’ practices and health systems. As information improves, P4P incentive payments could be increased, and P4P may become more powerful. Ironically, once information becomes complete, P4P can be replaced entirely by “optimal fee-for-service.” PMID:18798885

Social support and substitute voice acquisition on psychological adjustment among patients after laryngectomy.

PubMed

Kotake, Kumiko; Suzukamo, Yoshimi; Kai, Ichiro; Iwanaga, Kazuyo; Takahashi, Aya

2017-03-01

The objective is to clarify whether social support and acquisition of alternative voice enhance the psychological adjustment of laryngectomized patients and which part of the psychological adjustment structure would be influenced by social support. We contacted 1445 patients enrolled in a patient association using mail surveys and 679 patients agreed to participate in the study. The survey items included age, sex, occupation, post-surgery duration, communication method, psychological adjustment (by the Nottingham Adjustment Scale Japanese Laryngectomy Version: NAS-J-L), and the formal support (by Hospital Patient Satisfaction Questionnaire-25: HPSQ-25). Social support and communication methods were added to the three-tier structural model of psychological adjustment shown in our previous study, and a covariance structure analysis was conducted. Formal/informal supports and acquisition of alternative voice influence only the "recognition of oneself as voluntary agent", the first tier of the three-tier structure of psychological adjustment. The results suggest that social support and acquisition of alternative voice may enhance the recognition of oneself as voluntary agent and promote the psychological adjustment.

Effectiveness of Group Positive Parenting Program (Triple P) in Changing Child Behavior, Parenting Style, and Parental Adjustment: An Intervention Study in Japan

ERIC Educational Resources Information Center

Fujiwara, Takeo; Kato, Noriko; Sanders, Matthew R.

2011-01-01

The purpose of this study is to investigate the effectiveness of a group-based family intervention program known as the Group Positive Parenting Program (Triple P), with families in Japan. Reductions in children's behavioral problems, changes in dysfunctional parenting practices, and affects on parenting adjustment were examined. Participants of…

24 CFR 882.410 - Rent adjustments.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM) SECTION 8 MODERATE REHABILITATION PROGRAMS Special Procedures for Moderate Rehabilitation-Basic... Annual Adjustment Factor by the base rents. However, if the amounts borrowed to finance the rehabilitation costs or to finance purchase of the property are subject to a variable rate or are otherwise...

76 FR 2720 - Trade Adjustment Assistance Program; Designation of Certifying Officers

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-14

... DEPARTMENT OF LABOR Employment and Training Administration Trade Adjustment Assistance Program; Designation of Certifying Officers AGENCY: Employment and Training Administration, Labor. ACTION: Notice... workers and firms in the service sector; made benefits available to workers whose jobs have been off...

Structural MRI correlates of apathy symptoms in older persons without dementia

PubMed Central

Grool, Anne M.; Geerlings, Mirjam I.; Sigurdsson, Sigurdur; Eiriksdottir, Gudny; Jonsson, Palmi V.; Garcia, Melissa E.; Siggeirsdottir, Kristin; Harris, Tamara B.; Sigmundsson, Thordur; Gudnason, Vilmundur

2014-01-01

Objective: We aimed to investigate the relation between apathy symptoms and structural brain changes on MRI, including white matter lesions (WMLs) and atrophy, in a large cohort of older persons. Methods: Cross-sectional analyses are based on 4,354 persons without dementia (aged 76 ± 5 years) participating in the population-based Age, Gene/Environment Susceptibility–Reykjavik Study. Apathy symptoms were assessed with 3 items from the 15-item Geriatric Depression Scale. Brain volumes and total WML volume were estimated on 1.5-tesla MRI using an automated segmentation program; regional WML load was calculated using a semiquantitative scale. Regression analyses were adjusted for age, sex, education, intracranial volume, vascular risk factors, physical activity, brain infarcts, depressive symptoms, antidepressants, and cognitive status. Results: Compared to those with <2 apathy symptoms, participants with ≥2 apathy symptoms (49% of the cohort) had significantly smaller gray matter volumes (mean adjusted difference −3.6 mL, 95% confidence interval [CI] −6.2 to −1.0), particularly in the frontal and temporal lobes; smaller white matter volumes (mean adjusted difference −1.9 mL, 95% CI −3.6 to −0.3), mainly in the parietal lobe; and smaller thalamus volumes. They were also more likely to have WMLs in the frontal lobe (adjusted odds ratio = 1.08, 95% CI 0.9–1.3). Excluding participants with a depression diagnosis did not change the associations. Conclusions: In this older population without dementia, apathy symptoms are associated with a more diffuse loss of both gray and white matter volumes, independent of depression. PMID:24739783

Method and apparatus for control of a magnetic structure

DOEpatents

Challenger, Michael P.; Valla, Arthur S.

1996-06-18

A method and apparatus for independently adjusting the spacing between opposing magnet arrays in charged particle based light sources. Adjustment mechanisms between each of the magnet arrays and the supporting structure allow the gap between the two magnet arrays to be independently adjusted. In addition, spherical bearings in the linkages to the magnet arrays permit the transverse angular orientation of the magnet arrays to also be adjusted. The opposing magnet arrays can be supported above the ground by the structural support.

Success of a Faculty Development Program for Teachers at the Mayo Clinic

PubMed Central

Lee, Staci M.; Lee, Mark C.; Reed, Darcy A.; Halvorsen, Andrew J.; Berbari, Elie F.; McDonald, Furman S.; Beckman, Thomas J.

2014-01-01

Background There has been limited research on the improvement of underperforming clinical teachers. Objective To determine whether a faculty development program could improve the evaluations of clinical teachers in an internal medicine residency program. Methods A total of 123 teachers completed faculty development at the Mayo Clinic from 2009 to 2012. The faculty enhancement and education development program (FEED) consists of 6 interactive, small group, 2-hour sessions taught by experienced Mayo Clinic faculty over 1 year. These sessions address the following competencies: asking questions, diagnosing learners, giving feedback, using teaching frameworks, recognizing learning styles, and providing clinical supervision. Resident-of-faculty Mayo teaching effectiveness (MTE) scores have previously demonstrated content, internal structure, and criterion validity. Teachers were grouped into the top 80% or the bottom 20%, according to baseline MTE scores. Mixed linear models were used to compare these groups regarding changes in MTE scores after completion of FEED. Results were adjusted for teacher age, sex, medical specialty, academic rank, and teaching awards. Results For all participants combined, the adjusted MTE scores (mean; standard error) improved from baseline (3.80; 0.04) to completion of FEED (3.93; 0.04; P < .001). However, the bottom 20% had a significantly greater improvement in scores than the top 80% (score-change difference  =  0.166, P < .001). Conclusions We describe a low-intensity faculty development intervention that benefited all clinical teachers, but was particularly effective for underperforming teachers in internal medicine. The approach may be suitable for adoption or adaptation in other graduate medical education programs. PMID:26140122

Adjustments Needed in Vocational Agriculture Programs To Meet the Employment Needs of the Food and Fiber System in the Next Decade. A Position Paper.

ERIC Educational Resources Information Center

National Association of Supervisors of Agricultural Education.

The image of the instructional program in vocational agriculture must be changed to reflect a scientific and futuristic nature. The future of vocational agriculture depends upon a willingness of the agricultural education profession to analyze current programs and adjust them to meet the changes of today's rapidly advancing biotechnology and…

STS-92 Mission Specialist McArthur has his launch and entry suit adjusted

NASA Technical Reports Server (NTRS)

2000-01-01

In the Operations and Checkout Building, STS-92 Mission Specialist William S. McArthur Jr. has the gloves on his launch and entry suit adjusted during fit check. McArthur and the rest of the crew are at KSC for Terminal Countdown Demonstration Test activities. The TCDT provides emergency egress training, simulated countdown exercises and opportunities to inspect the mission payload. This mission will be McArthur's third Shuttle flight. STS-92 is scheduled to launch Oct. 5 at 9:38 p.m. EDT from Launch Pad 39A on the fifth flight to the International Space Station. It will carry two elements of the Space Station, the Integrated Truss Structure Z1 and the third Pressurized Mating Adapter. The mission is also the 100th flight in the Shuttle program.

Promoting a positive transition to parenthood: a randomized clinical trial of couple relationship education.

PubMed

Halford, W Kim; Petch, Jemima; Creedy, Debra K

2010-03-01

The transition to parenthood is often associated with a decline in couple relationship adjustment. Couples (n = 71) expecting their first child were randomly assigned to either: (a) Becoming a Parent (BAP), a maternal parenting education program; or (b) Couple CARE for Parents (CCP), a couple relationship and parenting education program. Couples were assessed pre-intervention (last trimester of pregnancy), post-intervention (5 months postpartum), and follow-up (12 months postpartum). Relative to BAP, CCP reduced negative couple communication from pre- to post-intervention, and prevented erosion of relationship adjustment and self-regulation in women but not men from pre-intervention to follow-up. Mean parenting stress reflected positive adjustment to parenthood with no differences between BAP and CCP. CCP shows promise as a brief program that can enhance couple communication and women's adjustment to parenthood.

Participation of pregnant women in a community-based nutrition program in Mumbai's informal settlements: Effect on exclusive breastfeeding practices

PubMed Central

Waingankar, Anagha; Shah More, Neena; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2018-01-01

Background In urban Maharashtra, India, approximately half of mothers exclusively breastfeed. For children residing in informal settlements of Mumbai, this study examines factors associated with exclusive breastfeeding, and whether exclusive breastfeeding, in a community-based nutrition program to prevent and treat wasting among children under age three, is associated with enrolment during the mother’s pregnancy. Methods The nutrition program conducted a cross-sectional endline survey (October-December 2015) of caregivers in intervention areas. Factors associated with exclusive breastfeeding for infants under six months of age were explored using multi-level logistic regressions. Additionally, program surveillance data collected during home-based counselling visits documented breastfeeding practices for children under six months of age. Using the surveillance data (January 2014-March 2016), exclusive breastfeeding status was regressed adjusting for child, maternal and socioeconomic characteristics, and whether the child was enrolled in the program in utero or after birth. Results The community-based endline survey included 888 mothers of infants. Mothers who received the nutrition program home visits or attended group counselling sessions were more likely to exclusively breastfeed (adjusted odds ratio 1.67, 95% CI 1.16, 2.41). Having a normal weight-for-height z-score (adjusted odds ratio 1.57, 95% CI 1.00, 2.45) was associated positively with exclusive breastfeeding. As expected, being an older infant aged three to five months (adjusted odds ratio 0.34, 95% CI 0.25, 0.48) and receiving a prelacteal feed after birth (adjusted odds ratio 0.57, 95% CI 0.41, 0.80) were associated with lower odds of exclusively breastfeeding. Surveillance data (N = 3420) indicate that infants enrolled in utero have significantly higher odds of being exclusively breastfed (adjusted odds ratio 1.55, 95% CI 1.30, 1.84) than infants enrolled after birth. Conclusions Prenatal enrolment in community-based programs working on child nutrition in urban informal settlements of India can improve exclusive breastfeeding practices. PMID:29621355

Participation of pregnant women in a community-based nutrition program in Mumbai's informal settlements: Effect on exclusive breastfeeding practices.

PubMed

Chanani, Sheila; Waingankar, Anagha; Shah More, Neena; Pantvaidya, Shanti; Fernandez, Armida; Jayaraman, Anuja

2018-01-01

In urban Maharashtra, India, approximately half of mothers exclusively breastfeed. For children residing in informal settlements of Mumbai, this study examines factors associated with exclusive breastfeeding, and whether exclusive breastfeeding, in a community-based nutrition program to prevent and treat wasting among children under age three, is associated with enrolment during the mother's pregnancy. The nutrition program conducted a cross-sectional endline survey (October-December 2015) of caregivers in intervention areas. Factors associated with exclusive breastfeeding for infants under six months of age were explored using multi-level logistic regressions. Additionally, program surveillance data collected during home-based counselling visits documented breastfeeding practices for children under six months of age. Using the surveillance data (January 2014-March 2016), exclusive breastfeeding status was regressed adjusting for child, maternal and socioeconomic characteristics, and whether the child was enrolled in the program in utero or after birth. The community-based endline survey included 888 mothers of infants. Mothers who received the nutrition program home visits or attended group counselling sessions were more likely to exclusively breastfeed (adjusted odds ratio 1.67, 95% CI 1.16, 2.41). Having a normal weight-for-height z-score (adjusted odds ratio 1.57, 95% CI 1.00, 2.45) was associated positively with exclusive breastfeeding. As expected, being an older infant aged three to five months (adjusted odds ratio 0.34, 95% CI 0.25, 0.48) and receiving a prelacteal feed after birth (adjusted odds ratio 0.57, 95% CI 0.41, 0.80) were associated with lower odds of exclusively breastfeeding. Surveillance data (N = 3420) indicate that infants enrolled in utero have significantly higher odds of being exclusively breastfed (adjusted odds ratio 1.55, 95% CI 1.30, 1.84) than infants enrolled after birth. Prenatal enrolment in community-based programs working on child nutrition in urban informal settlements of India can improve exclusive breastfeeding practices.

Dislocated Workers. Trade Adjustment Assistance Program Flawed. Statement of Linda G. Morra, Director of Education and Employment Issues, Human Resources Division. Testimony before the Subcommittee on Employment, Housing and Aviation, Committee on Government Operations, House of Representatives.

ERIC Educational Resources Information Center

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

The Trade Adjustment Assistance (TAA) program is designed to help the more than 1 million workers per year who lose their jobs because of permanent layoffs or plant closures, due in part because of imports. Studies show, however, that the TAA program fails to meet the seven goals of a successful reemployment assistance program: (1) TAA benefits…

Computer-aided system of evaluation for population-based all-in-one service screening (CASE-PASS): from study design to outcome analysis with bias adjustment.

PubMed

Chen, Li-Sheng; Yen, Amy Ming-Fang; Duffy, Stephen W; Tabar, Laszlo; Lin, Wen-Chou; Chen, Hsiu-Hsi

2010-10-01

Population-based routine service screening has gained popularity following an era of randomized controlled trials. The evaluation of these service screening programs is subject to study design, data availability, and the precise data analysis for adjusting bias. We developed a computer-aided system that allows the evaluation of population-based service screening to unify these aspects and facilitate and guide the program assessor to efficiently perform an evaluation. This system underpins two experimental designs: the posttest-only non-equivalent design and the one-group pretest-posttest design and demonstrates the type of data required at both the population and individual levels. Three major analyses were developed that included a cumulative mortality analysis, survival analysis with lead-time adjustment, and self-selection bias adjustment. We used SAS AF software to develop a graphic interface system with a pull-down menu style. We demonstrate the application of this system with data obtained from a Swedish population-based service screen and a population-based randomized controlled trial for the screening of breast, colorectal, and prostate cancer, and one service screening program for cervical cancer with Pap smears. The system provided automated descriptive results based on the various sources of available data and cumulative mortality curves corresponding to the study designs. The comparison of cumulative survival between clinically and screen-detected cases without a lead-time adjustment are also demonstrated. The intention-to-treat and noncompliance analysis with self-selection bias adjustments are also shown to assess the effectiveness of the population-based service screening program. Model validation was composed of a comparison between our adjusted self-selection bias estimates and the empirical results on effectiveness reported in the literature. We demonstrate a computer-aided system allowing the evaluation of population-based service screening programs with an adjustment for self-selection and lead-time bias. This is achieved by providing a tutorial guide from the study design to the data analysis, with bias adjustment. Copyright © 2010 Elsevier Inc. All rights reserved.

Access to health programs at the workplace and the reduction of work presenteeism: a population-based cross-sectional study.

PubMed

Bustillos, Arnaldo Sanchez; Trigoso, Oswaldo Ortiz

2013-11-01

To examine access to health programs at workplace as a determinant of presenteeism among adults. Data source was a subsample of the 2009-2010 Canadian Community Health Survey. The outcome was self-reported reduced activities at work (presenteeism). The explanatory variable was self-reported access to a health program at workplace. Logistic regression was used to measure the association between outcome and explanatory variables adjusting for potential confounders. Adjusting for sex, age, education, income, work stress, and chronic conditions, presenteeism was not associated with having access to a health program at workplace (adjusted odds ratio, 1.23; 95% confidence interval, 0.91 to 1.65). The odds of presenteeism were higher in workers who reported high work stress and those with chronic medical conditions. This study found that access to health programs at workplace is not significantly associated with a decline in presenteeism.

User's Manual for Program PeakFQ, Annual Flood-Frequency Analysis Using Bulletin 17B Guidelines

USGS Publications Warehouse

Flynn, Kathleen M.; Kirby, William H.; Hummel, Paul R.

2006-01-01

Estimates of flood flows having given recurrence intervals or probabilities of exceedance are needed for design of hydraulic structures and floodplain management. Program PeakFQ provides estimates of instantaneous annual-maximum peak flows having recurrence intervals of 2, 5, 10, 25, 50, 100, 200, and 500 years (annual-exceedance probabilities of 0.50, 0.20, 0.10, 0.04, 0.02, 0.01, 0.005, and 0.002, respectively). As implemented in program PeakFQ, the Pearson Type III frequency distribution is fit to the logarithms of instantaneous annual peak flows following Bulletin 17B guidelines of the Interagency Advisory Committee on Water Data. The parameters of the Pearson Type III frequency curve are estimated by the logarithmic sample moments (mean, standard deviation, and coefficient of skewness), with adjustments for low outliers, high outliers, historic peaks, and generalized skew. This documentation provides an overview of the computational procedures in program PeakFQ, provides a description of the program menus, and provides an example of the output from the program.

Health education programs may be as effective as exercise intervention on improving health-related quality of life among Japanese people over 65 years.

PubMed

Tamari, Kotaro; Kawamura, Kenji; Sato, Mitsuya; Harada, Kazuhiro

2012-09-01

The current study was aimed to examine the short-term effects of a 3-month health education program on health-related quality of life using the Short-Form 36. Twenty-five Japanese older people aged 65 and older in the health education program were compared with two historical control groups (n = 25 each) undertaking group and resistance exercise interventions and matched by age, sex and body mass index. A series of split-design two-way analyses of variance were conducted for data analysis. Significant improvements were observed in general health and vitality subscales of the Short-Form 36 in the educational program group. Multivariate analyses, adjusted for several confounding factors, revealed that the effects of the three programs were comparable. The findings suggest that a structured 3-month educational program may be as effective as exercise interventions in improving general health and vitality in a community-dwelling Japanese older population. © 2011 The Authors. Australasian Journal on Ageing © 2011 ACOTA.

Plastic material investment in load-bearing silk attachments in spiders.

PubMed

Wolff, Jonas O; Jones, Braxton; Herberstein, Marie E

2018-05-17

The nature and size of attachments is a fundamental element of animal constructions. Presumably, these adhesive structures are plastically deployed to balance material investment and attachment strength. Here we studied plasticity in dragline anchorages of the golden orb web spider, Nephila plumipes. Specifically, we predict that spiders adjust the size and structure of dragline anchorages with load, i.e. spider mass. Mass was manipulated by attaching lead pieces to the spider's abdomen resulting in a 50 percent increase in mass. Loaded spiders spun larger but structurally similar thread anchorages than unloaded spiders. Thus, the spinning program that determines the overall anchor structure is highly stereotypic, and flexibility is introduced through varying the anchor size by increasing material investment. Our study showcases substrate attachments as suitable models to investigate the interplay between innate and changeable elements in the economy of building behaviours. Copyright © 2018 Elsevier GmbH. All rights reserved.

Vibration assessment and structural monitoring of the Basilica of Maxentius in Rome

NASA Astrophysics Data System (ADS)

Pau, Annamaria; Vestroni, Fabrizio

2013-12-01

The present paper addresses the analysis of the ambient vibrations of the Basilica of Maxentius in Rome. This monument, in the city centre and close to busy roads, was the largest vaulted structure in the Roman Empire. Today, only one aisle of the structure remains, suffering from a complex crack scenario. The ambient vibration response is used to investigate traffic induced vibration and compare this to values that could be a potential cause of structural damage according to international standards. Using output-only methods, natural frequencies and mode shapes are obtained from the response, allowing comparison with predictions made with a finite element model. Notwithstanding simplifications regarding material behavior and crack pattern in the finite element model, an agreement between numerical and experimental results is reached once selected mechanical parameters are adjusted. A knowledge of modal characteristics and the availability of an updated model may be a first step of a structural monitoring program that could reveal any decay over time in the structural integrity of the monument.

Structural adjustment: the wrong prescription for Africa?

PubMed

Logie, D E; Woodroffe, J

1993-07-03

The medical and social consequences and the wide effects of the African structural adjustment program (SAP), specifically for women and children, and examples of the impact in Zimbabwe, Zambia, and Senegal, are discussed. Structural adjustment is defined and the history of its inception is provided. Significant economic and social welfare improvement occurred during the 1960s and 1970s, and considerable decline occurred during the 1980s. The present reality is that Africa,m contrary to popular myths about being a "bottomless pit of Western charity," transfers $10 billion/year to the rich North. Debtor countries are 61% more indebted in 1990 than they were in 1982. During the 1980s, oil prices and interest rates rose dramatically, African export prices dropped, and industrialized countries set up protectionist policies. In addition, there was civil war, drought, poor leadership which put military spending before poverty reduction, and the AIDS epidemic. The Western response was to restructure debt payments in return for implementation of SAPs. Structural adjustment involved a package of trade liberalization, devaluation, removal of government subsidies and price controls, privatization, credit shortages, higher interest rates, and "cost recovery" in health and education. The theory is that economic growth will "ultimately" lead to poverty reduction. A critical view is that SAP insures debt repayment, export of cheap raw materials to the North, and may not sustain longterm economic growth. The results for the poor have been high prices for food, transportation, school and medical fees, and a decline in wages and unemployment. Land is used for exports. A solution is to reduce the debt burden, to place the needs of the poor as a top priority in SAPs, and to put pressure on the World Bank, the International Monetary Fund, and governments to consider health outcomes. Other alternatives noted in the African Framework to SAPs are to place well being and self-reliance as development goals and outcome as a product of the society's value system. Education and training and food self-sufficiency need to be assured fully. The poor need better access to land and employment opportunities. The environment must be managed effectively. Economic development must expand beyond the export of cheap primary commodities.

Comparison of Surgical Outcomes Between Teaching and Nonteaching Hospitals in the Department of Veterans Affairs

PubMed Central

Khuri, Shukri F.; Najjar, Samer F.; Daley, Jennifer; Krasnicka, Barbara; Hossain, Monir; Henderson, William G.; Aust, J. Bradley; Bass, Barbara; Bishop, Michael J.; Demakis, John; DePalma, Ralph; Fabri, Peter J.; Fink, Aaron; Gibbs, James; Grover, Frederick; Hammermeister, Karl; McDonald, Gerald; Neumayer, Leigh; Roswell, Robert H.; Spencer, Jeannette; Turnage, Richard H.

2001-01-01

Objective To determine whether the investment in postgraduate education and training places patients at risk for worse outcomes and higher costs than if medical and surgical care was delivered in nonteaching settings. Summary Background Data The Veterans Health Administration (VA) plays a major role in the training of medical students, residents, and fellows. Methods The database of the VA National Surgical Quality Improvement Program was analyzed for all major noncardiac operations performed during fiscal years 1997, 1998, and 1999. Teaching status of a hospital was determined on the basis of a background and structure questionnaire that was independently verified by a research fellow. Stepwise logistic regression was used to construct separate models predictive of 30-day mortality and morbidity for each of seven surgical specialties and eight operations. Based on these models, a severity index for each patient was calculated. Hierarchical logistic regression models were then created to examine the relationship between teaching versus nonteaching hospitals and 30-day postoperative mortality and morbidity, after adjusting for patient severity. Results Teaching hospitals performed 81% of the total surgical workload and 90% of the major surgery workload. In most specialties in teaching hospitals, the residents were the primary surgeons in more than 90% of the operations. Compared with nonteaching hospitals, the patient populations in teaching hospitals had a higher prevalence of risk factors, underwent more complex operations, and had longer operation times. Risk-adjusted mortality rates were not different between the teaching and nonteaching hospitals in the specialties and operations studied. The unadjusted complication rate was higher in teaching hospitals in six of seven specialties and four of eight operations. Risk adjustment did not eliminate completely these differences, probably reflecting the relatively poor predictive validity of some of the risk adjustment models for morbidity. Length of stay after major operations was not consistently different between teaching and nonteaching hospitals. Conclusion Compared with nonteaching hospitals, teaching hospitals in the VA perform the majority of complex and high-risk major procedures, with comparable risk-adjusted 30-day mortality rates. Risk-adjusted 30-day morbidity rates in teaching hospitals are higher in some specialties and operations than in nonteaching hospitals. Although this may reflect the weak predictive validity of some of the risk adjustment models for morbidity, it may also represent suboptimal processes and structures of care that are unique to teaching hospitals. Despite good quality of care in teaching hospitals, as evidenced by the 30-day mortality data, efforts should be made to examine further the structures and processes of surgical care prevailing in these hospitals. PMID:11524590

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 3 2013-10-01 2013-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 3 2011-10-01 2011-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE ADVANTAGE PROGRAM Payments to...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 3 2012-10-01 2012-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

42 CFR 422.308 - Adjustments to capitation rates, benchmarks, bids, and payments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 3 2014-10-01 2014-10-01 false Adjustments to capitation rates, benchmarks, bids, and payments. 422.308 Section 422.308 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) MEDICARE ADVANTAGE PROGRAM...

Women in the Military Academies: US Army (Part 3 of 3).

ERIC Educational Resources Information Center

Welch, Michael J.

1989-01-01

The article looks at the 1979 physical development program for cadets at West Point's U.S. Military Academy, noting adjustments made to the physical education program for women and comparing physical abilities of female cadets in 1979 and 1989. Standards are adjusted as fitness test scores improve. (SM)

75 FR 63437 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... Service (FAS) has denied a petition (No. 2011016) for trade adjustment assistance (TAA) for northeast..., and FAS. After a review, the Administrator determined that the petition was able to demonstrate the... for Farmers Program Staff, Office of Trade Programs, FAS, USDA, at (202) 720-0638, or (202) 690-0633...

Flake-shell capsules: adjustable inorganic structures.

PubMed

Ji, Qingmin; Guo, Chunyan; Yu, Xiaoyan; Ochs, Christopher J; Hill, Jonathan P; Caruso, Frank; Nakazawa, Hiromoto; Ariga, Katsuhiko

2012-08-06

Structure-adjustable capsules are fabricated from inorganic components by using a self-template dissolution-regrowth mechanism to give flake-shell silica microcapsules. The capsules shrink under thermal stimulus and their structures can be adjusted by treatment at different pH values. Tuning of shell pore diameters leads to tailored drug release over prolonged periods. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

45 CFR 153.340 - Data collection under risk adjustment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... issuers offering risk adjustment covered plans in the State comply with data privacy and security... 45 Public Welfare 1 2014-10-01 2014-10-01 false Data collection under risk adjustment. 153.340... CARE ACT State Standards Related to the Risk Adjustment Program § 153.340 Data collection under risk...

7 CFR 1400.501 - Determination of average adjusted gross income.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 10 2011-01-01 2011-01-01 false Determination of average adjusted gross income. 1400... PAYMENT ELIGIBILITY FOR 2009 AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.501 Determination of average adjusted gross income. (a) Except as otherwise provided in...

7 CFR 701.17 - Average adjusted gross income limitation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 7 2010-01-01 2010-01-01 false Average adjusted gross income limitation. 701.17... RELATED PROGRAMS PREVIOUSLY ADMINISTERED UNDER THIS PART § 701.17 Average adjusted gross income limitation... 9003), each applicant must meet the provisions of the Adjusted Gross Income Limitations at 7 CFR part...

24 CFR 401.412 - Adjustment of rents based on operating cost adjustment factor (OCAF) or budget.

Code of Federal Regulations, 2013 CFR

2013-04-01

... HOUSING ASSISTANCE RESTRUCTURING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT MULTIFAMILY HOUSING MORTGAGE AND HOUSING ASSISTANCE RESTRUCTURING PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.412 Adjustment of rents based on operating cost adjustment factor (OCAF) or budget. (a) OCAF. (1) The Restructuring...

A Needs Assessment of International Students' Wives

ERIC Educational Resources Information Center

Martens, Vonda Plett; Grant, Peter R.

2008-01-01

Despite the unique adjustment challenges facing international students' spouses, little research has focused on their adjustment experiences or their programming needs. Understanding the adjustment of these individuals is important both in itself and because spouses play a key role in the adjustment and academic success of international students.…

75 FR 65534 - Immediate Disaster Assistance Program (IDAP)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... frequency at which the interest rate adjustment will occur (the ``adjustment period''), and such adjustments... adjustment period, plus one percentage point. The change in interest rate is effective on that day whether or... without the written agreement of the borrower. Any future change to interest rates on IDAP Loans will be...

Advanced Space Transportation Program (ASTP)

NASA Image and Video Library

2003-07-01

NASA's X-37 Approach and Landing Test Vehicle is installed is a structural facility at Boeing's Huntington Beach, California plant, where technicians make adjustments to composite panels. Tests, completed in July, were conducted to verify the structural integrity of the vehicle in preparation for atmospheric flight tests. Atmospheric flight tests of the Approach and Landing Test Vehicle are scheduled for 2004 and flight tests of the Orbital Vehicle are scheduled for 2006. The X-37 experimental launch vehicle is roughly 27.5 feet (8.3 meters) long and 15 feet (4.5 meters) in wingspan. It's experiment bay is 7 feet (2.1 meters) long and 4 feet (1.2 meters) in diameter. Designed to operate in both the orbital and reentry phases of flight, the X-37 will increase both safety and reliability, while reducing launch costs from $10,000 per pound to $1,000.00 per pound. The X-37 program is managed by the Marshall Space Flight Center and built by the Boeing Company.

Socioeconomic and family influences on dental treatment needs among Brazilian underprivileged schoolchildren participating in a dental health program

PubMed Central

2013-01-01

Background The objective of this study was to compare the socioeconomic and family characteristics of underprivileged schoolchildren with and without curative dental needs participating in a dental health program. Methods A random sample of 1411 of 8-to-10 year-old Brazilian schoolchildren was examined and two sample groups were included in the cross-sectional study: 544 presented curative dental needs and the other 867 schoolchildren were without curative dental needs. The schoolchildren were examined for the presence of caries lesions using the DMFT index and their parents were asked to answer questions about socioenvironmental characteristics of their families. Logistic regression models were adjusted estimating the Odds Ratios (OR), their 95% confidence intervals (CI), and significance levels. Results After adjusting for potential confounders, it was found that families earning more than one Brazilian minimum wage, having fewer than four residents in the house, families living in homes owned by them, and children living with both biological parents were protective factors for the presence of dental caries, and consequently, curative dental needs. Conclusions Socioeconomic status and family structure influences the curative dental needs of children from underprivileged communities. In this sense, dental health programs should plan and implement strategic efforts to reduce inequities in oral health status and access to oral health services of vulnerable schoolchildren and their families. PMID:24138683

Redesigning a clinical mentoring program for improved outcomes in the clinical training of clerks

PubMed Central

Lin, Chia-Der; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh; Lee, Cheng-Chun

2015-01-01

Introduction Mentorship has been noted as critical to medical students adapting to clinical training in the medical workplace. A lack of infrastructure in a mentoring program might deter relationship building between mentors and mentees. This study assessed the effect of a redesigned clinical mentoring program from the perspective of clerks. The objective was to assess the benefits of the redesigned program and identify potential improvements. Methods A redesigned clinical mentoring program was launched in a medical center according to previous theoretical and practical studies on clinical training workplaces, including the elements of mentor qualifications, positive and active enhancers for mentor–mentee relationship building, the timing of mentoring performance evaluation, and financial and professional incentives. A four-wave web survey was conducted, comprising one evaluation of the former mentoring program and three evaluations of the redesigned clinical mentoring program. Sixty-four fifth-year medical students in clerkships who responded to the first wave and to at least two of the three following waves were included in the study. A structured and validated questionnaire encompassing 15 items on mentor performance and the personal characteristics of the clerks was used. Mixed linear models were developed for repeated measurements and to adjust for personal characteristics. Results The results revealed that the redesigned mentoring program improved the mentors’ performance over time for most evaluated items regarding professional development and personal support provided to the mentees. Conclusions Our findings serve as an improved framework for the role of the institution and demonstrate how institutional policies, programs, and structures can shape a clinical mentoring program. We recommend the adoption of mentorship schemes for other cohorts of medical students and for different learning and training stages involved in becoming a physician. PMID:26384479

Behavioral adjustment of siblings of children with autism engaged in applied behavior analysis early intervention programs: the moderating role of social support.

PubMed

Hastings, Richard P

2003-04-01

There have been few studies of the impact of intensive home-based early applied behavior analysis (ABA) intervention for children with autism on family functioning. In the present study, behavioral adjustment was explored in 78 siblings of children with autism on ABA programs. First, mothers' ratings of sibling adjustment were compared to a normative sample. There were no reported increases in behavioral adjustment problems in the present sample. Second, regression analyses revealed that social support functioned as a moderator of the impact of autism severity on sibling adjustment rather than a mediator or compensatory variable. In particular, siblings in families with a less severely autistic child had fewer adjustment problems when more formal social support was also available to the family. The implications of these data for future research and for practice are discussed.

A Linear Programming Approach to Routing Control in Networks of Constrained Nonlinear Positive Systems with Concave Flow Rates

NASA Technical Reports Server (NTRS)

Arneson, Heather M.; Dousse, Nicholas; Langbort, Cedric

2014-01-01

We consider control design for positive compartmental systems in which each compartment's outflow rate is described by a concave function of the amount of material in the compartment.We address the problem of determining the routing of material between compartments to satisfy time-varying state constraints while ensuring that material reaches its intended destination over a finite time horizon. We give sufficient conditions for the existence of a time-varying state-dependent routing strategy which ensures that the closed-loop system satisfies basic network properties of positivity, conservation and interconnection while ensuring that capacity constraints are satisfied, when possible, or adjusted if a solution cannot be found. These conditions are formulated as a linear programming problem. Instances of this linear programming problem can be solved iteratively to generate a solution to the finite horizon routing problem. Results are given for the application of this control design method to an example problem. Key words: linear programming; control of networks; positive systems; controller constraints and structure.

Determining Appropriate Criteria in the Evaluation of Correctional Mental Health Treatment for Inmates.

ERIC Educational Resources Information Center

Alexander, Rudolph, Jr.

1992-01-01

Notes that, despite changed goals of mental health treatment for inmates, some prison treatment programs still evaluate effects in terms of adjustment indicators. Discusses and critiques proposals in Ohio to use adjustment indicators as outcome measures for new treatment program for mentally ill inmates. Discusses proper outcome measures for…

Extension Education Drives Economic Stimulus through Trade Adjustment Assistance for Farmers

ERIC Educational Resources Information Center

Neibergs, J. Shannon; Mahnken, Curtis; Moore, Danna L.; Kemper, Nathan P.; Nelson, John Glenn, III; Rainey, Ron; Hipple, Patricia

2015-01-01

Trade Adjustment Assistance for Farmers (TAAF) is a national multifaceted USDA program that provided technical and financial assistance to farmers and fishermen adversely affected by import competition. This article describes how Extension was successfully mobilized to deliver the TAAF program to 10,983 producers across the nation using innovative…

7 CFR 275.23 - Determination of State agency program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING... section, the adjusted regressed payment error rate shall be calculated to yield the State agency's payment error rate. The adjusted regressed payment error rate is given by r 1″ + r 2″. (ii) If FNS determines...

Patient Protection and Affordable Care Act; standards related to reinsurance, risk corridors, and risk adjustment. Final rule.

PubMed

2012-03-23

This final rule implements standards for States related to reinsurance and risk adjustment, and for health insurance issuers related to reinsurance, risk corridors, and risk adjustment consistent with title I of the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. These programs will mitigate the impact of potential adverse selection and stabilize premiums in the individual and small group markets as insurance reforms and the Affordable Insurance Exchanges ("Exchanges") are implemented, starting in 2014. The transitional State-based reinsurance program serves to reduce uncertainty by sharing risk in the individual market through making payments for high claims costs for enrollees. The temporary Federally administered risk corridors program serves to protect against uncertainty in rate setting by qualified health plans sharing risk in losses and gains with the Federal government. The permanent State-based risk adjustment program provides payments to health insurance issuers that disproportionately attract high-risk populations (such as individuals with chronic conditions).

Finite element fatigue analysis of rectangular clutch spring of automatic slack adjuster

NASA Astrophysics Data System (ADS)

Xu, Chen-jie; Luo, Zai; Hu, Xiao-feng; Jiang, Wen-song

2015-02-01

The failure of rectangular clutch spring of automatic slack adjuster directly affects the work of automatic slack adjuster. We establish the structural mechanics model of automatic slack adjuster rectangular clutch spring based on its working principle and mechanical structure. In addition, we upload such structural mechanics model to ANSYS Workbench FEA system to predict the fatigue life of rectangular clutch spring. FEA results show that the fatigue life of rectangular clutch spring is 2.0403×105 cycle under the effect of braking loads. In the meantime, fatigue tests of 20 automatic slack adjusters are carried out on the fatigue test bench to verify the conclusion of the structural mechanics model. The experimental results show that the mean fatigue life of rectangular clutch spring is 1.9101×105, which meets the results based on the finite element analysis using ANSYS Workbench FEA system.

Psychosocial Adjustment among Children Conceived via Donor Insemination by Lesbian and Heterosexual Mothers.

ERIC Educational Resources Information Center

Chan, Raymond W.; Raboy, Barbara; Patterson, Charlotte J.

1998-01-01

Examined relations among family structure, family process, and psychological adjustment of children who had been conceived via donor insemination. Found that the children were developing normally. Their adjustment was unrelated to structural variables such as parental sexual orientation. Parents with higher parenting stress and inter-parental…

7 CFR 701.117 - Average adjusted gross income limitation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 7 2011-01-01 2011-01-01 false Average adjusted gross income limitation. 701.117... Conservation Program § 701.117 Average adjusted gross income limitation. To be eligible for payments issued... the provisions of the Adjusted Gross Income Limitations at 7 CFR part 1400 subpart G. [72 FR 45880...

42 CFR § 512.300 - Determination of episode quality-adjusted target prices and actual episode payments.

Code of Federal Regulations, 2010 CFR

2017-10-01

... PROGRAMS EPISODE PAYMENT MODEL Pricing and Payment § 512.300 Determination of episode quality-adjusted... historical episode payments. (iii) For the AMI model, quality-adjusted target prices for anchor MS-DRGs 246... 100 percent regional historical episode payments. (iv) For the CABG model, quality-adjusted target...

75 FR 23227 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment... CONTACT: Trade Adjustment Assistance Staff, FAS, USDA, at (202) 720-0638, or by e-mail at: [email protected]fas.usda.gov . Additional program information can be obtained at the Web site for the Trade Adjustment...

42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) Drugs and biologicals that are paid under a separate APC; and (2) Items and services paid at charges... excluded from qualification for the payment adjustment in paragraph (g)(2) of this section: (i) Drugs and...) Payment adjustment for certain cancer hospitals—(1) General rule. CMS provides for a payment adjustment...

75 FR 23225 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... DEPARTMENT OF AGRICULTURE Foreign Agricultural Service Trade Adjustment Assistance for Farmers AGENCY: Foreign Agricultural Service, USDA. ACTION: Notice. The Administrator, Foreign Agricultural... program information can be obtained at the Web site for the Trade Adjustment Assistance for Farmers...

Students perceived stress in academic programs: consequences for its management.

PubMed

Neveu, D; Doron, J; Visier, L; Boiché, J; Trouillet, R; Dujols, P; Ninot, G

2012-08-01

Academic stress contributes to the deterioration of the students' quality of life. Psychological determinants involved in the stress process, trait anxiety and coping, have been neglected when assessing the role of academic programs in stress. This study aimed at determining whether academic programs are associated with a high level of perceived stress above and beyond potential personal and environmental risk factors, as well as coping strategies. A cross-sectional survey was conducted in 2009 among third-year medical (total n=170, participants 88%), dental (n=63, 94%), psychology (n=331, 61%) and sports sciences (n=312, 55%) students in Montpellier (France). The stress level experienced during the last 2months, trait anxiety and coping strategies were appraised. Substance use, psychological care, and stress triggers were also collected using a self-administered questionnaire. Compared with medicine and after adjusting for gender and age, only the sports program was associated with a lower perceived stress risk: adjusted odds ratio: 0.54 [95% Confidence interval: 0.30; 0.99]. Substantial reductions in perceived stress risks were observed in science students after additional adjustments for non-academic stress triggers, substance use, psychological care (adjusted odds ratio: 0.20 [95% Confidence interval: 0.09; 0.41]), and also for trait anxiety and coping strategies (adjusted odds ratio: 0.23 [95% Confidence interval: 0.10; 0.54]). Compared with medicine and after these additional adjustments, psychology had a significantly lower perceived stress risk (0.34 [0.18; 0.64]; 0.40 [0.19; 0.86], respectively), dentistry had a similar risk (0.82 [0.35; 1.91]; 0.53 [0.20; 1.43], respectively). Sports and psychology programs had a lower perceived stress risk compared with medicine. Personal and environmental risk factors and coping strategies modified the association between academic program and perceived stress. Developing efficient coping strategies in students and improving academic environment could contribute to prevent the potential deleterious consequences of stress. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Design and Implementation of Multifunctional Automatic Drilling End Effector

NASA Astrophysics Data System (ADS)

Wang, Zhanxi; Qin, Xiansheng; Bai, Jing; Tan, Xiaoqun; Li, Jing

2017-03-01

In order to realize the automatic drilling in aircraft assembly, a drilling end effector is designed by integrating the pressure unit, drilling unit, measurement unit, control system and frame structure. In order to reduce the hole deviation, this paper proposes a vertical normal adjustment program based on 4 laser distance sensors. The actual normal direction of workpiece surface can be calculated through the sensors measurements, and then robot posture is adjusted to realize the hole deviation correction. A base detection method is proposed to detect and locate the hole automatically by using the camera and the reference hole. The experiment results show that the position accuracy of the system is less than 0.3mm, and the normal precision is less than 0.5°. The drilling end effector and robot can greatly improve the efficiency of the aircraft parts and assembly quality, and reduce the product development cycle.

Transition to high rate aerospace NDI processes

NASA Astrophysics Data System (ADS)

Vanderheiden, Bert; Thomson, Clint; Ivakhnenko, Igor; Garner, Chuck

2018-04-01

With the rapidly expanding use of carbon fiber composite materials in military and commercial aircraft, processes to manufacture and inspect the structural components must evolve to ensure economic viability. Inspection techniques which were developed to inspect products produced at a rate of one or two structures a month are not fast or flexible enough to inspect more than 8500 parts per month. This presentation describes the evolution of phased array ultrasonic inspection systems to provide the increased rate capacity, the flexibility to accommodate multiple unique designs, and the ability to rapidly adjust to product design changes. The paper will describe how system developments were made in response to new programs resulting in a much less expensive, higher degree of accuracy, increased flexibility, and lower cycle time inspections.

Adolescent leisure dimensions, psychosocial adjustment, and gender effects.

PubMed

Bradley, Graham L; Inglis, Brad C

2012-10-01

Leisure provides the context for much of adolescent behaviour and development. While both theory and research point to the benefits of participation in leisure activities that are highly structured, the association between structured leisure and psychosocial adjustment is not uniformly high. This paper presents a model of adolescent leisure comprising three dimensions: structure, effort, and social contact. Adolescent adjustment is hypothesized to increase with participation in activities characterized by each of these attributes. Adjustment is also predicted to vary with gender, and with the interaction of gender and leisure participation. These propositions were tested in a questionnaire-based study of 433 Australian adolescents. Results revealed majority support for hypotheses pertaining to the positive effects of the leisure dimensions, and for gender differences in leisure participation and adjustment. Evidence was also obtained of gender-differentiated effects of leisure on adjustment, with social leisure predicting adjustment more strongly in females than males. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Knowledge, attitudes and practices related to tetanus toxoid vaccination in women of childbearing age: A cross-sectional study in peri-urban settlements of Karachi, Pakistan.

PubMed

Shafiq, Yasir; Khowaja, Asif Raza; Yousafzai, Mohammad Tahir; Ali, Syed Asad; Zaidi, Anita; Saleem, Ali Faisal

2017-09-01

A higher incidence of neonatal tetanus implies failure of the vaccination program in Pakistan. The objective of this study was to assess knowledge, attitudes and practices related to tetanus toxoid (TT) vaccine in women of childbearing age. We performed a cross-sectional survey in peri-urban Karachi, Pakistan, among women of childbearing age, stratified into three mutually exclusive groups as: married pregnant; married non-pregnant; and unmarried. Descriptive and inferential analyses were performed to estimate vaccine coverage and knowledge attributes. A total of 450 women participated, of which the largest proportion were married and non-pregnant (n = 185/450, 41%). Over 50% of women (n = 258/450) had not received TT vaccine. Most unmarried women (n = 139, 97%) were unvaccinated. Non-vaccination predictors included: women aged <25 years without any formal education (adjusted odds ratio [OR], 2.1; 95% confidence interval [CI], 1.0-4.4), lack of knowledge about free vaccination (adjusted OR, 4.0; 95% CI, 1.64-10.20), poor knowledge of tetanus disease/vaccination (adjusted OR, 4.6; 95%, 2.2-9.6), living with extended family (adjusted OR, 2.0; 95% CI, 1.04-3.96); family non-supporting vaccination (adjusted OR, 5.7; 95% CI, 2.3-13.9); and husband/other family member deciding upon issues related to women's health (adjusted OR, 2.9; 95% CI, 1.3-6.6). Low coverage of TT vaccine is largely influenced by poor knowledge, family structure and family decision-making in the local communities of Pakistan.

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

42 CFR 413.235 - Patient-level adjustments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PRINCIPLES OF REASONABLE COST REIMBURSEMENT; PAYMENT FOR END-STAGE RENAL DISEASE SERVICES... Disease (ESRD) Services and Organ Procurement Costs § 413.235 Patient-level adjustments. Adjustments to...

National Weatherization Assistance Program Characterization - Describing the Pre-ARRA Progam

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

Bensch, Ingo; Keene, Ashleigh; Cowan, Claire

2014-09-01

This report characterizes the Department of Energy s Weatherization Assistance Program (WAP) as it was administered in Program Year 2008. WAP has supported energy efficiency improvements to the homes of low-income households in the United States since 1976. The program provides grants, guidance, and other support to grantees: weatherization programs administered by each of the 50 states, the District of Columbia and some Native American tribes. Although there have been studies of some grantee-administered weatherization programs, the overall effectiveness of the national weatherization program has not been formally evaluated since Program Year 1989. Since that time, the program has evolvedmore » significantly, with an increased focus on baseload electric usage, continued evolution of diagnostic tools, new guidelines and best practices for heating-related measures, and adjustments in program rules. More recently, the program has also adjusted to large, temporary funding increases and changes in federal rules spurred by the American Recovery and Reinvestment Act (ARRA). Because the Weatherization Assistance Program of today is dramatically different from the one evaluated in 1989, DOE determined to undertake a new comprehensive evaluation of the national program. This new national evaluation is managed by Oak Ridge National Laboratory (ORNL). Under a competitive solicitation process, ORNL selected APPRISE, Inc., Blasnik & Associates, Dalhoff Associates and the Energy Center of Wisconsin to conduct the evaluation. The national evaluation comprises two independent evaluations. The first evaluation of which this report is a part focuses on Program Year 2008 (PY08). The second evaluation focuses on the ARRA-funded years of 2009 through 2011. This report, together with its companion the Eligible Population Study addresses specific program characterization goals established for the greater evaluation. The Energy Center led grantee and subgrantee data collection efforts, administering surveys to 51 grantees and 851 of the approximately 900 subgrantees that were slated to receive DOE weatherization funds in PY08. In all, seven different data collection instruments were used to gather the needed data two instruments for grantees and five for subgrantees. See Table 1 for a list of these survey instruments. These surveys were used to determine, among other things: Structure and funding of weatherization programs Training and staff development of service providers How weatherization services are delivered Clients served« less

A vocational rehabilitation intervention for young adults with physical disabilities: participants' perception of beneficial attributes.

PubMed

Bal, M I; Sattoe, J N T; van Schaardenburgh, N R; Floothuis, M C S G; Roebroeck, M E; Miedema, H S

2017-01-01

Finding and maintaining employment is a major challenge for young adults with physical disabilities and their work participation rate is lower than that of healthy peers. This paper is about a program that supports work participation amongst young adults with chronic physical disabilities. The study aims to explore their experienced barriers and facilitators for finding and maintaining employment after starting this program, the participant-perceived beneficial attributes of the program and participants' recommendations for additional intervention components. Semi-structured interviews (n = 19) were held with former intervention participations. Interviews were recorded and transcribed ad verbatim. Themes were derived using the phenomenological approach. Physical functions and capacities, supervisor's attitude, self-esteem and self-efficacy and openness and assertiveness were experienced barriers and facilitators for finding and maintaining employment. Improvement of self-promoting skills and disclosure skills through job interview-training, increased self-esteem or self-efficacy through peer-support, a suitable job through job placement, improvement of work ability through arrangement of adjusted work conditions and change of supervisor's attitude through education provided to the supervisor were perceived as beneficial attributes of the intervention. Respondents recommended to incorporate assertiveness and openness skills training into future intervention programs. The findings suggest that programs supporting work participation should be designed to provide challenging, real-world experiential opportunities that provide young adults with physical disabilities with new insights, self-efficacy and life skills. Also, such programs should facilitate context centered learning. Former intervention participants, therefore, evaluated job-interview training, sharing learning and social experiences with peers, job placement, arrangement of adjusted work conditions and education as beneficial attributes of the 'At Work' program. In addition, they recommended, to incorporate more training on assertiveness and disclosure. We advise professionals to include these beneficial attributes in similar interventions in other contexts. © 2016 John Wiley & Sons Ltd.

The effects of emission control system malfunctions or maladjustments on exhaust emissions. Technical report

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

Not Available

1976-10-01

The Environmental Protection Agency is currently undertaking programs that measure the exhaust emissions of in-use vehicles. One of these programs, the Emission Factors Program (EFP), has generated data indicating that a high percentage of in-use 1975 automobiles have exhaust emissions exceeding the Federal emission standards for 1975-1976 light-duty vehicles. Typical failing vehicles have very high CO emissions. High CO emissions may be indicative of improper adjustment of either the idle mixture or the choke. Since idle mixture and choke adjustments are easily accessible and adjusted on most cars, it seems probable that the maladjustment of these two items may bemore » responsible for some of the high emission levels measured in the EFP. In order to further investigate these possibilities, a test program was conducted by the EPA to quantify the effects of various engine maladjustments on exhaust emissions. This test program would help identify maladjustments resulting in the types of failures encountered in the EFP.« less

Women's Work Conditions and Marital Adjustment in Two-Earner Couples: A Structural Model.

ERIC Educational Resources Information Center

Sears, Heather A.; Galambos, Nancy L.

1992-01-01

Evaluated structural model of women's work conditions, women's stress, and marital adjustment using path analysis. Findings from 86 2-earner couples with adolescents indicated support for spillover model in which women's work stress and global stress mediated link between their work conditions and their perceptions of marital adjustment.…

Adjusting to Change. Technology and the American Economy, Appendix, Volume III.

ERIC Educational Resources Information Center

National Commission on Technology, Automation and Economic Progress, Washington, DC.

Seven studies dealing with adjustment to technological change which were done by independent experts are presented. "Programs in Aid of the Poor," by Sar A. Levitan assesses the state of social insurance, public assistance, the poverty program and other assistance to the poor and compares them to current proposals as the negative income…

Final Evaluation Report of the Sensory Adjustment for Effective Reading (SAFER) Project for the Encinitas Union School District.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento. Office of Program Planning and Development.

This final report on Sensory Adjustment for Effective Reading contains information related to the two major objectives of the reading program: to diagnose and treat sensorily deficient kindergarten and primary children, and to individualize the kindergarten and primary reading program utilizing sensory information. Activities conducted to achieve…

Applied Behavior Analysis Programs for Autism: Sibling Psychosocial Adjustment during and Following Intervention Use

ERIC Educational Resources Information Center

Cebula, Katie R.

2012-01-01

Psychosocial adjustment in siblings of children with autism whose families were using a home-based, applied behavior analysis (ABA) program was compared to that of siblings in families who were not using any intensive autism intervention. Data gathered from parents, siblings and teachers indicated that siblings in ABA families experienced neither…

Surviving Job Loss: Motivation among Second Year Trade Adjustment Assistance (TAA) Students

ERIC Educational Resources Information Center

Karnes, Sandra Lee

2012-01-01

This ethnographic case study investigated second year college students who participated in the Trade Adjustment Assistance (TAA) program at a technical college in northeastern Pennsylvania. In order to understand how learners stayed motivated in a college setting, I selected participants who were in their second year of the TAA program. A total of…

42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) Drugs and biologicals that are paid under a separate APC; and (2) Items and services paid at charges... excluded from qualification for the payment adjustment in paragraph (g)(2) of this section: (i) Drugs and...) Payment adjustment for certain cancer hospitals.—(1) General rule. CMS provides for a payment adjustment...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140 How does a school qualify for a Small School Adjustment? A school will receive a small school...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140 How does a school qualify for a Small School Adjustment? A school will receive a small school...

Risk Adjustment, Reinsurance Improved Financial Outcomes For Individual Market Insurers With The Highest Claims.

PubMed

Jacobs, Paul D; Cohen, Michael L; Keenan, Patricia

2017-04-01

The Affordable Care Act (ACA) reformed the individual health insurance market. Because insurers can no longer vary their offers of coverage based on applicants' health status, the ACA established a risk adjustment program to equalize health-related cost differences across plans. The ACA also established a temporary reinsurance program to subsidize high-cost claims. To assess the impact of these programs, we compared revenues to claims costs for insurers in the individual market during the first two years of ACA implementation (2014 and 2015), before and after the inclusion of risk adjustment and reinsurance payments. Before these payments were included, for the 30 percent of insurers with the highest claims costs, claims (not including administrative expenses) exceeded premium revenues by $90-$397 per enrollee per month. The effect was reversed after these payments were included, with revenues exceeding claims costs by $0-$49 per month. The risk adjustment and reinsurance programs were relatively well targeted in the first two years. While there is ongoing discussion regarding the future of the ACA, our findings can shed light on how risk-sharing programs can address risk selection among insurers-a pervasive issue in all health insurance markets. Project HOPE—The People-to-People Health Foundation, Inc.

Structure of weakly 2-dependent siphons

NASA Astrophysics Data System (ADS)

Chao, Daniel Yuh; Chen, Jiun-Ting

2013-09-01

Deadlocks arising from insufficiently marked siphons in flexible manufacturing systems can be controlled by adding monitors to each siphon - too many for large systems. Li and Zhou add monitors to elementary siphons only while controlling the rest of (called dependent) siphons by adjusting control depth variables of elementary siphons. Only a linear number of monitors are required. The control of weakly dependent siphons (WDSs) is rather conservative since only positive terms were considered. The structure for strongly dependent siphons (SDSs) has been studied earlier. Based on this structure, the optimal sequence of adding monitors has been discovered earlier. Better controllability has been discovered to achieve faster and more permissive control. The results have been extended earlier to S3PGR2 (systems of simple sequential processes with general resource requirements). This paper explores the structures for WDSs, which, as found in this paper, involve elementary resource circuits interconnecting at more than (for SDSs, exactly) one resource place. This saves the time to compute compound siphons, their complementary sets and T-characteristic vectors. Also it allows us (1) to improve the controllability of WDSs and control siphons and (2) to avoid the time to find independent vectors for elementary siphons. We propose a sufficient and necessary test for adjusting control depth variables in S3PR (systems of simple sequential processes with resources) to avoid the sufficient-only time-consuming linear integer programming test (LIP) (Nondeterministic Polynomial (NP) time complete problem) required previously for some cases.

The Application of LOGO! in Control System of a Transmission and Sorting Mechanism

NASA Astrophysics Data System (ADS)

Liu, Jian; Lv, Yuan-Jun

Logic programming of general logic control module LOGO! has been recommended the application in transmission and sorting mechanism. First, the structure and operating principle of the mechanism had been introduced. Then the pneumatic loop of the mechanism had been plotted in the software of FluidSIM-P. At last, pneumatic loop and motors had been control by LOGO!, which makes the control process simple and clear instead of the complicated control of ordinary relay. LOGO! can achieve the complicated interlock control composed of inter relays and time relays. In the control process, the logic control function of LOGO! is fully used to logic programming so that the system realizes the control of air cylinder and motor. It is reliable and adjustable mechanism after application.

A Bell-Curved Based Algorithm for Mixed Continuous and Discrete Structural Optimization

NASA Technical Reports Server (NTRS)

Kincaid, Rex K.; Weber, Michael; Sobieszczanski-Sobieski, Jaroslaw

2001-01-01

An evolutionary based strategy utilizing two normal distributions to generate children is developed to solve mixed integer nonlinear programming problems. This Bell-Curve Based (BCB) evolutionary algorithm is similar in spirit to (mu + mu) evolutionary strategies and evolutionary programs but with fewer parameters to adjust and no mechanism for self adaptation. First, a new version of BCB to solve purely discrete optimization problems is described and its performance tested against a tabu search code for an actuator placement problem. Next, the performance of a combined version of discrete and continuous BCB is tested on 2-dimensional shape problems and on a minimum weight hub design problem. In the latter case the discrete portion is the choice of the underlying beam shape (I, triangular, circular, rectangular, or U).

Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2016. Final rule.

PubMed

2015-08-06

This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2016 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF PPS's case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2016. This final rule also finalizes policy changes, including the adoption of an IRF-specific market basket that reflects the cost structures of only IRF providers, a 1-year phase-in of the revised wage index changes, a 3-year phase-out of the rural adjustment for certain IRFs, and revisions and updates to the quality reporting program (QRP).

42 CFR 419.43 - Adjustments to national program payment and beneficiary copayment amounts.

Code of Federal Regulations, 2011 CFR

2011-10-01

... adjustment under paragraph (d)(1) of this section: (1) Drugs and biologicals that are paid under a separate... adjustment in paragraph (g)(2) of this section: (i) Drugs and biologicals that are paid under a separate APC...

10 CFR 905.34 - Adjustment provisions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... continue to take place based on existing contract/marketing criteria principles. ... 10 Energy 4 2010-01-01 2010-01-01 false Adjustment provisions. 905.34 Section 905.34 Energy DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment...

22 CFR 217.44 - Academic adjustments.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 1 2014-04-01 2014-04-01 false Academic adjustments. 217.44 Section 217.44... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 217.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such...

22 CFR 217.44 - Academic adjustments.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Academic adjustments. 217.44 Section 217.44... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 217.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such...

22 CFR 217.44 - Academic adjustments.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 1 2013-04-01 2013-04-01 false Academic adjustments. 217.44 Section 217.44... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 217.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such...

22 CFR 217.44 - Academic adjustments.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 1 2012-04-01 2012-04-01 false Academic adjustments. 217.44 Section 217.44... PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Postsecondary Education § 217.44 Academic adjustments. (a) Academic requirements. A recipient to which this subpart applies shall make such...

Socioeconomic obstacles to HIV prevention and treatment in developing countries: the roles of the International Monetary Fund and the World Bank.

PubMed

Lurie, P; Hintzen, P; Lowe, R A

1995-06-01

This paper explores the socioeconomic obstacles to HIV prevention and treatment in developing countries. The opening sections explain the historical origins of structural adjustment programs and their characteristics. Structural adjustment programs undermine the social fabric of many developing countries, and potentially promote behaviors which place people at increased risk of HIV infection. The authors discuss the declining sustainability of the rural subsistence economy, development of a transportation infrastructure, migration and urbanization, and reductions in spending on health and social services. Social and economic interventions are needed to stem the spread of HIV and care for those who are already infected. While a substantial amount of biomedical research has been conducted, socioeconomic aspects of the AIDS epidemic have often been ignored. For HIV transmission in developing countries to be substantially reduced, economic policies which may have promoted the spread of disease must be modified. An alternative development strategy consists of satisfying people's basic human needs, shifting from an export-driven economy to diversified agricultural production in the interest of securing regional self-sufficiency, supporting marginal producers and subsistence farmers, and placing greater emphasis upon human resource development in developing countries. Moreover, the IMF and World Bank need to change their policy to one which is truly about cooperative development, while the charters of the IMF and World Bank need to be altered to permit the cancellation or rescheduling of debt. These institutions should also play a leading role in the restructuring of debt owed to private lenders.

Coherent Risk-Adjusted Decisions Over Time: a Bilevel Programming Approach

DTIC Science & Technology

2015-03-23

AFRL-AFOSR-VA-TR-2015-0310 Coherent Risk-Adjusted Decisions Over Time: a Bilevel Programming Approach Jonathan Eckstein RUTGERS THE STATE UNIVERSITY...FA9550-11-1-0164 5b. GRANT NUMBER FA9550-11-1-0164 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Eckstein, Jonathan Ruszczynski, Andrzej 5d. PROJECT... Jonathan Eckstein a. REPORT U b. ABSTRACT U c. THIS PAGE U 19b. TELEPHONE NUMBER (Include area code) 848-445-0510 Standard Form 298 (Rev. 8/98

Affordable Care Act risk adjustment: overview, context, and challenges.

PubMed

Kautter, John; Pope, Gregory C; Keenan, Patricia

2014-01-01

Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences.

10 CFR 905.34 - Adjustment provisions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... DEPARTMENT OF ENERGY ENERGY PLANNING AND MANAGEMENT PROGRAM Power Marketing Initiative § 905.34 Adjustment...-term firm power contracts only as required to respond to changes in hydrology and river operations... the date that existing contractual commitments expire. Any adjustment shall only take place after an...

Do adjusted clinical groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program.

PubMed

Ettner, Susan L; Johnson, Steven

2003-01-01

The adequacy of risk adjustment to eliminate incentives for managed care organizations (MCOs) to avoid enrolling costly patients had been questioned. This study explored systematic differences in expenditures between beneficiaries with and without substance disorders assigned to the same capitation rate group under the Maryland Medicaid HealthChoice program. The investigators used fiscal year (FY) 1995 to 1997 Medicaid data to assign beneficiaries to rate cells based on FY 1995 diagnoses and compared the distribution of expenditures for beneficiaries with and without substance disorders, defined using FY 1997 and FY 1995 diagnoses. Results showed that differences in FY 1997 expenditures between beneficiaries with and without FY 1995 substance disorders were negligible. However, MCOs could expect greater average losses and lower average profits on beneficiaries with FY 1997 substance disorders. Thus, the adjusted clinical groups methodology used to adjust capitation payments in the HealthChoice program attenuated, but did not eliminate, financial incentives for MCOs to avoid substance abusers.

An experimental evaluation of theory-based mother and mother-child programs for children of divorce.

PubMed

Wolchik, S A; West, S G; Sandler, I N; Tein, J Y; Coatsworth, D; Lengua, L; Weiss, L; Anderson, E R; Greene, S M; Griffin, W A

2000-10-01

This study evaluated the efficacy of 2 theory-based preventive interventions for divorced families: a program for mothers and a dual component mother-child program. The mother program targeted mother-child relationship quality, discipline, interparental conflict, and the father-child relationship. The child program targeted active coping, avoidant coping, appraisals of divorce stressors, and mother-child relationship quality. Families with a 9- to 12-year-old child (N = 240) were randomly assigned to the mother, dual-component, or self-study program. Postintervention comparisons showed significant positive program effects of the mother program versus self-study condition on relationship quality, discipline, attitude toward father-child contact, and adjustment problems. For several outcomes, more positive effects occurred in families with poorer initial functioning. Program effects on externalizing problems were maintained at 6-month follow-up. A few additive effects of the dual-component program occurred for the putative mediators; none occurred for adjustment problems.

25 CFR Appendix B to Subpart C - Population Adjustment Factor

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Population Adjustment Factor B Appendix B to Subpart C...—Population Adjustment Factor 1. The Population Adjustment Factor allows for participation in the IRR Program... Distribution factor* Number of tribes** Funding amount per tribe Less than 25 1 N1 MBA*** × 1 25-100 3.5 N2 MBA...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Can a school receive both a small school adjustment and a small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School...

25 CFR 39.145 - Can a school receive both a small school adjustment and a small high school adjustment?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Can a school receive both a small school adjustment and a small high school adjustment? 39.145 Section 39.145 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School...

Abuse and Diversion of Immediate Release Opioid Analgesics as Compared to Extended Release Formulations in the United States

PubMed Central

Iwanicki, Janetta L.; Severtson, S. Geoff; McDaniel, Heather; Rosenblum, Andrew; Fong, Chunki; Cicero, Theodore J.; Ellis, Matthew S.; Kurtz, Steven P.; Buttram, Mance E.; Dart, Richard C.

2016-01-01

Background Therapeutic use and abuse of prescription opioids in the United States increased substantially between 1990 and 2010. The Centers for Disease Control estimated deaths related to pharmaceutical opioids reached nearly 19,000 in 2014. Of prescription opioids sold, 10% are extended release (ER) and 90% immediate release (IR). However, most regulations and interventions have focused on decreasing ER abuse. Our objective was to compare rates of abuse and diversion of ER and IR opioid analgesics over time using multiple surveillance programs. Methods Rates of abuse and diversion of ER and IR opioid formulations were compared using data from four surveillance programs in the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS®) System. Data were evaluated from 2009 through 2015, and Poisson regression used to compare IR and ER opioid cases over time. Results From 2009 to 2015, IR opioids were prescribed at a rate 12 to 16 times higher than ER. In the Poison Center Program, population-adjusted rates of Intentional Abuse for IR were 4.6 fold higher than ER opioids (p<0.001). In the Drug Diversion Program, population-adjusted rates of diversion were 6.1 fold higher for IR than ER opioids (p<0.001). In the Opioid Treatment Program, population-adjusted rates of endorsements for abuse were 1.6 fold higher for IR opioids than ER (p = 0.002). In the Survey of Key Informants' Patients Program, population-adjusted rates of endorsements for abuse were 1.5 fold higher for IR opioids than ER (p<0.001). Conclusions Between 2009 and 2015, IR opioids were prescribed at a much higher rate than ER opioids. Results from four surveillance programs show population-adjusted rates of prescription opioid abuse were markedly higher for IR than ER medications. For the greatest public health benefit, future interventions to decrease prescription opioid abuse should focus on both IR and ER formulations. PMID:27936038

Abuse and Diversion of Immediate Release Opioid Analgesics as Compared to Extended Release Formulations in the United States.

PubMed

Iwanicki, Janetta L; Severtson, S Geoff; McDaniel, Heather; Rosenblum, Andrew; Fong, Chunki; Cicero, Theodore J; Ellis, Matthew S; Kurtz, Steven P; Buttram, Mance E; Dart, Richard C

2016-01-01

Therapeutic use and abuse of prescription opioids in the United States increased substantially between 1990 and 2010. The Centers for Disease Control estimated deaths related to pharmaceutical opioids reached nearly 19,000 in 2014. Of prescription opioids sold, 10% are extended release (ER) and 90% immediate release (IR). However, most regulations and interventions have focused on decreasing ER abuse. Our objective was to compare rates of abuse and diversion of ER and IR opioid analgesics over time using multiple surveillance programs. Rates of abuse and diversion of ER and IR opioid formulations were compared using data from four surveillance programs in the Researched Abuse, Diversion and Addiction Related Surveillance (RADARS®) System. Data were evaluated from 2009 through 2015, and Poisson regression used to compare IR and ER opioid cases over time. From 2009 to 2015, IR opioids were prescribed at a rate 12 to 16 times higher than ER. In the Poison Center Program, population-adjusted rates of Intentional Abuse for IR were 4.6 fold higher than ER opioids (p<0.001). In the Drug Diversion Program, population-adjusted rates of diversion were 6.1 fold higher for IR than ER opioids (p<0.001). In the Opioid Treatment Program, population-adjusted rates of endorsements for abuse were 1.6 fold higher for IR opioids than ER (p = 0.002). In the Survey of Key Informants' Patients Program, population-adjusted rates of endorsements for abuse were 1.5 fold higher for IR opioids than ER (p<0.001). Between 2009 and 2015, IR opioids were prescribed at a much higher rate than ER opioids. Results from four surveillance programs show population-adjusted rates of prescription opioid abuse were markedly higher for IR than ER medications. For the greatest public health benefit, future interventions to decrease prescription opioid abuse should focus on both IR and ER formulations.

Perspectives of Adjustment: Rural Chicano Youth. Volume 1 of a Four Volume Final Report.

ERIC Educational Resources Information Center

Henry, William F.; Miles, Guy H.

The objective of this volume (findings of the first 2 phases of a 4 phase research program) was to develop hypotheses (to be tested in future Federal youth programs) about the critical variables affecting the social and occupational adjustment of rural youth of Spanish surname. Some 59 hypotheses were derived from a literature survey, supplemented…

"It's an Adjustment": Experiences of Stay-at-Home Mothers in Graduate Teacher Education Programs

ERIC Educational Resources Information Center

Lukacs, Karrin

2018-01-01

Administrators, designers, and instructors of teacher education programs need to be aware of their students' lives and experiences both inside and outside the classroom. This applies especially to students who are also stay-at-home mothers, trying to balance the demands of their personal and professional lives and to adjust to the differing…

TIPS from PIP: Primary Intervention Program for At-Risk Students.

ERIC Educational Resources Information Center

Allen, Jackie M.; Rogers, Carolyn

It is estimated that, on average, three out of ten school (or as high as seven out of ten) children experience some type of school adjustment problem. This paper outlines a program designed for children who have mild school adjustment difficulties in the early grades (K-3) and who are at risk of more serious difficulties as they become older. This…

The Games Analysis Intervention: A Procedure to Increase the Peer Acceptance and Social Adjustment of a Retarded Child.

ERIC Educational Resources Information Center

Marlowe, Mike

1979-01-01

A study investigated the effectiveness of a therapeutic motor development program in increasing the social adjustment and peer acceptance of a mainstreamed 10-year-old educable mentally retarded boy. The motor development program was based on the games analysis model and involved the S and 13 of his normal classmates. (Author/DLS)

Internet-based modular program BADI for adjustment disorder: protocol of a randomized controlled trial.

PubMed

Skruibis, Paulius; Eimontas, Jonas; Dovydaitiene, Migle; Mazulyte, Egle; Zelviene, Paulina; Kazlauskas, Evaldas

2016-07-26

Adjustment disorder is one of the most common mental health diagnoses. Still it receives relatively little attention from researchers trying to establish best interventions to treat it. With high prevalence of stressful life events, which might be leading to adjustment disorder, and limited resources of mental health service providers, online interventions could be a very practical way of helping people who have these disorders or are in the risk to develop them. The proposed study protocol is aimed to describe a randomized controlled trial of an internet-based modular intervention for adjustment disorder as it is defined in a proposal for the ICD-11. This study is a two-armed Randomized Controlled Trial (RCT) to examine the effectiveness of a web-based intervention BADI (Brief Adjustment Disorder Intervention) for adjustment disorder symptoms. BADI has four modules: Relaxation, Time management, Mindfulness and Strengthening relationships. It is based on stress and coping research and integrates evidence-based treatment approaches such as Cognitive Behavioural therapy (CBT), mindfulness and body-mind practices, as well as exercises for enhancing social support. Primary outcome of the study are symptoms of adjustment disorder and well-being. Engagement into the program and motivation for change is a secondary outcome. All participants after completing the baseline assessment are randomly assigned to one of the two groups: either to the one in which participant will instantly gain access to the BADI intervention or a group in which participants will be given access to the BADI program after waiting one month. Participants of BADI can choose exercises of the program flexibly. There is no particular order in which the exercises should be completed. Study will provide new insights of modular internet-based interventions efficacy for adjustment disorders. The study will also provide information about the role of motivation and expectancies on engagement in modular internet-based interventions. In case this RCT supports effectiveness of fully automated version of BADI, it could be used very broadly. It could become a cost-effective and accessible intervention for adjustment disorder. The study was retrospectively registered with the Australian and New Zealand Clinical Trials Registry with the registration number ACTRN12616000883415 . Registered 5 July, 2016.

Space Station Furnace Facility. Volume 3: Program cost estimate

NASA Technical Reports Server (NTRS)

1992-01-01

The approach used to estimate costs for the Space Station Furnace Facility (SSFF) is based on a computer program developed internally at Teledyne Brown Engineering (TBE). The program produces time-phased estimates of cost elements for each hardware component, based on experience with similar components. Engineering estimates of the degree of similarity or difference between the current project and the historical data is then used to adjust the computer-produced cost estimate and to fit it to the current project Work Breakdown Structure (WBS). The SSFF Concept as presented at the Requirements Definition Review (RDR) was used as the base configuration for the cost estimate. This program incorporates data on costs of previous projects and the allocation of those costs to the components of one of three, time-phased, generic WBS's. Input consists of a list of similar components for which cost data exist, number of interfaces with their type and complexity, identification of the extent to which previous designs are applicable, and programmatic data concerning schedules and miscellaneous data (travel, off-site assignments). Output is program cost in labor hours and material dollars, for each component, broken down by generic WBS task and program schedule phase.

Treatment persistence and hospitalization rates among patients with schizophrenia: a quasi-experiment to evaluate a patient information program.

PubMed

Pilon, Dominic; Amos, Tony B; Germain, Guillaume; Lafeuille, Marie-Hélène; Lefebvre, Patrick; Benson, Carmela J

2017-04-01

The effective treatment of schizophrenia requires continuous antipsychotic maintenance therapy. However, poor persistence with treatment is common among patients with schizophrenia. The objective of this study was to compare persistence and hospitalization rates among patients with schizophrenia treated with long-acting injectable (LAI) antipsychotics (i.e. paliperidone palmitate and risperidone) and enrolled in a patient information program (program cohort) with patients treated with oral antipsychotics (OAs) who were not enrolled in a patient information program (nonprogram cohort). Using a quasi-experimental design, data from chart reviews (for program patients) and Medicaid claims (for nonprogram patients) was analyzed. Patients were eligible if they had ≥12 months of pre-index data, ≥6 months of post-index data, and no hospitalization at index. Persistence and hospitalization rates were assessed at 6 months post-index. Propensity score matching was used to control for observed differences in demographics and baseline clinical characteristics. Odds ratios (ORs) were calculated using generalized estimating equation models and adjusted for matched pairs and propensity score. A total of 102 program patients were matched to 408 nonprogram patients with similar baseline characteristics. Adjusted ORs indicated that the persistence rate at 6 months was significantly higher for the program cohort (88.2%) versus the nonprogram cohort (43.9%; OR: 9.70; P < .0001). The 6 month post-index hospitalization rate for the program cohort (14.7%) was significantly lower versus the nonprogram cohort after adjustments (22.5%; OR: 0.55; P = 0.0321). The data for the program and nonprogram patients were from two different and independent data sources (healthcare claims and chart reviews, respectively). Results were based on a relatively small number of program LAI patients. Program patients treated with LAI antipsychotics had higher persistence rates and significantly lower adjusted hospitalization rates compared with nonprogram patients treated with OAs.

7 CFR 1580.101 - General statement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF AGRICULTURE TRADE ADJUSTMENT ASSISTANCE FOR FARMERS § 1580.101 General statement. This part provides regulations for the Trade Adjustment Assistance for Farmers program. Under these provisions...

24 CFR 888.204 - Revision to the automatic annual adjustment factors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM-FAIR MARKET RENTS AND...

24 CFR 888.203 - Use of contract rent automatic annual adjustment factors.

Code of Federal Regulations, 2010 CFR

2010-04-01

... DIRECT LOAN PROGRAM, SECTION 202 SUPPORTIVE HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM-FAIR MARKET...

Ant colony optimization and event-based dynamic task scheduling and staffing for software projects

NASA Astrophysics Data System (ADS)

Ellappan, Vijayan; Ashwini, J.

2017-11-01

In programming change organizations from medium to inconceivable scale broadens, the issue of wander orchestrating is amazingly unusual and testing undertaking despite considering it a manual system. Programming wander-organizing requirements to deal with the issue of undertaking arranging and in addition the issue of human resource portion (also called staffing) in light of the way that most of the advantages in programming ventures are individuals. We propose a machine learning approach with finds respond in due order regarding booking by taking in the present arranging courses of action and an event based scheduler revives the endeavour arranging system moulded by the learning computation in perspective of the conformity in event like the begin with the Ander, the instant at what time possessions be free starting to ended errands, and the time when delegates stick together otherwise depart the wander inside the item change plan. The route toward invigorating the timetable structure by the even based scheduler makes the arranging method dynamic. It uses structure components to exhibit the interrelated surges of endeavours, slip-ups and singular all through different progression organizes and is adjusted to mechanical data. It increases past programming wander movement ask about by taking a gander at a survey based process with a one of a kind model, organizing it with the data based system for peril assessment and cost estimation, and using a choice showing stage.

Pre/post evaluation of a pilot prevention with positives training program for healthcare providers in North West Province, Republic of South Africa.

PubMed

Kemp, Christopher G; de Kadt, Julia; Pillay, Erushka; Gilvydis, Jennifer M; Naidoo, Evasen; Grignon, Jessica; Weaver, Marcia R

2017-05-02

Prevention interventions for people living with HIV/AIDS are an important component of HIV programs. We report the results of a pilot evaluation of a four-hour, clinic-based training for healthcare providers in South Africa on HIV prevention assessments and messages. This pre/post pilot evaluation examined whether the training was associated with providers delivering more prevention messages. Seventy providers were trained at four public primary care clinics with a high volume of HIV patients. Pre- and post-training patient exit surveys were conducted using Audio-Computer Assisted Structured Interviews. Seven provider appropriate messaging outcomes and one summary provider outcome were compared pre- and post-training using Poisson regression. Four hundred fifty-nine patients pre-training and 405 post-training with known HIV status were interviewed, including 175 and 176 HIV positive patients respectively. Among HIV positive patients, delivery of all appropriate messages by providers declined post-training. The summary outcome decreased from 56 to 50%; adjusted rate ratio 0.92 (95% CI = 0.87-0.97). Sensitivity analyses adjusting for training coverage and time since training detected fewer declines. Among HIV negative patients the summary score was stable at 32% pre- and post-training; adjusted rate ratio 1.05 (95% CI = 0.98-1.12). Surprisingly, this training was associated with a decrease in prevention messages delivered to HIV positive patients by providers. Limited training coverage and delays between training and post-training survey may partially account for this apparent decrease. A more targeted approach to prevention messages may be more effective.

7 CFR 1400.502 - Compliance and enforcement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.502 Compliance and enforcement. (a) To comply with the average adjusted gross income limitation, a person or... CCC from a certified public accountant or attorney that the average adjusted gross income of the...

42 CFR 412.500 - Basis and scope of subpart.

Code of Federal Regulations, 2010 CFR

2010-10-01

... appropriate adjustments to that system, including adjustments to DRG weights, area wage adjustments... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Long... payment system for long-term care hospitals described in section 1886(d)(1)(B)(iv) of the Act. (2) Section...

24 CFR 882.510 - Adjustment of utility allowance.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Adjustment of utility allowance. 882.510 Section 882.510 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN... Moderate Rehabilitation-Program Development and Operation § 882.510 Adjustment of utility allowance. The...

7 CFR 718.110 - Adjustments.

Code of Federal Regulations, 2010 CFR

2010-01-01

... MARKETING QUOTAS, ACREAGE ALLOTMENTS, AND PRODUCTION ADJUSTMENT PROVISIONS APPLICABLE TO MULTIPLE PROGRAMS... in order to avoid a marketing quota penalty if such person: (1) Notifies the county committee of such... committee; and (2) Pays the cost of a farm inspection to determine the adjusted acreage prior to the date...

The Sociocultural Adjustment Trajectory of International University Students and the Role of University Structures: A Qualitative Investigation

ERIC Educational Resources Information Center

Coles, Rebecca; Swami, Viren

2012-01-01

The present research explores the sociocultural adjustment of international students and the role played by university structures in the process. The adjustment process of international students has been modelled in psychological literature as a U-curve, a learning curve and most recently as a long, uneven and unending process of change. Yet,…

Structural Turnbuckle Bears Compressive or Tensile Loads

NASA Technical Reports Server (NTRS)

Bateman, W. A.; Lang, C. H.

1985-01-01

Column length adjuster based on turnbuckle principle. Device consists of internally and externally threaded bushing, threaded housing and threaded rod. Housing attached to one part and threaded rod attached to other part of structure. Turning double threaded bushing contracts or extends rod in relation to housing. Once adjusted, bushing secured with jamnuts. Device used for axially loaded members requiring length adjustment during installation.

In Search of Speedier Searches.

ERIC Educational Resources Information Center

Peterson, Ivars

1984-01-01

Methods to make computer searching as simple and efficient as possible have led to the development of various data structures. Data structures specify the items involved in searching and what can be done to them. The nature and advantages of using "self-adjusting" data structures (self-adjusting binary search trees) are discussed. (JN)

24 CFR 888.201 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... HOUSING FOR THE ELDERLY PROGRAM AND SECTION 811 SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES PROGRAM) SECTION 8 HOUSING ASSISTANCE PAYMENTS PROGRAM-FAIR MARKET RENTS AND CONTRACT RENT ANNUAL ADJUSTMENT...

Assessing Factors in Adolescent Adjustment as Precursors to Recidivism in Court-Referred Youth

ERIC Educational Resources Information Center

Balkin, Richard S.; Miller, Janeen; Ricard, Richard J.; Garcia, Roberto; Lancaster, Chloe

2011-01-01

Court-referred youth participated in an intervention program and completed the Reynolds Adolescent Adjustment Screening Inventory. Reoffending rates were tracked for 2 years. Antisocial behavior, anger control, and emotional distress were influencing characteristics for recidivism. The Reynolds Adolescent Adjustment Screening Inventory may serve…

24 CFR 203.288 - Discontinuance of adjusted premium charge.

Code of Federal Regulations, 2010 CFR

2010-04-01

... instrument, there shall be no adjusted mortgage insurance premium due the Commissioner on account of the... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Discontinuance of adjusted premium... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER...

24 CFR 203.288 - Discontinuance of adjusted premium charge.

Code of Federal Regulations, 2011 CFR

2011-04-01

... instrument, there shall be no adjusted mortgage insurance premium due the Commissioner on account of the... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Discontinuance of adjusted premium... HOUSING AND URBAN DEVELOPMENT MORTGAGE AND LOAN INSURANCE PROGRAMS UNDER NATIONAL HOUSING ACT AND OTHER...

75 FR 59685 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied petitions (Nos. 2011024, 2011025) for trade adjustment assistance for lamb filed under the fiscal year (FY) 2011 program by lamb producers from Ohio. The petitions were accepted for... Administrator was not able to certify them, making lamb producers in Ohio ineligible for trade adjustment...

[Effects of Group Counseling Program Based on Goal Attainment Theory for Middle School Students with Emotional and Behavioral Problems].

PubMed

Jeong, In Ju; Kim, Soo Jin

2017-04-01

The purpose of this study was to examine the effects of a group counseling program based on goal attainment theory on self-esteem, interpersonal relationships, and school adjustment of middle school students with emotional and behavioral problems. Forty-four middle school students with emotional and behavioral problems (22 in the experimental group and 22 in the control group) from G city participated in this study. Data were collected from July 30 to September 24, 2015. The experimental group received the 8-session program, scheduled once a week, with each session lasting 45 minutes. Outcome variables included self-esteem, interpersonal relationship, and school adjustment. There were significant increases for self-esteem (t=3.69, p=.001), interpersonal relationship (t=8.88, p<.001), and school adjustment (t=4.92, p<.001) in the experimental group compared to the control group. These results indicate that the group counseling program based on goal attainment theory is very effective in increasing self-esteem, interpersonal relationship, and school adjustment for middle school students with emotional and behavioral problems. Therefore, it is recommended that the group counseling program based on goal attainment theory be used as an effective psychiatric nursing intervention for mental health promotion and the prevention of mental illness in adolescents. © 2017 Korean Society of Nursing Science

Floodplain management: Land acquisition versus preservation of historic buildings in Cambridge, Ontario, Canada

NASA Astrophysics Data System (ADS)

Bennett, Wendy J.; Mitchell, Bruce

1983-07-01

Non-structural adjustments in floodplain management are often avoided because they are seen to infringe on personal rights, adversely affect property values and restrict local tax bases. Land acquisition programs in urban areas encounter a further problem when they lead to demolition of buildings and other structures considered to have historical or architectural value. An experience in Cambridge, Ontario demonstrates that the potential conflict between flood damage reduction and historical preservation objectives can be exacerbated as a result of uncoordinated planning efforts, inflexibility in interpreting mandates, unclear roles for participating agencies, and lack of cooperation Many of these dilemmas can be resolved through consultation and discussion early in the planning process as well as through a willingness to be flexible and to search for a compromise

The relationships between father involvement and parental acceptance on the psychological adjustment of children and adolescents: The moderating effects of clinical status.

PubMed

Rodríguez Ruiz, Mercedes; Holgado-Tello, Francisco Pablo; Carrasco, Miguel Ángel

2017-10-01

This study analyzes how a child's clinical condition modifies the relationship of father involvement, parental (fathers and mothers) acceptance and the child´s psychological adjustment, including the internalizing and externalizing problems. The cohort studied was composed of 226 subjects (61.94% males) with a mean age of 14.08 years, of which 113 children were from an incidental clinical sample and 113 from the general population. Both groups were matched by sex, age and family status, and the data show that the same structure of parent-child relationships that predict the child´s psychological adjustment can be accepted for both the clinical and non-clinical groups of children. However, the intensity of the relationships between the variables father involvement, parental acceptance and the child´s outcomes differed in function of the child's clinical status. Specifically, in the clinically-referred sample compared to non-clinical sample father involvement had a stronger effect on the children´s internalizing (but not the externalizing) problems and on their global psychological adjustment via their perceived maternal acceptance. The role of father involvement in the family relationships of clinical children is discussed. This study provides important evidence to support the need for enhanced paternal participation in the intervention programs for families. Copyright © 2017 Elsevier B.V. All rights reserved.

The Effects of the Marriage Enrichment Program Based on the Cognitive-Behavioral Approach on the Marital Adjustment of Couples

ERIC Educational Resources Information Center

Kalkan, Melek; Ersanli, Ercumend

2008-01-01

The aim of this study is to investigate the effects of the marriage enrichment program based on the cognitive-behavioral approach on levels of marital adjustment of individuals. The experimental and control group of this research was totally composed of 30 individuals. A pre-test post-test research model with control group was used in this…

The Minority Recruitment Program at the Pennsylvania College of Optometry.

ERIC Educational Resources Information Center

Cohen, Karen

1987-01-01

A program to recruit and retain minority group optometry students is described, including the program's design, student financial aid, a preenrollment enrichment program to ease the adjustment to professional school, and the personal and academic program outcomes. (MSE)

Classroom Goal Structures, Social Achievement Goals, and Adjustment in Middle School

ERIC Educational Resources Information Center

Shim, Sungok Serena; Cho, YoonJung; Wang, Cen

2013-01-01

The current study investigated the mediating role of social achievement goals in the relation between classroom goal structures and academic engagement and social adjustment among 373 middle school students (52.8% female). Students' perceptions of classroom goal structures were measured in Fall; social achievement goals and academic and social…

Technology Enabled Work: The Role of Self-Efficacy in Determining Telecommuter Adjustment and Structuring Behavior.

ERIC Educational Resources Information Center

Raghuram, Sumita; Wiesenfeld, Batia; Garud, Raghu

2003-01-01

Responses from 31.5% of 723 telecommuters revealed a positive association between self-efficacy and both adjustment to teleworking and behaviors for structuring work. The more extensive the telecommuting, the stronger these positive relationships. Women were more proactive in structuring work behavior. (Contains 43 references.) (SK)

7 CFR 1400.503 - Commensurate reduction.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.503... legal entity determined to have an average adjusted gross income in excess of the applicable limitation...

7 CFR 1400.503 - Commensurate reduction.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND SUBSEQUENT CROP, PROGRAM, OR FISCAL YEARS Average Adjusted Gross Income Limitation § 1400.503... legal entity determined to have an average adjusted gross income in excess of the applicable limitation...

Helping public sector health systems innovate: the strategic approach to strengthening reproductive health policies and programs.

PubMed

Fajans, Peter; Simmons, Ruth; Ghiron, Laura

2006-03-01

Public sector health systems that provide services to poor and marginalized populations in developing countries face great challenges. Change associated with health sector reform and structural adjustment often leaves these already-strained institutions with fewer resources and insufficient capacity to relieve health burdens. The Strategic Approach to Strengthening Reproductive Health Policies and Programs is a methodological innovation developed by the World Health Organization and its partners to help countries identify and prioritize their reproductive health service needs, test appropriate interventions, and scale up successful innovations to a subnational or national level. The participatory, interdisciplinary, and country-owned process can set in motion much-needed change. We describe key features of this approach, provide illustrations from country experiences, and use insights from the diffusion of innovation literature to explain the approach's dissemination and sustainability.

[Implementation of telemedicine programs in Spain: experience of the main actors involved in the decision-making process].

PubMed

Mahtani Chugani, Vinita; Martín Fernández, Roberto Luis; Soto Pedre, Enrique; Yanes López, Virginia; Serrano Aguilar, Pedro

2009-01-01

To identify the main benefits and risks related to the implementation of telemedicine programs in Spain, based on the experience of the actors influencing the decision-making process. We performed a qualitative study based on audiotaped semi-structured telephone interviews. Eleven interviews were carried out, and the perspective of four physicians, three administrators, two researchers and two telecommunications industry workers were included. Theoretical sampling was used and thematic inductive analysis was performed. The following factors were identified as necessary to successfully resolve problems by using telemedicine programs: the commitment of the persons involved, technological aspects, economic and institutional support, acceptance by healthcare professionals and patients, the existence of protocols adjusted to the context, the need for information and training prior to the development of telemedicine programs, a forward-looking approach, routine use and full acceptance of telemedicine programs in the organization, and the need to defend equity for professionals and users. Successfully developing a telemedicine program requires a favorable environment in which risk can be foreseen. The main key element seems to be the human factor. The factors identified in this study should be considered when developing strategies to increase the chances of success of telemedicine programs in Spain.

Investing in communities: evaluating the added value of community mobilization on HIV prevention outcomes among FSWs in India.

PubMed

Kuhlmann, Anne Sebert; Galavotti, Christine; Hastings, Philip; Narayanan, Pradeep; Saggurti, Niranjan

2014-04-01

Community mobilization often requires greater time and resource investments than typical interventions, yet few evaluations exist to justify these investments. We evaluated the added benefit of community mobilization on HIV prevention outcomes among female sex workers (FSWs) using a composite measure of volunteer participation in program committees by FSWs. After adjusting for treatment propensity, we used multilevel structural equation modeling (MSEM) to test our program theory. We hypothesized that stronger community mobilization would be associated with increased levels of consistent condom use and with increased levels of perceived fairness, mediated by psychosocial processes. Community mobilization had an indirect effect on consistent condom use mediated through social cohesion and an indirect effect on perceived fairness mediated by collective efficacy. Our results suggest higher levels of community mobilization help improve condom use and reduce perceived discrimination beyond the effects of the core HIV intervention program. We recommend further testing of this model.

"Taking Training to the Next Level": The American College of Surgeons Committee on Residency Training Survey.

PubMed

Damewood, Richard B; Blair, Patrice Gabler; Park, Yoon Soo; Lupi, Linda K; Newman, Rachel Williams; Sachdeva, Ajit K

The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. Two surveys were developed, pilot tested, and administered to PDs following Institutional Review Board approval. PDs from 247 Accreditation Council for Graduate Medical Education-accredited general surgery programs were randomized to receive 1 of the 2 surveys. Bias analyses were conducted, and adjusted Pearson χ 2 tests were used to test for differences in response patterns by program type and size. All accredited general surgery programs in the United States were included in the sampling frame of the survey; 10 programs with initial or withdrawn accreditation were excluded from the sampling frame. A total of 135 PDs responded, resulting in a 54.7% response rate (Survey A: n = 67 and Survey B: n = 68). The respondent sample was determined to be representative of program type and size. Nearly 52% of PD responses were from university-based programs, and 41% had over 6 residents per graduating cohort. More than 61% of PDs reported that, compared to 10 years ago, both entering and graduating residents are less prepared in technical skills. PDs expressed significant concerns regarding the effect of duty-hour restrictions on the overall preparation of graduating residents (61%) and quality of patient care (57%). The current 5-year training structure was viewed as needing a significant or extensive increase in opportunities for resident autonomy (63%), and the greatest barriers to resident autonomy were viewed to be patient preferences not to be cared for by residents (68%), liability concerns (68%), and Centers for Medicare and Medicaid Services regulations (65%). Although 64% of PDs believe that moderate or significant changes are needed in the current structure of residency training, 35% believe that no changes in the structure are needed. When asked for their 1 best recommendation regarding the structure of surgical residency, only 22% of PDs selected retaining the current 5-year structure. The greatest percentage of PDs (28%) selected the "4 + 2" model as their 1 best recommendation for the structure to be used. In the area of faculty development, 56% of PDs supported a significant or extensive increase in Train the Teacher programs, and 41% supported a significant or extensive increase in faculty certification in education. Information regarding the valuable perspectives of PDs gathered through these surveys should help in implementing important changes in residency training and faculty development. These efforts will need to be pursued collaboratively with involvement of key stakeholders, including the organizations represented on this ACS committee. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Sources of stress for students in high school college preparatory and general education programs: group differences and associations with adjustment.

PubMed

Suldo, Shannon M; Shaunessy, Elizabeth; Thalji, Amanda; Michalowski, Jessica; Shaffer, Emily

2009-01-01

Navigating puberty while developing independent living skills may render adolescents particularly vulnerable to stress, which may ultimately contribute to mental health problems (Compas, Orosan, & Grant, 1993; Elgar, Arlett, & Groves, 2003). The academic transition to high school presents additional challenges as youth are required to interact with a new and larger peer group and manage greater academic expectations. For students enrolled in academically rigorous college preparatory programs, such as the International Baccalaureate (IB) program, the amount of stress perceived may be greater than typical (Suldo, Shaunessy, & Hardesty, 2008). This study investigated the environmental stressors and psychological adjustment of 162 students participating in the IB program and a comparison sample of 157 students in general education. Factor analysis indicated students experience 7 primary categories of stressors, which were examined in relation to students' adjustment specific to academic and psychological functioning. The primary source of stress experienced by IB students was related to academic requirements. In contrast, students in the general education program indicated higher levels of stressors associated with parent-child relations, academic struggles, conflict within family, and peer relations, as well as role transitions and societal problems. Comparisons of correlations between categories of stressors and students' adjustment by curriculum group reveal that students in the IB program reported more symptoms of psychopathology and reduced academic functioning as they experienced higher levels of stress, particularly stressors associated with academic requirements, transitions and societal problems, academic struggles, and extra-curricular activities. Applied implications stem from findings suggesting that students in college preparatory programs are more likely to (a) experience elevated stress related to academic demands as opposed to more typical adolescent concerns, and (b) manifest worse outcomes in the face of stress.

24 CFR 266.417 - Authority to adjust mortgage insurance amount.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AND OTHER AUTHORITIES HOUSING FINANCE AGENCY RISK-SHARING PROGRAM FOR INSURED AFFORDABLE MULTIFAMILY PROJECT LOANS Mortgage and Closing Requirements; HUD Endorsement § 266.417 Authority to adjust mortgage...

7 CFR 1956.68 - Compromise or adjustment without debtor's signature.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 14 2010-01-01 2009-01-01 true Compromise or adjustment without debtor's signature... Loan Programs and Multi-Family Housing § 1956.68 Compromise or adjustment without debtor's signature... made to obtain the debtor's signature and the date(s) of such effort. (c) The specific reasons why it...

77 FR 21775 - Risk Adjustment Meeting-May 7, 2012 and May 8, 2012

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-11

... notice announces a meeting on the risk adjustment program, which is open to the public. The purpose of... plan average actuarial risk, calculation of payments and charges, data collection approach, and the..., calculation of payments and charges, data collection approach, and the schedule for running risk adjustment...

45 CFR 153.630 - Data validation requirements when HHS operates risk adjustment.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Data validation requirements when HHS operates... Program § 153.630 Data validation requirements when HHS operates risk adjustment. (a) General requirement... performed on its risk adjustment data as described in this section. (b) Initial validation audit. (1) An...

45 CFR 153.630 - Data validation requirements when HHS operates risk adjustment.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Data validation requirements when HHS operates... Program § 153.630 Data validation requirements when HHS operates risk adjustment. (a) General requirement... performed on its risk adjustment data as described in this section. (b) Initial validation audit. (1) An...

How to Implement Differentiated Instruction? Adjust, Adjust, Adjust: North Carolina Project Begins with Encouragement from Administrators

ERIC Educational Resources Information Center

Lewis, Sylvia G.; Batts, Kelly

2005-01-01

To help teachers meet the diverse needs of individual students, North Topsail Elementary School in North Carolina developed a differentiated instruction program. North Topsail began its change with staff focusing on the principles of Accelerated Schools, including differentiation. Teachers reflected, developed a vision, and set priorities for…

75 FR 2491 - Trade Adjustment Assistance for Firms Program Fiscal Year 2009 Annual Report

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-15

... strengthen their marketing channels to more effectively reach service firms, it is expected that the number... a marketing/sales project or production/engineering project in their Adjustment Proposals, and 35... types of projects in Adjustment Proposals. More than half of all firms proposed to implement marketing...

75 FR 51978 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-24

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633: or by e-mail at: [email protected]fas.usda.gov ; or visit the TAA for Farmers' Web site...

75 FR 48642 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-11

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... benefits. FOR FURTHER INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: [email protected]fas.usda.gov ; or visit...

75 FR 49886 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

... Service (FAS) today accepted and began a review of a petition for trade adjustment assistance filed under... INFORMATION CONTACT: Trade Adjustment Assistance for Farmers Program Staff, FAS, USDA by phone: (202) 720-0638 or (202) 690- 0633; or by e-mail at: [email protected]fas.usda.gov ; or visit [[Page 49887

75 FR 23226 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-03

... Service (FAS), today accepted a petition, and began a review of a petition, for trade adjustment... Adjustment Assistance Staff, FAS, USDA, at (202) 720-0638, or by e-mail at: [email protected]fas.usda.gov... Farmers program. The URL is http://www.fas.usda.gov/itp/taa . Dated: April 27, 2010. John D. Brewer...

76 FR 3926 - Notice of Funding Opportunity and Solicitation for Grant Application (SGA) for Trade Adjustment...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-21

... Solicitation for Grant Application (SGA) for Trade Adjustment Assistance Community College and Career Training... (Reconciliation Act) from the Trade Adjustment Assistance Community College and Career Training Grants funding... expand and improve their ability to deliver education and career training programs that can be completed...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2014 CFR

2014-04-01

... lower grades and has a diploma-awarding high school component with an average instructional daily... 25 Indians 1 2014-04-01 2014-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2012 CFR

2012-04-01

... lower grades and has a diploma-awarding high school component with an average instructional daily... 25 Indians 1 2012-04-01 2011-04-01 true How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140...

25 CFR 39.140 - How does a school qualify for a Small School Adjustment?

Code of Federal Regulations, 2013 CFR

2013-04-01

... lower grades and has a diploma-awarding high school component with an average instructional daily... 25 Indians 1 2013-04-01 2013-04-01 false How does a school qualify for a Small School Adjustment... INDIAN SCHOOL EQUALIZATION PROGRAM Indian School Equalization Formula Small School Adjustment § 39.140...

Challenges and solutions in the evaluation of a low back pain disease management program.

PubMed

Kotsos, Thomas; Muldowney, Kevin; Chapa, Griselda; Martin, J Eric; Linares, Antonio

2009-02-01

This paper examines a novel approach to evaluating a nurse-run telephonic low back pain (LBP) disease management (DM) program offered by a fully-insured commercial health plan population with approximately 150,000 members located in the northeastern United States. Members with at least 6 member months of eligibility were identified to have LBP using administrative claims and eligibility data. The LBP program relies on telephonic nurse management augmented by printed materials, adapting and advocating HEDIS imaging guidelines, and drug utilization review. Outcomes of this LBP DM program were assessed using a pre-post population-based approach as recommended in the DMAA Outcomes Guidelines Report. Baseline year and program year populations were segmented into 5 LBP clinical categories and each was weight adjusted using population size. LBP-related medical service utilization and pharmacy utilization also were evaluated. Individuals under active LBP management exhibited a decrease in LBP-related imaging and surgeries. Overall analgesic use also decreased. These data suggest the LBP DM program is associated with a decrease in imaging, surgeries, and analgesic use. The magnitude of the clinically segmented weight-adjusted return on investment (ROI) was lower than the unadjusted ROI, but was directionally positive indicating program impact. This adjustment is necessary in order to gain insight into and consistency of the results of a comprehensive LBP DM program evaluation.

Effect of additional brief counselling after periodic health examination on motivation for health behavior change [corrected].

PubMed

Son, Ki Young; Lee, Cheol Min; Cho, BeLong; Lym, Youl Lee; Oh, Seung Won; Chung, Wonjoo; Lee, Jin-Seok; Park, DuShin; Kim, Han Suk

2012-11-01

This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program.

Effect of Aditional Brief Counselling after Periodic Health Examination on Motivation for Health Behavior Change

PubMed Central

Son, Ki Young; Lee, Cheol Min; Lym, Youl Lee; Oh, Seung Won; Chung, Wonjoo; Lee, Jin-Seok; Park, DuShin; Kim, Han Suk

2012-01-01

This study was to evaluate the effect of additional brief counseling by a primary care physician on lifestyle modification of examinees after a periodic health examination. 1,000 participants of the 2007 Korean national health screening program were asked to note any variation in their health behavior after participating in the screening program. The degree of comprehensive motivation for lifestyle modification was assessed in terms of stages of health behavior change. We calculated odds ratio of positive change (enhanced stage of change) with multiple logistic regression analysis and age-adjusted proportion of positive changers. Of 989 respondents, 486 and 503 received the basic and additional programs, respectively. Additional group were more likely to be positive changer than basic group (adjusted OR 1.78; 95% CI 1.19-2.65), and this was more prominent in older age group (adjusted OR 2.38, 95% CI 1.23-4.58). The age-adjusted proportions of positive changers were 22.7% (95% CI, 17.9-28.3) and 36.2% (95% CI, 30.4-42.4) in the basic and additional groups, respectively (P < 0.001). The additional consultation led to improvements in the stage of health behavior change after the health examination. Thus, such a consultation should be considered when designing a health-screening program. PMID:23166407

75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... Children's Health Insurance Program Reauthorization Act of 2009 for Adjustments to the Federal Medical... section 614 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law... Medicaid program and required by Section 614 of the Children's Health Insurance Program Reauthorization Act...

Automated torso organ segmentation from 3D CT images using structured perceptron and dual decomposition

NASA Astrophysics Data System (ADS)

Nimura, Yukitaka; Hayashi, Yuichiro; Kitasaka, Takayuki; Mori, Kensaku

2015-03-01

This paper presents a method for torso organ segmentation from abdominal CT images using structured perceptron and dual decomposition. A lot of methods have been proposed to enable automated extraction of organ regions from volumetric medical images. However, it is necessary to adjust empirical parameters of them to obtain precise organ regions. This paper proposes an organ segmentation method using structured output learning. Our method utilizes a graphical model and binary features which represent the relationship between voxel intensities and organ labels. Also we optimize the weights of the graphical model by structured perceptron and estimate the best organ label for a given image by dynamic programming and dual decomposition. The experimental result revealed that the proposed method can extract organ regions automatically using structured output learning. The error of organ label estimation was 4.4%. The DICE coefficients of left lung, right lung, heart, liver, spleen, pancreas, left kidney, right kidney, and gallbladder were 0.91, 0.95, 0.77, 0.81, 0.74, 0.08, 0.83, 0.84, and 0.03, respectively.

Predicted Water and Carbon Fluxes as well as Vegetation Distribution on the Korean Peninsula in the Future with the Ecosystem Demography Model version 2

NASA Astrophysics Data System (ADS)

Kim, J. B.; Kim, Y.

2017-12-01

This study investigates how the water and carbon fluxes as well as vegetation distribution on the Korean peninsula would vary with climate change. Ecosystem Demography (ED) Model version 2 (ED2) is used in this study, which is an integrated terrestrial biosphere model that can utilize a set of size- and age- structured partial differential equations that track the changing structure and composition of the plant canopy. With using the vegetation distribution data of Jeju Island, located at the southern part of the Korean Peninsula, ED2 is setup and driven for the past 10 years. Then the results of ED2 are evaluated and adjusted with observed forestry data, i.e., growth and mortality, and the flux tower and MODIS satellite data, i.e., evapotranspiration (ET) and gross primary production (GPP). This adjusted ED2 are used to simulate the water and carbon fluxes as well as vegetation dynamics in the Korean Peninsula for the historical period with evaluating the model against the MODIS satellite data. Finally, the climate scenarios of RCP 2.6 and 6.0 are used to predict the fluxes and vegetation distribution of the Korean Peninsula in the future. With using the state-of-art terrestrial ecosystem model, this study would provide us better understanding of the future ecosystem vulnerability of the Korean Peninsula. AcknowledgementsThis work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2015R1C1A2A01054800) and by the Korea Meteorological Administration R&D Program under Grant KMIPA 2015-6180. This work was also supported by the Yonsei University Future-leading Research Initiative of 2015(2016-22-0061).

History of POIC Capabilities and Limitations to Conduct International Space Station Payload Operations

NASA Technical Reports Server (NTRS)

Grimaldi, Rebecca; Horvath, Tim; Morris, Denise; Willis, Emily; Stacy, Lamar; Shell, Mike; Faust, Mark; Norwood, Jason

2011-01-01

Payload science operations on the International Space Station (ISS) have been conducted continuously twenty-four hours per day, 365 days a year beginning February, 2001 and continuing through present day. The Payload Operations Integration Center (POIC), located at the Marshall Space Flight Center in Huntsville, Alabama, has been a leader in integrating and managing NASA distributed payload operations. The ability to conduct science operations is a delicate balance of crew time, onboard vehicle resources, hardware up-mass to the vehicle, and ground based flight control team manpower. Over the span of the last ten years, the POIC flight control team size, function, and structure has been modified several times commensurate with the capabilities and limitations of the ISS program. As the ISS vehicle has been expanded and its systems changed throughout the assembly process, the resources available to conduct science and research have also changed. Likewise, as ISS program financial resources have demanded more efficiency from organizations across the program, utilization organizations have also had to adjust their functionality and structure to adapt accordingly. The POIC has responded to these often difficult challenges by adapting our team concept to maximize science research return within the utilization allocations and vehicle limitations that existed at the time. In some cases, the ISS and systems limitations became the limiting factor in conducting science. In other cases, the POIC structure and flight control team size were the limiting factors, so other constraints had to be put into place to assure successful science operations within the capabilities of the POIC. This paper will present the POIC flight control team organizational changes responding to significant events of the ISS and Shuttle programs.

Risk-Adjustment Simulation: Plans May Have Incentives To Distort Mental Health And Substance Use Coverage

PubMed Central

Montz, Ellen; Layton, Tim; Busch, Alisa B.; Ellis, Randall P.; Rose, Sherri; McGuire, Thomas G.

2016-01-01

Under the Affordable Care Act, the risk-adjustment program is designed to compensate health plans for enrolling people with poorer health status so that plans compete on cost and quality rather than the avoidance of high-cost individuals. This study examined health plan incentives to limit covered services for mental health and substance use disorders under the risk-adjustment system used in the health insurance Marketplaces. Through a simulation of the program on a population constructed to reflect Marketplace enrollees, we analyzed the cost consequences for plans enrolling people with mental health and substance use disorders. Our assessment points to systematic underpayment to plans for people with these diagnoses. We document how Marketplace risk adjustment does not remove incentives for plans to limit coverage for services associated with mental health and substance use disorders. Adding mental health and substance use diagnoses used in Medicare Part D risk adjustment is one potential policy step toward addressing this problem in the Marketplaces. PMID:27269018

Meeting the Challenges of Completing a Counseling Doctoral Program.

ERIC Educational Resources Information Center

Boes, Susan R.; Ullery, Elizabeth K.; Millner, Vaughn S.; Cobia, Debra C.

1999-01-01

Tasks of a doctoral program are discussed, including selecting a program, maneuvering through initial experiences, making adjustments, completing coursework, preparing for comprehensive examinations, choosing an internship, and completing the dissertation. (Author)

75 FR 1345 - Solicitation of Applications for the Community Trade Adjustment Assistance Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-11

... Administration, Seattle Regional Office, Jackson Federal Building, Room 1890, 915 Second Avenue, Seattle... Community TAA Program supplements and builds upon the other TAA programs by providing comprehensive...

Adjustment Problems of Korean American Elderly.

ERIC Educational Resources Information Center

Kiefer, Christie W.; And Others

1985-01-01

Interviewed 50 elderly Korean immigrants to identify adjustment problems. Ratings of overall stress and adjustment were made in five areas of functioning: social, cultural, economic, health, and emotional/cognitive. Adjustment was positively related to education, length of residence in the United States, and multigenerational household structure.…

Motorized Beam Alignment of a Commercial X-ray Diffractometer

NASA Technical Reports Server (NTRS)

Van Zandt, Noah R.; Myers, James F.; Rogers, Richard B

2013-01-01

X-ray diffraction (XRD) is a powerful analysis method that allows researchers to noninvasively probe the crystalline structure of a material. This includes the ability to determine the crystalline phases present, quantify surface residual stresses, and measure the distribution of crystallographic orientations. The Structures and Materials Division at the NASA Glenn Research Center (GRC) heavily uses the on-site XRD lab to characterize advanced metal alloys, ceramics, and polymers. One of the x-ray diffractometers in the XRD lab (Bruker D8 Discover) uses three different x-ray tubes (Cu, Cr, and Mn) for optimal performance over numerous material types and various experimental techniques. This requires that the tubes be switched out and aligned between experiments. This alignment maximizes the x-ray tube s output through an iterative process involving four set screws. However, the output of the x-ray tube cannot be monitored during the adjustment process due to standard radiation safety engineering controls that prevent exposure to the x-ray beam when the diffractometer doors are open. Therefore, the adjustment process is a very tedious series of blind adjustments, each followed by measurement of the output beam using a PIN diode after the enclosure doors are shut. This process can take up to 4 hr to perform. This technical memorandum documents an in-house project to motorize this alignment process. Unlike a human, motors are not harmed by x-ray radiation of the energy range used in this instrument. Therefore, using motors to adjust the set screws will allow the researcher to monitor the x-ray tube s output while making interactive adjustments from outside the diffractometer. The motorized alignment system consists of four motors, a motor controller, and a hand-held user interface module. Our goal was to reduce the alignment time to less than 30 min. The time available was the 10-week span of the Lewis' Educational and Research Collaborative Internship Project (LERCIP) summer internship program and the budget goal was $1200. In this report, we will describe our motorization design and discuss the results of its implementation.

Do Medicaid incentive payments boost quality? Florida's direct care staffing adjustment program.

PubMed

Hyer, Kathryn; Thomas, Kali S; Johnson, Christopher E; Harman, Jeffrey S; Weech-Maldonado, Robert

2013-01-01

Beginning in April 2000 and continuing for 21 months, Florida's legislature allocated $31.6 million (annualized) to nursing homes through a Medicaid direct care staffing adjustment. Florida's legislature paid the highest incentives to nursing homes with the lowest staffing levels and the greatest percentage of Medicaid residents--the bottom tier of quality. Using Donabedian's structure-process-outcomes framework, this study tracks changes in staffing, wages, process of care, and outcomes. The incentive payments increased staffing and wages in nursing home processes (decreased restraint use and feeding tubes) for the facilities receiving the largest amount of money but had no change on pressure sores or decline in activities of daily living. The group receiving the lowest incentives payment (those highest staffed at baseline) saw significant improvement in two quality measures: pressure sores and decline in activities of daily living. All providers receiving more resources improved on deficiency scores, suggesting more Medicaid spending improves quality of care regardless of total incentive payments.

Alternatives for using multivariate regression to adjust prospective payment rates

PubMed Central

Sheingold, Steven H.

1990-01-01

Multivariate regression analysis has been used in structuring three of the adjustments to Medicare's prospective payment rates. Because the indirect-teaching adjustment, the disproportionate-share adjustment, and the adjustment for large cities are responsible for distributing approximately $3 billion in payments each year, the specification of regression models for these adjustments is of critical importance. In this article, the application of regression for adjusting Medicare's prospective rates is discussed, and the implications that differing specifications could have for these adjustments are demonstrated. PMID:10113271

The medicine that might kill the patient: Structural Adjustment and its impacts on health care in Bangladesh.

PubMed

Hossen, Md Abul; Westhues, Anne

2012-01-01

Over the past decade, reforms of the health sector have evolved as a global phenomenon. There is, by now, a fair literature on the relationship between globalization and health. Within this literature, however, there is relatively little attention given to the Structural Adjustment Program (SAP), one aspect of globalization, and its impact on health. It can be observed that the SAP has had a dramatic impact on the status of education, health, the environment, and women and children in many developing countries. The restructuring of the health sector has led to the collapse of preventive and curative care due to the lack of medical equipment, supplies, poor working conditions, low pay of medical personnel, and the resulting low morale in Ghana, Philippines, and Zimbabwe. User fees in primary health care have led to the exclusion of a large section of the population from accessing health services as they are unable to pay. This article discusses the health specific impact of the SAP and the economic reforms initiated under it in Bangladesh. In particular, it will analyze how these policies affect the health care delivery system in Bangladesh in relation to geographic accessibility, affordability, quality of services, administrative efficiency, the rural urban service gap, public provision of health care, and donor influence on health policy.

Symposia in undergraduate medical education: tailoring training in competencies to students' needs.

PubMed

Reefman, Karin; Daelmans, Hester E M; Klumpers, Ursula M H; Croiset, Gerda

2017-12-01

In mastering competencies, it is a challenge to create training sessions which acknowledge individual students' needs and are logistically feasible in the medical master's program. Symposia were implemented in the medical master's program to provide knowledge and training of skills in a number of topics, providing a positive contribution to students' competencies and personal development. Each symposium contained a morning and afternoon program, structured around medical and societal themes addressing various competencies and covering current national and international events. Alternating interactive teaching methods were used. Students were asked to rate each daypart program on a 5-point Likert scale in terms of both teaching methods and content, and to comment on the best aspects of the symposium as well as areas for improvement. Scores higher than 3.5 were interpreted as a predominantly favourable outcome. In 2016, 10 symposia were organized with an average of 108 attendees and a response rate of 63% (1,366 completed questionnaires). Mean overall scores on 'teaching methods' and 'usefulness for professional development' were 3.8 and 3.7, respectively. The overall results corresponded with a high level of student appreciation. Symposia offer a podium for training students in subject matter and competencies that is greatly appreciated. Using alternating interactive teaching methods, symposia are structured around medical and societal themes and adjusted to the latest developments and current events in healthcare. By allowing students to select the symposia they would like to participate in, a tailor-made medical master's program in competencies is created.

Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

PubMed

Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

2014-03-01

To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

25 CFR 39.807 - How will the Student Unit Value be adjusted annually?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false How will the Student Unit Value be adjusted annually? 39.807 Section 39.807 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR EDUCATION THE INDIAN... Program § 39.807 How will the Student Unit Value be adjusted annually? (a) The student unit instructional...

75 FR 34614 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... footnoted).'' c. Third column, the title, ``Table 4J.--Out-Migration Adjustment-- FY 2010 (April 1, 2010 through September 30, 2010)'' is corrected to read ``Table 4J.--(Abbreviated) Out-Migration Adjustment for... corrected to read as follows: Table 4J--(Abbreviated) Out-Migration Adjustment for Acute Care Hospitals--FY...

The impact of premorbid adjustment, neurocognition, and depression on social and role functioning in patients in an early psychosis treatment program.

PubMed

Minor, Kyle S; Friedman-Yakoobian, Michelle; Leung, Y Jude; Meyer, Eric C; Zimmet, Suzanna V; Caplan, Brina; Monteleone, Thomas; Bryant, Caitlin; Guyer, Margaret; Keshavan, Matcheri S; Seidman, Larry J

2015-05-01

Functional impairments are debilitating concomitants of psychotic disorders and are present early in the illness course and, commonly, prior to psychosis onset. The factors affecting social and role functioning in early psychosis (EP) following treatment are unclear. We evaluated whether six months of participation in the PREP(R), Boston, EP treatment program, part of a public-academic community mental health center, was related to improvements in social and role functioning and whether premorbid adjustment in adolescence, baseline neurocognition, and depression symptoms predicted functional improvement. The Global Functioning Social and Role scales, MATRICS neurocognitive battery, and Calgary Depression Scale were assessed at baseline and six months during naturalistic treatment, while premorbid adjustment was measured at baseline. All participants were psychotic disorder patients in PREP(R) (n = 46 with social functioning and 47 with role functioning measures at both time points). Large improvements were observed in role functioning (d = 0.84) and medium to large improvements were observed in social functioning (d = 0.70). Models consisting of adolescent premorbid adjustment and change in depression symptoms predicted social and role functioning change, whereas neuropsychological functioning did not. Substantial improvements in social and role functioning were observed among this sample participating in a recovery-based EP program. The impact of clinical factors on social and role functioning was highlighted. Further studies of premorbid adjustment in adolescence and the treatment of depression in EP programs in controlled treatment trials are needed to confirm these findings. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Hospital performance recognition with the Get With The Guidelines Program and mortality for acute myocardial infarction and heart failure.

PubMed

Heidenreich, Paul A; Lewis, William R; LaBresh, Kenneth A; Schwamm, Lee H; Fonarow, Gregg C

2009-10-01

Many hospitals enrolled in the American Heart Association's Get With The Guidelines (GWTG) Program achieve high levels of recommended care for heart failure, acute myocardial infarction (MI) and stroke. However, it is unclear if outcomes are better in those hospitals recognized by the GWTG program for their processes of care. We compared hospitals enrolled in GWTG and receiving achievement awards for high levels of recommended processes of care with other hospitals using data on risk-adjusted 30-day survival for heart failure and acute MI reported by the Center for Medicare and Medicaid Services. Among the 3,909 hospitals with 30-day data reported by Center for Medicare and Medicaid Services 355 (9%) received GWTG achievement awards. Risk-adjusted mortality for hospitals receiving awards was lower for both heart failure (11.0% vs 11.2%, P = .0005) and acute MI (16.1% vs 16.5%, P < .0001) compared to those not receiving awards. After additional adjustment for hospital characteristics and noncardiac performance measures, the reduction in mortality remained significantly lower for GWTG award hospitals for acute myocardial infraction (-0.19%, 95% CI -0.33 to -0.05), but not for heart failure (-0.11%, 95% CI -0.25 to 0.02). Additional adjustment for cardiac processes of care reduced the benefit of award hospitals by 28% for heart failure mortality and 43% for acute MI mortality. Hospitals receiving achievement awards from the GWTG program have modestly lower risk adjusted mortality for acute MI and to a lesser extent, heart failure, explained in part by better process of care.

"Bounce at the Bell": a novel program of short bouts of exercise improves proximal femur bone mass in early pubertal children

PubMed Central

McKay, H; MacLean, L; Petit, M; MacKelvie-O'Brien, K; Janssen, P; Beck, T; Khan, K

2005-01-01

Objectives: To examine the effects of a simple and inexpensive physical activity intervention on change in bone mass and structure in school aged children. Methods: Fifty one children (n = 23 boys and 28 girls; mean age 10.1 years) participated in "Bounce at the Bell" which consisted of 10 counter-movement jumps 3x per day (total ∼3 min/day). Controls were 71 matched children who followed usual school practice. We assessed dietary calcium, physical activity, physical performance, and anthropometry in September and after 8 months of intervention (June). We measured bone mineral content (BMC) and bone area at the lumbar spine, total body, and proximal femur. Proximal femur scans were also analysed for bone geometry and structural strength using the hip structural analysis program. Lean and fat mass (g) were also calculated. Results: Groups were similar at baseline and did not differ in weight, height, total body, lumbar spine, proximal femur, or femoral neck BMC. Control children had a greater increase in adjusted total body BMC (1.4%). Intervention children gained significantly more BMC at the total proximal femur (2%) and the intertrochanteric region (27%). Change in bone structural parameters did not differ between groups. Conclusions: This novel, easily implemented exercise program, took only a few minutes each day and enhanced bone mass at the weight bearing proximal femur in early pubertal children. A large, randomised study of boys and girls should be undertaken powered to test the effectiveness of Bounce at the Bell in children at different stages of maturity, and in boys and girls independently. PMID:16046335

Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uganda.

PubMed

Weiser, Sheri D; Palar, Kartika; Frongillo, Edward A; Tsai, Alexander C; Kumbakumba, Elias; Depee, Saskia; Hunt, Peter W; Ragland, Kathleen; Martin, Jeffrey; Bangsberg, David R

2014-01-02

Food insecurity is a potentially important barrier to the success of antiretroviral therapy (ART) programs in resource-limited settings. We undertook a longitudinal study in rural Uganda to estimate the associations between food insecurity and HIV treatment outcomes. Longitudinal cohort study. Participants were from the Uganda AIDS Rural Treatment Outcomes study and were followed quarterly for blood draws and structured interviews. We measured food insecurity with the validated Household Food Insecurity Access Scale. Our primary outcomes were: ART nonadherence (adherence <90%) measured by visual analog scale; incomplete viral load suppression (>400 copies/ml); and low CD4 T-cell count (<350 cells/μl). We used generalized estimating equations to estimate the associations, adjusting for socio-demographic and clinical variables. We followed 438 participants for a median of 33 months; 78.5% were food insecure at baseline. In adjusted analyses, food insecurity was associated with higher odds of ART nonadherence [adjusted odds ratio (AOR) 1.56, 95% confidence interval (CI) 1.10-2.20, P < 0.05], incomplete viral suppression (AOR 1.52, 95% CI 1.18-1.96, P < 0.01), and CD4 T-cell count less than 350 (AOR 1.47, 95% CI 1.24-1.74, P < 0.01). Adding adherence as a covariate to the latter two models removed the association between food insecurity and viral suppression, but not between food insecurity and CD4 T-cell count. Food insecurity is longitudinally associated with poor HIV outcomes in rural Uganda. Intervention research is needed to determine the extent to which improved food security is causally related to improved HIV outcomes and to identify the most effective policies and programs to improve food security and health.

Assessing the effectiveness of a pharmacist-delivered smoking cessation program in the State of Qatar: study protocol for a randomized controlled trial.

PubMed

El Hajj, Maguy Saffouh; Kheir, Nadir; Al Mulla, Ahmad Mohd; Al-Badriyeh, Daoud; Al Kaddour, Ahmad; Mahfoud, Ziyad R; Salehi, Mohammad; Fanous, Nadia

2015-02-26

It had been reported that up to 37% of the adult male population smokes cigarettes in Qatar. The Global Youth Tobacco Survey also stated that 13.4% of male school students aged 13 to 15 years in Qatar smoke cigarettes. Smoking cessation is key to reducing smoking-related diseases and deaths. Healthcare providers are in an ideal position to encourage smoking cessation. Pharmacists are the most accessible healthcare providers and are uniquely situated to initiate behavior change among patients. Many studies have shown that pharmacists can be successful in helping patients quit smoking. Studies demonstrating the effectiveness of pharmacist-delivered smoking cessation programs are lacking in Qatar. This proposal aims to test the effect of a structured smoking cessation program delivered by trained ambulatory pharmacists in Qatar. A prospective, randomized, controlled trial is conducted at eight ambulatory pharmacies in Qatar. Participants are randomly assigned to receive an at least four-session face-to-face structured patient-specific smoking cessation program conducted by the pharmacist or 5 to 10 min of unstructured brief smoking cessation advice (emulating current practice) given by the pharmacist. Both groups are offered nicotine replacement therapy if feasible. The primary outcome of smoking cessation will be confirmed by an exhaled carbon monoxide test at 12 months. Secondary outcomes constitute quality-of-life adjustment as well as cost analysis of program resources consumed, including per case and patient outcome. If proven to be effective, this smoking cessation program will be considered as a model that Qatar and the region can apply to decrease the smoking burden. Clinical Trials NCT02123329 .

20 CFR 631.40 - State program operational plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false State program operational plan. 631.40 Section 631.40 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS... Federal-State Unemployment Compensation System, the Trade Adjustment Assistance Program, the State...

Brock BaseCamp--Outdoor Orientation Programs Come to Canada

ERIC Educational Resources Information Center

O'Connell, Tim

2011-01-01

What exactly is an "outdoor orientation program?" First offered in the United States in the 1930s by Dartmouth College, outdoor orientation programs (OOPs) use adventure programming to help incoming students adjust to university or college. Typically, these programs are conducted in a wilderness or backcountry setting, are several days…

Exploiting a negative supply shock to understand better macroeconomic adjustments in the Brazilian economy

NASA Astrophysics Data System (ADS)

Tracy, Brandon Shane

In 2001 the Brazilian government implemented a national electricity rationing program that lasted nine months and mandated the reduction of electricity consumption by 20 percent. The rationing program received much blame when the economy grew only one percent in 2001. This dissertation motivates the questions: What were the effects of the rationing program on the Brazilian economy? Were existing economic relationships altered by the rationing program? And, What role did substitution play in allowing the economy to adjust to the reduced electricity consumption? Univariate and multivariate forecasting techniques are used with monthly data to estimate the impact of the rationing program. During the intervention period, industrial electricity consumption was 16.4 percent below trend values and commercial electricity consumption was 25.2 below trend values; GDP was 3.1 percent below trend values. Economic relationships, as indicated by Granger causality, do change between the pre-intervention and post-intervention periods. Elasticities of substitution, calculated from the parameters of a translog cost function using annual data, are quite stable during the intervention. Fuel substitution does not appear to be the primary means of adjusting to the input shock.

Severe hypoglycemia and diabetic ketoacidosis in young persons with preschool onset of type 1 diabetes mellitus: An analysis of three nationwide population-based surveys.

PubMed

Lindner, Lena M E; Gontscharuk, Veronika; Bächle, Christina; Castillo, Katty; Stahl-Pehe, Anna; Tönnies, Thaddäus; Yossa, Rhuphine; Holl, Reinhard W; Rosenbauer, Joachim

2018-06-01

To describe incidence rates and temporal trends of severe hypoglycemia (SH) and of hospitalizations for SH or diabetic ketoacidosis (DKA) in persons with early-onset, long-term type 1 diabetes (T1D) and associations of these short-term complications with potential risk factors. This study includes data of 1,875 persons 11.2 to 21.9 years of age with early-onset (<5 years) and long-term (>10 years) T1D from 3 cross-sectional nationwide, population-based surveys conducted in 2009/2010, 2012/2013 and 2015/2016 using standardized questionnaires. Negative binomial regression was used to estimate incidence rates per 100 person-years (py), temporal trends and associations between potential risk factors and outcomes. The crude incidence rate of SH showed a decreasing trend over time (P for trend = .004), disappearing after adjustment for confounders (P for trend = .341). In contrast, adjusted rates of SH- and DKA-associated hospitalizations did not change significantly between 2009 and 2016 (P for trend = .306 and .774, respectively). Associations between sex, diabetes duration, insulin treatment regimen, hypoglycemia awareness as well as physical activity and SH were found, while family structure was associated with hospitalizations for SH. Family structure, socioeconomic status (SES), diabetes duration, and hemoglobin A1c values showed associations with DKA-related hospitalizations. After adjustment, rates of SH and SH- or DKA-associated hospitalization showed no significant changes in recent years. Structured education programs focusing on high-risk groups as, for example, persons with T1D living with 1 biological parent and the parents' partner or those with a low SES, should be implemented to reduce incidence rates of hospitalizations. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Quality of pancreatic transplant program assessment using a risk-adjusted cumulative sum chart: experience from a single, small center.

PubMed

Grochowiecki, T; Jakimowicz, T; Grabowska-Derlatka, L; Szmidt, J

2014-10-01

The high rate of complication after pancreas transplantation not only had an impact on recipient quality of life and survival but also had significant financial implications. Thus, monitoring transplant center performance was crucial to indentifying changes in clinical practice that result in quality deterioration. To evaluate retrospectively the quality of the single, small pancreatic transplant program and to establish prospective monitoring of the center using risk-adjusted cumulative sum (CUSUM). From 1988 to 2014, 119 simultaneous pancreas and the kidney transplantations (SPKTx) were performed. The program was divided into 3 eras, based on surgical technique and immunosuppression. Analyses of the 15 fatal outcomes due to complication from pancreatic graft were performed. The risk model was developed using multivariable logistic regression analysis based on retrospective data of 112 SPKTx recipients. The risk-adjusted 1-sided CUSUM chart was plotted for retrospective and prospective events. The upper control limit was set to 2. There were 2 main causes of death: multiorgan failure (73.3%; 11/15) and septic hemorrhage (26.7%; 4/15). Quality analysis using the CUSUM chart revealed that the process was not homogeneous; however, no significant signal of program deterioration was obtained and the performance of the whole program was within the settled control limit. For a single pancreatic transplant center. The risk-adjusted CUSUM chart was a useful tool for quality program assessment. It could support decision making during traditional surgical morbidity and mortality conferences. For small transplant centers, increasing the sensitivity of the CUSUM method by lowering the upper control limit should be considered. However, an individual assessment approach of the for particular centers is recommended.

Wilderness Orientation Programs. AEE White Papers

ERIC Educational Resources Information Center

Association for Experiential Education (NJ1), 2011

2011-01-01

Wilderness orientation programs (sometimes referred to as outdoor orientation programs) use adventure programming for incoming college/university students to aid students' adjustment to college. These experiences usually occur in the days or weeks immediately prior to the first semester of the students' college coursework. They are typically…

The effects of a disease management program on self-reported health behaviors and health outcomes: evidence from the "Florida: a healthy state (FAHS)" Medicaid program.

PubMed

Morisky, Donald E; Kominski, Gerald F; Afifi, Abdelmonem A; Kotlerman, Jenny B

2009-06-01

Premature morbidity and mortality from chronic diseases account for a major proportion of expenditures for health care cost in the United States. The purpose of this study was to measure the effects of a disease management program on physiological and behavioral health indicators for Medicaid patients in Florida. A two-year prospective study of 15,275 patients with one or more chronic illnesses (congestive heart failure, hypertension, diabetes, or asthma) was undertaken. Control of hypertension improved from baseline to Year 1 (adjusted odds ratio = 1.60, p < .05), with maintenance at Year 2. Adjusted cholesterol declined by 6.41 mg/dl from baseline to Year 1 and by 12.41 mg/dl (p < .01) from baseline to Year 2. Adjusted average medication compliance increased by 0.19 points (p < .01) in Year 1 and 0.29 points (p < .01) in Year 2. Patients in the disease management program benefited in terms of controlling hypertension, asthma symptoms, and cholesterol and blood glucose levels.

Better big data.

PubMed

Al Kazzi, Elie S; Hutfless, Susan

2015-01-01

By 2018, Medicare payments will be tied to quality of care. The Centers for Medicare and Medicaid Services currently use quality-based metric for some reimbursements through their different programs. Existing and future quality metrics will rely on risk adjustment to avoid unfairly punishing those who see the sickest, highest-risk patients. Despite the limitations of the data used for risk adjustment, there are potential solutions to improve the accuracy of these codes by calibrating data by merging databases and compiling information collected for multiple reporting programs to improve accuracy. In addition, healthcare staff should be informed about the importance of risk adjustment for quality of care assessment and reimbursement. As the number of encounters tied to value-based reimbursements increases in inpatient and outpatient care, coupled with accurate data collection and utilization, the methods used for risk adjustment could be expanded to better account for differences in the care delivered in diverse settings.

A new biodegradation prediction model specific to petroleum hydrocarbons.

PubMed

Howard, Philip; Meylan, William; Aronson, Dallas; Stiteler, William; Tunkel, Jay; Comber, Michael; Parkerton, Thomas F

2005-08-01

A new predictive model for determining quantitative primary biodegradation half-lives of individual petroleum hydrocarbons has been developed. This model uses a fragment-based approach similar to that of several other biodegradation models, such as those within the Biodegradation Probability Program (BIOWIN) estimation program. In the present study, a half-life in days is estimated using multiple linear regression against counts of 31 distinct molecular fragments. The model was developed using a data set consisting of 175 compounds with environmentally relevant experimental data that was divided into training and validation sets. The original fragments from the Ministry of International Trade and Industry BIOWIN model were used initially as structural descriptors and additional fragments were then added to better describe the ring systems found in petroleum hydrocarbons and to adjust for nonlinearity within the experimental data. The training and validation sets had r2 values of 0.91 and 0.81, respectively.

The cost-effectiveness of New York City's Safe Routes to School Program.

PubMed

Muennig, Peter A; Epstein, Michael; Li, Guohua; DiMaggio, Charles

2014-07-01

We evaluated the cost-effectiveness of a package of roadway modifications in New York City funded under the Safe Routes to School (SRTS) program. We used a Markov model to estimate long-term impacts of SRTS on injury reduction and the associated savings in medical costs, lifelong disability, and death. Model inputs included societal costs (in 2013 US dollars) and observed spatiotemporal changes in injury rates associated with New York City's implementation of SRTS relative to control intersections. Structural changes to roadways were assumed to last 50 years before further investment is required. Therefore, costs were discounted over 50 consecutive cohorts of modified roadway users under SRTS. SRTS was associated with an overall net societal benefit of $230 million and 2055 quality-adjusted life years gained in New York City. SRTS reduces injuries and saves money over the long run.

Rio + 5 -- INSTRAW's activities regarding the implementation of Agenda 21.

PubMed

1997-01-01

The International Research and Training Institute for the Advancement of Women (INSTRAW) was involved in research analysis and training activities that address women's issues on water supply, sanitation and waste management, development of new and renewable sources of energy, and natural resources since 1982. The four main thrusts of the INSTRAW program include: 1) the economic and political empowerment of the women; 2) women, media and communications; 3) women, environment and sustainable development; and 4) statistics and indicators on gender issues. These areas are approached in an integrated and holistic manner, which is crosscutting and cross disciplinary with relevant chapters Agenda 21. In addition, poverty, population growth, health, structural adjustment policies, education and training, water, energy, agriculture and forestry are addressed within the women's roles and activities context. This article presents an overview of the succeeding chapters, which focus on the programs developed and implemented to promote the well being of the women worldwide.

Reconfigurable photonic crystals enabled by pressure-responsive shape-memory polymers

PubMed Central

Fang, Yin; Ni, Yongliang; Leo, Sin-Yen; Taylor, Curtis; Basile, Vito; Jiang, Peng

2015-01-01

Smart shape-memory polymers can memorize and recover their permanent shape in response to an external stimulus (for example, heat). They have been extensively exploited for a wide spectrum of applications ranging from biomedical devices to aerospace morphing structures. However, most of the existing shape-memory polymers are thermoresponsive and their performance is hindered by heat-demanding programming and recovery steps. Although pressure is an easily adjustable process variable such as temperature, pressure-responsive shape-memory polymers are largely unexplored. Here we report a series of shape-memory polymers that enable unusual ‘cold' programming and instantaneous shape recovery triggered by applying a contact pressure at ambient conditions. Moreover, the interdisciplinary integration of scientific principles drawn from two disparate fields—the fast-growing photonic crystal and shape-memory polymer technologies—enables fabrication of reconfigurable photonic crystals and simultaneously provides a simple and sensitive optical technique for investigating the intriguing shape-memory effects at nanoscale. PMID:26074349

42 CFR 412.152 - Definitions for the Hospital Readmissions Reduction Program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... disproportionate share of low-income patients under § 412.106, outliers under subpart F of this part, and a low.... The floor adjustment factor is set at 0.99 for FY 2013, 0.98 for FY 2014, and 0.97 for FY 2015 and... standardized amount adjusted for resource utilization by the applicable MS-DRG relative weight and adjusted for...

42 CFR 412.152 - Definitions for the Hospital Readmissions Reduction Program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... disproportionate share of low-income patients under § 412.106, outliers under subpart F of this part, and a low.... The floor adjustment factor is set at 0.99 for FY 2013, 0.98 for FY 2014, and 0.97 for FY 2015 and... standardized amount adjusted for resource utilization by the applicable MS-DRG relative weight and adjusted for...

42 CFR 412.152 - Definitions for the Hospital Readmissions Reduction Program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... disproportionate share of low-income patients under § 412.106, outliers under subpart F of this part, and a low.... The floor adjustment factor is set at 0.99 for FY 2013, 0.98 for FY 2014, and 0.97 for FY 2015 and... standardized amount adjusted for resource utilization by the applicable MS-DRG relative weight and adjusted for...

Toward the Development of Integrative Risk-Adjusted Measures of Quality Using Large Clinical Data Bases: The Case of Anesthesia Services.

ERIC Educational Resources Information Center

Fleming, Steven T.

1992-01-01

The concept of risk-adjusted measures of quality is discussed, and a methodology is proposed for risk-adjusting and integrating multiple adverse outcomes of anesthesia services into measures for quality assurance and quality improvement programs. Although designed for a new anesthesiology database, the methods should apply to other health…

75 FR 34611 - Medicare Program; Supplemental Proposed Changes to the Hospital Inpatient Prospective Payment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-17

... the out-migration adjustment values presented in the May 4, 2010 FY 2011 IPPS/LTCH PPS proposed rule and that the out-migration adjustment values in revised Table 4J are based on corrected wage data as... 31049 through 31057 in Table 4J.--Proposed Out-Migration Adjustment for Acute Care Hospitals--FY 2011...

Relating engagement to outcomes in prevention: the case of a parenting program for couples.

PubMed

Brown, Louis D; Goslin, Megan C; Feinberg, Mark E

2012-09-01

Analyses of program engagement can provide critical insight into how program involvement leads to outcomes. This study examines the relation between participant engagement and program outcomes in Family Foundations (FF), a universal preventive intervention designed to help couples manage the transition to parenthood by improving coparenting relationship quality. Previous intent-to-treat outcome analyses from a randomized trial indicate FF improves parental adjustment, interparental relationships, and parenting. Analyses for the current study use the same sample, and yield statistically reliable relations between participant engagement and interparental relationships but not parental adjustment or parenting. Discussion considers implications for FF and the difficulties researchers face when examining the relation between engagement and outcomes in preventive interventions.

Relating Engagement to Outcomes in Prevention: The Case of a Parenting Program for Couples

PubMed Central

Brown, Louis D.; Goslin, Megan C.; Feinberg, Mark E.

2011-01-01

Analyses of program engagement can provide critical insight into how program involvement leads to outcomes. This study examines the relation between participant engagement and program outcomes in Family Foundations (FF), a universal preventive intervention designed to help couples manage the transition to parenthood by improving coparenting relationship quality. Previous intent-to-treat outcome analyses from a randomized trial indicate FF improves parental adjustment, interparental relationships, and parenting. Analyses for the current study use the same sample, and yield statistically reliable relations between participant engagement and interparental relationships but not parental adjustment or parenting. Discussion considers implications for FF and the difficulities researchers face when examining the relation between engagement and outcomes in preventive interventions. PMID:21826536

Predicting school adjustment from multiple perspectives on parental behaviors.

PubMed

Ratelle, Catherine F; Duchesne, Stéphane; Guay, Frédéric

2017-01-01

Past research supported the importance of parental autonomy support, involvement, and structure for student outcomes. The goal of this study was to test the contribution of these behaviors from mothers and fathers in predicting adolescents' adjustment in school using a multi-informant approach. A sample of 522 adolescents (233 boys, 389 girls), their mothers (n = 535), and fathers (n = 296) participated in the study. Results revealed that parents' self-evaluations explained additional variance in children's school adjustment, over and beyond the contribution of children's evaluation of their parents. Maternal reports on their positive behaviors (autonomy support, involvement, and structure) predicted their child's academic and emotional adjustment while their reported control predicted lower levels of these. Fathers' self-reported positive behaviors predicted academic adjustment while their control predicted lower academic and personal-emotional adjustment. These findings support the importance of multiple assessments of parental behaviors for improving the prediction of adjustment in school. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Influence of social motivation, self-perception of social efficacy and normative adjustment in the peer setting.

PubMed

Herrera López, Mauricio; Romera Félix, Eva M; Ortega Ruiz, Rosario; Gómez Ortiz, Olga

2016-01-01

The first objective of this study was to adapt and test the psychometric properties of the Social Achievement Goal Scale (Ryan & Shim, 2006) in Spanish adolescent students. The second objective sought to analyse the influence of social goals, normative adjustment and self-perception of social efficacy on social adjustment among peers. A total of 492 adolescents (54.1% females) attending secondary school (12-17 years; M = 13.8, SD = 1.16) participated in the study. Confirmatory factor analysis and structural equation modelling were performed. The validation confirmed the three-factor structure of the original scale: social development goals, social demonstration-approach goals and social demonstration-avoidance goals. The structural equation model indicated that social development goals and normative adjustment have a direct bearing on social adjustment, whereas the social demonstration-approach goals (popularity) and self-perception of social efficacy with peers and teachers exert an indirect influence. The Spanish version of the Social Achievement Goal Scale (Ryan & Shim, 2006) yielded optimal psychometric properties. Having a positive motivational pattern, engaging in norm-adjusted behaviours and perceiving social efficacy with peers is essential to improving the quality of interpersonal relationships.

Impact of a joint labor-management ergonomics program on upper extremity musculoskeletal symptoms among garment workers.

PubMed

Herbert, R; Dropkin, J; Warren, N; Sivin, D; Doucette, J; Kellogg, L; Bardin, J; Kass, D; Zoloth, S

2001-10-01

This study evaluated the effect of an ergonomics intervention program on the prevalence and intensity of symptoms of upper extremity work-related musculoskeletal disorders among 36 garment workers performing an operation called spooling. Adjustable chairs were introduced and workers were trained in their use. Symptom surveys were administered prior to and 6 months after introduction of adjustable chairs. Quantitative pre- and post-intervention measurement of joint position was performed utilizing videotapes among a subgroup of nineteen. Eighty nine percent of the cohort reported pain in either the neck or at least one upper extremity anatomic site prior to the adjustable chair intervention. Among subjects reporting pain at baseline, there were significantly decreased pain levels in 10 of 11 anatomic sites after the intervention. Among all subjects, the proportion reporting pain decreased for each anatomic site following the intervention, with statistically significant decreases in 3 sites. However, there were only modest declines in awkward posture among the videotaped subgroup. This study suggests that introduction of an ergonomics program focused on education and introduction of an adjustable chair may diminish musculoskeletal symptomatology in apparel manufacturing workers.

The case and opportunity for public-supported financial incentives to implement integrated pest management.

PubMed

Brewer, Michael J; Hoard, Robert J; Landis, Joy N; Elworth, Lawrence E

2004-12-01

Food, water, and worker protection regulations have driven availability, and loss, of pesticides for use in pest management programs. In response, public-supported research and extension projects have targeted investigation and demonstration of reduced-risk integrated pest management (IPM) techniques. But these new techniques often result in higher financial burden to the grower, which is counter to the IPM principle that economic competitiveness is critical to have IPM adopted. As authorized by the 2002 Farm Bill and administered by the U.S. Department of Agriculture (USDA) Natural Resources Conservation Service (NRCS), conservation programs exist for delivering public-supported financial incentives to growers to increase environmental stewardship on lands in production. NRCS conservation programs are described, and the case for providing financial incentives to growers for implementing IPM is presented. We also explored the opportunity and challenge to use one key program, the Environmental Quality Incentives Program (EQIP), to aid grower adoption of IPM. The EQIP fund distribution to growers from 1997 to 2002 during the last Farm Bill cycle totaled approximately 1.05 billion dollars with a portion of funds supporting an NRCS-designed pest management practice. The average percentage of allocation of EQIP funds to this pest management practice among states was 0.77 +/- 0.009% (mean +/- SD). Using Michigan as an example, vegetable and fruit grower recognition of the program's use to implement IPM was modest (25% of growers surveyed), and their recognition of its use in aiding implementation of IPM was improved after educational efforts (74%). Proposals designed to enhance program usefulness in implementing IPM were delivered through the NRCS advisory process in Michigan. Modifications for using the NRCS pest management practice to address resource concerns were adopted, incentive rates for pest management were adjusted, and an expanded incentive structure for IPM technique adoption was tabled for future consideration. The case is strong for using public-supported financial incentives offered by the EQIP to aid grower adoption of IPM as a means to address resource concerns, but current use of the EQIP for this purpose is modest to meager. With appropriate program adjustments and increased grower awareness, USDA NRCS conservation programs, and the EQIP in particular, may provide an important opportunity for growers to increase their use of IPM as a resource conservation and farm management tool.

American College of Surgeons National Surgical Quality Improvement Program Pediatric: a beta phase report.

PubMed

Bruny, Jennifer L; Hall, Bruce L; Barnhart, Douglas C; Billmire, Deborah F; Dias, Mark S; Dillon, Peter W; Fisher, Charles; Heiss, Kurt F; Hennrikus, William L; Ko, Clifford Y; Moss, Lawrence; Oldham, Keith T; Richards, Karen E; Shah, Rahul; Vinocur, Charles D; Ziegler, Moritz M

2013-01-01

The American College of Surgeons (ACS) National Surgical Quality Improvement Program Pediatric (NSQIP-P) expanded to beta phase testing with the enrollment of 29 institutions. Data collection and analysis were aimed at program refinement and development of risk-adjusted models for inter-institutional comparisons. Data from the first full year of beta-phase NSQIP-P were analyzed. Patient accrual used ACS-NSQIP methodology tailored to pediatric specialties. Preliminary risk adjusted modeling for all pediatric and neonatal operations and pediatric (excluding neonatal) abdominal operations was performed for all cause morbidity (other than death) and surgical site infections (SSI) using hierarchical logistic regression methodology and eight predictor variables. Results were expressed as odds ratios with 95% confidence intervals. During calendar year 2010, 29 institutions enrolled 37,141 patients. 1644 total CPT codes were entered, of which 456 accounted for 90% of the cases. 450 codes were entered only once (1.2% of cases). For all cases, overall mortality was 0.25%, overall morbidity 7.9%, and the SSI rate 1.8%. For neonatal cases, mortality was 2.39%, morbidity 18.7%, and the SSI rate 3%. For the all operations model, risk-adjusted morbidity institutional odds ratios ranged 0.48-2.63, with 9/29 hospitals categorized as low outliers and 9/29 high outliers, while risk-adjusted SSI institutional odds ratios ranged 0.36-2.04, with 2/29 hospitals low outliers and 7/29 high outliers. This report represents the first risk-adjusted hospital-level comparison of surgical outcomes in infants and children using NSQIP-P data. Programmatic and analytic modifications will improve the impact of this program as it moves into full implementation. These results indicate that NSQIP-P has the potential to serve as a model for determining risk-adjusted outcomes in the neonatal and pediatric population with the goal of developing quality improvement initiatives for the surgical care of children. Copyright © 2013 Elsevier Inc. All rights reserved.

Boston children's hospital community asthma initiative: Five-year cost analyses of a home visiting program.

PubMed

Bhaumik, Urmi; Sommer, Susan J; Giller-Leinwohl, Judith; Norris, Kerri; Tsopelas, Lindsay; Nethersole, Shari; Woods, Elizabeth R

2017-03-01

To evaluate the costs and benefits of the Boston Children's Hospital Community Asthma Initiative (CAI) through reduction of Emergency Department (ED) visits and hospitalizations for the full pilot-phase program participants. A cost-benefit analyses was conducted using hospital administrative data to determine an adjusted Return on Investment (ROI): on all 268 patients enrolled in the CAI program during the 33-month pilot program phase of CAI intervention between October 1, 2005 and June 30, 2008 using a comparison group of 818 patients from a similar cohort in neighboring ZIP codes without CAI intervention. Cost data through June 30, 2013 were used to examine cost changes and calculate an adjusted ROI over a 5-year post-intervention period. CAI patients had a cost reduction greater than the comparison group of $1,216 in Year 1 (P = 0.001), $1,320 in Year 2 (P < 0.001), $1,132 (P = 0.002) in Year 3, $1,123 (P = 0.004) in Year 4, and $997 (P = 0.022) in Year 5. Adjusting for the cost savings for the comparison group, the cost savings from the intervention resulted in an adjusted ROI of 1.91 over 5 years. Community-based, multidisciplinary, coordinated disease management programs can decrease the incidence of costly hospitalizations and ED visits from asthma. An ROI of greater than one, as found in this cost analysis, supports the business case for the provision of community-based asthma services as part of patient-centered medical homes and Accountable Care Organizations.

The American College of Surgeons National Surgical Quality Improvement Program: achieving better and safer surgery.

PubMed

Ko, Clifford Y; Hall, Bruce L; Hart, Amy J; Cohen, Mark E; Hoyt, David B

2015-05-01

The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), in operation since late 2004, evaluates surgical quality and safety by feeding back valid, timely, risk-adjusted outcomes, which providers use to improve care. A number of components have been developed and refined in the more than a decade since ACS NSQIP's initiation. These items can be grouped into areas of data collection, case sampling, risk adjustment, feedback reporting, the expansion into procedure-targeted sampling, development of improvement collaboratives, and the development of improvement tools. Although ACS NSQIP was originally designed as a hospital-based program, it now also allows for surgeon-specific reporting that can be used by individual surgeons as a feedback tool to improve their performance. There are more than 600 ACS NSQIP hospitals in 49 of the 50 states of the United States and in 13 other countries. Virtually all surgical (sub)specialties are touched by ACS NSQIP, which contains several million patient records and more than 100 statistically risk-adjusted models. In studies that have used ACS NSQIP clinical data, demonstrable improvement has been reported in local hospitals, in regional collaboratives, and across the program overall. Concomitantly, substantial cost savings for individual hospitals, as well as at regional and national levels, have been reported. ACS NSQIP has not only demonstrated how and why the use of accurate clinical data is crucial, but also how the program, through its risk-adjusted feedback, improvement tools, and hospital collaboratives, helps hospitals and providers to achieve safer surgery and better patient care.

Oil shale development and its environmental considerations

USGS Publications Warehouse

Stone, R.T.; Johnson, H.; Decora, A.

1974-01-01

The petroleum shortage recently experienced by many nations throughout the world has created an intense interest in obtaining new and supplemental energy sources. In the United States, this interest has been centered on oil shale. Any major action by the federal government having significant environmental effects requires compliance with the National Environmental Policy Act of 1969 (NEPA). Since most oil shale is found on federal lands, and since its development involves significant environmental impacts, leasing oil shale lands to private interests must be in compliance with NEPA. For oil shale, program planning began at approximately the same time that NEPA was signed into law. By structuring the program to permit a resource and technological inventory by industry and the federal agencies, the Department of the Interior was able simultaneously to conduct the environmental assessments required by the act. This required: 1. Clearly defined program objections; 2. An organization which could integrate public policy with diverse scientific disciplines and environmental concerns; and 3. Flexible decisionmaking to adjust to policy changes as well as to evolving interpretations on EPA as clarified by court decisions. This paper outlines the program, the organization structure that was created for this specific task, and the environmental concerns which were investigated. The success of the program has been demonstrated by meeting the requirements of NEPA, without court challenge, and by industry's acceptance of a leasing program that included the most stringent environmental protection provisions ever required. The need for energy development has spurred the acceptance of the program. However, by its awareness and willingness to meet the environmental challenges of the future, industry has shown a reasonable understanding of its commitments. The pros and cons of development were publicly considered in hearings and analyzed in the final environmental statement. This action aided greatly in preventing legal challenges. The prototype oil shale program is now under way and this new energy source, developed with strict environmental safeguards, may soon be available to our nation.

76 FR 62415 - Medicare Program; Establishment of the Medicare Economic Index Technical Advisory Panel and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-07

..., and productivity adjustment. We noted that we would ask the panel to assess the relevance and accuracy..., price-measurement proxies, and productivity adjustment. The Panel will be asked to assess the relevance...

PACE and the Medicare+Choice risk-adjusted payment model.

PubMed

Temkin-Greener, H; Meiners, M R; Gruenberg, L

2001-01-01

This paper investigates the impact of the Medicare principal inpatient diagnostic cost group (PIP-DCG) payment model on the Program of All-Inclusive Care for the Elderly (PACE). Currently, more than 6,000 Medicare beneficiaries who are nursing home certifiable receive care from PACE, a program poised for expansion under the Balanced Budget Act of 1997. Overall, our analysis suggests that the application of the PIP-DCG model to the PACE program would reduce Medicare payments to PACE, on average, by 38%. The PIP-DCG payment model bases its risk adjustment on inpatient diagnoses and does not capture adequately the risk of caring for a population with functional impairments.

Evaluation of a standardized patient education program for inpatient asthma rehabilitation: Impact on patient-reported health outcomes up to one year.

PubMed

Bäuerle, Kathrin; Feicke, Janine; Scherer, Wolfgang; Spörhase, Ulrike; Bitzer, Eva-Maria

2017-05-01

To modify and evaluate a patient education program for adult asthma patients in consideration of quality criteria for teaching. This was a prospective single-center controlled trial in an inpatient rehabilitation center. The control group (n=215) received the usual lecture-based education program, and the intervention group (n=209) the modified patient education program. Data were assessed at admission, discharge, 6 and 12 months post discharge. The primary outcome was asthma control, the secondary outcomes were asthma knowledge, quality of life, and program acceptance. Analysis of change was performed by ANCOVA for each follow-up, adjusting for baseline values. Statistically significant increases in all health outcomes and in asthma control were maintained in both groups at 12 months: CG: +1.9 (95%-CI 1.3-2.6) IG: +1.6 (95%-CI 0.8-2.3). We observed no significant differences between the programs for asthma control and quality of life. Regarding practical asthma knowledge, after 12 months, a group*time interaction emerged with a small effect size (P=0.06, η2=0.01). The modified program was not superior to traditional patient education concerning asthma control. It permanently increased self-management knowledge. Structured and behavioral patient education fosters patient's disease management ability. Possible ways of improving asthma control need to be explored. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Understanding the mediating role of corporal punishment in the association between maternal stress, efficacy, co-parenting and children's adjustment difficulties among Arab mothers.

PubMed

Khoury-Kassabri, Mona; Attar-Schwartz, Shalhevet; Zur, Hana

2014-06-01

This study, guided by the Family Systems Theory, examines the direct effect of maternal use of corporal punishment on children's adjustment difficulties. Also, it explores whether corporal punishment serves as a mediating factor in the relationship between several maternal characteristics, marital relationships, and children's adjustment difficulties. A total of 2,447 Arab mothers completed anonymous, structured, self-report questionnaires. The use of corporal punishment was generally strongly supported by the Arab mothers in our sample. A greater likelihood of using corporal punishment was found among mothers of boys rather than girls, among mothers with lower perceived self-efficacy to discipline children, and among mothers with a lower perception of their husbands' participation in child-related labor. In addition, the higher a mother's reports on disagreement with her husband about discipline methods and the stronger her level of maternal stress, the more likely she was to use corporal punishment. Corporal punishment also mediated the association between the above mentioned factors and child adjustment difficulties. Furthermore, a husband's emotional support and family socioeconomic status were directly associated to children's adjustment difficulties. The results of the current study emphasize the need to observe children's development within the context of their family systems and to consider the mutual influences of different subsystems such as marital relationships and mother-child interactions. Prevention and intervention programs should raise parents' awareness concerning the harmful effects of corporal punishment and take into account the impact of dynamic transactions of parental conflicts and disagreements regarding discipline methods on child outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

Global/local methods for probabilistic structural analysis

NASA Technical Reports Server (NTRS)

Millwater, H. R.; Wu, Y.-T.

1993-01-01

A probabilistic global/local method is proposed to reduce the computational requirements of probabilistic structural analysis. A coarser global model is used for most of the computations with a local more refined model used only at key probabilistic conditions. The global model is used to establish the cumulative distribution function (cdf) and the Most Probable Point (MPP). The local model then uses the predicted MPP to adjust the cdf value. The global/local method is used within the advanced mean value probabilistic algorithm. The local model can be more refined with respect to the g1obal model in terms of finer mesh, smaller time step, tighter tolerances, etc. and can be used with linear or nonlinear models. The basis for this approach is described in terms of the correlation between the global and local models which can be estimated from the global and local MPPs. A numerical example is presented using the NESSUS probabilistic structural analysis program with the finite element method used for the structural modeling. The results clearly indicate a significant computer savings with minimal loss in accuracy.

Global/local methods for probabilistic structural analysis

NASA Astrophysics Data System (ADS)

Millwater, H. R.; Wu, Y.-T.

1993-04-01

A probabilistic global/local method is proposed to reduce the computational requirements of probabilistic structural analysis. A coarser global model is used for most of the computations with a local more refined model used only at key probabilistic conditions. The global model is used to establish the cumulative distribution function (cdf) and the Most Probable Point (MPP). The local model then uses the predicted MPP to adjust the cdf value. The global/local method is used within the advanced mean value probabilistic algorithm. The local model can be more refined with respect to the g1obal model in terms of finer mesh, smaller time step, tighter tolerances, etc. and can be used with linear or nonlinear models. The basis for this approach is described in terms of the correlation between the global and local models which can be estimated from the global and local MPPs. A numerical example is presented using the NESSUS probabilistic structural analysis program with the finite element method used for the structural modeling. The results clearly indicate a significant computer savings with minimal loss in accuracy.

The Structural Adjustment Programme and the Elderly in Nigeria.

ERIC Educational Resources Information Center

Ekpenyong, Stephen

1995-01-01

Analyzes the impact of recent economic changes accompanying the introduction of the Structural Adjustment Programme (SAP) and ongoing cultural styles on the aged in Nigeria. Compared to younger generations, the relative position of the elderly has not changed significantly, although the latter's position has deteriorated on dimensions such as…

The Concept of Adjustment: A Structural Model.

ERIC Educational Resources Information Center

Dodds, A.; And Others

1994-01-01

This study analyzed scores of 469 British adult clients with recent loss of sight on the Nottingham Adjustment Scale using LISREL structural modeling techniques. Results supported a theoretical model of the self in terms of two latent factors--internal self-worth and self as agent. Implications for rehabilitation and intervention with cognitive…

Adolescent Leisure Dimensions, Psychosocial Adjustment, and Gender Effects

ERIC Educational Resources Information Center

Bradley, Graham L.; Inglis, Brad C.

2012-01-01

Leisure provides the context for much of adolescent behaviour and development. While both theory and research point to the benefits of participation in leisure activities that are highly structured, the association between structured leisure and psychosocial adjustment is not uniformly high. This paper presents a model of adolescent leisure…

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2014 CFR

2014-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... otherwise payable to the advanced biofuel producer if there is a difference between the amount actually...

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2013 CFR

2013-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... to the advanced biofuel producer if there is a difference between the amount actually produced and...

7 CFR 4288.132 - Payment adjustments.

Code of Federal Regulations, 2012 CFR

2012-01-01

... RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE PAYMENT PROGRAMS Advanced Biofuel Payment Program... to the advanced biofuel producer if there is a difference between the amount actually produced and...

Can your software engineer program your PLC?

NASA Astrophysics Data System (ADS)

Borrowman, Alastair J.; Taylor, Philip

2016-07-01

The use of Programmable Logic Controllers (PLCs) in the control of large physics experiments is ubiquitous1, 2, 3. The programming of these controllers is normally the domain of engineers with a background in electronics, this paper introduces PLC program development from the software engineer's perspective. PLC programs provide the link between control software running on PC architecture systems and physical hardware controlled and monitored by digital and analog signals. The higher-level software running on the PC is typically responsible for accepting operator input and from this deciding when and how hardware connected to the PLC is controlled. The PLC accepts demands from the PC, considers the current state of its connected hardware and if correct to do so (based upon interlocks or other constraints) adjusts its hardware output signals appropriately for the PC's demands. A published ICD (Interface Control Document) defines the PLC memory locations available to be written and read by the PC to control and monitor the hardware. Historically the method of programming PLCs has been ladder diagrams that closely resemble circuit diagrams, however, PLC manufacturers nowadays also provide, and promote, the use of higher-level programming languages4. Based on techniques used in the development of high-level PC software to control PLCs for multiple telescopes, this paper examines the development of PLC programs to operate the hardware of a medical cyclotron beamline controlled from a PC using the Experimental Physics and Industrial Control System (EPICS), which is also widely used in telescope control5, 6, 7. The PLC used is the new generation Siemens S7-1200 programmed using Siemens Pascal based Structured Control Language (SCL), which is their implementation of Structured Text (ST). The approach described is that from a software engineer's perspective, utilising Siemens Totally Integrated Automation (TIA) Portal integrated development environment (IDE) to create modular PLC programs based upon reusable functions capable of being unit tested without the PLC connected to hardware. Emphasis has been placed on designing an interface between EPICS and SCL that enforces correct operation of hardware through stringent separation of PC accessible PLC memory and hardware I/O addresses used only by the PLC. The paper also introduces the method used to automate the creation, from the same source document, the PLC memory structure (tag) definitions (defining memory used to access hardware I/O and that accessed by the PC) and creation of the PC program data structures (EPICS database records) used to access the permitted PLC addresses. From direct experience this paper demonstrates the advantages of PLC program development being shared between electronic and software engineers, to enable use of the most appropriate processes from both the perspective of the hardware and the higher-level software used to control it.

School adjustment of children in residential care: a multi-source analysis.

PubMed

Martín, Eduardo; Muñoz de Bustillo, María del Carmen

2009-11-01

School adjustment is one the greatest challenges in residential child care programs. This study has two aims: to analyze school adjustment compared to a normative population, and to carry out a multi-source analysis (child, classmates, and teacher) of this adjustment. A total of 50 classrooms containing 60 children from residential care units were studied. The "Método de asignación de atributos perceptivos" (Allocation of perceptive attributes; Díaz-Aguado, 2006), the "Test Autoevaluativo Multifactorial de Adaptación Infantil" (TAMAI [Multifactor Self-assessment Test of Child Adjustment]; Hernández, 1996) and the "Protocolo de valoración para el profesorado (Evaluation Protocol for Teachers; Fernández del Valle, 1998) were applied. The main results indicate that, compared with their classmates, children in residential care are perceived as more controversial and less integrated at school, although no differences were observed in problems of isolation. The multi-source analysis shows that there is agreement among the different sources when the externalized and visible aspects are evaluated. These results are discussed in connection with the practices that are being developed in residential child care programs.

Can structural adjustment work for women farmers.

PubMed

Mehra, R

1991-12-01

This article discusses the impact of structural adjustment programs (SAPs) on women farmers in developing countries. SAPs aim to improve economic efficiency and promote more rapid economic growth. SAPs are introduced in two phases. The first phase involves short-term loans with the condition that the country adopt monetary restraints and currency devaluation measures. In the second phase, long-term loans are given with the provision that the country deregulate their economy and open up markets. The agricultural sector is affected by SAPs because of their importance in employment, income generation, and export earnings. SAPs result in lower farm commodity prices due to currency devaluations and in removal of subsidies, which results in market-sensitive pricing or higher food prices. The impact of SAPs on agriculture vary between countries. In Morocco and Algeria, agriculture expanded under SAPs. In Indonesia, Bolivia, Costa Rica, and Mexico, the agriculture stagnated or declined. Agricultural growth was slowest in Africa. SAPs were somewhat successful in increasing agricultural exports. Food production grew slowly in many adjusting countries. Blame for failures of SAPs has been placed on government failure to implement reforms properly and overly optimistic assumptions about the timing of productive gains. Little attention has focused on the constraints facing women farmers, who are a large proportion of farmers, particularly in sub-Saharan Africa. This article focuses on the issues of limited access to resources, credit, agricultural extension and information, land ownership, education, and time as constraints to women farmers. Women also must ensure household food security. For SAPs to work effectively, complementary policies must be implemented that reallocate available productive resources and new technologies to women and that deal with women's constraints.

Interdisciplinary collaboration between social workers and dieticians in nutrition education programs for children-at-risk.

PubMed

Shor, Ron

2010-01-01

Bio-psycho-social risk factors may lead to situations of poor nutrition of children. However, despite the multiple risk factors involved in such situations, interdisciplinary collaboration between experts in the psycho-social dimensions and experts in the bio-dimension of poor nutrition has not been a common model of practice. An evaluation was conducted in Israel of the experience of collaboration between social workers and dieticians in leading nutrition-education programs. A qualitative methodology was implemented with 22 participants. The findings illuminate the potential that interdisciplinary collaboration has to enhance the response of each of the professions to the risks for poor nutrition. The barriers affecting collaboration are: (a) role ambiguity about the non-administrative functions of social workers; (b) the dieticians' lack of sufficient familiarity with the life circumstances of low-income families and how to adjust the nutrition-related contents to their circumstances; and (c) difficulties to achieve a balance between the structured methods of knowledge delivery of the dieticians and the less structured methods of intervention of social workers. The findings illuminate the significance of incorporating suitable approaches into the collaboration for reducing these barriers.

38 CFR 21.4234 - Change of program.

Code of Federal Regulations, 2010 CFR

2010-07-01

... commuting distance. (ii) Unexpected financial difficulties preventing completion of the last program because... eligible person's program. For example, an eligible person enrolled for a bachelor of science degree may... considered only an adjustment in the program, not a change, so long as the subjects he or she pursues lead to...

38 CFR 21.4234 - Change of program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... commuting distance. (ii) Unexpected financial difficulties preventing completion of the last program because... eligible person's program. For example, an eligible person enrolled for a bachelor of science degree may... considered only an adjustment in the program, not a change, so long as the subjects he or she pursues lead to...

38 CFR 21.4234 - Change of program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... commuting distance. (ii) Unexpected financial difficulties preventing completion of the last program because... eligible person's program. For example, an eligible person enrolled for a bachelor of science degree may... considered only an adjustment in the program, not a change, so long as the subjects he or she pursues lead to...

38 CFR 21.4234 - Change of program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... commuting distance. (ii) Unexpected financial difficulties preventing completion of the last program because... eligible person's program. For example, an eligible person enrolled for a bachelor of science degree may... considered only an adjustment in the program, not a change, so long as the subjects he or she pursues lead to...

38 CFR 21.4234 - Change of program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... commuting distance. (ii) Unexpected financial difficulties preventing completion of the last program because... eligible person's program. For example, an eligible person enrolled for a bachelor of science degree may... considered only an adjustment in the program, not a change, so long as the subjects he or she pursues lead to...

Grid-coordinate generation program

USGS Publications Warehouse

Cosner, Oliver J.; Horwich, Esther

1974-01-01

This program description of the grid-coordinate generation program is written for computer users who are familiar with digital aquifer models. The program computes the coordinates for a variable grid -used in the 'Pinder Model' (a finite-difference aquifer simulator), for input to the CalComp GPCP (general purpose contouring program). The program adjusts the y-value by a user-supplied constant in order to transpose the origin of the model grid from the upper left-hand corner to the lower left-hand corner of the grid. The user has the options of, (1.) choosing the boundaries of the plot; (2.) adjusting the z-values (altitudes) by a constant; (3.) deleting superfluous z-values and (4.) subtracting the simulated surfaces from each other to obtain the decline. Output of this program includes the fixed format CNTL data cards and the other data cards required for input to GPCP. The output from GPCP then is used to produce a potentiometric map or a decline map by means of the CalComp plotter.

Facilitating adaptive management in a government program: A household energy efficiency case study.

PubMed

Curtis, Jim; Graham, Alex; Ghafoori, Eraj; Pyke, Susan; Kaufman, Stefan; Boulet, Mark

2017-02-01

Interim evaluations of government programs can sometimes reveal lower than expected outcomes, leading to the question of how adjustments can be made while the program is still underway. Although adaptive management frameworks can provide a practical roadmap to address this question, a lack of successful learnings and poor implementation have hampered the progress and wider application of adaptive management. Using a case study involving an energy efficiency government program targeting low-income households, this article provides supporting evidence on how adaptive management can be facilitated and applied. Factors such as proactive and responsive leadership, establishing a research-practice interface, and recognizing the skills, expertise, and contributions of multiple stakeholders guided adjustments to the program, and later paved the way for longer-term organizational learning that impacted how other programs are delivered. Implications for knowledge and practice, and a discussion of the challenges faced in the program, advance current thinking in adaptive management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Design of a radiator shade for testing in a simulated lunar environment

NASA Technical Reports Server (NTRS)

Huff, Jaimi; Remington, Randy; Tang, Toan

1992-01-01

The National Aeronautics and Space Administration (NASA) and The Universities Space Research Association (USRA) have chosen the parabolic/catenary concept from their sponsored Fall 1991 lunar radiation shade project for further testing and development. NASA asked the design team to build a shading device and support structure for testing in a vacuum chamber. Besides the support structure for the catenary shading device, the design team was asked to develop a system for varying the shade shape so that the device can be tested at different focal lengths. The design team developed concept variants and combined the concept variants to form overall designs. Using a decision matrix, an overall design was selected by the team from several overall design alternatives. Concept variants were developed for three primary functions. The three functions were structural support, shape adjustments, and end shielding. The shade adjustment function was divided into two sub-functions, arc length adjustment, and width adjustment.

Applied behavior analysis programs for autism: sibling psychosocial adjustment during and following intervention use.

PubMed

Cebula, Katie R

2012-05-01

Psychosocial adjustment in siblings of children with autism whose families were using a home-based, applied behavior analysis (ABA) program was compared to that of siblings in families who were not using any intensive autism intervention. Data gathered from parents, siblings and teachers indicated that siblings in ABA families experienced neither significant drawbacks nor benefits in terms of their behavioral adjustment, sibling relationship quality and self-concept compared to control group siblings, either during or following intervention use. Parents and siblings perceived improvements in sibling interaction since the outset of ABA, with parents somewhat more positive in their views than were siblings. Social support was associated with better sibling outcomes in all groups. Implications for supporting families using ABA are considered.

Improving Culture, One Quality Improvement Project at a Time.

PubMed

Vander Schaaf, Emily B; Cornett, Amanda C; Randolph, Greg D

A culture of quality improvement (QI) values collaboration, transparency, and staff empowerment. Organizations exhibiting a culture of QI are more likely to engage in QI. We examined whether local health departments' (LHDs') participation in a longitudinal, experiential QI training program changes QI culture. Prior to and following participation in a QI training program, all employees of participating LHDs were asked to complete an 8-item survey assessing components of QI culture on a 5-point scale. From 2010 to 2015, multidisciplinary teams from North Carolina LHDs participated in sequential cohorts of a 6-month QI training program, during which the teams completed a QI project. We dichotomized culture survey responses, with 4 or 5 being "Supportive." We compared adjusted proportions, using linear regression, clustering at LHD, and controlling for cohort. Data from 42 LHDs were included. At baseline, 7.8% responded that their LHD had a supportive culture for all 8 components, compared with 12% at follow-up (P < .001), adjusted for cohort and clustering by LHD. At follow-up, the percentage of employees responding that their LHDs had supportive cultures increased for all components of culture including communication by 4.1% (95% CI: 2.0%-6.2%), problem solving by 2.9% (95% CI: 1.6%-5.5%), team work by 5.2% (95% CI: 2.5%-7.8%), vision by 4.3% (95% CI: 1.1%-7.5%), performance measures by 5.6% (95% CI: 1.6%-9.6%), recognition by 4.7% (95% CI: 1.4%-8.0%), for conflict by 5.5% (95% CI: 1.7%-9.4%), and alignment by 5.8% (95% CI: 2.3%-9.2%). Engagement with structured QI training programs-and perhaps simply completing QI projects-can cause small, but important changes in organizations' cultures, thus increasing engagement in future QI and improving overall care and services. The article demonstrates that when LHDs participate in a longitudinal, experiential QI training program, their cultures of QI improve. Local health departments participating in similar training programs might experience similar improvements in culture, increasing subsequent participation in QI projects and improving related health outcomes.

Shape adjustment optimization and experiment of cable-membrane reflectors

NASA Astrophysics Data System (ADS)

Du, Jingli; Gu, Yongzhen; Bao, Hong; Wang, Congsi; Chen, Xiaofeng

2018-05-01

Cable-membrane structures are widely employed for large space reflectors due to their lightweight, compact and easy package. In these structures, membranes are attached to cable net, serving as reflectors themselves or as supporting structures for other reflective surface. The cable length and membrane shape have to be carefully designed and fabricated to guarantee the desired reflector surface shape. However, due to inevitable error in cable length and membrane shape during the manufacture and assembly of cable-membrane reflectors, some cables have to be designed to be capable of length adjustment. By carefully adjusting the length of these cables, the degeneration in reflector shape precision due to this inevitable error can be effectively reduced. In the paper a shape adjustment algorithm for cable-membrane reflectors is proposed. Meanwhile, model updating is employed during shape adjustment to decrease the discrepancy of the numerical model with respect to the actual reflector. This discrepancy has to be considered because during attaching membranes to cable net, the accuracy of the membrane shape is hard to guarantee. Numerical examples and experimental results demonstrate the proposed method.

Impact of a structured ICU training programme in resource-limited settings in Asia.

PubMed

Haniffa, Rashan; Lubell, Yoel; Cooper, Ben S; Mohanty, Sanjib; Alam, Shamsul; Karki, Arjun; Pattnaik, Rajya; Maswood, Ahmed; Haque, R; Pangeni, Raju; Schultz, Marcus J; Dondorp, Arjen M

2017-01-01

To assess the impact on ICU performance of a modular training program in three resource-limited general adult ICUs in India, Bangladesh, and Nepal. A modular ICU training programme was evaluated using performance indicators from June 2009 to June 2012 using an interrupted time series design with an 8 to 15 month pre-intervention and 18 to 24 month post-intervention period. ICU physicians and nurses trained in Europe and the USA provided training for ICU doctors and nurses. The training program consisted of six modules on basic intensive care practices of 2-3 weeks each over 20 months. The performance indicators consisting of ICU mortality, time to ICU discharge, rate at which patients were discharged alive from the ICU, discontinuation of mechanical ventilation or vasoactive drugs and duration of antibiotic use were extracted. Stepwise changes and changes in trends associated with the intervention were analysed. Pre-Training ICU mortality in Rourkela (India), and Patan (Nepal) Chittagong (Bangladesh), was 28%, 41% and 62%, respectively, compared to 30%, 18% and 51% post-intervention. The intervention was associated with a stepwise reduction in cumulative incidence of in-ICU mortality in Chittagong (adjusted subdistribution hazard ratio [aSHR] (95% CI): 0.62 (0.40, 0.97), p = 0.03) and Patan (aSHR 0.16 (0.06, 0.41), p<0.001), but not in Rourkela (aSHR: 1.17 (0.75, 1.82), p = 0.49). The intervention was associated with earlier discontinuation of vasoactive drugs at Rourkela (adjusted hazard ratio for weekly change [aHR] 1.08 (1.03, 1.14), earlier discontinuation of mechanical ventilation in Chittagong (aHR 2.97 (1.24, 7.14), p = 0.02), and earlier ICU discharge in Patan (aHR 1.87 (1.02, 3.43), p = 0.04). This structured training program was associated with a decrease in ICU mortality in two of three sites and improvement of other performance indicators. A larger cluster randomised study assessing process outcomes and longer-term indicators is warranted.

Recent Changes in Pgopher: a General Purpose Program for Simulating Rotational Structure

NASA Astrophysics Data System (ADS)

Western, Colin

2010-06-01

Key features of the PGOPHER program include the simulation and fitting of the rotational structure of linear molecules and symmetric and asymmetric tops, including effects due to unpaired electrons and nuclear spin. The program is written to be as general as possible, and can handle many effects such as multiple interacting states, predissociation and multiphoton transitions. It is designed to be easy to use, with a flexible graphical user interface. PGOPHER has been released as an open source program, and can be freely downloaded from the website at http://pgopher.chm.bris.ac.uk. Recent additions include a mode which allows the calculation of vibrational energy levels starting from a harmonic model and the multidimensional Franck-Condon factors required to calculate intensities of vibronic transitions. PGOPHER takes account of both the displacement along normal co-ordinates and mixing between modes (the Duschinsky effect). l matrices produced from ab initio programs can be directly read by PGOPHER or the mode displacements and mixing can be fit to observed spectra. In addition the effects of external electric and/or magnetic fields can now be calculated, including plots of energy level against electric field suitable for predicting Stark deceleration, focussing and trapping of molecules. The figure shows a typical plot, showing the electric field tuning of the M = 0 levels of 202, 111 and 110 levels of (NO)_2. Other new features include fits to combination differences, simulation of the Doppler split peak typical of Fourier transform microwave spectroscopy, specifying a nuclear spin temperature independent of rotational temperature and interactive adjustment of parameter values with the mouse in addition to typing values.

Controllable synthesis of Ce{sub 1-x}Zr{sub x}O{sub 2} hollow nanospheres via supercritical anti-solvent precipitation

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

Jiang Haoxi; Post-Doctor Station for Science and Technology of Chemical Engineering and Technology, Tianjin University, Tianjin 300072; Post-Doctor Workstation for Science and Technology, Shandong Haihua Group Co. Ltd, Weifang, Shandong 262737

2012-01-15

Nanocrystalline Ce{sub 1-x}Zr{sub x}O{sub 2} hollow nanospheres were successfully synthesized via supercritical anti-solvent precipitation using supercritical CO{sub 2} as the anti-solvent. It was found that the as-produced samples exhibited hollow spherical structures with uniform diameters ranging from 30 to 50 nm and the sphere walls were composed of various oriented nanocrystallites, with sizes of 3-7 nm. The results of high-resolution transmission electron microscopy showed that the formation of the hollow structures could be controlled by adjusting the solution concentration. The results of temperature-programmed reduction and oxygen storage capacity measurements showed that the hollow nanospheres had enhanced redox properties. A possiblemore » mechanism for the formation of Ce{sub 1-x}Zr{sub x}O{sub 2} hollow nanospheres has also been proposed and experimental investigated.« less

Application of a lower-upper implicit scheme and an interactive grid generation for turbomachinery flow field simulations

NASA Technical Reports Server (NTRS)

Choo, Yung K.; Soh, Woo-Yung; Yoon, Seokkwan

1989-01-01

A finite-volume lower-upper (LU) implicit scheme is used to simulate an inviscid flow in a tubine cascade. This approximate factorization scheme requires only the inversion of sparse lower and upper triangular matrices, which can be done efficiently without extensive storage. As an implicit scheme it allows a large time step to reach the steady state. An interactive grid generation program (TURBO), which is being developed, is used to generate grids. This program uses the control point form of algebraic grid generation which uses a sparse collection of control points from which the shape and position of coordinate curves can be adjusted. A distinct advantage of TURBO compared with other grid generation programs is that it allows the easy change of local mesh structure without affecting the grid outside the domain of independence. Sample grids are generated by TURBO for a compressor rotor blade and a turbine cascade. The turbine cascade flow is simulated by using the LU implicit scheme on the grid generated by TURBO.

A structural topological optimization method for multi-displacement constraints and any initial topology configuration

NASA Astrophysics Data System (ADS)

Rong, J. H.; Yi, J. H.

2010-10-01

In density-based topological design, one expects that the final result consists of elements either black (solid material) or white (void), without any grey areas. Moreover, one also expects that the optimal topology can be obtained by starting from any initial topology configuration. An improved structural topological optimization method for multi- displacement constraints is proposed in this paper. In the proposed method, the whole optimization process is divided into two optimization adjustment phases and a phase transferring step. Firstly, an optimization model is built to deal with the varied displacement limits, design space adjustments, and reasonable relations between the element stiffness matrix and mass and its element topology variable. Secondly, a procedure is proposed to solve the optimization problem formulated in the first optimization adjustment phase, by starting with a small design space and advancing to a larger deign space. The design space adjustments are automatic when the design domain needs expansions, in which the convergence of the proposed method will not be affected. The final topology obtained by the proposed procedure in the first optimization phase, can approach to the vicinity of the optimum topology. Then, a heuristic algorithm is given to improve the efficiency and make the designed structural topology black/white in both the phase transferring step and the second optimization adjustment phase. And the optimum topology can finally be obtained by the second phase optimization adjustments. Two examples are presented to show that the topologies obtained by the proposed method are of very good 0/1 design distribution property, and the computational efficiency is enhanced by reducing the element number of the design structural finite model during two optimization adjustment phases. And the examples also show that this method is robust and practicable.

Developmental Aquatics: Assessment and Instructional Programming.

ERIC Educational Resources Information Center

Doremus, Wendy A.

1992-01-01

This article provides an assessment tool and guidelines for creating instructional programing in aquatic skills development for children with disabilities functioning below levels required for most adapted beginning aquatics programs. It covers individualized goals and objectives, adjustment to the water, and specific aquatic skills. (DB)

77 FR 42482 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-19

... Public Works and Economic Development program, as well as its Economic Adjustment Assistance (EEA) program. Public Works and Economic Development Program investments help support the construction or rehabilitation of essential public infrastructure and facilities necessary to generate or retain private sector...

Adaptive Programming Improves Outcomes in Drug Court: An Experimental Trial.

PubMed

Marlowe, Douglas B; Festinger, David S; Dugosh, Karen L; Benasutti, Kathleen M; Fox, Gloria; Croft, Jason R

2012-04-01

Prior studies in Drug Courts reported improved outcomes when participants were matched to schedules of judicial status hearings based on their criminological risk level. The current experiment determined whether incremental efficacy could be gained by periodically adjusting the schedule of status hearings and clinical case-management sessions in response to participants' ensuing performance in the program. The adjustments were made pursuant to a priori criteria specified in an adaptive algorithm. Results confirmed that participants in the full adaptive condition (n = 62) were more than twice as likely as those assigned to baseline-matching only (n = 63) to be drug-abstinent during the first 18 weeks of the program; however, graduation rates and the average time to case resolution were not significantly different. The positive effects of the adaptive program appear to have stemmed from holding noncompliant participants more accountable for meeting their attendance obligations in the program. Directions for future research and practice implications are discussed.

The impact of structural adjustment and the changing nature of women's work in the People's Republic of China.

PubMed

Roy, S

2000-01-01

This paper examines the impact of structural adjustment and the changing nature of women's work in the People's Republic of China (PRC). It is noted that more than two-thirds of the developing countries have adopted structural adjustment policy packages as an answer to the economic crisis they are facing. Such an adjustment is a conscious change in the fundamental nature of economic relationships within a society. In relation to women, the structural changes have resulted to the collapse of many small and home-based industries, thus changing the role of women in economy. It is noted that although the policy shifts have created a wide range of job opportunities for women in other countries, in PRC gender inequalities exist in the economic area wherein women experience low employment and lack of work benefits. In addition, the fact that the rate of women's employment in China is higher than other developing and some developed countries worsens the situation as it indicates that more women suffer under the discriminatory employment system.

Preretirement Counseling, Retirement Adjustment, and the Older Employee.

ERIC Educational Resources Information Center

Greene, Mark R.; And Others

This study analyzed relationships between successful adjustment to retirement, preretirement counseling, and the psychological, economic, and other background characteristics of individual employees. A preliminary study in the western states showed no small companies, and relatively few other, with preretirement counseling programs of any…

75 FR 61121 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

...) for trade adjustment assistance (TAA) for lobster filed under the fiscal year (FY) 2011 program on behalf of lobster producers in Connecticut, Maine, Massachusetts, New Hampshire, and Rhode Island. The... 2011 lobster petitions under petition number 2011003. SUPPLEMENTARY INFORMATION: All petitions were...

The scheme of a blindless positioning structure with parallel adjusting tables and swing rods for 4000 optical fibres of LAMOST.

NASA Astrophysics Data System (ADS)

Yunguo, Gao

1996-12-01

This scheme structure is for positioning 4000 optical fibres of LAMOST telescope. It adopts the swing rods adjusted parallel and simultaneously by many small tables. The problems, for example, positioning accuracy of the optical fibers, the time to readjust all the 4000 optical fibres and error correction, etc. have been considered in the scheme. The structure has no blind area.

Marketing and Distribution: Michigan Program Standards Mean Improved Quality in DE

ERIC Educational Resources Information Center

Daenzer, John A.

1977-01-01

Various program activities are described which the State of Michigan requires its local education agencies to be involved in as the basis for making program adjustments that would improve program quality, e.g., occupational advisory committees, placement services, followup studies, performance based education, and annual and long-range planning.…

Using the Wilderness to Facilitate Adjustment to College: An Updated Description of Wilderness Orientation Programs.

ERIC Educational Resources Information Center

Davis-Berman, Jennifer; Berman, Dene

1996-01-01

Updated description of 38 wilderness orientation programs currently affiliated with U.S. colleges and universities includes program enrollment, length, cost, types of leaders, training, and sponsorship. Discusses program philosophies, goals, reasons for using the wilderness, and critical and emerging issues. Compares data to previous research.…

Specialized Vocational Services for the Individual with Epilepsy.

ERIC Educational Resources Information Center

Fraser, Robert T.; And Others

A specialized vocational program served 108 epileptic individuals who participated in the program during the first 18 months of its operation. The following are some of the aspects of the program: utilization of the neuropsychological data in rehabilitation planning, brief work adjustment, a job station program, training in job seeking skills,…

Literacy Outcomes of a Chinese/English Bilingual Program in Ontario

ERIC Educational Resources Information Center

Koh, Poh Wee; Chen, Xi; Cummins, James; Li, Jia

2017-01-01

This study examined the performance of Mandarin-speaking students in a K-Grade 4 50/50 Chinese/English bilingual program. The program was intended to facilitate students' learning of English and their adjustment to English-medium instruction within the school context. The bilingual-program students were compared to students from Mandarin-speaking…

The Impact of a Telephone-Based Chronic Disease Management Program on Medical Expenditures.

PubMed

Avery, George; Cook, David; Talens, Sheila

2016-06-01

The impact of a payer-provided telephone-based chronic disease management program on medical expenditures was evaluated using claims data from 126,245 members in employer self-ensured health plans (16,224 with a chronic disease in a group enrolled in the self-management program, 13,509 with a chronic disease in a group not participating in the program). A random effects regression model controlling for retrospective risk, age, sex, and diagnosis with a chronic disease was used to determine the impact of program participation on market-adjusted health care expenditures. Further confirmation of results was obtained by an ordinary least squares model comparing market- and risk-adjusted costs to the length of participation in the program. Participation in the program is associated with an average annual savings of $1157.91 per enrolled member in health care expenditures. Savings increase with the length of participation in the program. The results support the use of telephone-based patient self-management of chronic disease as a cost-effective means to reduce health care expenditures in the working-age population. (Population Health Management 2016;19:156-162).

Premium-Based Financial Incentives Did Not Promote Workplace Weight Loss In A 2013-15 Study.

PubMed

Patel, Mitesh S; Asch, David A; Troxel, Andrea B; Fletcher, Michele; Osman-Koss, Rosemary; Brady, Jennifer; Wesby, Lisa; Hilbert, Victoria; Zhu, Jingsan; Wang, Wenli; Volpp, Kevin G

2016-01-01

Employers commonly use adjustments to health insurance premiums as incentives to encourage healthy behavior, but the effectiveness of those adjustments is controversial. We gave 197 obese participants in a workplace wellness program a weight loss goal equivalent to 5 percent of their baseline weight. They were randomly assigned to a control arm, with no financial incentive for achieving the goal, or to one of three intervention arms offering an incentive valued at $550. Two intervention arms used health insurance premium adjustments, beginning the following year (delayed) or in the first pay period after achieving the goal (immediate). A third arm used a daily lottery incentive separate from premiums. At twelve months there were no statistically significant differences in mean weight change either between the control group (whose members had a mean gain of 0.1 pound) and any of the incentive groups (delayed premium adjustment, -1.2 pound; immediate premium adjustment, -1.4 pound; daily lottery incentive, -1.0 pound) or among the intervention groups. The apparent failure of the incentives to promote weight loss suggests that employers that encourage weight reduction through workplace wellness programs should test alternatives to the conventional premium adjustment approach by using alternative incentive designs, larger incentives, or both. Project HOPE—The People-to-People Health Foundation, Inc.

Action-concept learning in retarded children using photographic slides, motion pictures, sequences, and live demonstrations.

PubMed

Stephens, W E; Ludy, I E

1975-11-01

The inadequate use of action concepts by mentally retarded children has been reported in several recent studies, but little is yet known concerning the level of performance that might be expected to result from direct instruction designed to remedy this deficit. In the present study, it was found that three different instructional approaches yielded higher adjusted posttest scores. The highest adjusted posttest score was yielded by an instructional program in which motion picture sequences were used. This program was significantly more effective than two paralled programs, one using photographic slides, and the other using live demonstration by a teacher. An explanation for these findings was suggested.

Independent Association of Postdoctoral Training with Subsequent Careers in Cancer Prevention

PubMed Central

Faupel-Badger, Jessica M.; Nelson, David E.; Izmirlian, Grant; Ross, Katherine H.; Raue, Kimberley; Tsakraklides, Sophia; Miyaoka, Atsushi; Spiegelman, Maura

2015-01-01

The purpose of this study was to examine the career paths of alumni from the National Cancer Institute (NCI) Cancer Prevention Fellowship Program (CPFP), a structured in-house postdoctoral training program of 3–4 years duration, and specifically what proportion of the alumni were currently performing cancer prevention-related activities. The analyses here included 119 CPFP alumni and 85 unsuccessful CPFP applicants, all of whom completed postdoctoral training between 1987–2011 and are currently employed. Postdoctoral training experiences and current career outcomes data were collected via online surveys. Differences between groups were assessed using chi-square and Fisher’s exact test p-values and subsequent regression analyses adjusted for differences between the groups. Compared to 15.3% of unsuccessful CPFP applicants, 52.1% of CPFP alumni (odds ratio [OR] = 4.99, 95% confidence interval [95% CI): 1.91–13.0) were currently spending the majority of their time working in cancer prevention. Among those doing any cancer prevention-focused work, 54.3% of CPFP alumni spent the majority of their time performing cancer prevention research activities when compared to 25.5% of unsuccessful applicants (OR = 4.26, 95% CI: 1.38–13.2). In addition to the independent effect of the NCI CPFP, scientific discipline, and employment sector were also associated with currently working in cancer prevention and involvement in cancer prevention research-related activities. These results from a structured postdoctoral training program are relevant not only to the cancer prevention community but also to those interested in evaluating alignment of postdoctoral training programs with available and desired career paths more broadly. PMID:26659381

Independent Association of Postdoctoral Training with Subsequent Careers in Cancer Prevention.

PubMed

Faupel-Badger, Jessica M; Nelson, David E; Izmirlian, Grant; Ross, Katherine H; Raue, Kimberley; Tsakraklides, Sophia; Miyaoka, Atsushi; Spiegelman, Maura

2015-01-01

The purpose of this study was to examine the career paths of alumni from the National Cancer Institute (NCI) Cancer Prevention Fellowship Program (CPFP), a structured in-house postdoctoral training program of 3-4 years duration, and specifically what proportion of the alumni were currently performing cancer prevention-related activities. The analyses here included 119 CPFP alumni and 85 unsuccessful CPFP applicants, all of whom completed postdoctoral training between 1987-2011 and are currently employed. Postdoctoral training experiences and current career outcomes data were collected via online surveys. Differences between groups were assessed using chi-square and Fisher's exact test p-values and subsequent regression analyses adjusted for differences between the groups. Compared to 15.3% of unsuccessful CPFP applicants, 52.1% of CPFP alumni (odds ratio [OR] = 4.99, 95% confidence interval [95% CI): 1.91-13.0) were currently spending the majority of their time working in cancer prevention. Among those doing any cancer prevention-focused work, 54.3% of CPFP alumni spent the majority of their time performing cancer prevention research activities when compared to 25.5% of unsuccessful applicants (OR = 4.26, 95% CI: 1.38-13.2). In addition to the independent effect of the NCI CPFP, scientific discipline, and employment sector were also associated with currently working in cancer prevention and involvement in cancer prevention research-related activities. These results from a structured postdoctoral training program are relevant not only to the cancer prevention community but also to those interested in evaluating alignment of postdoctoral training programs with available and desired career paths more broadly.

Review of a two-year methicillin-resistant Staphylococcus aureus screening program and cost-effectiveness analysis in Singapore.

PubMed

Win, Mar-Kyaw; Soliman, Tarek Abdellatif Aly; Lee, Linda Kay; Wong, Chia Siong; Chow, Angela; Ang, Brenda; Roman, Carrasco L; Leo, Yee-Sin

2015-09-29

Methicillin-resistant Staphylococcus aureus (MRSA) poses an increasingly large disease and economic burden worldwide. The effectiveness of screening programs in the tropics is poorly understood. The aims of this study are: (i) to analyze the factors affecting MRSA colonization at admission and acquisition during hospitalization and (ii) to evaluate the cost-effectiveness of a screening program which aims to control MRSA incidence during hospitalization. We conducted a retrospective case-control study of patients admitted to the Communicable Disease Centre (CDC) in Singapore between Jan 2009 and Dec 2010 when there was an ongoing selective screening and isolation program. Risk factors contributing to MRSA colonization on admission and acquisition during hospital stay were evaluated using a logistic regression model. In addition, a cost-effectiveness analysis was conducted to determine the cost per disability-adjusted life year (DALY) averted due to implementing the screening and isolation program. The average prevalence rate of screened patients at admission and the average acquisition rate at discharge during the study period were 12.1 and 4.8 % respectively. Logistic regression models showed that older age (adjusted odds ratio (OR) 1.03, 95 % CI 1.02-1.04, p < 0.001) and dermatological conditions (adjusted OR 1.49, 95 % CI 1.11-1.20, p = 0.008) were independently associated with an increased risk of MRSA colonization at admission. Age (adjusted OR 1.02, 95 % CI 1.01-1.03, p = 0.002) and length of stay in hospital (adjusted OR 1.04, 95 % CI 1.03-1.06, p < 0.001) were independent factors associated with MRSA acquisition during hospitalization. The screening and isolation program reduced the acquisition rate by 1.6 % and was found to be cost saving. For the whole study period, the program cost US$129,916, while it offset hospitalization costs of US$103,869 and loss of productivity costs of US$50,453 with -400 $/DALY averted. This study is the first to our knowledge that evaluates the cost-effectiveness of screening and isolation of MRSA patients in a tropical country. Another unique feature of the analysis is the evaluation of acquisition rates among specific types of patients (dermatological, HIV and infectious disease patients)and the comparison of the cost-effectiveness of screening and isolation between them. Overall our results indicate high MRSA prevalence that can be cost effectively reduced by selective screening and isolation programs in Singapore.

Mother-child relationship quality and effective discipline as mediators of the 6-year effects of the New Beginnings Program for children from divorced families.

PubMed

Zhou, Qing; Sandler, Irwin N; Millsap, Roger E; Wolchik, Sharlene A; Dawson-McClure, Spring R

2008-08-01

This study examines whether program effects on mother-child relationship quality and effective discipline mediated the 6-year longitudinal effects of the New Beginnings Program (NBP) to improve mental health and competence outcomes in 218 adolescents from divorced families in a randomized experimental trial. The NBP is a theory-based and parenting-focused preventive intervention to help children adjust to divorce, and it has previously shown significant main and/or Program x Baseline Risk interaction effects to reduce adolescents' mental health and social adaptation problems and to promote competence. Mediation analyses were conducted using single- and two-group (high and low baseline risk) structural equation modeling. A multiple-methods and multiple-informants approach was used to assess the putative mediators and adolescents' outcomes. Results indicated that program-induced improvement in maternal effective discipline at posttest mediated the intervention effect on adolescents' GPA at the 6-year follow-up. Moreover, program-induced improvement in mother-child relationship quality mediated the intervention effect on adolescents' mental health problems for those with high baseline risk for maladjustment. The discussion focuses on the implications of the mediation findings for advancing the developmental theories that informed the design of the NBP and the implications for implementation of the NBP in community settings. Copyright 2008 APA, all rights reserved.

Strength conditions for the elastic structures with a stress error

NASA Astrophysics Data System (ADS)

Matveev, A. D.

2017-10-01

As is known, the constraints (strength conditions) for the safety factor of elastic structures and design details of a particular class, e.g. aviation structures are established, i.e. the safety factor values of such structures should be within the given range. It should be noted that the constraints are set for the safety factors corresponding to analytical (exact) solutions of elasticity problems represented for the structures. Developing the analytical solutions for most structures, especially irregular shape ones, is associated with great difficulties. Approximate approaches to solve the elasticity problems, e.g. the technical theories of deformation of homogeneous and composite plates, beams and shells, are widely used for a great number of structures. Technical theories based on the hypotheses give rise to approximate (technical) solutions with an irreducible error, with the exact value being difficult to be determined. In static calculations of the structural strength with a specified small range for the safety factors application of technical (by the Theory of Strength of Materials) solutions is difficult. However, there are some numerical methods for developing the approximate solutions of elasticity problems with arbitrarily small errors. In present paper, the adjusted reference (specified) strength conditions for the structural safety factor corresponding to approximate solution of the elasticity problem have been proposed. The stress error estimation is taken into account using the proposed strength conditions. It has been shown that, to fulfill the specified strength conditions for the safety factor of the given structure corresponding to an exact solution, the adjusted strength conditions for the structural safety factor corresponding to an approximate solution are required. The stress error estimation which is the basis for developing the adjusted strength conditions has been determined for the specified strength conditions. The adjusted strength conditions presented by allowable stresses are suggested. Adjusted strength conditions make it possible to determine the set of approximate solutions, whereby meeting the specified strength conditions. Some examples of the specified strength conditions to be satisfied using the technical (by the Theory of Strength of Materials) solutions and strength conditions have been given, as well as the examples of stress conditions to be satisfied using approximate solutions with a small error.

ORBSIM- ESTIMATING GEOPHYSICAL MODEL PARAMETERS FROM PLANETARY GRAVITY DATA

NASA Technical Reports Server (NTRS)

Sjogren, W. L.

1994-01-01

The ORBSIM program was developed for the accurate extraction of geophysical model parameters from Doppler radio tracking data acquired from orbiting planetary spacecraft. The model of the proposed planetary structure is used in a numerical integration of the spacecraft along simulated trajectories around the primary body. Using line of sight (LOS) Doppler residuals, ORBSIM applies fast and efficient modelling and optimization procedures which avoid the traditional complex dynamic reduction of data. ORBSIM produces quantitative geophysical results such as size, depth, and mass. ORBSIM has been used extensively to investigate topographic features on the Moon, Mars, and Venus. The program has proven particulary suitable for modelling gravitational anomalies and mascons. The basic observable for spacecraft-based gravity data is the Doppler frequency shift of a transponded radio signal. The time derivative of this signal carries information regarding the gravity field acting on the spacecraft in the LOS direction (the LOS direction being the path between the spacecraft and the receiving station, either Earth or another satellite). There are many dynamic factors taken into account: earth rotation, solar radiation, acceleration from planetary bodies, tracking station time and location adjustments, etc. The actual trajectories of the spacecraft are simulated using least squares fitted to conic motion. The theoretical Doppler readings from the simulated orbits are compared to actual Doppler observations and another least squares adjustment is made. ORBSIM has three modes of operation: trajectory simulation, optimization, and gravity modelling. In all cases, an initial gravity model of curved and/or flat disks, harmonics, and/or a force table are required input. ORBSIM is written in FORTRAN 77 for batch execution and has been implemented on a DEC VAX 11/780 computer operating under VMS. This program was released in 1985.

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-07

...This proposed rule provides further detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for a Federally- facilitated Exchange; advance payments of the premium tax credit; a Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. The cost-sharing reductions and advanced payments of the premium tax credit, combined with new insurance market reforms, will significantly increase the number of individuals with health insurance coverage, particularly in the individual market. The premium stabilization programs--risk adjustment, reinsurance, and risk corridors--will protect against adverse selection in the newly enrolled population. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) protections and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance.

78 FR 15409 - Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2014

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-11

...This final rule provides detail and parameters related to: the risk adjustment, reinsurance, and risk corridors programs; cost-sharing reductions; user fees for Federally-facilitated Exchanges; advance payments of the premium tax credit; the Federally-facilitated Small Business Health Option Program; and the medical loss ratio program. Cost-sharing reductions and advance payments of the premium tax credit, combined with new insurance market reforms, are expected to significantly increase the number of individuals with health insurance coverage, particularly in the individual market. In addition, we expect the premium stabilization programs--risk adjustment, reinsurance, and risk corridors--to protect against the effects of adverse selection. These programs, in combination with the medical loss ratio program and market reforms extending guaranteed availability (also known as guaranteed issue) and prohibiting the use of factors such as health status, medical history, gender, and industry of employment to set premium rates, will help to ensure that every American has access to high-quality, affordable health insurance.

[Determinants of participation among primiparous women in a prenatal education program].

PubMed

Martínez Galiano, Juan Miguel; Delgado Rodríguez, Miguel

2013-01-01

To determine the factors associated with participation in a prenatal education program among primiparous mothers. A multicenter observational study was carried out in four Andalusian hospitals (Spain) in primiparous women in 2010. Sociodemographic characteristics, obstetric history, and previous diseases were collected through an interview and from the clinical charts. Crude and adjusted odds ratios were calculated. The study population consisted of 520 women. According to multivariate analysis, the factors associated with participation in the program were educational level (p <0.001), higher income levels (p <0.001), birth in Spain (p <0.001) and viewing the program as useful (p <0.001). After adjusting for these variables, no other variable was related to participation. The main reason given by women for not attending prenatal education was lack of an invitation to attend. Participation in the prenatal education program was favored by a higher educational level and income, birth in Spain, and viewing the program as useful. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

41 CFR 101-26.607-2 - Adjustments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Adjustments. 101-26.607-2 Section 101-26.607-2 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND PROGRAM...

76 FR 63933 - Notice of Adjustment of Disaster Grant Amounts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... amount for Small Project Grants to State and local governments and private nonprofit facilities for... DEPARTMENT OF HOMELAND SECURITY Notice of Adjustment of Disaster Grant Amounts AGENCY: Federal... grant amount made under section 422, Simplified Procedures, relating to the Public Assistance program...

7 CFR 1435.315 - Adjustments to proportionate shares.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.315 Adjustments to proportionate shares. Whenever CCC determines that, because of... sufficient to enable state processors to produce sufficient sugar to meet the State's cane sugar allotment...

7 CFR 1435.315 - Adjustments to proportionate shares.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.315 Adjustments to proportionate shares. Whenever CCC determines that, because of... sufficient to enable state processors to produce sufficient sugar to meet the State's cane sugar allotment...

7 CFR 631.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... program is to assist farm, ranch and other land users to make changes in their cropping systems and land... lands. This purpose is achieved by controlling erosion, conserving water, and adjusting land use to... the Secretary of Agriculture for applying needed land use adjustments and conservation treatment...

40 CFR 152.410 - Adjustment of fees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 152.410 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS... fee schedule will be adjusted annually by the same percentage as the percent change in the Federal... rule and will be effective 30 days or more after promulgation. (b) Processing costs and fees will be...

40 CFR 152.410 - Adjustment of fees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 152.410 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS... fee schedule will be adjusted annually by the same percentage as the percent change in the Federal... rule and will be effective 30 days or more after promulgation. (b) Processing costs and fees will be...

7 CFR 1435.315 - Adjustments to proportionate shares.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.315 Adjustments to proportionate shares. Whenever CCC determines that, because of... sufficient to enable state processors to produce sufficient sugar to meet the State's cane sugar allotment...

7 CFR 1435.315 - Adjustments to proportionate shares.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.315 Adjustments to proportionate shares. Whenever CCC determines that, because of... sufficient to enable state processors to produce sufficient sugar to meet the State's cane sugar allotment...

7 CFR 1435.315 - Adjustments to proportionate shares.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.315 Adjustments to proportionate shares. Whenever CCC determines that, because of... sufficient to enable state processors to produce sufficient sugar to meet the State's cane sugar allotment...

The Pennsylvania Trauma Outcomes Study Risk-Adjusted Mortality Model: Results of a Statewide Benchmarking Program

PubMed Central

WIEBE, DOUGLAS J.; HOLENA, DANIEL N.; DELGADO, M. KIT; McWILLIAMS, NATHAN; ALTENBURG, JULIET; CARR, BRENDAN G.

2018-01-01

Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups). Patient demographic variables, physiology, mechanism of injury, transfer status, injury severity, and pre-existing conditions were included as predictor variables. The statistical model had excellent discrimination (area under the curve = 0.94). Funnel plots of observed-to-expected identified five centers with lower than expected mortality and two centers with higher than expected mortality. No centers were outliers for management of penetrating trauma, but five centers had lower and three had higher than expected mortality for blunt trauma. It is feasible to use Trauma Quality Improvement Program methodology to develop risk-adjusted models for statewide trauma systems. Even with smaller numbers of trauma centers that are available in national datasets, it is possible to identify high and low outliers in performance. PMID:28541852

The Pennsylvania Trauma Outcomes Study Risk-Adjusted Mortality Model: Results of a Statewide Benchmarking Program.

PubMed

Wiebe, Douglas J; Holena, Daniel N; Delgado, M Kit; McWilliams, Nathan; Altenburg, Juliet; Carr, Brendan G

2017-05-01

Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups). Patient demographic variables, physiology, mechanism of injury, transfer status, injury severity, and pre-existing conditions were included as predictor variables. The statistical model had excellent discrimination (area under the curve = 0.94). Funnel plots of observed-to-expected identified five centers with lower than expected mortality and two centers with higher than expected mortality. No centers were outliers for management of penetrating trauma, but five centers had lower and three had higher than expected mortality for blunt trauma. It is feasible to use Trauma Quality Improvement Program methodology to develop risk-adjusted models for statewide trauma systems. Even with smaller numbers of trauma centers that are available in national datasets, it is possible to identify high and low outliers in performance.

Canada's northern food subsidy Nutrition North Canada: a comprehensive program evaluation.

PubMed

Galloway, Tracey

2017-01-01

Nutrition North Canada (NNC) is a retail subsidy program implemented in 2012 and designed to reduce the cost of nutritious food for residents living in Canada's remote, northern communities. The present study evaluates the extent to which NNC provides access to perishable, nutritious food for residents of remote northern communities. Program documents, including fiscal and food cost reports for the period 2011-2015, retailer compliance reports, audits of the program, and the program's performance measurement strategy are examined for evidence that the subsidy is meeting its objectives in a manner both comprehensive and equitable across regions and communities. NNC lacks price caps or other means of ensuring food is affordable and equitably priced in communities. Gaps in food cost reporting constrain the program's accountability. From 2011-15, no adjustments were made to community eligibility, subsidy rates, or the list of eligible foods in response to information provided by community members, critics, the Auditor General of Canada, and the program's own Advisory Board. Measures to increase program accountability, such as increasing subsidy information on point-of-sale receipts, make NNC more visible but do nothing to address underlying accountability issues Conclusions: The current structure and regulatory framework of NNC are insufficient to ensure the program meets its goal. Both the volume and cost of nutritious food delivered to communities is highly variable and dependent on factors such as retailers' pricing practices, over which the program has no control. It may be necessary to consider alternative forms of policy in order to produce sustainable improvements to food security in remote, northern communities.

75 FR 16987 - Trade Adjustment Assistance; Merit Staffing of State Administration and Allocation of Training...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

...The Employment and Training Administration (ETA) of the Department of Labor (Department) issues this final rule to implement changes to the regulations for the Trade Adjustment Assistance for Workers (TAA) program under the Trade Act of 1974, as amended (Trade Act). This rule requires that personnel engaged in TAA-funded functions undertaken to carry out the worker adjustment assistance provisions must be State employees covered by a merit system of personnel administration. This rule also prescribes the system for allocating training funds to the States, as required by amendments to the Trade Act contained in the American Recovery and Reinvestment Act of 2009, commonly called the Recovery Act. The Recovery Act included provisions which reauthorized and significantly amended the TAA program.

KSC-00pp1340

NASA Image and Video Library

2000-09-13

During pre-pack and fit check on his launch and entry suit, STS-92 Commander Brian Duffy adjusts his helmet. Duffy and the rest of the crew are at KSC for Terminal Countdown Demonstration Test activities. The TCDT provides emergency egress training, simulated countdown exercises and opportunities to inspect the mission payload. This mission will be Duffy’s fourth Shuttle flight. STS-92 is scheduled to launch Oct. 5 at 9:38 p.m. EDT from Launch Pad 39A on the fifth flight to the International Space Station. It will carry two elements of the Space Station, the Integrated Truss Structure Z1 and the third Pressurized Mating Adapter. The mission is also the 100th flight in the Shuttle program

Do Males and Females Conceptualise Work and Social Impairment Differently Following Treatment for Different Mental Health Problems?

PubMed

Smith, David; Fairweather-Schmidt, A Kate; Riley, Ben; Javidi, Zhila; Zabeen, Sara; Lawn, Sharon; Battersby, Malcolm

2018-04-01

The Work and Social Adjustment Scale (WSAS) is used by psychiatric nurses for screening and evaluating patients' treatment outcomes for a variety of mental health problems. This study investigated longitudinal and gender measurement invariance of WSAS using structural equation modeling within a help-seeking problem gambling sample (n=445), and an intervention program for depression and anxiety sample (n=444). The concept of functional impairment was defined by all WSAS items in males and females at pre- and post-treatment assessments. These findings confirm that the WSAS is a robust and efficacious instrument for evaluating treatment outcomes in two differing populations. Copyright © 2017 Elsevier Inc. All rights reserved.

Exercise and ankle sprain injuries: a comprehensive review.

PubMed

Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan Carlos; Flandez, Jorge; Page, Phil; Andersen, Lars L

2014-02-01

Ankle sprains are common in team sports and sports played on courts, and often result in structural and functional alterations that lead to a greater reinjury risk. Specific exercises are often used to promote neuromuscular improvements in the prevention and rehabilitation of ankle injuries. This literature review summarizes the neuromuscular characteristics of common ankle sprains and the effectiveness of exercise as an intervention for improving neuromuscular function and preventing reinjury. Our review found that appropriate exercise prescription can increase static and dynamic balance and decrease injury recurrence. In particular, the addition of dynamic activities in the exercise program can be beneficial because of the anticipatory postural adjustments identified as a key factor in the injury mechanism.

Determining integral density distribution in the mach reflection of shock waves

NASA Astrophysics Data System (ADS)

Shevchenko, A. M.; Golubev, M. P.; Pavlov, A. A.; Pavlov, Al. A.; Khotyanovsky, D. V.; Shmakov, A. S.

2017-05-01

We present a method for and results of determination of the field of integral density in the structure of flow corresponding to the Mach interaction of shock waves at Mach number M = 3. The optical diagnostics of flow was performed using an interference technique based on self-adjusting Zernike filters (SA-AVT method). Numerical simulations were carried out using the CFS3D program package for solving the Euler and Navier-Stokes equations. Quantitative data on the distribution of integral density on the path of probing radiation in one direction of 3D flow transillumination in the region of Mach interaction of shock waves were obtained for the first time.

A Simple Laser Teaching Aid for Transverse Mode Structure Demonstration

ERIC Educational Resources Information Center

Ren, Cheng; Zhang, Shulian

2009-01-01

A teaching aid for demonstrating the transverse mode structure in lasers is described. A novel device called "multi-dimension adjustable combined cat-eye reflector" has been constructed from easily available materials to form a He-Ne laser resonator. By finely adjusting the cat-eye, the boundary conditions of the laser cavity can be altered, which…

Near-field testing of the 15-meter hoop-column antenna

NASA Technical Reports Server (NTRS)

Schroeder, Lyle C.; Adams, Richard R.; Bailey, M. C.; Belvin, W. Keith; Butler, David H.; Campbell, Thomas G.

1989-01-01

A 15-m-diameter antenna was tested to verify that dimensional tolerances for acceptable performance could be achieved and to verify structural, electromagnetic, and mechanical performance predictions. This antenna utilized the hoop column structure, a gold plated molybdenum mesh reflector, and 96 control cables to adjust the reflector conformance with a paraboloid. The dimensional conformance of the antenna structure and surface was measured with metric camera and theodolites. Near field pattern data were used to assess the electromagnetic performance at five frequencies from 2.225 to 11.6 GHz. The reflector surface was adjusted to greatly improve electromagnetic performance with a finite element model and the surface measurements. Measurement results show that antenna surface figure and adjustments and electromagnetic patterns agree well with predictions.

Design and evaluation of an architecture for a digital signal processor for instrumentation applications

NASA Astrophysics Data System (ADS)

Fellman, Ronald D.; Kaneshiro, Ronald T.; Konstantinides, Konstantinos

1990-03-01

The authors present the design and evaluation of an architecture for a monolithic, programmable, floating-point digital signal processor (DSP) for instrumentation applications. An investigation of the most commonly used algorithms in instrumentation led to a design that satisfies the requirements for high computational and I/O (input/output) throughput. In the arithmetic unit, a 16- x 16-bit multiplier and a 32-bit accumulator provide the capability for single-cycle multiply/accumulate operations, and three format adjusters automatically adjust the data format for increased accuracy and dynamic range. An on-chip I/O unit is capable of handling data block transfers through a direct memory access port and real-time data streams through a pair of parallel I/O ports. I/O operations and program execution are performed in parallel. In addition, the processor includes two data memories with independent addressing units, a microsequencer with instruction RAM, and multiplexers for internal data redirection. The authors also present the structure and implementation of a design environment suitable for the algorithmic, behavioral, and timing simulation of a complete DSP system. Various benchmarking results are reported.

Description and performance analysis of a generalized optimal algorithm for aerobraking guidance

NASA Technical Reports Server (NTRS)

Evans, Steven W.; Dukeman, Greg A.

1993-01-01

A practical real-time guidance algorithm has been developed for aerobraking vehicles which nearly minimizes the maximum heating rate, the maximum structural loads, and the post-aeropass delta V requirement for orbit insertion. The algorithm is general and reusable in the sense that a minimum of assumptions are made, thus greatly reducing the number of parameters that must be determined prior to a given mission. A particularly interesting feature is that in-plane guidance performance is tuned by adjusting one mission-dependent, the bank margin; similarly, the out-of-plane guidance performance is tuned by adjusting a plane controller time constant. Other features of the algorithm are simplicity, efficiency and ease of use. The trimmed vehicle with bank angle modulation as the method of trajectory control. Performance of this guidance algorithm is examined by its use in an aerobraking testbed program. The performance inquiry extends to a wide range of entry speeds covering a number of potential mission applications. Favorable results have been obtained with a minimum of development effort, and directions for improvement of performance are indicated.

Custodial grandmothers' psychological distress, dysfunctional parenting, and grandchildren's adjustment.

PubMed

Smith, Gregory C; Palmieri, Patrick A; Hancock, Gregory R; Richardson, Rhonda A

2008-01-01

An adaptation of the Family Stress Model (FSM) with hypothesized linkages between family contextual factors, custodial grandmothers' psychological distress, parenting practices, and grandchildren's adjustment was tested with structural equation modeling. Interview data from 733 custodial grandmothers of grandchildren between ages 4-17 revealed that the effect of grandmothers' distress on grandchildren's adjustment was mediated by dysfunctional parenting, especially regarding externalizing problems. The effects of contextual factors on grandchildren's adjustment were also indirect. The model's measurement and structural components were largely invariant across grandmothers' race and age, as well as grandchildren's gender and age. Group differences were more prevalent regarding the magnitude of latent means for model constructs. We conclude that parenting models like the FSM are useful for investigating custodial grandfamilies.

Custodial Grandmothers' Psychological Distress, Dysfunctional Parenting, and Grandchildren's Adjustment*ł

PubMed Central

Smith, Gregory C.; Palmieri, Patrick A.; Hancock, Gregory R.; Richardson, Rhonda A.

2009-01-01

An adaptation of the Family Stress Model (FSM) with hypothesized linkages between family contextual factors, custodial grandmothers' psychological distress, parenting practices, and grandchildren's adjustment was tested with structural equation modeling. Interview data from 733 custodial grandmothers of grandchildren between ages 4-17 revealed that the effect of grandmothers' distress on grandchildren's adjustment was mediated by dysfunctional parenting, especially regarding externalizing problems. The effects of contextual factors on grandchildren's adjustment were also indirect. The model's measurement and structural components were largely invariant across grandmothers' race and age, as well as grandchildren's gender and age. Group differences were more prevalent regarding the magnitude of latent means for model constructs. We conclude that parenting models like the FSM are useful for investigating custodial grandfamilies. PMID:19266869

The self as a mediator between personality and adjustment.

PubMed

Graziano, W G; Jensen-Campbell, L A; Finch, J F

1997-08-01

The self can be conceptualized as a mediating agent that translates personality into situated goal-directed activities and adaptation. This research used a level-of-analysis approach to link personality dimensions (Level I) to self-systems (Level II) and to teacher ratings of adjustment in African American, Mexican American, and European American students (N = 317). The authors hypothesized that links among aspects of self-esteem and teacher ratings of adjustment would be domain specific, and those links to dimensions of the 5-factor model would reflects the domain specificity. Structural equation modeling corroborated hypotheses about domain specificity in links between adjustment and 5-factor dimensions. Results were discussed in terms of levels of analysis for personality structure, personality development, and age-related adaptations to social contexts.

Mobile health care operations and return on investment in predominantly underserved children with asthma: the breathmobile program.

PubMed

Morphew, Tricia; Scott, Lyne; Li, Marilyn; Galant, Stanley P; Wong, Webster; Garcia Lloret, Maria I; Jones, Felita; Bollinger, Mary Elizabeth; Jones, Craig A

2013-08-01

Underserved populations have limited access to care. Improved access to effective asthma care potentially improves quality of life and reduces costs associated with emergency department (ED) visits. The purpose of this study is to examine return on investment (ROI) for the Breathmobile Program in terms of improved patient quality-adjusted life years saved and reduced costs attributed to preventable ED visits for 2010, with extrapolation to previous years of operation. It also examines cost-benefit related to reduced morbidity (ED visits, hospitalizations, and school absenteeism) for new patients to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits). This is a retrospective analysis of data for 15,986 pediatric patients, covering 88,865 visits, participating in 4 Southern California Breathmobile Programs (November 16, 1995-December 31, 2010). The ROI calculation expressed the cost-benefit ratio as the net benefits (ED costs avoided+relative value of quality-adjusted life years saved) over the per annum program costs (∼$500,000 per mobile). The ROI across the 4 California programs in 2010 was $6.73 per dollar invested. Annual estimated emergency costs avoided in the 4 regions were $2,541,639. The relative value of quality-adjusted life years saved was $24,381,000. For patients new to the Breathmobile Program during 2008-2009 who engaged in care (≥3 visits), total annual morbidity costs avoided per patient were $1395. This study suggests that mobile health care is a cost-effective strategy to deliver medical care to underserved populations, consistent with the Triple Aims of Therapy.

Practical Programming.

ERIC Educational Resources Information Center

Pipe, Peter

Programed instruction causes the student to take an active role in the instructional process and stimulates interchange between student and teacher. Since it adjusts itself to individual differences in students' learning rates, it can have delegated to it some parts of a teacher's task. Characteristics of programed instruction are small steps,…

A FORTRAN version implementation of block adjustment of CCD frames and its preliminary application

NASA Astrophysics Data System (ADS)

Yu, Y.; Tang, Z.-H.; Li, J.-L.; Zhao, M.

2005-09-01

A FORTRAN version implementation of the block adjustment (BA) of overlapping CCD frames is developed and its flowchart is shown. The program is preliminarily applied to obtain the optical positions of four extragalactic radio sources. The results show that because of the increase in the number and sky coverage of reference stars the precision of optical positions with BA is improved compared with the single CCD frame adjustment.

Child-Visiting and Domestic Abuse.

ERIC Educational Resources Information Center

Shepard, Melanie

1992-01-01

Explains problems with child visiting in cases of domestic abuse. Data on domestic abuse, child care concerns, and child adjustment problems were collected from 25 mothers and 22 fathers at a child visiting program serving separated and abusive families. Psychological abuse of mothers correlated with child adjustment problems. (BB)

42 CFR 416.180 - Basis and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICARE PROGRAM AMBULATORY SURGICAL SERVICES Adjustment in Payment Amounts for New Technology Intraocular... of new technology IOLs; (2) Factors that CMS considers for determination of a new class of new... implements section 141 of Public Law 103-432, which provides for adjustments to payment amounts for new...

42 CFR 403.750 - Estimate of expenditures and adjustments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Estimate of expenditures and adjustments. 403.750 Section 403.750 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions...

42 CFR 403.750 - Estimate of expenditures and adjustments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Estimate of expenditures and adjustments. 403.750 Section 403.750 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions...

42 CFR 403.750 - Estimate of expenditures and adjustments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Estimate of expenditures and adjustments. 403.750 Section 403.750 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions...

42 CFR 403.750 - Estimate of expenditures and adjustments.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Estimate of expenditures and adjustments. 403.750 Section 403.750 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions...

42 CFR 403.750 - Estimate of expenditures and adjustments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Estimate of expenditures and adjustments. 403.750 Section 403.750 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS SPECIAL PROGRAMS AND PROJECTS Religious Nonmedical Health Care Institutions...

42 CFR 57.214 - Repayment of loans made after November 17, 1971, for failure to complete a program of study.

Code of Federal Regulations, 2011 CFR

2011-10-01

... have failed to complete the course of study leading to the first professional degree for which an..., adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary for use in this...

Correlates of Work Adjustment among the Mentally Retarded.

ERIC Educational Resources Information Center

Ho, Hua-Kuo

The study sought to determine the relationships between work adjustment and selected personal, educational, vocational, and familial variables among 116 mentally retarded trainees from two vocational training programs in Taiwan. Findings included, among others: older trainees were more likely to accept rules/authority than younger workers; males…

40 CFR 94.205 - Prohibited controls, adjustable parameters.

Code of Federal Regulations, 2010 CFR

2010-07-01

... PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions... new engine to enable the engine to conform to the standards contained in this part: (1) Shall not..., except as otherwise allowed by this part. (b)(1) Category 1 marine engines equipped with adjustable...

40 CFR 94.205 - Prohibited controls, adjustable parameters.

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions... new engine to enable the engine to conform to the standards contained in this part: (1) Shall not..., except as otherwise allowed by this part. (b)(1) Category 1 marine engines equipped with adjustable...

40 CFR 94.205 - Prohibited controls, adjustable parameters.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions... new engine to enable the engine to conform to the standards contained in this part: (1) Shall not..., except as otherwise allowed by this part. (b)(1) Category 1 marine engines equipped with adjustable...

40 CFR 94.205 - Prohibited controls, adjustable parameters.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions... new engine to enable the engine to conform to the standards contained in this part: (1) Shall not..., except as otherwise allowed by this part. (b)(1) Category 1 marine engines equipped with adjustable...

40 CFR 94.205 - Prohibited controls, adjustable parameters.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE COMPRESSION-IGNITION ENGINES Certification Provisions... new engine to enable the engine to conform to the standards contained in this part: (1) Shall not..., except as otherwise allowed by this part. (b)(1) Category 1 marine engines equipped with adjustable...

20 CFR 617.2 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Purpose. 617.2 Section 617.2 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR TRADE ADJUSTMENT ASSISTANCE FOR WORKERS UNDER THE TRADE ACT OF 1974 General § 617.2 Purpose. The Act created a program of trade adjustment...

42 CFR 57.214 - Repayment of loans made after November 17, 1971, for failure to complete a program of study.

Code of Federal Regulations, 2010 CFR

2010-10-01

... have failed to complete the course of study leading to the first professional degree for which an..., adjusted annually for changes in the Consumer Price Index, and adjusted by the Secretary for use in this...

44 CFR 62.22 - Judicial review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Judicial review. 62.22... HOMELAND SECURITY INSURANCE AND HAZARD MITIGATION National Flood Insurance Program SALE OF INSURANCE AND ADJUSTMENT OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.22 Judicial review. (a) Upon...

76 FR 63936 - Notice of Adjustment of Statewide Per Capita Impact Indicator

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

... Statewide Per Capita Impact Indicator AGENCY: Federal Emergency Management Agency, DHS. ACTION: Notice. SUMMARY: FEMA gives notice that the statewide per capita impact indicator under the Public Assistance... FEMA will adjust the statewide per capita impact indicator under the Public Assistance program to...

Psychological adjustment and levels of self esteem in children with visual-motor integration difficulties influences the results of a randomized intervention trial.

PubMed

Lahav, Orit; Apter, Alan; Ratzon, Navah Z

2013-01-01

This study evaluates how much the effects of intervention programs are influenced by pre-existing psychological adjustment and self-esteem levels in kindergarten and first grade children with poor visual-motor integration skills, from low socioeconomic backgrounds. One hundred and sixteen mainstream kindergarten and first-grade children, from low socioeconomic backgrounds, scoring below the 25th percentile on a measure of visual-motor integration (VMI) were recruited and randomly divided into two parallel intervention groups. One intervention group received directive visual-motor intervention (DVMI), while the second intervention group received a non-directive supportive intervention (NDSI). Tests were administered to evaluate visual-motor integration skills outcome. Children with higher baseline measures of psychological adjustment and self-esteem responded better in NDSI while children with lower baseline performance on psychological adjustment and self-esteem responded better in DVMI. This study suggests that children from low socioeconomic backgrounds with low VMI performance scores will benefit more from intervention programs if clinicians choose the type of intervention according to baseline psychological adjustment and self-esteem measures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reentry Orientation and Alumni Networking in U.S. Colleges and Universities with Agriculture and Natural Resources Programs. Survey Report.

ERIC Educational Resources Information Center

Huntsberger, Paul E.

This report presents results of a survey of U.S. postsecondary institutions with agriculture and natural resources programs, concerning institutional support for reentry orientation and alumni networking programs. Reentry orientation" involves programs that help international students become aware of the adjustment aspects of returning home,…

A Meta-Analytic Review of Components Associated with Parent Training Program Effectiveness

ERIC Educational Resources Information Center

Kaminski, Jennifer Wyatt; Valle, Linda Anne; Filene, Jill H.; Boyle, Cynthia L.

2008-01-01

This component analysis used meta-analytic techniques to synthesize the results of 77 published evaluations of parent training programs (i.e., programs that included the active acquisition of parenting skills) to enhance behavior and adjustment in children aged 0-7. Characteristics of program content and delivery method were used to predict effect…

Cost-effectiveness of a multicomponent primary care program targeting frail elderly people.

PubMed

Ruikes, Franca G H; Adang, Eddy M; Assendelft, Willem J J; Schers, Henk J; Koopmans, Raymond T C M; Zuidema, Sytse U

2018-05-16

Over the last 20 years, integrated care programs for frail elderly people aimed to prevent functional dependence and reduce hospitalization and institutionalization. However, results have been inconsistent and merely modest. To date, evidence on the cost-effectiveness of these programs is scarce. We evaluated the cost-effectiveness of the CareWell program, a multicomponent integrated care program for frail elderly people. Economic evaluation from a healthcare perspective embedded in a cluster controlled trial of 12 months in 12 general practices in (the region of) Nijmegen. Two hundred and four frail elderly from 6 general practices in the intervention group received care according to the CareWell program, consisting of multidisciplinary team meetings, proactive care planning, case management, and medication reviews; 165 frail elderly from 6 general practices in the control group received usual care. In cost-effectiveness analyses, we related costs to daily functioning (Katz-15 change score i.e. follow up score minus baseline score) and quality adjusted life years (EQ-5D-3 L). Adjusted mean costs directly related to the intervention were €456 per person. Adjusted mean total costs, i.e. intervention costs plus healthcare utilization costs, were €1583 (95% CI -4647 to 1481) higher in the intervention group than in the control group. Incremental Net Monetary Benefits did not show significant differences between groups, but on average tended to favour usual care. The CareWell primary program was not cost-effective after 12 months. From a cost-effectiveness perspective, widespread implementation of the program in its current form cannot be recommended. The study was registered in the ClinicalTrials.govProtocol Registration System: ( NCT01499797 ; December 26, 2011). Retrospectively registered.

Decoupling effect and forecasting of economic growth and energy structure under the peak constraint of carbon emissions in China.

PubMed

Wang, Shijin; Li, Cunfang; Yang, Lizhu

2018-06-26

The decoupling effect between economic growth and energy structure was quantitatively analyzed from 1999 to 2014 across China. The results showed it existed weak decoupling effects in most regions. Based on the analysis of the influence of energy structure on carbon intensity, using scenario simulation methods and Markov chain modeling, the carbon intensity was predicted for China in 2020. The impact of energy structure adjustment on the carbon intensity to meet China's carbon target by 18 possible scenarios are calculated. Furthermore, the peak value of carbon emissions was also calculated in 2030. The results showed that the carbon intensity predicted for China in 2020 can be achieved regardless of whether the energy structure was adjusted or not when energy saving and carbon reduction policies maintained with economic growth at 6-7%. Moreover, given fixed energy structure growth, for each 1% of economic growth, the carbon intensity will decrease by about 3.5%. Given fixed economic growth, the decrease of energy intensity will be greater if the control of energy consumption is stronger. The effect of energy structure adjustment on the decreasing of carbon intensity will be 4% higher under constraints than without constraints. On average, the contribution of energy structure adjustment to achieving the carbon intensity target was calculated as 4% higher than that with constraints. In addition, given relatively fixed economic growth at 6-7%, the peak value of carbon emission in 2030 was calculated as 13.209 billion tons with constraints and 14.38 billion tons without constraints.

The contribution of dance to daily physical activity among adolescent girls

PubMed Central

2011-01-01

Background Structured physical activity (PA) programs are well positioned to promote PA among youth, however, little is known about these programs, particularly dance classes. The aims of this study were to: 1) describe PA levels of girls enrolled in dance classes, 2) determine the contribution of dance classes to total moderate-to-vigorous physical activity (MVPA), and 3) compare PA between days with a dance class (program days) and days without a dance class (non-program days). Methods Participants were 149 girls (11-18 years) enrolled in dance classes in 11 dance studios. Overall PA was assessed with accelerometry for 8 consecutive days, and girls reported when they attended dance classes during those days. The percent contribution of dance classes to total MVPA was calculated, and data were reduced to compare PA on program days to non-program days. Data were analyzed using mixed models, adjusting for total monitoring time. Results Girls engaged in 25.0 ± 0.9 minutes/day of MVPA. Dance classes contributed 28.7% (95% CI: 25.9%-31.6%) to girls' total MVPA. Girls accumulated more MVPA on program (28.7 ± 1.4 minutes/day) than non-program days (16.4 ± 1.5 minutes/day) (p < 0.001). Girls had less sedentary behavior on program (554.0 ± 8.1 minutes/day) than non-program days (600.2 ± 8.7 minutes/day) (p < 0.001). Conclusions Dance classes contributed a substantial proportion (29%) to girls' total MVPA, and girls accumulated 70% more MVPA and 8% less sedentary behavior on program days than on non-program days. Dance classes can make an important contribution to girls' total physical activity. PMID:21816074

Project STYLE: a multisite RCT for HIV prevention among youths in mental health treatment.

PubMed

Brown, Larry K; Hadley, Wendy; Donenberg, Geri R; DiClemente, Ralph J; Lescano, Celia; Lang, Delia M; Crosby, Richard; Barker, David; Oster, Danielle

2014-03-01

The study examined the efficacy of family-based and adolescent-only HIV prevention programs in decreasing HIV risk and improving parental monitoring and sexual communication among youths in mental health treatment. A randomized controlled trial (RCT) with 721 adolescents (ages 13-18 years) and their caregivers from mental health settings in three U.S. cities were randomly assigned to one of three theory-based, structured group interventions: family-based HIV prevention, adolescent-only HIV prevention, and adolescent-only health promotion. Interventions were delivered during an all-day workshop. Assessments were completed at baseline and three months postintervention. Compared with those in the health intervention, adolescents in the HIV prevention interventions reported fewer unsafe sex acts (adjusted rate ratio=.49, p=.01), greater condom use (adjusted relative change=59%, p=.01), and greater likelihood of avoiding sex (adjusted odds ratio=1.44, p=.05). They also showed improved HIV knowledge (p<.01) and self-efficacy (p<.05). The family-based intervention, compared with the other interventions, produced significant improvements in parent-teen sexual communication (p<.01), parental monitoring (p<.01), and parental permissiveness (p=.05). This RCT found that the HIV prevention interventions reduced sexual risk behavior over three months in a large, diverse sample of youths in mental health treatment and that the family-based intervention improved parental monitoring and communication with teens about sex. These interventions show promise.

Development of Evaluation Indicators for Hospice and Palliative Care Professionals Training Programs in Korea.

PubMed

Kang, Jina; Park, Kyoung-Ok

2017-01-01

The importance of training for Hospice and Palliative Care (HPC) professionals has been increasing with the systemization of HPC in Korea. Hence, the need and importance of training quality for HPC professionals are growing. This study evaluated the construct validity and reliability of the Evaluation Indicators for standard Hospice and Palliative Care Training (EIHPCT) program. As a framework to develop evaluation indicators, an invented theoretical model combining Stufflebeam's CIPP (Context-Input-Process-Product) evaluation model with PRECEDE-PROCEED model was used. To verify the construct validity of the EIHPCT program, a structured survey was performed with 169 professionals who were the HPC training program administrators, trainers, and trainees. To examine the validity of the areas of the EIHPCT program, exploratory factor analysis and confirmatory factor analysis were conducted. First, in the exploratory factor analysis, the indicators with factor loadings above 0.4 were chosen as desirable items, and some cross-loaded items that loaded at 0.4 or higher on two or more factors were adjusted as the higher factor. Second, the model fit of the modified EIHPCT program was quite good in the confirmatory factor analysis (Goodness-of-Fit Index > 0.70, Comparative Fit Index > 0.80, Normed Fit Index > 0.80, Root Mean square of Residuals < 0.05). The modified model of the EIHPCT comprised 4 areas, 13 subdomains, and 61 indicators. The evaluation indicators of the modified model will be valuable references for improving the HPC professional training program.

Indonesian medical students' preferences associated with the intention toward rural practice.

PubMed

Syahmar, Ikrar; Putera, Ikhwanuliman; Istatik, Yun; Furqon, Muhammad A; Findyartini, Ardi

2015-01-01

The aim of this study was to identify the preference of Indonesian medical students to work in rural areas, to enroll in the (PTT; which means 'temporary employment') program, and to identify factors that influence their choice of a preferred future practice area. Under the PTT program, doctors are obliged to work as temporary staff on a contract basis for a certain period in a rural area of Indonesia. The study design was cross-sectional and a total sampling method was used. The subjects were year 4 and 5 medical students from the Faculty of Medicine at Universitas Indonesia and had already been exposed to clinical practice rotations within their education program. Students rated the importance of 21 factors influencing their future workplace preference using a questionnaire with a five-point Likert scale. A total of 310 students (83.3%) responded to the questionnaire. The authors found that 27 out of 310 (8.71%) subjects wanted to work in rural areas, while 128 out of 264 (48.5%) students who chose other than rural areas wanted to enroll in the PTT program. A previous experience of living in rural areas seemed to be the only factor favouring students' choice to have future practice in rural areas (adjusted odds ratio (OR) 3.20, 95% confidence interval (CI) 1.27-8.08, =0.01). Factors that influenced respondents to say they didn't intend to practice rurally were the influence of spouse (adjusted OR 0.38, 95%CI 0.16-0.89, =0.03), and the opportunities for career advancement (adjusted OR 0.28, 95%CI 0.11-0.73, =0.009). The choice of enrollment in the PTT program was positively associated with opportunity for an academic career (adjusted OR 2.39, 95%CI 1.27-4.50, =0.007) and negatively associated with proximity to family/friends (adjusted OR 0.38, 95%CI 0.22-0.65, 0.001). Only 8.7% of the students were interested in rural areas for their future practice location. Multiple factors were associated with students' interest to choose a career in rural areas later, after graduation from medical school.

7 CFR 760.4 - Normal marketings of milk.

Code of Federal Regulations, 2014 CFR

2014-01-01

... AGRICULTURE SPECIAL PROGRAMS INDEMNITY PAYMENT PROGRAMS Dairy Indemnity Payment Program Payments to Dairy... section are adjusted for any change in the daily average number of cows milked during each pay period the milk is off the market compared with the average number of cows milked daily during the base period. (d...

20 CFR 356.2 - Program Fraud Civil Remedies Act of 1986.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Program Fraud Civil Remedies Act of 1986. 356.2 Section 356.2 Employees' Benefits RAILROAD RETIREMENT BOARD ADMINISTRATIVE REMEDIES FOR FRAUDULENT CLAIMS OR STATEMENTS CIVIL MONETARY PENALTY INFLATION ADJUSTMENT § 356.2 Program Fraud Civil Remedies Act...

8 CFR 245a.30 - Description of program.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Description of program. 245a.30 Section 245a.30 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF... IMMIGRATION AND NATIONALITY ACT LIFE Act Amendments Family Unity Provisions § 245a.30 Description of program...

8 CFR 245a.30 - Description of program.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Description of program. 245a.30 Section 245a.30 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF... IMMIGRATION AND NATIONALITY ACT LIFE Act Amendments Family Unity Provisions § 245a.30 Description of program...

8 CFR 245a.30 - Description of program.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Description of program. 245a.30 Section 245a.30 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF... IMMIGRATION AND NATIONALITY ACT LIFE Act Amendments Family Unity Provisions § 245a.30 Description of program...

7 CFR 760.108 - Payment limitation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 2008 program year under TAP. (b) For 2009 and subsequent program years, no person or legal entity... SURE combined; or (2) $100,000 per program year under TAP. (c) The Deputy Administrator may take such..., LIP, SURE, and TAP if the individual's or entity's average adjusted gross income (AGI) exceeds $2.5...

Psychiatry and the Deaf.

ERIC Educational Resources Information Center

Rainer, John D., Ed.; Altshuler, Kenneth Z., Ed.

A compilation of presentations from a meeting on psychiatry and the deaf, the text includes the following discussions: background and history of the New York State mental health program for the deaf; an introduction to the program of the New York School for the Deaf; school psychiatric preventive programs; adjustment problems presented by a panel…

76 FR 4614 - Trade Adjustment Assistance for Firms Program Fiscal Year 2010 Annual Report

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... U.S. businesses develop strategies to compete in the global economy. In general, the program provides cost-sharing technical assistance to eligible businesses to create and implement targeted business... program and in the development and implementation of business recovery plans. Firms that completed the...

29 CFR 90.22 - Dissemination of program knowledge and assistance to workers.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) of the Act that increased imports are a substantial cause of serious injury or threat thereof with... industry full information about programs which may facilitate their adjustment to the import competition...

Using Career Pathways to Guide Students through Programs of Study

ERIC Educational Resources Information Center

Bragg, Debra D.; Krismer, Marianne

2016-01-01

This chapter describes career pathways that evolved through a Trade Adjustment Assistance Community College and Career Training consortium grant designed to help students complete programs of study and enter health care careers.

45 CFR 303.8 - Review and adjustment of child support orders.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Review and adjustment of child support orders. 303.8 Section 303.8 Public Welfare Regulations Relating to Public Welfare OFFICE OF CHILD SUPPORT ENFORCEMENT (CHILD SUPPORT ENFORCEMENT PROGRAM), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF...

42 CFR 405.355 - Waiver of adjustment or recovery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

42 CFR 405.352 - Adjustment of title XVIII incorrect payments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Adjustment of title XVIII incorrect payments. 405.352 Section 405.352 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

42 CFR 405.355 - Waiver of adjustment or recovery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Waiver of adjustment or recovery. 405.355 Section 405.355 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

42 CFR 405.352 - Adjustment of title XVIII incorrect payments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Adjustment of title XVIII incorrect payments. 405.352 Section 405.352 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED Suspension of Payment...

7 CFR 1435.303 - Adjustment of the overall allotment quantity.

Code of Federal Regulations, 2011 CFR

2011-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.303 Adjustment of the overall allotment quantity. (a) The... than 85 percent of the estimated quantity of sugar for domestic human consumption for the crop year: (1...

7 CFR 1530.106 - License charges and credits.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., DEPARTMENT OF AGRICULTURE THE REFINED SUGAR RE-EXPORT PROGRAM, THE SUGAR CONTAINING PRODUCTS RE-EXPORT... charged or credited for the quantity of sugar entered, transferred, exported, or used, adjusted to a dry... 100 degrees polarity on a dry weight basis. (1) To adjust the raw value for sugar with a polarization...

7 CFR 1435.303 - Adjustment of the overall allotment quantity.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.303 Adjustment of the overall allotment quantity. (a) The... than 85 percent of the estimated quantity of sugar for domestic human consumption for the crop year: (1...

42 CFR § 510.300 - Determination of episode quality-adjusted target prices.

Code of Federal Regulations, 2010 CFR

2017-10-01

... OF HEALTH AND HUMAN SERVICES (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS COMPREHENSIVE CARE FOR JOINT REPLACEMENT MODEL Pricing and Payment § 510.300 Determination of episode quality... hospitals for each performance year of the model as specified in this section. Episode quality-adjusted...

77 FR 38837 - Medicare Program; Meeting of the Medicare Economic Index Technical Advisory Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-29

... weights, price-measurement proxies, and productivity adjustment. This meeting is open to the public in... productivity adjustment. For more information on the Panel, see the October 7, 2011 Federal Register (76 FR... recommendations regarding the MEI's inputs, input weights, price- measurement proxies, and the productivity...

40 CFR 85.2233 - Steady state test equipment calibrations, adjustments, and quality control-EPA 91.

Code of Federal Regulations, 2010 CFR

2010-07-01

... compensated for automatically and statistical process control demonstrates equal or better quality control... calibrations, adjustments, and quality control-EPA 91. 85.2233 Section 85.2233 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF AIR POLLUTION FROM MOBILE...

75 FR 59683 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied a petition (No. 2011020) for trade adjustment assistance for coffee filed under... of the Chief Economist, Farm Service Agency, Agricultural Marketing Service, and FAS. After a review... Trade Programs, FAS, USDA; or by phone at (202) 720-0638 or (202) 690-0633; or by e-mail at...

75 FR 63437 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-15

... Service (FAS) has denied a petition (No. 2011032) for trade adjustment assistance (TAA) for blueberries... USDA's Office of the Chief Economist, Farm Service Agency, Agricultural Marketing Service, and FAS..., Office of Trade Programs, FAS, USDA, at (202) 720-0638, or (202) 690-0633, or by e-mail at...

7 CFR 1435.303 - Adjustment of the overall allotment quantity.

Code of Federal Regulations, 2013 CFR

2013-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.303 Adjustment of the overall allotment quantity. (a) The... than 85 percent of the estimated quantity of sugar for domestic human consumption for the crop year: (1...

7 CFR 1435.303 - Adjustment of the overall allotment quantity.

Code of Federal Regulations, 2012 CFR

2012-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.303 Adjustment of the overall allotment quantity. (a) The... than 85 percent of the estimated quantity of sugar for domestic human consumption for the crop year: (1...

7 CFR 1435.303 - Adjustment of the overall allotment quantity.

Code of Federal Regulations, 2014 CFR

2014-01-01

... CREDIT CORPORATION, DEPARTMENT OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS SUGAR PROGRAM Flexible Marketing Allotments For Sugar § 1435.303 Adjustment of the overall allotment quantity. (a) The... than 85 percent of the estimated quantity of sugar for domestic human consumption for the crop year: (1...

50 CFR 648.55 - Framework adjustments to management measures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... establish OFL, ABC, ACL, ACT, DAS allocations, rotational area management programs, percentage allocations... measures will be adjusted. (c) OFL, ABC, ACL, ACT, and AMs. The Council shall specify OFL, ABC, ACL, ACT... derive specifications for ABC, ACL, and ACT, as specified in paragraphs (c)(2) through (c)(5) of this...

50 CFR 648.55 - Framework adjustments to management measures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... establish OFL, ABC, ACL, ACT, DAS allocations, rotational area management programs, percentage allocations... measures will be adjusted. (c) OFL, ABC, ACL, ACT, and AMs. The Council shall specify OFL, ABC, ACL, ACT... derive specifications for ABC, ACL, and ACT, as specified in paragraphs (c)(2) through (c)(5) of this...

50 CFR 648.55 - Framework adjustments to management measures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... establish OFL, ABC, ACL, ACT, DAS allocations, rotational area management programs, percentage allocations... measures will be adjusted. (c) OFL, ABC, ACL, ACT, and AMs. The Council shall specify OFL, ABC, ACL, ACT... derive specifications for ABC, ACL, and ACT, as specified in paragraphs (c)(2) through (c)(5) of this...

50 CFR 648.55 - Framework adjustments to management measures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... establish OFL, ABC, ACL, ACT, DAS allocations, rotational area management programs, percentage allocations... measures will be adjusted. (c) OFL, ABC, ACL, ACT, and AMs. The Council shall specify OFL, ABC, ACL, ACT... derive specifications for ABC, ACL, and ACT, as specified in paragraphs (a)(2) through (5) of this...

76 FR 18930 - Medicare Programs: Changes to the End-Stage Renal Disease Prospective Payment System Transition...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... Payment System Transition Budget-Neutrality Adjustment AGENCY: Centers for Medicare & Medicaid Services... comment will revise the end-stage renal disease (ESRD) transition budget-neutrality adjustment finalized... on April 1, 2011 through December 31, 2011. We are revising the transition budget-neutrality...

75 FR 59681 - Trade Adjustment Assistance for Farmers

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-28

... Service (FAS) has denied a petition (No. 2011004) for trade adjustment assistance for lamb filed under the fiscal year (FY) 2011 program by lamb producers from Idaho, Utah, and Wyoming. The petition was accepted...' criterion, the Administrator was not able to certify the petition, making lamb producers in Idaho, Utah, and...

Adjustment Problems of Sibling and Nonsibling Pairs Referred to a School Mental Health Program

ERIC Educational Resources Information Center

Gallagher, Richard; Cowen, Emory L.

1976-01-01

In this study, siblings who developed school adjustment problems had more similar referral patterns than demographically matched, unrelated referral pairs. This effect was strongest among like sex pairs. Common environmental characteristics leading to similar coping patterns were seen to explain the results. (NG)

Personality Adjustment and Job Satisfaction among the Lecturers Working in Junior Colleges

ERIC Educational Resources Information Center

Raju, T. J. M. S.

2011-01-01

The present study focused on the relationship between personality adjustment and job satisfaction among junior college Lecturers in Vizianagaram District of Andhra Pradesh, India. The successfulness of any educational program basically depends on the right performance and acceptance of teacher community. This mainly depends on their satisfaction…

The Minnesota Defense Industry Conversion Project. A Partnership for Retraining.

ERIC Educational Resources Information Center

Daines, James R.; And Others

The Minnesota Defense Conversion Adjustment Project was initiated in 1993 with funding provided through the U.S. Department of Labor's Defense Conversion Adjustment Program to help workers at a Minnesota defense plant make the transition from assembler and related production classifications to machinists and other positions requiring specific job…