Numbered Heads Together as a Tier 1 Instructional Strategy in Multitiered Systems of Support

ERIC Educational Resources Information Center

Hunter, William C.; Maheady, Lawrence; Jasper, Andrea D.; Williamson, Robert L.; Murley, Renee C.; Stratton, Elizabeth

2015-01-01

Federal mandates (Individuals with Disabilities Education Improvement Act, 2004; No Child Left Behind Act, 2001) require teachers to accommodate students with more diverse academic and behavioral needs in inclusive general educational settings. To assist general educators in meeting this instructional challenge, multi-tiered systems of support…

National Airspace System : current efforts and proposed changes to improve performance of FAA's air traffic control system

DOT National Transportation Integrated Search

2003-05-01

To accelerate the modernization and improve the performance of the air traffic control system, the Wendell H. Ford Aviation Investment and Reform Act for the 21st Century (AIR-21) created the Air Traffic Services Subcommittee (subcommittee) to overse...

Nursing Home Staffing and Quality under the Nursing Home Reform Act

ERIC Educational Resources Information Center

Zhang, Xinzhi; Grabowski, David C.

2004-01-01

Purpose: We examine whether the Nursing Home Reform Act (NHRA) improved nursing home staffing and quality. Design and Methods: Data from 5,092 nursing homes were linked across the 1987 Medicare/Medicaid Automated Certification System and the 1993 Online Survey, Certification and Reporting system. A dummy-year model was used to examine the effects…

Evaluation of low wing-loading fuel conservative, short-haul transports

NASA Technical Reports Server (NTRS)

Pasley, L. H.; Waldeck, T. A.

1976-01-01

Fuel conservation that could be attained with two technology advancements, Q fan propulsion system and active control technology (ACT) was studied. Aircraft incorporating each technology were sized for a Federal Aviation Regulation (FAR) field length of 914 meters (3,000 feet), 148 passengers, and a 926 kilometer (500 nautical mile) mission. The cruise Mach number was .70 at 10100 meter (33,000 foot) altitude. The improvement resulting from application of the Q fan propulsion system was computed relative to an optimized fuel conservative transport design. The performance improvements resulting from application of ACT technology were relative to the optimized Q fan propulsion system configuration.

United States Health Care Reform Progress to Date and Next Steps

PubMed Central

Obama, Barack

2016-01-01

IMPORTANCE The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. OBJECTIVES To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. EVIDENCE Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. FINDINGS The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law’s reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600–$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. CONCLUSIONS AND RELEVANCE Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation’s most complex challenges. PMID:27400401

United States Health Care Reform: Progress to Date and Next Steps.

PubMed

Obama, Barack

2016-08-02

The Affordable Care Act is the most important health care legislation enacted in the United States since the creation of Medicare and Medicaid in 1965. The law implemented comprehensive reforms designed to improve the accessibility, affordability, and quality of health care. To review the factors influencing the decision to pursue health reform, summarize evidence on the effects of the law to date, recommend actions that could improve the health care system, and identify general lessons for public policy from the Affordable Care Act. Analysis of publicly available data, data obtained from government agencies, and published research findings. The period examined extends from 1963 to early 2016. The Affordable Care Act has made significant progress toward solving long-standing challenges facing the US health care system related to access, affordability, and quality of care. Since the Affordable Care Act became law, the uninsured rate has declined by 43%, from 16.0% in 2010 to 9.1% in 2015, primarily because of the law's reforms. Research has documented accompanying improvements in access to care (for example, an estimated reduction in the share of nonelderly adults unable to afford care of 5.5 percentage points), financial security (for example, an estimated reduction in debts sent to collection of $600-$1000 per person gaining Medicaid coverage), and health (for example, an estimated reduction in the share of nonelderly adults reporting fair or poor health of 3.4 percentage points). The law has also begun the process of transforming health care payment systems, with an estimated 30% of traditional Medicare payments now flowing through alternative payment models like bundled payments or accountable care organizations. These and related reforms have contributed to a sustained period of slow growth in per-enrollee health care spending and improvements in health care quality. Despite this progress, major opportunities to improve the health care system remain. Policy makers should build on progress made by the Affordable Care Act by continuing to implement the Health Insurance Marketplaces and delivery system reform, increasing federal financial assistance for Marketplace enrollees, introducing a public plan option in areas lacking individual market competition, and taking actions to reduce prescription drug costs. Although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation's most complex challenges.

77 FR 41774 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-16

... records is deleted: (18-05-14) Human Capital Learning and Performance Improvement System, 69 FR 19171... Department published in the Federal Register by using the article search feature at: www.federalregister.gov... name 18-05-14 Human Capital Learning and Performance Improvement System. [FR Doc. 2012-17310 Filed 7-13...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

28 CFR 42.215 - Other actions authorized under the JSIA.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-Implementation of Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.215 Other actions... receives funds made available under the JSIA or the Juvenile Justice Act and the conduct allegedly violates... payment of any funds under the JSIA and the Juvenile Justice Act to that specific program or activity...

Phase I Recommendations by the Air Quality Management Work Group to the Clean Air Act Advisory Committee

EPA Pesticide Factsheets

Recommendations to the Clean Air Act Advisory Committee by Air Quality Management Work Group addressing the recommendations made by the National Research Council to improve the U.S. air quality management system.

Clean Water Act (CWA) Action Plan Implementation Priorities: Changes to Improve Water Quality, Increase Compliance and Expand Transparency

EPA Pesticide Factsheets

The Clean Water Act (CWA) Action Plan Implementation Priorities describes the new approaches to revamp the National Pollutant Discharge Elimination System (NPDES) permitting, compliance and enforcement program.Issued May 11, 2011

Defense Finance and Accounting Service Needs to Strengthen Procedures to Comply with the Federal Financial Management Improvement Act

DTIC Science & Technology

2012-08-14

Improvement Act requirements and secure access to two payroll offices at Indianapolis, Indiana, that process sensitive payroll information. We...Without adequate controls over physical access, individuals could gain unauthorized access to computers and sensitive payroll data contained in online...and resolved. 2  Personnel and payroll data transmitted to and from interfacing systems were transferred completely, accurately, and timely

Postsecondary Education Reform in Kentucky. Issue Brief.

ERIC Educational Resources Information Center

Rabuzzi, Daniel A.; Carson, Ron

As governors and states seek to improve the responsiveness of postsecondary education, Kentucky's experience provides a powerful example of a systemic reform strategy. In 1997, Kentucky's governor proposed, and the General Assembly approved, the Postsecondary Education Improvement Act (House Bill 1), which reshaped the state system of public…

Report: EPA Is Taking Steps to Improve State Drinking Water Program Reviews and Public Water Systems Compliance Data

EPA Pesticide Factsheets

Report #17-P-0326, July 18, 2017. The EPA is taking action to improve oversight tools used to determine whether public water systems are monitoring and reporting drinking water quality in accordance with the Safe Drinking Water Act.

77 FR 3123 - Special Regulations, Areas of the National Park System, Cape Hatteras National Seashore-Off-Road...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-23

... budget to pay for these improvements. Architectural Barriers Act of 1968. A large number of those... of their receipt. The Architectural Barriers Act of 1968, as amended, 41 U.S.C. 4151 et seq., imposes...

28 CFR 42.201 - Purpose and application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Administration, the National Institute of Justice, or the Bureau of Justice Statistics. These regulations also... Justice System Improvement Act of 1979, or the Juvenile Justice and Delinquency Prevention Act of 1974, as... engaged in prohibited discrimination, the Office of Justice Assistance, Research, and Statistics will...

28 CFR 42.210 - Compliance not secured.

Code of Federal Regulations, 2010 CFR

2010-07-01

... payment of any funds under the JSIA or Juvenile Justice Act, as appropriate, to the specific program or....210 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...) of the Justice System Improvement Act of 1979 § 42.210 Compliance not secured. (a) If, at the...

28 CFR 42.210 - Compliance not secured.

Code of Federal Regulations, 2011 CFR

2011-07-01

... payment of any funds under the JSIA or Juvenile Justice Act, as appropriate, to the specific program or....210 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...) of the Justice System Improvement Act of 1979 § 42.210 Compliance not secured. (a) If, at the...

28 CFR 42.210 - Compliance not secured.

Code of Federal Regulations, 2014 CFR

2014-07-01

... payment of any funds under the JSIA or Juvenile Justice Act, as appropriate, to the specific program or....210 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...) of the Justice System Improvement Act of 1979 § 42.210 Compliance not secured. (a) If, at the...

28 CFR 42.210 - Compliance not secured.

Code of Federal Regulations, 2012 CFR

2012-07-01

... payment of any funds under the JSIA or Juvenile Justice Act, as appropriate, to the specific program or....210 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...) of the Justice System Improvement Act of 1979 § 42.210 Compliance not secured. (a) If, at the...

28 CFR 42.210 - Compliance not secured.

Code of Federal Regulations, 2013 CFR

2013-07-01

... payment of any funds under the JSIA or Juvenile Justice Act, as appropriate, to the specific program or....210 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...) of the Justice System Improvement Act of 1979 § 42.210 Compliance not secured. (a) If, at the...

Farewell to the Tick Box Inspector? Ofsted and the Changing Regime of School Inspection in England

ERIC Educational Resources Information Center

Baxter, Jacqueline; Clarke, John

2013-01-01

Since its inception in 1992 Ofsted (The Office for Standards in Education, Children's Services and Skills) has inspected schools under Section 9 of the Education (Schools) Act 1992; Section 10 of the School Inspections Act 1996; and Section 5 of the Education Act 2005. Pressure on England to improve its system of education has not only emerged…

Water Quality Indicators Data Usability Improvement Project ...

EPA Pesticide Factsheets

ECHO, Enforcement and Compliance History Online, provides compliance and enforcement information for approximately 800,000 EPA-regulated facilities nationwide. ECHO includes permit, inspection, violation, enforcement action, and penalty information about facilities regulated under the Clean Air Act (CAA) Stationary Source Program, Clean Water Act (CWA) National Pollutant Elimination Discharge System (NPDES), and/or Resource Conservation and Recovery Act (RCRA). Information also is provided on surrounding demographics when available.

Supporting Parents through Parent Education. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Zepeda, Marlene; Morales, Alex

California's Proposition 10, the "Children and Families Act," has targeted three general areas for improvement in support of families and young children: improved family functioning, improved child development, and improved child health. Proposition 10 views parents as critical to the development of young children. Noting that parent…

28 CFR 42.213 - Full hearing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... to have terminated the payment of funds under the JSIA and/or the Juvenile Justice Act; and (iii) If... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Justice System Improvement Act of 1979 § 42.213 Full hearing. (a) At any time after notification of...

28 CFR 42.213 - Full hearing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... to have terminated the payment of funds under the JSIA and/or the Juvenile Justice Act; and (iii) If... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Justice System Improvement Act of 1979 § 42.213 Full hearing. (a) At any time after notification of...

28 CFR 42.213 - Full hearing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... to have terminated the payment of funds under the JSIA and/or the Juvenile Justice Act; and (iii) If... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Justice System Improvement Act of 1979 § 42.213 Full hearing. (a) At any time after notification of...

28 CFR 42.213 - Full hearing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... to have terminated the payment of funds under the JSIA and/or the Juvenile Justice Act; and (iii) If... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Justice System Improvement Act of 1979 § 42.213 Full hearing. (a) At any time after notification of...

28 CFR 42.213 - Full hearing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... to have terminated the payment of funds under the JSIA and/or the Juvenile Justice Act; and (iii) If... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Justice System Improvement Act of 1979 § 42.213 Full hearing. (a) At any time after notification of...

28 CFR 42.204 - Applicants' obligations.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) of the Justice System Improvement Act of 1979 § 42.204 Applicants' obligations. (a) Every application... grant of $500,000 or more under the JSIA or the Juvenile Justice Act, must submit a copy of its current... 42.204 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...

28 CFR 42.204 - Applicants' obligations.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) of the Justice System Improvement Act of 1979 § 42.204 Applicants' obligations. (a) Every application... grant of $500,000 or more under the JSIA or the Juvenile Justice Act, must submit a copy of its current... 42.204 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...

28 CFR 42.204 - Applicants' obligations.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) of the Justice System Improvement Act of 1979 § 42.204 Applicants' obligations. (a) Every application... grant of $500,000 or more under the JSIA or the Juvenile Justice Act, must submit a copy of its current... 42.204 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...

28 CFR 42.204 - Applicants' obligations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) of the Justice System Improvement Act of 1979 § 42.204 Applicants' obligations. (a) Every application... grant of $500,000 or more under the JSIA or the Juvenile Justice Act, must submit a copy of its current... 42.204 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...

28 CFR 42.204 - Applicants' obligations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) of the Justice System Improvement Act of 1979 § 42.204 Applicants' obligations. (a) Every application... grant of $500,000 or more under the JSIA or the Juvenile Justice Act, must submit a copy of its current... 42.204 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...

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

PubMed

2015-07-01

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

Highway effects on vehicle performance

DOT National Transportation Integrated Search

1995-01-01

Improving our nation's transportation system is the goal of the Intermodal Surface Transportation Efficiency Act of 1991 (ISTEA), which authorizes Federal highway and transit funding programs. The ISTEA views planning as a key strategy to improve the...

28 CFR 42.211 - Resumption of suspended funds.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.211 Resumption of suspended funds. (a) Payment of suspended funds made available under the JSIA or the Juvenile Justice Act shall resume only if... Section 42.211 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT...

28 CFR 42.211 - Resumption of suspended funds.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.211 Resumption of suspended funds. (a) Payment of suspended funds made available under the JSIA or the Juvenile Justice Act shall resume only if... Section 42.211 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT...

28 CFR 42.211 - Resumption of suspended funds.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.211 Resumption of suspended funds. (a) Payment of suspended funds made available under the JSIA or the Juvenile Justice Act shall resume only if... Section 42.211 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT...

28 CFR 42.211 - Resumption of suspended funds.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.211 Resumption of suspended funds. (a) Payment of suspended funds made available under the JSIA or the Juvenile Justice Act shall resume only if... Section 42.211 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT...

28 CFR 42.211 - Resumption of suspended funds.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 815(c)(1) of the Justice System Improvement Act of 1979 § 42.211 Resumption of suspended funds. (a) Payment of suspended funds made available under the JSIA or the Juvenile Justice Act shall resume only if... Section 42.211 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT...

Implications of recent EIA changes in Thailand

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

Tongcumpou, C.; Harvey, N.

The practice of environmental impact assessment (EIA) was implemented in Thailand after the revision of the National Environmental Quality Act in 1978. This led to more than 3,000 EIA documents being prepared and officially submitted up to 1992. More recently, a new act, the Enhancement and Conservation of National Environmental Quality Act, was introduced in 1992. As a consequence, some aspects of environmental legislation have been improved including the EIA process, which is expected to be more effective under the new act. This article examines the development and implementation of the EIA process in Thailand and its effectiveness in themore » context of its performance as an environmental management tool. The strengths and weaknesses of the EIA process under the original act are analyzed and compared to the new act, using two case studies in order to gain an insight into the EIA system. The first is the Second Stage Expressway in Bangkok, and the second is the Pak Mun Hydroelectric Dam project in Ubon Rachathani, a northeastern province of Thailand. EIAs for these projects were originally submitted according to the requirements of the old act. Both are public projects that have aroused controversy for different environmental reasons, although final decisions have been made facilitating the implementation of these projects. Finally, the article presents some suggestions for improving the content and procedures for the EIA system in Thailand.« less

Oxide Protective Coats for Ir/Re Rocket Combustion Chambers

NASA Technical Reports Server (NTRS)

Fortini, Arthur; Tuffias, Robert H.

2003-01-01

An improved material system has been developed for rocket engine combustion chambers for burning oxygen/ hydrogen mixtures or novel monopropellants, which are highly oxidizing at operating temperatures. The baseline for developing the improved material system is a prior iridium/rhenium system for chambers burning nitrogen tetroxide/monomethyl hydrazine mixtures, which are less oxidizing. The baseline combustion chamber comprises an outer layer of rhenium that provides structural support, plus an inner layer of iridium that acts as a barrier to oxidation of the rhenium. In the improved material system, the layer of iridium is thin and is coated with a thermal fatigue-resistant refractory oxide (specifically, hafnium oxide) that serves partly as a thermal barrier to decrease the temperature and thus the rate of oxidation of the rhenium. The oxide layer also acts as a barrier against the transport of oxidizing species to the surface of the iridium. Tests in which various oxygen/hydrogen mixtures were burned in iridium/rhenium combustion chambers lined with hafnium oxide showed that the operational lifetimes of combustion chambers of the improved material system are an order of magnitude greater than those of the baseline combustion chambers.

The patient protection and affordable care act: what does it mean for mental health services for older adults?

PubMed

Sorrell, Jeanne M

2012-11-01

The U.S. Supreme Court recently upheld the constitutionality of the Patient Protection and Affordable Care Act (PPACA). It is important to think about how this act will affect mental health services for older adults. The act has the potential to improve health outcomes across all income and age groups. There are specific provisions that are expected to improve care for individuals with mental illness, but there is little information about how these provisions will affect older adults with mental illness. As we move toward implementation of the PPACA, psychiatric nurses need to be aware of myths surrounding the act and to think about changes in the health care system, such as collaborative models of care, that may help identify and overcome barriers to treatment of older adults with mental illness. Copyright 2012, SLACK Incorporated.

75 FR 59108 - Positive Train Control Systems

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... established. No railroad had supplied data supporting further track exceptions from PTC system installation...-0132, Notice No. 4] RIN 2130-AC03 Positive Train Control Systems AGENCY: Federal Railroad... Control (PTC) systems for railroads as mandated by the Rail Safety Improvement Act of 2008. With...

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Final ACT configuration evaluation

NASA Technical Reports Server (NTRS)

1982-01-01

The Final ACT Configuration Evaluation Task of the Integrated Application of Active Controls (IAAC) technology project within the energy efficient transport program is summarized. The Final ACT Configuration, through application of Active Controls Technology (ACT) in combination with increased wing span, exhibits significant performance improvements over the conventional baseline configuration. At the design range for these configurations, 3590 km, the block fuel used is 10% less for the Final ACT Configuration, with significant reductions in fuel usage at all operational ranges. Results of this improved fuel usage and additional system and airframe costs and the complexity required to achieve it were analyzed to determine its economic effects. For a 926 km mission, the incremental return on investment is nearly 25% at 1980 fuel prices. For longer range missions or increased fuel prices, the return is greater. The technical risks encountered in the Final ACT Configuration design and the research and development effort required to reduce these risks to levels acceptable for commercial airplane design are identified.

A Comparison of the Six Principles of the Individuals with Disabilities Education Improvement Act of the United States and the Persons with Disability Act of Ghana

ERIC Educational Resources Information Center

Mumuni, Samad Dimbie

2010-01-01

This study compared the six principles of IDEIA of the United States and the Persons with Disability Act of Ghana with the view to determining their similarities and differences. Recommendations were made with the ultimate aim of exploring the need for change in the special education delivery systems in the United States and Ghana. The comparative…

77 FR 19295 - Privacy Act of 1974; Report of an Altered System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... for the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care..., 2010 (75 FR 60763). The Health Care Quality Improvement Act of 1986, as amended, title IV of Public Law... conduct of physicians, dentists, and other health care practitioners. By law, the information is...

Abuse and Young Children with Disabilities: A Review of the Literature

ERIC Educational Resources Information Center

Corr, Catherine; Santos, Rosa Milagros

2017-01-01

Legislation in the United States, such as the Child Abuse Prevention and Treatment Act and the Individuals With Disabilities Education Improvement Act, mandates service system collaboration to meet the complex needs of young children with disabilities who have experienced abuse. This literature review examines extant literature related to young…

Charge exchange system

DOEpatents

Anderson, Oscar A.

1978-01-01

An improved charge exchange system for substantially reducing pumping requirements of excess gas in a controlled thermonuclear reactor high energy neutral beam injector. The charge exchange system utilizes a jet-type blanket which acts simultaneously as the charge exchange medium and as a shield for reflecting excess gas.

Adoptive immunotherapy for the treatment of glioblastoma: progress and possibilities.

PubMed

Kuramitsu, Shunichiro; Yamamichi, Akane; Ohka, Fumiharu; Motomura, Kazuya; Hara, Masahito; Natsume, Atsushi

2016-12-01

Patients with glioblastoma have a very poor prognosis. Adoptive cellular therapy (ACT) is defined as the collection of circulating or tumor-infiltrating lymphocytes, their selection, modification, expansion and activation, and their re-administration to patients in order to induce antitumor activity. Although various ACTs have been attempted, most failed to improve the outcome. Immune checkpoint blockade antibodies and T cell engineering with tumor-specific chimeric antigen receptors suggest the emergence of a new era of immunotherapy. Here, we summarize approaches with ACTs using genetically modified T cells, which have been improved by enhancing their antitumor activity, and discuss strategies to develop these therapies. The mechanisms by which gliomas modulate and evade the immune system are also discussed.

An Update on the Surgeons Scope and Depth of Practice to All Hazards Emergency Response

DTIC Science & Technology

2006-06-01

initiatives that are designed to react to and deal effectively with acts of terrorism. All aspects of the surgeon’s role in response to mass casualty...endpoint in terrorism’s designs. Increasingly frequent and effective terrorist acts have forced public health systems worldwide to examine and im...prove their abilities to care for mass casualties. Frykberg and Tepas noted that the most efficient and effective medical response systems have been

Partnering for Quality under the Workforce Investment Act: A Tool Kit for One-Stop System Building. Module 5: Building a Process for Continuous Improvement. Training Manual with Participant Workbook.

ERIC Educational Resources Information Center

Kogan, Deborah; Koller, Vinz; Kozumplik, Richalene; Lawrence, Mary Ann

This document is part of a five-module training package to help employment and training service providers comply with the Workforce Investment Act (WIA) of 1998 and develop a one-stop training and employment services system. It consists of the participant workbook, trainer manual, and activity worksheets for a module on building a process for…

Technology for Education Act of 1993. Hearings on S. 1040 before the Committee on Labor and Human Resources. United States Senate. One Hundred Third Congress, First Session (Washington, D.C., July 21, 1993 and Albequerque, New Mexico, August 18, 1993).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

Hearings were held on the Technology for Education Act of 1993 (S. 1040) to support systemic improvement of education and the development of a technologically literate citizenry and internationally competitive work force by establishing a comprehensive system through which appropriate technology-enhanced curriculum, instruction, and administrative…

Anticipating the effect of the Patient Protection and Affordable Care Act for patients with urologic cancer.

PubMed

Ellimoottil, Chandy; Miller, David C

2014-02-01

The Affordable Care Act seeks to overhaul the US health care system by providing insurance for more Americans, improving the quality of health care delivery, and reducing health care expenditures. Although the law's intent is clear, its implementation and effect on patient care remains largely undefined. Herein, we discuss major components of the Affordable Care Act, including the proposed insurance expansion, payment and delivery system reforms (e.g., bundled payments and Accountable Care Organizations), and other reforms relevant to the field of urologic oncology. We also discuss how these proposed reforms may affect patients with urologic cancers.

77 FR 68140 - Privacy Act of 1974; New System of Records, Office of General Counsel E-Discovery Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-15

... System of Records, Office of General Counsel E-Discovery Management System: Republication of System... Counsel (OGC) E- Discovery Management System (EDMS). EDMS was first announced and described in a July 17... for OGC's E-Discovery Management System (OGC-EDMS), a system expected to significantly improve the...

The Special Commission on the Conditions of Teaching Report. Leading the Way.

ERIC Educational Resources Information Center

Massachusetts State Legislature, Boston. Special Commission on REACH and School Improvement Councils.

To improve learning and the work lives of teachers, in 1985 Massachusetts enacted Chapter 188, the Public School Improvement Act, which establishes and implements a system for testing and evaluating school and student performance. Since Chapter 188 was implemented, Massachusetts schools have improved faster than the national rate. Proposals for…

7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Drinking Water Act, as amended (42 U.S.C. 300f et seq.); (iv) Clean Air Act, as amended (42 U.S.C. 7401 et... Innovation Center Demonstration program (note to 7 U.S.C. 1621). (30) Administer the Renewable Energy Systems and Energy Efficiency Improvements program (7 U.S.C. 8106). (30) Administer the renewable energy...

7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Drinking Water Act, as amended (42 U.S.C. 300f et seq.); (iv) Clean Air Act, as amended (42 U.S.C. 7401 et... Innovation Center Demonstration program (note to 7 U.S.C. 1621). (30) Administer the Renewable Energy Systems and Energy Efficiency Improvements program (7 U.S.C. 8106). (30) Administer the renewable energy...

7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Drinking Water Act, as amended (42 U.S.C. 300f et seq.); (iv) Clean Air Act, as amended (42 U.S.C. 7401 et... Innovation Center Demonstration program (note to 7 U.S.C. 1621). (30) Administer the Renewable Energy Systems and Energy Efficiency Improvements program (7 U.S.C. 8106). (30) Administer the renewable energy...

7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Drinking Water Act, as amended (42 U.S.C. 300f et seq.); (iv) Clean Air Act, as amended (42 U.S.C. 7401 et... Innovation Center Demonstration program (note to 7 U.S.C. 1621). (30) Administer the Renewable Energy Systems and Energy Efficiency Improvements program (7 U.S.C. 8106). (30) Administer the renewable energy...

75 FR 42475 - Agency Information Collection Activities; Revision of a Currently-Approved Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-21

... records system 32,700 hours = 5,556,000]. Background: The Motor Carrier Safety Improvement Act of 1999 (Public Law 106-159, 113 Stat. 1749, December 9, 1999) (MCSIA) authorized the Secretary of Transportation... Transportation Equity Act: A Legacy for Users (Pub. L. 109- 59, 119 Stat. 1144, Aug. 10, 2005) (SAFETEA-LU...

78 FR 15007 - Notice of Open House-Draft Environmental Impact Statement for Revised Water Control Manuals for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-08

... by USACE to operate a system of five Federal reservoir projects in the basin--Allatoona Dam and Lake... manuals for the ACT Basin in order to improve operations for authorized purposes to reflect changed... determine how the federal projects in the ACT Basin should adjust operations for their authorized purposes...

A Self-instructional Model to Teach Systems-based Practice and Practice-based Learning and Improvement

PubMed Central

Kimura, Joe; Ladden, MaryJoan D.; March, Elizabeth; Moore, Gordon T.

2008-01-01

Background When mandated as resident competencies in 1999, systems-based practice (SBP) and practice-based learning and improvement (PBLI) were new concepts to many. Objective To describe and evaluate a 4-week clinical elective (Achieving Competence Today—ACT) to teach residents SBP and PBLI. Design ACT consisted of a four-week active learning course and follow-up teaching experience, guided and supported by web-based materials. The curriculum included readings, scheduled activities, work products including an improvement project, and weekly meetings with a non-expert preceptor. The evaluation used a before–after cross-comparison of ACT residents and their peers. Participants Seventy-eight residents and 42 faculty in 18 US Internal Medicine residency programs participated between 2003 and 2005. Results and Main Measurements All residents and faculty preceptors responded to a knowledge test, survey of attitudes, and self-assessment of competency to do 15 tasks related to SBP/PBLI. All measures were normalized to a 100-point scale. Each program’s principal investigator (PI) identified aspects of ACT that were most and least effective in enhancing resident learning. ACT residents’ gains in knowledge (4.4 on a 100-point scale) and self-assessed competency (11.3) were greater than controls’ (−1.9, −8.0), but changes in attitudes were not significantly different. Faculty preceptors’ knowledge scores did not change, but their attitudes became more positive (15.8). PIs found a ready-to-use curriculum effective (rated 8.5 on a 10-point scale). Conclusions ACT increased residents’ knowledge and self-assessment of their own competency and raised faculty’s assessment of the importance of residents’ learning SBP/PBLI. Faculty content expertise is not required for residents to learn SBP/PBLI. PMID:18612719

A self-instructional model to teach systems-based practice and practice-based learning and improvement.

PubMed

Peters, Antoinette S; Kimura, Joe; Ladden, Maryjoan D; March, Elizabeth; Moore, Gordon T

2008-07-01

When mandated as resident competencies in 1999, systems-based practice (SBP) and practice-based learning and improvement (PBLI) were new concepts to many. To describe and evaluate a 4-week clinical elective (Achieving Competence Today-ACT) to teach residents SBP and PBLI. ACT consisted of a four-week active learning course and follow-up teaching experience, guided and supported by web-based materials. The curriculum included readings, scheduled activities, work products including an improvement project, and weekly meetings with a non-expert preceptor. The evaluation used a before-after cross-comparison of ACT residents and their peers. Seventy-eight residents and 42 faculty in 18 US Internal Medicine residency programs participated between 2003 and 2005. RESULTS AND MAIN MEASUREMENTS: All residents and faculty preceptors responded to a knowledge test, survey of attitudes, and self-assessment of competency to do 15 tasks related to SBP/PBLI. All measures were normalized to a 100-point scale. Each program's principal investigator (PI) identified aspects of ACT that were most and least effective in enhancing resident learning. ACT residents' gains in knowledge (4.4 on a 100-point scale) and self-assessed competency (11.3) were greater than controls' (-1.9, -8.0), but changes in attitudes were not significantly different. Faculty preceptors' knowledge scores did not change, but their attitudes became more positive (15.8). PIs found a ready-to-use curriculum effective (rated 8.5 on a 10-point scale). ACT increased residents' knowledge and self-assessment of their own competency and raised faculty's assessment of the importance of residents' learning SBP/PBLI. Faculty content expertise is not required for residents to learn SBP/PBLI.

Case studies for GSHP demonstration projects in the US

DOE PAGES

Liu, Xiaobing; Malhotra, Mini; Im, Piljae

2015-07-01

Under the American Recovery and Reinvestment Act , twenty-six ground source heat pump (GSHP) projects were competitively selected and carried out to demonstrate the benefits of GSHP systems and innovative technologies for cost reduction and/or performance improvement. This article gives an overview of the case studies for six of the systems. These case studies evaluated efficiencies, energy savings, and costs of the demonstrated systems. In addition, it was found that more energy savings could be achieved if controls of GSHP system are improved.

Current NASA Earth Remote Sensing Observations

NASA Technical Reports Server (NTRS)

Luvall, Jeffrey C.; Sprigg, William A.; Huete, Alfredo; Pejanovic, Goran; Nickovic, Slobodan; Ponce-Campos, Guillermo; Krapfl, Heide; Budge, Amy; Zelicoff, Alan; Myers, Orrin;

76 FR 21109 - Rural Energy for America Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

...The Rural Business-Cooperative Service (Agency) is establishing an interim rule for the Rural Energy for America Program (REAP), which is authorized under the Food, Conservation, and Energy Act of 2008. This interim rule modifies the existing grant and guaranteed loan program for renewable energy systems and energy efficiency improvements. In addition, it adds a grant program for feasibility studies for renewable energy systems and a grant program for energy audits and renewable energy development assistance, as provided in the Food, Conservation, and Energy Act of 2008.

Connecting a cognitive architecture to robotic perception

NASA Astrophysics Data System (ADS)

Kurup, Unmesh; Lebiere, Christian; Stentz, Anthony; Hebert, Martial

2012-06-01

We present an integrated architecture in which perception and cognition interact and provide information to each other leading to improved performance in real-world situations. Our system integrates the Felzenswalb et. al. object-detection algorithm with the ACT-R cognitive architecture. The targeted task is to predict and classify pedestrian behavior in a checkpoint scenario, most specifically to discriminate between normal versus checkpoint-avoiding behavior. The Felzenswalb algorithm is a learning-based algorithm for detecting and localizing objects in images. ACT-R is a cognitive architecture that has been successfully used to model human cognition with a high degree of fidelity on tasks ranging from basic decision-making to the control of complex systems such as driving or air traffic control. The Felzenswalb algorithm detects pedestrians in the image and provides ACT-R a set of features based primarily on their locations. ACT-R uses its pattern-matching capabilities, specifically its partial-matching and blending mechanisms, to track objects across multiple images and classify their behavior based on the sequence of observed features. ACT-R also provides feedback to the Felzenswalb algorithm in the form of expected object locations that allow the algorithm to eliminate false-positives and improve its overall performance. This capability is an instance of the benefits pursued in developing a richer interaction between bottom-up perceptual processes and top-down goal-directed cognition. We trained the system on individual behaviors (only one person in the scene) and evaluated its performance across single and multiple behavior sets.

Be All That We Can Be: Lessons from the Military for Improving Our Nation's Child Care System.

ERIC Educational Resources Information Center

Campbell, Nancy Duff; Appelbaum, Judith C.; Martinson, Karin; Martin, Emily

In response to increasing demands for military child care and lack of comprehensive care standards, the Military Child Care Act of 1989 (MCCA) mandated improvements in military child care. Today, the Department of Defense runs a model child care system serving over 200,000 children daily at over 300 locations worldwide. Noting that most of the…

A Plan for Evaluating the District of Columbia's Public Schools: From Impressions to Evidence

ERIC Educational Resources Information Center

National Academies Press, 2011

2011-01-01

The District of Columbia (DC) has struggled for decades to improve its public education system. In 2007 the DC government made a bold change in the way it governs public education with the goal of shaking up the system and bringing new energy to efforts to improve outcomes for students. The Public Education Reform Amendment Act (PERAA) shifted…

Analysis of Productivity Improvement Act for Clinical Staff Working in the Health System: A Qualitative Study

PubMed Central

Vali, Leila; Tabatabaee, Seyed Saeed; Kalhor, Rohollah; Amini, Saeed; Kiaei, Mohammad Zakaria

2016-01-01

Introduction: The productivity of healthcare staff is one of the main issues for health managers. This study explores the concept of executive regulation of Productivity Improvement Act of clinical staff in health. Methods: In this study phenomenological methodology has been employed. The data were collected through semi-structured interviews and focus group composed of 10 hospital experts and experts in human resources department working in headquarter of Mashhad University of Medical Sciences and 16 nursing managers working in public and private hospitals of Mashhad using purposive sampling. Findings were analyzed using Colaizzi’s seven step method. Results: The strengths of this Act included increasing spirit of hope in nurses, paying attention to quality of nursing care and decreasing problems related to the work plan development. Some of the weaknesses of Productivity Improvement Act included lack of required executive mechanisms, lack of considering nursing productivity indicator, increasing non-public hospitals problems, discrimination between employees, and removal of resting on night shifts. Suggestions were introduced to strengthen the Act such as increased organizational posts, use of a coefficient for wage in unusual work shifts and consideration of a performance indicator. Conclusion: The results may be used as a proper tool for long term management planning at organization level. Finally, if high quality care by health system staff is expected, in the first step, we should take care of them through proper policy making and focusing on occupational characteristics of the target group so that it does not result in discrimination among the staff. PMID:26383203

Opportunities in the Affordable Care Act to Advance Long-Term Services and Supports: The Role of Rehabilitation Counseling

ERIC Educational Resources Information Center

Caldwell, Joe; Alston, Reginald J.

2012-01-01

The Affordable Care Act includes many new provisions for long-term services and supports (LTSS). Among these are several new options, improvements, and incentives within Medicaid to balance service systems and expand access to home and community-based services. This article discusses some of the major provisions, implementations, and implications…

Stronger by Degrees: A Plan to Create a More Educated & Prosperous Kentucky. 2016-2021 Strategic Agenda for Postsecondary and Adult Education

ERIC Educational Resources Information Center

Kentucky Council on Postsecondary Education, 2016

2016-01-01

In 1997, the General Assembly adopted the "Postsecondary Education Improvement Act of 1997" (HB 1), a bold and visionary act to reform Kentucky's public system of higher education. This piece of legislation established broad goals for increasing educational attainment at all levels, and charged the Kentucky Council on Postsecondary…

What Are Teacher Attitudes toward the Response to Intervention Model as Implemented in Middle Georgia School Systems?

ERIC Educational Resources Information Center

Russ, Deborah Daniel

2012-01-01

Response to Intervention (RTI) is an initiative first outlined by the federal government in the No Child Left Behind Act (2001) and the Individuals with Disabilities Improvement Act (2004). The purpose of the model is twofold: to address the needs of struggling students with research-based interventions and regular progress monitoring and to…

Measuring and Articulating the Value of Community Engagement: Lessons Learned from 100 Years of Cooperative Extension Work

ERIC Educational Resources Information Center

Franz, Nancy

2014-01-01

The Cooperative Extension System was created in 1914 with the passage of the Smith-Lever Act. The act provided resources to improve access to education by creating this nationwide organization to bring land-grant university research and resources to people where they lived and worked. Cooperative Extension was the first formal nationwide structure…

Teacher Perceptions of the Value of Teacher Evaluations: New Jersey's ACHIEVE NJ

ERIC Educational Resources Information Center

Callahan, Kathe; Sadeghi, Leila

2015-01-01

The Teacher Effectiveness and Accountability for the Children of New Jersey (TEACHNJ) Act was adopted by the New Jersey legislature in August 2012 with the intent to raise student achievement by improving the overall quality of instruction. As a result of this act, new teacher evaluation systems, known as ACHIEVE NJ, have been introduced in school…

34 CFR 200.40 - Technical assistance.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic... full compliance with all of the reporting provisions of Title II of the Higher Education Act of 1965... system, and other examples of student work, to identify and develop solutions to problems in— (i...

34 CFR 200.40 - Technical assistance.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic... full compliance with all of the reporting provisions of Title II of the Higher Education Act of 1965... system, and other examples of student work, to identify and develop solutions to problems in— (i...

34 CFR 200.40 - Technical assistance.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic... full compliance with all of the reporting provisions of Title II of the Higher Education Act of 1965... system, and other examples of student work, to identify and develop solutions to problems in— (i...

34 CFR 200.40 - Technical assistance.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic... full compliance with all of the reporting provisions of Title II of the Higher Education Act of 1965... system, and other examples of student work, to identify and develop solutions to problems in— (i...

34 CFR 200.40 - Technical assistance.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., DEPARTMENT OF EDUCATION TITLE I-IMPROVING THE ACADEMIC ACHIEVEMENT OF THE DISADVANTAGED Improving Basic... full compliance with all of the reporting provisions of Title II of the Higher Education Act of 1965... system, and other examples of student work, to identify and develop solutions to problems in— (i...

Future considerations for clinical dermatology in the setting of 21st century American policy reform: The Medicare Access and Children's Health Insurance Program Reauthorization Act and the Merit-based Incentive Payment System.

PubMed

Barbieri, John S; Miller, Jeffrey J; Nguyen, Harrison P; Forman, Howard P; Bolognia, Jean L; VanBeek, Marta J

2017-06-01

As the implementation of the Medicare Access and Children's Health Insurance Program Reauthorization Act begins, many dermatologists who provide Medicare Part B services will be subject to the reporting requirements of the Merit-based Incentive Payment System (MIPS). Clinicians subject to MIPS will receive a composite score based on performance across 4 categories: quality, advancing care information, improvement activities, and cost. Depending on their overall MIPS score, clinicians will be eligible for a positive or negative payment adjustment. Quality will replace the Physician Quality Reporting System and clinicians will report on 6 measures from a list of over 250 options. Advancing care information will replace meaningful use and will assess clinicians on activities related to integration of electronic health record technology into their practice. Improvement activities will require clinicians to attest to completion of activities focused on improvements in care coordination, beneficiary engagement, and patient safety. Finally, cost will be determined automatically from Medicare claims data. In this article, we will provide a detailed review of the Medicare Access and Children's Health Insurance Program Reauthorization Act with a focus on MIPS and briefly discuss the potential implications for dermatologists. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Building on a Foundation of Strength: Fiscal Year 2012 United States Army Annual Financial Report

DTIC Science & Technology

2012-01-01

competency-based training in conjunction with the Army competency management system. Â Fellowships and experience-broadening interagency, international ...operations. This section focuses on the Army’s system of internal controls to comply with such laws as the Federal Financial Management Improvement Act...accurate financial information through efficient and effective internal controls. By having effective internal controls, the Army is able to improve

76 FR 73025 - Medicare Program; Payment Policies Under the Physician Fee Schedule, Five-Year Review of Work...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-28

...This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.

Effect of the Medicare Prescription Drug Improvement and Modernization Act on the bottom line.

PubMed

Jarrett, Anne T

2006-11-01

An historical perspective on the impact of the Medicare Prescription Drug Improvement and Modernization Act (MMA) on pharmaceutical reimbursement, and the financial bottom line at health systems and various strategies to use in the inpatient and outpatient setting to improve the bottom line are described. Implementation of MMA has affected the entire healthcare continuum by reducing pharmaceutical reimbursement rates and health system revenues and increasing prescription drug copayments, emergency department visits, and hospital admissions. Physician-owned clinics are less profitable than in the past because of MMA, which may prompt clinic closures and shift the patient care burden to clinics at public hospitals. Negotiating carve-outs for costly drugs and evaluating the feasibility of obtaining outlier payments can improve the bottom line in the hospital inpatient setting. Ensuring that billing codes are accurate and verifying that reimbursement was received can help minimize the impact of MMA on the financial bottom line in the outpatient setting. Negotiating favorable purchasing contracts and ensuring that drugs are used appropriately by following evidence-based guidelines can improve the financial bottom line in both the inpatient and outpatient settings. Strategies to decrease drug acquisition costs and increase reimbursement rates can help minimize the adverse impact of MMA on the financial bottom line at health systems.

76 FR 71554 - Civil Penalties; Notice of Adjusted Maximum Amounts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

..., and the Flammable Fabrics Act. On August 14, 2009, the Consumer Product Safety Improvement Act of 2008... Product Safety Improvement Act of 1990 (Improvement Act), Public Law 101-608, 104 Stat. 3110 (November 16, 1990), and the Consumer Product Safety Improvement Act of 2008 (CPSIA), Public Law 110-314, 122 Stat...

EPAS: A System that Works

ERIC Educational Resources Information Center

ACT, Inc., 2006

2006-01-01

ACT's Educational Planning and Assessment System (EPAS[R]) is designed to guide and support schools, districts, and states in their efforts to improve students' readiness for life after high school. EPAS provides a longitudinal approach to educational and career planning, assessment, instructional support, and evaluation. EPAS components are…

Introduction to Observing System Simulation Experiments (OSSEs)

NASA Technical Reports Server (NTRS)

Prive, Nikki C.

2014-01-01

This presentation gives a brief overview of Observing System Simulation Experiments (OSSEs), including what OSSEs are, and how and why they are performed. The intent is to educate the audience in light of the OSSE-related sections of the Forecast Improvement Act (H.R. 2413).

Aviation security : terrorist acts demonstrate urgent need to improve security at the nation's airports

DOT National Transportation Integrated Search

2001-09-20

A safe and secure civil aviation system is a critical component of the nation's overall security, physical infrastructure, and economic foundation. Billions of dollars and a myriad of programs and policies have been devoted to achieving such a system...

The Utility of Corporate-Style Balance Sheets for DoD Managers

DTIC Science & Technology

2014-06-01

operations of the executive branch ( United States Department of Commerce, 2014, p. 3- 2). 19 5. The Federal Financial Management Improvement Act of...federal financial management systems requirements, applicable federal accounting standards, and the United States Government Standard General Ledger at...General Accountability Office (1991). The Chief Financial Officers Act: A mandate for federal financial management reform. Washington, DC: Author. United

Intentions and Impacts: A Comparison of Sources of Influence on Local School Systems.

ERIC Educational Resources Information Center

Rossman, Gretchen B.; And Others

This report is based on data collected in a 2-year study of the implementation of Chapter 2 of the Educational Consolidation and Improvement Act of 1981, which combined the funds from 28 federal programs into a single block grant. This study investigated the effects of the act on 12 school districts, in an effort to obtain a better general…

46 CFR 393.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Act, as set forth in Chapter 551 of Title 46, United States Code. (d) Corridor Sponsor. An entity that... emissions, energy savings, improved safety, system resiliency, and/or reduced infrastructure costs. Routes...

Advanced Launch Technology Life Cycle Analysis Using the Architectural Comparison Tool (ACT)

NASA Technical Reports Server (NTRS)

McCleskey, Carey M.

2015-01-01

Life cycle technology impact comparisons for nanolauncher technology concepts were performed using an Affordability Comparison Tool (ACT) prototype. Examined are cost drivers and whether technology investments can dramatically affect the life cycle characteristics. Primary among the selected applications was the prospect of improving nanolauncher systems. As a result, findings and conclusions are documented for ways of creating more productive and affordable nanolauncher systems; e.g., an Express Lane-Flex Lane concept is forwarded, and the beneficial effect of incorporating advanced integrated avionics is explored. Also, a Functional Systems Breakdown Structure (F-SBS) was developed to derive consistent definitions of the flight and ground systems for both system performance and life cycle analysis. Further, a comprehensive catalog of ground segment functions was created.

The impact of a pay-for-performance system on timing to hip fracture surgery: experience from the Lazio Region (Italy)

PubMed Central

2013-01-01

Background A tariff modulation mechanisms has been introduced in some Italian regions with the aim of reducing inappropriate admissions and improving quality of care. In response to a regional act, hospitals in Lazio adopted a clinical pathway for elderly patients with hip fracture and introduced a compensation system based on the quality of health care, as in a pay-for-performance model. The objective of the present study was to compare the proportion of surgery for hip fracture performed within 48 hours of admission among Lazio hospitals according to different payment systems, before and after the implementation of the regional act. Methods A retrospective cohort study of patients aged 65 years and over, residing in the Lazio region and admitted to an acute care hospital for hip fracture before (1 July 2008 - 30 June 2009) and after (1 July 2010 - 30 June 2011) the pay-for-performance act. The proportion of surgeries performed within 48 h of hospital arrival was calculated. An adjusted multivariate regression analysis was applied to assess the effect of hospital payment type on the likelihood of surgery within 48 h of hospital arrival. Results The share of patients with hip fracture that had surgery within 48 hours was 11.7% before the introduction of the pay-for-performance act and 22.2% after. The proportion of early hip fracture operations increased after the pay-for-performance act, regardless of hospital payment type. The largest increase of surgery within 48 h occurred in private hospitals (adjusted Relative Risk = 2.80, p < 0.001). Conclusions The introduction of a compensation system based on health care quality is associated with improved quality of care for elderly patients with hip fracture, especially in hospitals that only use the Diagnosis Related Group system. PMID:24099264

Changing the cytology laboratory information system to improve cytology performance.

PubMed

Renshaw, Andrew A; Birdsong, George G

2014-02-01

A central tenet in the Patient Protection and Affordable Care Act is the increased use of information technology to improve patient care. However, areas for improvement in cytology are not well defined. Improvements in information technology could improve quality assessment in gynecologic cytology, but the cytology community must identify and ask for changes in information technology that can improve the care of patients. Cancer (Cancer Cytopathol) 2014;122:87-91. © 2013 American Cancer Society. © 2013 American Cancer Society.

Impact of franchisee-protection legislation on the performance of a marketing system: the case of gasoline retailing. [Petroleum Marketing Practices Act of 1978

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

Heinzelmann, R.

1982-01-01

The Petroleum Marketing Practices Act of 1978 intended to protect franchisee dealers, preserve competition, and maintain trends towards productivity improvements. As such, it represented an expression of countervailing power, service station dealers against their suppliers - large oil companies. This dissertation examines the impact of similar previous laws on the performance of the gasoline-marketing system. Marketing theory and previous research findings suggest that focus towards greater efficiency supporting competitor conditions contribute more performance benefits than legislation of franchisee dealer protection. Such laws, as the Robinson-Patman Act and the Automobile Dealers' Good Faith Act, were found to have only a limitedmore » impact. Their long-term benefits did not materialize. It is, therefore, hypothesized that the law will not have favorable results and serve its purpose satisfactorily.« less

High Stakes Assessment: A Local District Perspective.

ERIC Educational Resources Information Center

Oldham, Ben R.

The Kentucky Education Reform Act legislated by the 1990 General Assembly created a high-stakes school performance accountability system to monitor the progress of implementation. One major component of the accountability system is a schedule of consequences designed to reward those schools making sufficient progress in improving student…

77 FR 62602 - Privacy Act of 1974, as Amended; System of Records Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-15

... Record; (12) Statistical Reports--retrievable by names: (a) Personnel Transcript Report, (b) Class... training processes, such as the collection of statistical information on training programs, development of... systems, creating and reviewing statistics to improve the quality of services provided, or conducting debt...

Assessment of candidate communications systems and technologies for use with intelligent transportation systems (ITS) : task D/E report

DOT National Transportation Integrated Search

1997-11-01

The Clean Air Act Amendments of 1990 (CAAA) require that states submit State Implementation Plans (SIPs) detailing strategies to improve air quality in nonattainment areas. This analysis first reviews the administrative procedures that states and the...

Analysis of signal to noise enhancement using a highly selective modulation tracking filter

NASA Technical Reports Server (NTRS)

Haden, C. R.; Alworth, C. W.

1972-01-01

Experiments are reported which utilize photodielectric effects in semiconductor loaded superconducting resonant circuits for suppressing noise in RF communication systems. The superconducting tunable cavity acts as a narrow band tracking filter for detecting conventional RF signals. Analytical techniques were developed which lead to prediction of signal-to-noise improvements. Progress is reported in optimization of the experimental variables. These include improved Q, new semiconductors, improved optics, and simplification of the electronics. Information bearing signals were passed through the system, and noise was introduced into the computer model.

Effectiveness of Population Health Management Using the Propeller Health Asthma Platform: A Randomized Clinical Trial.

PubMed

Merchant, Rajan K; Inamdar, Rubina; Quade, Robert C

2016-01-01

Telehealth strategies for asthma have focused primarily on adherence to controller medications. Telemonitoring of short-acting β-agonist (SABA) focuses on patterns of use and may allow more timely action to avert exacerbations. Studies assessing this approach are lacking. This pragmatic controlled study was designed to measure real-world effectiveness of the Propeller Health Asthma Platform to reduce use of SABA and improve asthma control. A total of 495 patients were enrolled in parallel arms (1:1) for 12 months of monitoring SABA use. Intervention group (IG) patients received access to and feedback from the Propeller Health system. Routine care (RC) patients were outfitted with sensors but did not receive feedback. Physicians were able to monitor the status of their patients in the IG and receive proactive notifications. The daily mean number of SABA uses per person decreased by 0.41 for the IG and by 0.31 for RC between the first week and the remainder of the study period (P < .001 for the difference between groups). Similarly, the proportion of SABA-free days increased 21% for the IG and 17% for RC (P < .01 for the difference between groups). Asthma Control Test (ACT) scores were not significantly different between arms in the entire study population, but adults with initially uncontrolled ACT scores showed a significantly larger improvement in the proportion with controlled asthma in IG versus RC (63% controlled in the study period vs 49%, respectively; P < .05 comparing the 2 improvements). Compared with RC, the study arm monitoring SABA use with the Propeller Health system significantly decreased SABA use, increased SABA-free days, and improved ACT scores (the latter among adults initially lacking asthma control). Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Identification of siRNA delivery enhancers by a chemical library screen.

PubMed

Gilleron, Jerome; Paramasivam, Prasath; Zeigerer, Anja; Querbes, William; Marsico, Giovanni; Andree, Cordula; Seifert, Sarah; Amaya, Pablo; Stöter, Martin; Koteliansky, Victor; Waldmann, Herbert; Fitzgerald, Kevin; Kalaidzidis, Yannis; Akinc, Akin; Maier, Martin A; Manoharan, Muthiah; Bickle, Marc; Zerial, Marino

2015-09-18

Most delivery systems for small interfering RNA therapeutics depend on endocytosis and release from endo-lysosomal compartments. One approach to improve delivery is to identify small molecules enhancing these steps. It is unclear to what extent such enhancers can be universally applied to different delivery systems and cell types. Here, we performed a compound library screen on two well-established siRNA delivery systems, lipid nanoparticles and cholesterol conjugated-siRNAs. We identified fifty-one enhancers improving gene silencing 2-5 fold. Strikingly, most enhancers displayed specificity for one delivery system only. By a combination of quantitative fluorescence and electron microscopy we found that the enhancers substantially differed in their mechanism of action, increasing either endocytic uptake or release of siRNAs from endosomes. Furthermore, they acted either on the delivery system itself or the cell, by modulating the endocytic system via distinct mechanisms. Interestingly, several compounds displayed activity on different cell types. As proof of principle, we showed that one compound enhanced siRNA delivery in primary endothelial cells in vitro and in the endocardium in the mouse heart. This study suggests that a pharmacological approach can improve the delivery of siRNAs in a system-specific fashion, by exploiting distinct mechanisms and acting upon multiple cell types. © The Author(s) 2015. Published by Oxford University Press on behalf of Nucleic Acids Research.

3 CFR 8595 - Proclamation 8595 of October 29, 2010. National Native American Heritage Month, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

..., which permanently reauthorized the Indian Health Care Improvement Act, a cornerstone of health care for American Indians and Alaska Natives. This vital legislation will help modernize the Indian health care system and improve health care for 1.9 million American Indians and Alaska Natives. To combat the high...

Especially for Teachers: The Connection. An Invitation to School Improvement in North Carolina, 3.

ERIC Educational Resources Information Center

North Carolina State Dept. of Public Instruction, Raleigh.

North Carolina's educational reform effort is composed of three related programs--the Basic Education Program (BEP), the School Improvement and Accountability Act (Senate Bill 2), and a new system of state accreditation. Information about the complementary and interdependent connection among the three programs is provided in this publication. The…

76 FR 30959 - Bogue Chitto National Wildlife Refuge, LA and MS; Draft Comprehensive Conservation Plan and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-27

... National Wildlife Refuge System Improvement Act of 1997, requires us to develop a CCP for each national...; however, the island could still be subjected to habitat improvement projects, such as forest thinning and... temporarily, compromise Holmes Island's wilderness character. Under Alternative A, negative effects to soils...

Development and application of a T7 RNA polymerase-dependent expression system for antibiotic production improvement in Streptomyces.

PubMed

Wei, Junhong; Tian, Jinjin; Pan, Guoqing; Xie, Jie; Bao, Jialing; Zhou, Zeyang

2017-06-01

To develop a reliable and easy to use expression system for antibiotic production improvement of Streptomyces. A two-compound T7 RNA polymerase-dependent gene expression system was developed to fulfill this demand. In this system, the T7 RNA polymerase coding sequence was optimized based on the codon usage of Streptomyces coelicolor. To evaluate the functionality of this system, we constructed an activator gene overexpression strain for enhancement of actinorhodin production. By overexpression of the positive regulator actII-ORF4 with this system, the maximum actinorhodin yield of engineered strain was 15-fold higher and the fermentation time was decreased by 48 h. The modified two-compound T7 expression system improves both antibiotic production and accelerates the fermentation process in Streptomyces. This provides a general and useful strategy for strain improvement of important antibiotic producing Streptomyces strains.

Public health and food safety: a historical association.

PubMed Central

Wagstaff, D J

1986-01-01

Since the initial passage in 1906 of the first Pure Food and Drug Act and the Meat Inspection Act, public health, as measured by mortality trends, has greatly improved. These acts have been amended several times, and other laws dealing with safety of foods and drinks have been enacted. Food- and beverage-transmitted infectious diseases that were so devastating after the Civil War have been controlled. Nutritional deficiencies such as pellagra are almost nonexistent. Mass episodes of poisoning of food by chemical contaminants that have plagued some other countries have not occurred in the United States. Other factors such as refrigeration and improved transportation have helped, but it is probable that food safety regulatory activities have contributed to the saving of the 1.8 million Americans who would die each year if the public health advances since 1900 had not been made. Effective use of information was a key factor in the improvement in public health. Now, as then, effective information systems are needed. PMID:3097743

The affordable care act and long-term care: comprehensive reform or just tinkering around the edges?

PubMed

Miller, Edward Alan

2012-01-01

The Patient Protection and Affordable Care Act (ACA) includes several provisions that aim to improve prevailing deficiencies in the nation's long-term care system. But just how effective is the ACA likely to be in addressing these challenges? Will it result in meaningful or marginal reform? This special issue of Journal of Aging & Social Policy seeks to answer these questions. The most prominent long-term care provision is the now-suspended Community Living Assistance Services and Supports Act. Others include incentives and options for expanding home- and community-based care, a number of research and demonstration projects in the areas of chronic care coordination and the dually eligible, and nursing home quality reforms. There are also elements that seek to improve workforce recruitment and retention, in addition to benefit improvements and spending reductions under Medicare. This article reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them. It also includes a brief overview of issue content.

The revitalization of health and education in Rural America Act of 1992

NASA Technical Reports Server (NTRS)

English, Glenn

1991-01-01

During the preceding decade of the 1980's, rural communities witnessed an exodus of over 5 million residents to urban and suburban areas of the nation. It has become increasingly clear that rural parts of the country must adopt aggressive strategies to strengthen rural communities and enhance the quality of life for its citizens into the 21st century. Studies by the U.S. Department of Commerce, Office of Technology Assessment, and the Aspen Institute all identify advanced telecommunications systems as the linchpin for a vigorous future for rural America. The Revitalization of Health and Education in Rural America Act of 1992 incorporates these recommendations into viable strategies to improve health care and educational services for rural citizens. By linking up hospitals and schools through advanced telecommunications technology, vast geographic distances are instantly reduced. With the proper infrastructure in place, up-to-date telecommunications services will facilitate endless opportunities for improving the quality of life in remote areas. This comprehensive legislation is the critical first step in forging a partnership with urban communities to create an economically sound and technologically advanced America for generations to come. Improvement of health care and educational services in rural areas through the implementation of interactive telecommunications systems is addressed. A copy of the Act is included.

A system dynamics approach for modeling construction workers' safety attitudes and behaviors.

PubMed

Shin, Mingyu; Lee, Hyun-Soo; Park, Moonseo; Moon, Myunggi; Han, Sangwon

2014-07-01

Construction accidents are caused by an unsafe act (i.e., a person's behavior or activity that deviates from normal accepted safe procedure) and/or an unsafe condition (i.e., a hazard or an unsafe mechanical or physical environment). While there has been dramatic improvement in creating safer construction environments, relatively little is known regarding the elimination of construction workers' unsafe acts. To address this deficiency, this paper aims to develop a system dynamics (SD)-based model of construction workers' mental processes that can help analyze the feedback mechanisms and the resultant dynamics regarding the workers' safety attitudes and safe behaviors. The developed model is applied to examine the effectiveness of three safety improvement policies: incentives for safe behaviors, and increased levels of communication and immersion in accidents. Application of the model verifies the strong potential of the developed model to provide a better understanding of how to eliminate unsafe acts, and to function as a robust test-bed to assess the effectiveness of safety programs or training sessions before their implementation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Human Interoperability: Experimentation to Understand & Improve the Human Component of Complex Systems

DTIC Science & Technology

2008-09-30

and Accountability Act of 1996 ) prohibit health care providers from sharing certain information about patients, and the Posse Comitatus Act (1878...Publishers, pp. 333-380. Carley, K.M., and Svoboda, D.M. ( 1996 ). Modeling Organizational Adaptation as a Simulated Annealing Process. Sociological...Privacy: Interdisciplinary Frameworks and Solution. Hershey , PA: IGI Global. Salas, E., Sims, D.E., & Burke, C.S. (2005). Is there a big five in

Mechanisms Affecting the Sustainability and Scale-up of a System-Wide Numeracy Reform

ERIC Educational Resources Information Center

Bobis, Janette

2011-01-01

With deliberate system-level reform now being acted upon around the world, both successful and unsuccessful cases provide a rich source of knowledge from which we can learn to improve large-scale reform. Research surrounding the effectiveness of a theory-based system-wide numeracy reform operating in primary schools across Australia is examined to…

CAI: A Model for the Comparison and Selection of Integrated Learning Systems in Large School Districts.

ERIC Educational Resources Information Center

Resta, Paul E.; Rost, Paul

The Albuquerque (New Mexico) Public Schools conducted a three-year study of integrated computer-based learning systems, including WICAT, Dolphin, PLATO, CCC, and DEGEM. Through cooperation with the Education Consolidation Improvement Act Chapter 1 program, four large integrated learning systems (ILS) were purchased and studied. They were installed…

Adoptive cell transfer after chemotherapy enhances survival in patients with resectable HNSCC.

PubMed

Jiang, Pan; Zhang, Yan; J Archibald, Steve; Wang, Hua

2015-09-01

The aims of this study were to evaluate the therapeutic efficacy and to determine the immune factors for treatment success in patients with head and neck squamous cell carcinoma (HNSCC) treated with chemotherapy followed by adoptive cell transfer (ACT). A total of 43 HNSCC patients who received radical resection and chemotherapy were analysed in this study. Twenty-one of the patients were repeatedly treated with ACT after chemotherapy (ACT group), and the other twenty-two patients without ACT treatment were included as part of the control group. To investigate the immunological differences underlying these observations, we expanded and profiled improving cytokine-induced killer cells (iCIK) from peripheral blood mononuclear cells (PBMCs) with the timed addition of RetroNectin, OKT3 mAb, IFN γ and IL-2. The median of progression-free survival (PFS) and overall survival (OS) in the ACT group were significantly higher as compared to the control group (56 vs. 40; 58 vs. 45 months). In iCIK culture, there was a significant reduction in CD3+CD4+ T-cell proliferation and cytokines (IL-2, TNF) production from patients who received chemotherapy compared to patients without chemotherapy. Intra-arterial infusion of iCIK, in coordination with chemotherapy, considerably rescued iCIK culture from the suppression of systemic immunity induced by chemotherapy and induced tumour regression. Altogether, these findings suggest that ACT is an effective neo-adjuvant therapy for rescuing systemic immune suppression and improving survival time in patients with HNSCC. Copyright © 2015 Elsevier B.V. All rights reserved.

77 FR 4002 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... the methodological research previously included in the original System of Record Notice (SORN). This... methodological research on improving various aspects of surveys authorized by Title 13, U.S.C. 8(b), 182, and 196, such as: survey sampling frame design; sample selection algorithms; questionnaire development, design...

Leadership Motivation and Mentoring Can Improve Efficiency of a Classroom Teacher and Workers in Institutions

ERIC Educational Resources Information Center

Onjoro, Veronica; Arogo, Rebecca Bwari; Embeywa, Henry Etende

2015-01-01

Motivational strategies guarantee quality assurance in the educational system. Motivational strategies like staff training and development, promotion, salary, remuneration, working conditions, status and participatory decision making, acted as a barrier towards achieving quality assurance in the educational system. The study adopted the…

Harnessing the Affordable Care Act to catalyze delivery system reform and strengthen emergency care in America.

PubMed

Maa, John

2015-01-01

As health care reform in the US evolves beyond insurance reform to encompass delivery system reform, the opportunity arises to harness the Affordable Care Act to strengthen patient care in America. One area for dedicated individuals to lead this effort is by improving transitions in patient care across the continuum of team members, specialties, settings, and systems. This article will describe innovations of the surgicalist and acute care surgeon that have emerged in response to the challenges facing surgery in specialization, geography, and the need to comply with health care reform mandates. Three ways will be described to integrate these innovations with pilot programs in the Affordable Care Act: to promote teamwork, to reduce readmissions, and to strengthen emergency care because the key location where the joint efforts intersect most acutely with patient need is in our nation's Emergency Departments.

Harnessing the Affordable Care Act to Catalyze Delivery System Reform and Strengthen Emergency Care in America

PubMed Central

Maa, John

2015-01-01

As health care reform in the US evolves beyond insurance reform to encompass delivery system reform, the opportunity arises to harness the Affordable Care Act to strengthen patient care in America. One area for dedicated individuals to lead this effort is by improving transitions in patient care across the continuum of team members, specialties, settings, and systems. This article will describe innovations of the surgicalist and acute care surgeon that have emerged in response to the challenges facing surgery in specialization, geography, and the need to comply with health care reform mandates. Three ways will be described to integrate these innovations with pilot programs in the Affordable Care Act: to promote teamwork, to reduce readmissions, and to strengthen emergency care because the key location where the joint efforts intersect most acutely with patient need is in our nation’s Emergency Departments. PMID:25663212

Tribal Set-Aside Program of the Drinking Water Infrastructure Grant

EPA Pesticide Factsheets

The Safe Drinking Water Act (SWDA), as amended in 1996, established the Drinking Water State Revolving Fund (DWSRF) to make funds available to drinking water systems to finance infrastructure improvements.

Early Warning Reporting System Improvement Act of 2014

THOMAS, 113th Congress

Sen. Markey, Edward J. [D-MA

2014-03-25

Senate - 03/25/2014 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A Review on Phytosome Technology as a Novel Approach to Improve The Bioavailability of Nutraceuticals

NASA Astrophysics Data System (ADS)

Amin, Tawheed; Bhat, Suman Vikas

2012-08-01

The bioavailability and absorption of water soluble phytoconstituents is erratic due to poor solubility of these constituents in gastrointestinal tract. This can be overcome by a novel delivery system known as phytosome technology in which water soluble phytoconstituents are allowed to react with phospholipids. For better and improved bioavailability, natural phytoconstituents must have a good balance between hydrophilicity (helps in dissolution in gastro-intestinal fluids) and hydrophobicity (helps to cross lipid rich cell membranes). This is achieved through phytosome technology. Phospholipids have a dual solubility and acts as an emulsifier. Phytosome technology acts as a bridge between novel and conventional delivery systems. Many products are available in the market based on this phytosome technology which include popular herbal extracts such as Ginkgo biloba, Silybum marianum, grape seed, olive oil flavonoids etc.

Rheumatologist and Primary Care Management of Cardiovascular Disease Risk in Rheumatoid Arthritis: Patient and Provider Perspectives.

PubMed

Bartels, Christie M; Roberts, Tonya J; Hansen, Karen E; Jacobs, Elizabeth A; Gilmore, Andrea; Maxcy, Courtney; Bowers, Barbara J

2016-04-01

Despite increased cardiovascular disease (CVD) risk, rheumatoid arthritis (RA) patients often lack CVD preventive care. We examined CVD preventive care processes from RA patient and provider perspectives to develop a process map for identifying targets for future interventions to improve CVD preventive care. Thirty-one participants (15 patients, 7 rheumatologists, and 9 primary care physicians [PCPs]) participated in interviews that were coded using NVivo software and analyzed using grounded theory techniques. Patients and providers reported that receipt of preventive care depends upon identifying and acting on risk factors, although most noted that both processes rarely occurred. Engagement in these processes was influenced by various provider-, system-, visit-, and patient-related conditions, such as patient activation or patients' knowledge about their risk. While nearly half of patients and PCPs were unaware of RA-CVD risk, all rheumatologists were aware of risk. Rheumatologists reported not systematically identifying risk factors, or, if identified, they described communicating about CVD risk factors via clinic notes to PCPs instead of acting directly due to perceived role boundaries. PCPs suggested that scheduling PCP visits could improve CVD risk management, and all participants viewed comanagement positively. Findings from this study illustrate important gaps and opportunities to support identifying and acting on CVD risk factors in RA patients from the provider, system, visit, and patient levels. Future work should investigate professional role support through improved guidelines, patient activation, and system-based RA-CVD preventive care strategies. © 2016, American College of Rheumatology.

Management of febrile children under five years in hospitals and health centres of rural Ghana.

PubMed

Webster, Jayne; Baiden, Frank; Bawah, Justina; Bruce, Jane; Tivura, Mathilda; Delmini, Rupert; Amenga-Etego, Seeba; Chandramohan, Daniel; Owusu-Agyei, Seth

2014-07-09

The case management of febrile children in hospitals' and health centres' pre-roll out of the new WHO policy on parasitological diagnosis was assessed. The delivery of artemisinin combination therapy (ACT) at these two levels of the health system was compared. Structured observations and exit interviews of 1,222 febrile children attending five hospitals and 861 attending ten health centres were conducted in six districts of the Brong Ahafo Region of Ghana. Effectiveness of delivery of case management of malaria was assessed. Proportions of children receiving ACT, anti-malarial monotherapy and antibiotics were described. Predictors of: a febrile child being given an ACT, a febrile child being given an antibiotic and of carers knowing how to correctly administer the ACT were assessed using logistic regression models stratified by hospitals and health centres. The system's effectiveness of delivering an ACT to febrile children diagnosed with malaria (parasitologically or clinically) was 31.4 and 42.4% in hospitals and health centres, respectively. The most ineffective process was that of ensuring that carers knew how to correctly administer the ACT. Overall 278 children who were not given an ACT were treated with anti-malarial monotherapy other than quinine. The majority of these children, 232/278 were given amodiaquine, 139 of these were children attending hospitals and 93 attending health centres. The cadre of health staff conducting consultation was a common predictor of the outcomes of interest. Presenting symptoms and examinations conducted were predictive of being given an ACT in hospitals and antibiotic in hospitals and health centres but not of being given an ACT in health centres. Treatment-seeking factors were predictive of being given an ACT if it was more than seven days since the fever began and an antibiotic in hospitals but not in health centres. Interventions to improve adherence to negative parasitological tests are needed, together with guidance on dispensing of antibiotics, but improving the education of carers on how to administer ACT will lead to the greatest immediate increase in the effectiveness of case management. Guidance is needed on implementation of the new test-based treatment for malaria policy in health facilities.

Anticipating the Impact of the Patient Protection and Affordable Care Act for Patients with Urological Cancer

PubMed Central

Ellimoottil, Chandy; Miller, David C.

2014-01-01

The Affordable Care Act seeks to overhaul the US healthcare system by providing insurance for more Americans, improving the quality of healthcare delivery, and reducing healthcare expenditures. While the law’s intent is clear, its implementation and effect on patient care remains largely undefined. Herein, we discuss major components of the ACA, including the proposed insurance expansion, payment and delivery system reforms (e.g. bundled payments and Accountable Care Organizations) and other reforms relevant to the field of urologic oncology. We also discuss how these proposed reforms may impact patients with urological cancers. PMID:24588021

A Better IDEA: Best Practice and Outcomes-Oriented Remedies in Public Impact Litigation for Students with Disabilities

ERIC Educational Resources Information Center

Noonan, Kathleen G.; McCarthy, Megan A.; Shea, Lindsay; Marcus, Steven C.; Mandell, David S.

2016-01-01

Class action lawsuits filed in violation of Individuals with Disabilities Education Act (IDEA) raise questions for those concerned with improving the education system for students with disabilities. First, do the lawsuits result in changes that can be directly linked to improved student outcomes? Second, do these lawsuits and the "consent…

Graduation Matters: Improving Accountability for High School Graduation

ERIC Educational Resources Information Center

Hall, Daria

2007-01-01

An analysis of accountability for high school graduation rates under the federal No Child Left Behind Act (NCLB) reveals two major problems: (1) State goals for raising graduation rates are far too low to spur needed improvement and (2) Gaps between student groups are allowed to persist by an accountability system that looks only at average…

Counterfeit Compliance with the HIPAA Security Rule: A Study of Information System Success

ERIC Educational Resources Information Center

Johnson, James R.

2013-01-01

The intent of the security standards adopted by the Department of Health and Human Services (DHS) implementing some of the requirements of the Administrative Simplification (AS) subtitle of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was to improve Federal and private health care programs and to improve the…

Practices of Assistive Technology Implementation and Facilitation: Experiences of Teachers of Students with Visual Impairments in Singapore

ERIC Educational Resources Information Center

Wong, Meng Ee; Law, Janet S. P.

2016-01-01

Assistive technology is defined by the Individuals With Disabilities Education Improvement Act (IDEIA) of 2004 as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability"…

African goat improvement project: A feed the future initiative harnessing genetic diversity for conservation, disease resistance, and improved productivity

USDA-ARS?s Scientific Manuscript database

Food production systems in Africa depend heavily on the use of locally adapted animals. These animals are of agricultural, cultural, and economic importance to humans. Goats, in particular, are critical to the small-scale farmer as they are easier to acquire, maintain, and act as scavengers in spar...

Improving the Juvenile Justice System for Girls Act of 2013

THOMAS, 113th Congress

Rep. DeLauro, Rosa L. [D-CT-3

2013-05-06

House - 07/08/2013 Referred to the Subcommittee on Early Childhood, Elementary, and Secondary Education. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 13076 - Privacy Act of 1974; Altered System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

....C., Sections 141 and 193 and the U.S. Census Bureau; and to undertake methodological evaluations and enhancements leading to improved data collection and quality control studies. Also, information collected by...

14 CFR 13.3 - Investigations (general).

Code of Federal Regulations, 2010 CFR

2010-01-01

....), the Airport and Airway Improvement Act of 1982 (49 U.S.C. 2201 et seq.), the Airport and Airway Improvement Act of 1982 (as amended, 49 U.S.C. App. 2201 et seq., Airport and Airway Safety and Capacity... Improvement Act of 1982, the Airport and Airway Improvement Act of 1982 as amended by the Airport and Airway...

77 FR 76075 - Whistleblower Protection Advisory Committee (WPAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-26

... workers and employers, improving the investigative and enforcement process, improvements of regulations..., 49 U.S.C. 42121; the Sarbanes-Oxley Act, 18 U.S.C. 1514A; the Pipeline Safety Improvement Act, 49 U.S... Act, 6 U.S.C. 1142; the Consumer Product Safety Improvement Act, 15 U.S.C. 2087; Section 1558 of the...

16 CFR 1500.88 - Exemptions from lead limits under section 101 of the Consumer Product Safety Improvement Act for...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 101 of the Consumer Product Safety Improvement Act for certain electronic devices. 1500.88 Section... from lead limits under section 101 of the Consumer Product Safety Improvement Act for certain electronic devices. (a) The Consumer Product Safety Improvement Act (CPSIA) provides for specific lead limits...

Recovery Act: Cedarville School District Retrofit of Heating and Cooling Systems with Geothermal Heat Pumps and Ground Source Water Loops

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

Jarrell, Mark

Cedarville School District retrofitted the heating and cooling systems in three campus areas (High School, Middle School, and Upper Elementary School) with geothermal heat pumps and ground source water loops, as a demonstration project for the effective implementation of geothermal heat pump systems and other energy efficiency and air quality improvements.

Systems analysis techniques for annual cycle thermal energy storage solar systems

NASA Astrophysics Data System (ADS)

Baylin, F.

1980-07-01

Community-scale annual cycle thermal energy storage solar systems are options for building heat and cooling. A variety of approaches are feasible in modeling ACTES solar systems. The key parameter in such efforts, average collector efficiency, is examined, followed by several approaches for simple and effective modeling. Methods are also examined for modeling building loads for structures based on both conventional and passive architectural designs. Two simulation models for sizing solar heating systems with annual storage are presented. Validation is presented by comparison with the results of a study of seasonal storage systems based on SOLANSIM, an hour-by-hour simulation. These models are presently used to examine the economic trade-off between collector field area and storage capacity. Programs directed toward developing other system components such as improved tanks and solar ponds or design tools for ACTES solar systems are examined.

Early Warning Systems: Re-Engaging Chronic Truants

ERIC Educational Resources Information Center

Chorneau, Tom

2012-01-01

School attendance can be an early indicator that something is going wrong with a student. Gathering, analyzing, and acting on attendance information is a first step toward school improvement. Meanwhile, the majority of the states are moving to build and enhance what are called "early warning systems," intended to flag at-risk students during their…

Equality and Quality in U.S. Education: Systemic Problems, Systemic Solutions. Policy Brief

ERIC Educational Resources Information Center

O'Day, Jennifer A.; Smith, Marshall S.

2016-01-01

Recent passage of the federal Every Student Succeeds Act (ESSA), coupled with recognition of rising inequality in American society, has rekindled debate about how U.S. schools might address long-standing disparities in educational and economic opportunities while improving the educational outcomes for all students. This paper enters that debate…

75 FR 28035 - Privacy Act of 1974; Department of Homeland Security/U.S. Citizenship and Immigration Services...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

..., Parent Company or Corporate Company, Name of Company Point of Contact (POC) for E-Verify Usage, POC Phone... information about user system usage. The information collected specifically on users includes: Name (last... improvement efforts and system enhancement planning, which may include conducting surveys, user interviews...

75 FR 20420 - Privacy Act of 1974: System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-19

... project are covered by this system of records. These individuals are employees of three rail carriers participating in the C\\3\\RS demonstration project. The rail carriers are: Union Pacific Railroad, Canadian Pacific Railroad, and New Jersey Transit. The C\\3\\RS demonstration project is a research effort to improve...

Management filters and species traits: Weed community assembly in long-term organic and conventional systems

USDA-ARS?s Scientific Manuscript database

Community assembly theory provides a useful framework to assess the response of weed communities to agricultural management systems and to improve the predictive power of weed science. Under this framework, weed community assembly is constrained by abiotic and biotic "filters" that act on species tr...

Rules of the Mind.

ERIC Educational Resources Information Center

Anderson, John R.

Related to the earlier ACT production system theory, this book's basic goal is to present evidence for the psychological reality of a production system model of mind. Distinguished from the original theory in three ways, this volume uses previous rational analyses to improve upon that theory and extend its scope. It also relates the theory to new…

National Aeronautics and Space Administration: Leadership and Systems Needed to Effect Financial Management Improvements

DTIC Science & Technology

2002-03-20

financial reporting requirements-an unqualified opinion on its financial statements, no material internal control weaknesses, and financial management systems that are in substantial compliance the requirements of the Federal Financial Management Improvement Act (FFMIA). This implied that NASA not only could generate reliable information once a year for external financial reporting purposes but also could provide accurate, reliable information for day-today decision-making. In contrast with the unqualified or clean audit opinions of its previous

[New developments in the treatment and monitoring of type 1 diabetes mellitus].

PubMed

Otto-Buczkowska, Ewa; Jarosz-Chobot, Przemysława; Tucholski, Krzysztof

2008-01-01

In recent years, insulin analogues are the benefits of the use in functional intensive insulin therapy for the treatment of diabetes. Shortacting insulin (lispro, aspart and glulisine) and long-acting insulin (glargine and detemir) have been developed for the management of diabetes. Short-acting insulin analogues are an alternative to regular human insulin before meals. These new short-acting insulin analogues show more rapid onset of activity and a shorter duration of action. As a result of these pharmacokinetic differences, an improved postprandial glycemic control is achieved, without increasing the risk of hypoglycemia. In addition, these insulin analogues can be administered immediately before a meal. The long-acting insulin analogues provide basal insulin levels for 24 h when administered once (glargine) or two (detemir) daily. Compared with previous intermediate- or long-acting conventional insulin, these insulins shows a flat profile of plasma insulin levels . The use of these long-acting insulin analogues appears to be associated with a reduced incidence of hypoglycemia, especially at night. The availability of these new insulin analogues has the potential to significantly improve long-term control over blood glucose in diabetic patients. In recent years more and more frequently the method of multiple daily injections (MDI) of insulin is being replaced by the method of continuous subcutaneous insulin infusion (CSII). It is the most physiological way to administer insulin. In recent years treatment with insulin pumps has been used more frequently in the pediatric patients and in the treatment of diabetes in pregnancy. Use of continuous glucose monitoring systems enables detection of glycemia fluctuations unrevealed by selfmonitoring of blood glucose, such as night hypoglycemias and early postprandial hyperglycemias. Real-time systems allow to reduce HbA1c levels and limit number of excursions. Non-invasive glucose measurement devices are introduced. Fully automated continuous glucose monitoring systems integrated with insulin pumps operating in closed-loop model, requiring no patient assistance, are still being researched. Commercially available systems operate in open-loop model, where the patient has to decide on administration and dose of insulin.

Quality improvement in basic histotechnology: the lean approach.

PubMed

Clark, David

2016-01-01

Lean is a comprehensive system of management based on the Toyota production system (TPS), encompassing all the activities of an organization. It focuses management activity on creating value for the end-user by continuously improving operational effectiveness and removing waste. Lean management creates a culture of continuous quality improvement with a strong emphasis on developing the problem-solving capability of staff using the scientific method (Deming's Plan, Do, Check, Act cycle). Lean management systems have been adopted by a number of histopathology departments throughout the world to simultaneously improve quality (reducing errors and shortening turnround times) and lower costs (by increasing efficiency). This article describes the key concepts that make up a lean management system, and how these concepts have been adapted from manufacturing industry and applied to histopathology using a case study of lean implementation and evidence from the literature. It discusses the benefits, limitations, and pitfalls encountered when implementing lean management systems.

Acquisition Quality Improvement Within Naval Facilities Engineering Command Southwest

DTIC Science & Technology

2015-06-01

Act BMS Business Management System BPA Blanket Purchase Agreement COR Contracting Officer Representative CS Contract Specialist DASN...Services (MOPAS) missing in two service contract files. (2) Blanket Purchase Agreement ( BPA ) procedures were not followed. (3) Business

A history of biological and chemical warfare and terrorism.

PubMed

Malloy, C D

2000-07-01

This article provides a brief history of biological warfare and terrorism. It contends that examining disease in history provides public health specialists with the knowledge necessary to improve our surveillance system for potential acts of bioterrorism.

Use of Process Improvement Tools in Radiology.

PubMed

Rawson, James V; Kannan, Amogha; Furman, Melissa

2016-01-01

Process improvement techniques are common in manufacturing and industry. Over the past few decades these principles have been slowly introduced in select health care settings. This article reviews the Plan, Do, Study, and Act cycle, Six Sigma, the System of Profound Knowledge, Lean, and the theory of constraints. Specific process improvement tools in health care and radiology are presented in the order the radiologist is likely to encounter them in an improvement project. Copyright © 2015 Mosby, Inc. All rights reserved.

Benefits and drawbacks of electronic health record systems

PubMed Central

Menachemi, Nir; Collum, Taleah H

2011-01-01

The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way. PMID:22312227

Gut microbiota modulates adoptive cell therapy via CD8α dendritic cells and IL-12.

PubMed

Uribe-Herranz, Mireia; Bittinger, Kyle; Rafail, Stavros; Guedan, Sonia; Pierini, Stefano; Tanes, Ceylan; Ganetsky, Alex; Morgan, Mark A; Gill, Saar; Tanyi, Janos L; Bushman, Frederic D; June, Carl H; Facciabene, Andrea

2018-02-22

Adoptive T cell therapy (ACT) is a promising new modality for malignancies. Here, we report that adoptive T cell efficacy in tumor-bearing mice is significantly affected by differences in the native composition of the gut microbiome or treatment with antibiotics, or by heterologous fecal transfer. Depletion of bacteria with vancomycin decreased the rate of tumor growth in mice from The Jackson Laboratory receiving ACT, whereas treatment with neomycin and metronidazole had no effect, indicating the role of specific bacteria in host response. Vancomycin treatment induced an increase in systemic CD8α+ DCs, which sustained systemic adoptively transferred antitumor T cells in an IL-12-dependent manner. In subjects undergoing allogeneic hematopoietic cell transplantation, we found that oral vancomycin also increased IL-12 levels. Collectively, our findings demonstrate an important role played by the gut microbiota in the antitumor effectiveness of ACT and suggest potentially new avenues to improve response to ACT by altering the gut microbiota.

Gut microbiota modulates adoptive cell therapy via CD8α dendritic cells and IL-12

PubMed Central

Bittinger, Kyle; Rafail, Stavros; Pierini, Stefano; Tanes, Ceylan; Ganetsky, Alex; Morgan, Mark A.; Gill, Saar; Tanyi, Janos L.; Bushman, Frederic D.; June, Carl H.

2018-01-01

Adoptive T cell therapy (ACT) is a promising new modality for malignancies. Here, we report that adoptive T cell efficacy in tumor-bearing mice is significantly affected by differences in the native composition of the gut microbiome or treatment with antibiotics, or by heterologous fecal transfer. Depletion of bacteria with vancomycin decreased the rate of tumor growth in mice from The Jackson Laboratory receiving ACT, whereas treatment with neomycin and metronidazole had no effect, indicating the role of specific bacteria in host response. Vancomycin treatment induced an increase in systemic CD8α+ DCs, which sustained systemic adoptively transferred antitumor T cells in an IL-12–dependent manner. In subjects undergoing allogeneic hematopoietic cell transplantation, we found that oral vancomycin also increased IL-12 levels. Collectively, our findings demonstrate an important role played by the gut microbiota in the antitumor effectiveness of ACT and suggest potentially new avenues to improve response to ACT by altering the gut microbiota. PMID:29467322

Strategic plans open for comment

NASA Astrophysics Data System (ADS)

Under the Government Performance and Results Act (the Results Act), agencies of the U.S. government are required to submit a 5-year strategic plan to the U.S. Congress by September 30, 1997 explaining how, when, and why they are spending tax dollars.Enacted in 1993, the Results Act is in tended to "improve efficiency and effective ness of Federal programs by establishing a system to set goals for program performance and to measure results." Thus according to the U.S. House of Representatives Committee on Science, the aim is for agencies to measure their performances by the results of their task and services, not by the number of tasks and services performed. Toward that goal, the Act requires that federal entities complete the following 3-step process:

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of Federal financial participation--HCFA. Final rule.

PubMed

1985-07-30

This final rule provides the additional requirements to the conditions and procedures for initial approval and reapproval of Medicaid Management Information Systems (MMIS) that were added by section 1903(r) of the Social Security Act (as amended by section 901 of the Mental Health Systems Act of 1980, Pub. L. 96-398). These provisions are intended to improve States' MMIS, ensure efficient system operations, and make the procedures for detection of fraud, waste, and abuse more effective. In addition, this final rule specifies the procedures we follow in reducing the level of Federal financial participation in State administrative expenditures if a State fails to meet the conditions for initial operation, initial approval, or reapproval of an MMIS.

Environmental Compliance Assessment and Management System (ECAMP), U.S. Air Force - German Supplement

DTIC Science & Technology

1993-10-01

ECP, was Associate Investigator. Dr. Diane K. Mann, CECER-ECP, is Acting Team Leader. Dr. John T. Bandy is Acting Chief, CECER-EC, and William D. Goran...Officer. (1)(3) Officer must discharge certain responsibilities - works toward improved safety on the installation (BImSchG, Section 58b). - informs the...objects, glass or mineral fibers, or materials in the form of webs or boards, including associated drying facilities, when the following are used: a

76 FR 24213 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

...This proposed rule would implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This proposed rule would also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required by the Social Security Act (the Act). The Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also proposing to consolidate, clarify, and revise existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled ``Improving Regulation and Regulatory Review,'' we are proposing to amend existing regulatory provisions regarding ``new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.

Teachers' Perceptions of the Relationship between Principal's Support and Perceived Effectiveness of Professional Learning Communities

ERIC Educational Resources Information Center

Speier, Karen Margaret

2011-01-01

Since the passage of the No Child Left Behind Act of 2001, standardized test scores have revealed that the U.S. public education system has been unable to adequately address improvement of academic achievement. For 20 years, educators have been promoting professional learning communities (PLCs) as a solution to improving K-12 academic achievement.…

Specialty Care Access in the Safety Net-the Role of Public Hospitals and Health Systems.

PubMed

Makaroun, Lena K; Bowman, Chelsea; Duan, Kevin; Handley, Nathan; Wheeler, Daniel J; Pierluissi, Edgar; Chen, Alice Hm

2017-01-01

Access to specialty care in the United States safety net, already strained, is fac-ing increasing pressure with an influx of patients following the passage of the Affordable Care Act (ACA). We surveyed 18 public hospitals and health systems across the country to describe the current state of specialty care delivery in safety-net systems. We elicited information regarding challenges, provider models, metrics of access and productivity, and strategies for improving access. Based on our findings, we propose a framework for assessing and improving specialty care access with a focus on population health planning.

5 CFR 430.301 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... systems that hold senior executives accountable for their individual and organizational performance in order to improve the overall performance of Government by— (1) Expecting excellence in senior executive... and Results Act of 1993; (3) Setting and communicating individual and organizational goals and...

5 CFR 430.301 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... systems that hold senior executives accountable for their individual and organizational performance in order to improve the overall performance of Government by— (1) Expecting excellence in senior executive... and Results Act of 1993; (3) Setting and communicating individual and organizational goals and...

16 CFR 1500.91 - Determinations regarding lead content for certain materials or products under section 101 of the...

Code of Federal Regulations, 2010 CFR

2010-01-01

... certain materials or products under section 101 of the Consumer Product Safety Improvement Act. 1500.91 Section 1500.91 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT... Safety Improvement Act. (a) The Consumer Product Safety Improvement Act provides for specific lead limits...

The Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).

PubMed

Kops, S R

1997-01-01

The purpose of this article is to provide a general overview and reference source for the Health Insurance Portability and Accountability Act, which was signed into law by President Clinton last August. The focus of the article is on Title I--Improved Availability and Portability of Health Insurance Coverage, and on Title III--Tax-Related Health Provisions. The author points out that due to the trend towards an incremental approach to health care legislation, this act must be viewed as one of a series of initiatives being taken by the federal government intended to impact the cost of the U.S. health care delivery system.

Medicare program; payment policies under the physician fee schedule, five-year review of work relative value units, clinical laboratory fee schedule: signature on requisition, and other revisions to part B for CY 2012. Final rule with comment period.

PubMed

2011-11-28

This final rule with comment period addresses changes to the physician fee schedule and other Medicare Part B payment policies to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. It also addresses, implements or discusses certain statutory provisions including provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008. In addition, this final rule with comment period discusses payments for Part B drugs; Clinical Laboratory Fee Schedule: Signature on Requisition; Physician Quality Reporting System; the Electronic Prescribing (eRx) Incentive Program; the Physician Resource-Use Feedback Program and the value modifier; productivity adjustment for ambulatory surgical center payment system and the ambulance, clinical laboratory, and durable medical equipment prosthetics orthotics and supplies (DMEPOS) fee schedules; and other Part B related issues.

Project UCARE : Uniform Commuter Assistance Reporting and Evaluation for transportation demand management programs, [summary].

DOT National Transportation Integrated Search

2013-09-01

The federal transportation reauthorization called : Moving Ahead for Progress in the 21st Century Act : (MAP-21) creates a program that addresses many : challenges facing the U.S. transportation system. : These challenges include improving safety, : ...

The commercial vehicle information systems and networks program, 2014.

DOT National Transportation Integrated Search

2015-05-01

The Federal Motor Carrier Safety Administration (FMCSA) was created as an operating administration within the U.S. Department of Transportation (USDOT) by the Motor Carrier Safety Improvement Act of 1999. The primary mission of the FMCSA is to reduce...

The Commercial Vehicle Information Systems and Networks Program, 2015.

DOT National Transportation Integrated Search

2016-08-01

The Federal Motor Carrier Safety Administration (FMCSA) was created as an operating administration within the U.S. Department of Transportation (USDOT) by the Motor Carrier Safety Improvement Act of 1999. The primary mission of FMCSA is to reduce cra...

Merit-Based Incentive Payment System (MIPS): Harsh Choices For Interventional Pain Management Physicians.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

2016-01-01

The Merit-based Incentive Payment System (MIPS) was created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to improve the health of all Americans by providing incentives and policies to improve patient health outcomes. MIPS combines 3 existing programs, Meaningful Use (MU), now called Advancing Care Information (ACI), contributing 25% of the composite score; Physician Quality Reporting System (PQRS), changed to Quality, contributing 50% of the composite score; and Value-based Payment (VBP) system to Resource Use or cost, contributing 10% of the composite score. Additionally, Clinical Practice Improvement Activities (CPIA), contributing 15% of the composite score, create multiple strategic goals to design incentives that drive movement toward delivery system reform principles with inclusion of Advanced Alternative Payment Models (APMs). Under the present proposal, the Centers for Medicare and Medicaid Services (CMS) has estimated approximately 30,000 to 90,000 providers from a total of over 761,000 providers will be exempt from MIPS. About 87% of solo practitioners and 70% of practitioners in groups of less than 10 will be subjected to negative payments or penalties ranging from 4% to 9%. In addition, MIPS also will affect a provider's reputation by making performance measures accessible to consumers and third-party physician rating Web sites.The MIPS composite performance scoring method, at least in theory, utilizes weights for each performance category, exceptional performance factors to earn bonuses, and incorporates the special circumstances of small practices.In conclusion, MIPS has the potential to affect practitioners negatively. Interventional Pain Medicine practitioners must understand the various MIPS measures and how they might participate in order to secure a brighter future. Medicare Access and CHIP Reauthorization Act of 2015, merit-based incentive payment system, quality performance measures, resource use, clinical practice improvement activities, advancing care information performance category.

75 FR 50021 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NASDAQ OMX PHLX, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

... SECURITIES AND EXCHANGE COMMISSION [Release No. 34-62678; File No. SR-Phlx-2010-108] Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NASDAQ OMX PHLX, Inc. Relating to a Proposed Price Improvement System, Price Improvement XL (PIXL\\SM\\) August 10, 2010. Pursuant to Section 19(b)(1) of the Securities Exchange Act of 1934...

Quality Information--Informed Choices: Advancing the Workforce Information System. Secretary of Labor's Workforce Information System Plan for Federal Fiscal Years 2001-2005.

ERIC Educational Resources Information Center

Workforce Information Council (DOL), Washington, DC.

The Workforce Investment Act of 1998 emphasizes the importance of high quality, accessible, and relevant information about the labor market for making sound decisions. In order to help both workers and employers, as well as the government agencies that serve them, the Workforce Information System was created and is being improved. The action plan…

Risk management and measuring productivity with POAS--point of act system.

PubMed

Akiyama, Masanori; Kondo, Tatsuya

2007-01-01

The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man, Material, Money and Information completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

Filtering Data Based on Human-Inspired Forgetting.

PubMed

Freedman, S T; Adams, J A

2011-12-01

Robots are frequently presented with vast arrays of diverse data. Unfortunately, perfect memory and recall provides a mixed blessing. While flawless recollection of episodic data allows increased reasoning, photographic memory can hinder a robot's ability to operate in real-time dynamic environments. Human-inspired forgetting methods may enable robotic systems to rid themselves of out-dated, irrelevant, and erroneous data. This paper presents the use of human-inspired forgetting to act as a filter, removing unnecessary, erroneous, and out-of-date information. The novel ActSimple forgetting algorithm has been developed specifically to provide effective forgetting capabilities to robotic systems. This paper presents the ActSimple algorithm and how it was optimized and tested in a WiFi signal strength estimation task. The results generated by real-world testing suggest that human-inspired forgetting is an effective means of improving the ability of mobile robots to move and operate within complex and dynamic environments.

The Army's Use of the Advanced Communications Technology Satellite

NASA Technical Reports Server (NTRS)

Ilse, Kenneth

1996-01-01

Tactical operations require military commanders to be mobile and have a high level of independence in their actions. Communications capabilities providing intelligence and command orders in these tactical situations have been limited to simple voice communications or low-rate narrow bandwidth communications because of the need for immediate reliable connectivity. The Advanced Communications Technology Satellite (ACTS) has brought an improved communications tool to the tactical commander giving the ability to gain access to a global communications system using high data rates and wide bandwidths. The Army has successfully tested this new capability of bandwidth-on-demand and high data rates for commanders in real-world conditions during Operation UPHOLD DEMOCRACY in Haiti during the fall and winter of 1994. This paper examines ACTS use by field commanders and details the success of the ACTS system in support of a wide variety of field condition command functions.

An evaluation of federal order reform.

PubMed

Bailey, K; Tozer, P

2001-04-01

The Federal Agricultural Improvement and Reform Act of 1996 required the Secretary of Agriculture to reform federal milk marketing orders. The Secretary carried out this task and issued a final rule on March 31, 1999, that was eventually approved by dairy farmers in a national referendum. However, a temporary restraining order (TRO) was issued on September 28, 1999, that halted the reform process. The TRO was effectively overturned and the reform process restarted when President Bill Clinton signed the Consolidated Appropriations Act of 2000 on November 29, 1999. The final rule as amended consolidates the number of orders, develops a multiple component pricing system that determines new formulas for class prices, and provides a new system for pricing fluid milk based on county-level price differentials. The impact of these changes is to provide more transparency in pricing and improved market signals to farmers. But the new system is also much more vulnerable to changes in dairy commodity prices. The objective of this report is to provide a comprehensive overview of federal order reform and to analyze the impact of recent changes in class price formulas.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Wing planform study and final configuration selection

NASA Technical Reports Server (NTRS)

1981-01-01

This report summarizes the Wing Planform Study Task and Final Configuration Selection of the Integrated Application of Active Controls (IAAC) Technology Project within the Energy Efficient Transport Program. Application of Active Controls Technology (ACT) in combination with increased wing span resulted in significant improvements over the Conventional Baseline Configuration (Baseline) and the Initial ACT Configuration previously established. The configurations use the same levels of technology (except for ACT), takeoff gross weight, and payload as the Baseline. The Final ACT Configuration (Model 768-107) incorporates pitch-augmented stability (which enabled an approximately 10% aft shift in cruise center of gravity and a 45% reduction in horizontal tail sizes), lateral/directional-augmented stability, an angle-of-attack limiter, and wing-load alleviation. Flutter-mode control was not beneficial for this configuration. This resulted in an 890 kg (1960 lb) reduction in airplane takeoff gross weight and a 9.8% improvement in cruise lift/drag. At the Baseline mission range (3590 km) (1938 nmi), this amounts to 10% block fuel reduction. Good takeoff performance at high-altitude airports on a hot day was also achieved. Results of this task strongly indicate that the IAAC Project should proceed with the Final ACT evaluation and begin the required control system development and testing.

General Fund Enterprise Business System Did Not Provide Required Financial Information

DTIC Science & Technology

2012-03-26

Management of the General Fund Enterprise Business System,” January 14, 2008 Army AAA Report No. A-2010-0187- FFM , “General Fund Enterprise Business System...A-2009-0232- FFM , “General Fund Enterprise Business System – Federal Financial Management Improvement Act Compliance, Examination of Releases...1.4.1, 1.4.2, 1.4.3, and 1.4.4 Requirements,” September 30, 2009 AAA Report No. A-2009-0231- FFM , “General Fund Enterprise Business System – Federal

Student, Teacher and School Performance. Eighth Annual Report Submitted to the Governor and the General Assembly of the State of Tennessee.

ERIC Educational Resources Information Center

Tennessee State Board of Education, Nashville.

This report establishes the performance goals for Tennessee school systems, established in accordance with the Education Improvement Act (EIA) of 1992, and describes the initiatives undertaken to assist school systems in achieving the goals. It also summarizes the results from various measures of student, teacher, and school performance.…

Review of the Community College System's Performance-Based Program Budgeting Measures and Incentive Fund. Report 97-49.

ERIC Educational Resources Information Center

Florida State Legislature, Tallahassee. Office of Program Policy Analysis and Government Accountability.

This report addresses the Florida Community College System's (FCCS) performance based on measures established by the General Appropriations Act. Discussed are: (1) FCCS' performance on the measures used in the performance-based budgeting (PBB) incentive fund; (2) improvements that can be made to the PBB incentive fund; and (3) changes to community…

76 FR 47190 - Privacy Act of 1974; Report of Modified or Altered System

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... use in service area determination. Support for Plan-supplied residence address will improve the..., employers, self-insurers, managed care organizations, and other supplemental insurers; (6) facilitate... companies, third party administrators (TPA), employers, self-insurers, managed care organizations, other...

Report: American Recovery and Reinvestment Act Site Inspection of Sewer System Improvement Projects, City of Parma, Ohio

EPA Pesticide Factsheets

Report #11-R-0083, February 2, 2011. Based upon our site inspection, no problems were identified that would require action from the city, the State of Ohio, or the U.S. Environmental Protection Agency.

Factors influencing adverse events reporting within the health care system: the case of artemisinin-based combination treatments in northern Ghana.

PubMed

Chatio, Samuel; Aborigo, Raymond; Adongo, Philip Baba; Anyorigiya, Thomas; Dalinjong, Philip Ayizem; Akweongo, Patricia; Oduro, Abraham

2016-02-27

The use of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria was a policy recommended by World Health Organization. In 2004, Ghana changed her first-line anti-malarial drug policy to use ACT. This study examined factors affecting adverse events reporting in northern Ghana after the introduction of ACT. This was a qualitative study based on sixty in-depth interviews with health workers, chemical shop owners and patients with malaria who were given ACT at the health facilities. Purposive sampling method was used to select study participants. The interviews were transcribed, coded into themes using Nvivo 9 software. The thematic analysis framework was used to analyse the data. Study respondents reported body weakness and dizziness as the most frequent side effects they had experienced from the used of ACT. Other side effects they reported were swollen testes, abdominal pain and shivering. These side effects were mostly associated with the use of artesunate-amodiaquine compared to other artemisinin-based combinations. Patients were not provided information about the side effects of the drugs and so did not report when they experienced them. Also long queues at health facilities and unfriendly health worker attitude were the main factors affecting adverse events reporting. Other factors such as wrong use of ACT at home, farming and commercial activities also affected effective adverse events reporting in the study area. Patients' lack of knowledge and health sector drawbacks affected side effect reporting on ACT. Intensive health education on likely side effects of ACT should be provided to patients by health workers. Also, improving health worker attitude toward clients will encourage patients to visit the health facilities when they react negatively to ACT and, subsequently, will improve on adverse events reporting.

A case of allergic bronchopulmonary aspergillosis successfully treated with mepolizumab.

PubMed

Terashima, Takeshi; Shinozaki, Taro; Iwami, Eri; Nakajima, Takahiro; Matsuzaki, Tatsu

2018-03-27

Allergic bronchopulmonary aspergillosis (ABPA) is an allergic pulmonary disease comprising a complex hypersensitivity reaction to Aspergillus fumigatus. Clinical features of ABPA are wheezing, mucoid impaction, and pulmonary infiltrates. Oral corticosteroids and anti-fungal agents are standard therapy for ABPA, but long-term use of systemic corticosteroids often causes serious side effects. A 64-year-old woman was diagnosed with ABPA based on a history of bronchial asthma (from 40 years of age), elevated total IgE, the presence of serum precipitating antibodies and elevated specific IgE antibody to A. fumigatus, and pulmonary infiltration. Bronchoscopy showed eosinophilic mucoid impaction. Systemic corticosteroid therapy was initiated, and her symptoms disappeared. Peripheral eosinophilia and pulmonary infiltration recurred five months after cessation of corticosteroid treatment. Systemic corticosteroids were re-initiated and itraconazole was added as an anti-fungal agent. The patient was free of corticosteroids, aside from treatment with a short course of systemic corticosteroids for asthma exacerbation, and clinically stable with itraconazole and asthma treatments for 3 years. In 2017, she experienced significant deterioration. Laboratory examination revealed marked eosinophilia (3017/μL) and a chest computed tomography (CT) scan demonstrated pulmonary infiltration in the left upper lobe and mucoid impaction in both lower lobes. The patient was treated with high-dose inhaled corticosteroid/long-acting beta-agonist, a long-acting muscarinic antagonist, a leukotriene receptor antagonist, and theophylline; spirometry revealed a forced expiratory volume in 1 s (FEV 1 ) of 1.01 L. An uncontrolled asthma state was indicated by an Asthma Control Test (ACT) score of 18. Mepolizumab, 100 mg every 4 weeks, was initiated for the treatment of severe bronchial asthma with ABPA exacerbation. Bronchial asthma symptoms dramatically improved, and ACT score increased to 24, by 4 weeks after mepolizumab treatment. Peripheral eosinophil count decreased to 174/μL. Spirometry revealed improvement of lung function (FEV 1 : 1.28 L). A chest CT scan demonstrated the disappearance of pulmonary infiltration and mucoid impaction. To our knowledge, this is the first case of ABPA to be treated with mepolizumab. Dramatic improvements were observed in symptoms, lung function, peripheral eosinophil counts, and chest images. Mepolizumab could serve as an alternative treatment with the potential to provide a systemic corticosteroid-sparing effect.

Hospital quality: a product of good management as much as good treatment.

PubMed

Hyde, Andy; Frafjord, Anders

2013-01-01

In Norway, as in most countries, the demands placed on hospitals to reduce costs and improve the quality of services are intense. Although many say that improving quality reduces costs, few can prove it. Futhermore, how many people can show that improving quality improves patient satisfaction. Diakonhjemmet hospital in Norway has designed and implemented a hospital management system based on lean principles and the PDCA (Plan-Do-Check-Act) quality circle introduced by WE Deming (Deming 2000). The results are quite impressive with improvements in quality and patient satisfaction. The hospital also runs at a profit.

Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System Policy Changes and Fiscal Year 2016 Rates; Revisions of Quality Reporting Requirements for Specific Providers, Including Changes Related to the Electronic Health Record Incentive Program; Extensions of the Medicare-Dependent, Small Rural Hospital Program and the Low-Volume Payment Adjustment for Hospitals. Final rule; interim final rule with comment period.

PubMed

2015-08-17

We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital related costs of acute care hospitals to implement changes arising from our continuing experience with these systems for FY 2016. Some of these changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act), the Pathway for Sustainable Growth Reform(SGR) Act of 2013, the Protecting Access to Medicare Act of 2014, the Improving Medicare Post-Acute Care Transformation Act of 2014, the Medicare Access and CHIP Reauthorization Act of 2015, and other legislation. We also are addressing the update of the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits for FY 2016.As an interim final rule with comment period, we are implementing the statutory extensions of the Medicare dependent,small rural hospital (MDH)Program and changes to the payment adjustment for low-volume hospitals under the IPPS.We also are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) for FY 2016 and implementing certain statutory changes to the LTCH PPS under the Affordable Care Act and the Pathway for Sustainable Growth Rate (SGR) Reform Act of 2013 and the Protecting Access to Medicare Act of 2014.In addition, we are establishing new requirements or revising existing requirements for quality reporting by specific providers (acute care hospitals,PPS-exempt cancer hospitals, and LTCHs) that are participating in Medicare, including related provisions for eligible hospitals and critical access hospitals participating in the Medicare Electronic Health Record (EHR)Incentive Program. We also are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program.

The protein-protein interface evolution acts in a similar way to antibody affinity maturation.

PubMed

Li, Bohua; Zhao, Lei; Wang, Chong; Guo, Huaizu; Wu, Lan; Zhang, Xunming; Qian, Weizhu; Wang, Hao; Guo, Yajun

2010-02-05

Understanding the evolutionary mechanism that acts at the interfaces of protein-protein complexes is a fundamental issue with high interest for delineating the macromolecular complexes and networks responsible for regulation and complexity in biological systems. To investigate whether the evolution of protein-protein interface acts in a similar way as antibody affinity maturation, we incorporated evolutionary information derived from antibody affinity maturation with common simulation techniques to evaluate prediction success rates of the computational method in affinity improvement in four different systems: antibody-receptor, antibody-peptide, receptor-membrane ligand, and receptor-soluble ligand. It was interesting to find that the same evolutionary information could improve the prediction success rates in all the four protein-protein complexes with an exceptional high accuracy (>57%). One of the most striking findings in our present study is that not only in the antibody-combining site but in other protein-protein interfaces almost all of the affinity-enhancing mutations are located at the germline hotspot sequences (RGYW or WA), indicating that DNA hot spot mechanisms may be widely used in the evolution of protein-protein interfaces. Our data suggest that the evolution of distinct protein-protein interfaces may use the same basic strategy under selection pressure to maintain interactions. Additionally, our data indicate that classical simulation techniques incorporating the evolutionary information derived from in vivo antibody affinity maturation can be utilized as a powerful tool to improve the binding affinity of protein-protein complex with a high accuracy.

Using baldrige performance excellence program approaches in the pursuit of radiation oncology quality care, patient satisfaction, and workforce commitment.

PubMed

Sternick, Edward S

2011-01-01

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance US business competitiveness and economic growth. Administered by the National Institute of Standards and Technology, the Act created the Baldrige National Quality Program, recently renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well-suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self-assessment approach is used for radiotherapy program evaluation and development in order to generate a fact-based, knowledge-driven system for improving quality of care, increasing patient satisfaction, enhancing leadership effectiveness, building employee engagement, and boosting organizational innovation. This methodology also provides a valuable framework for benchmarking an individual radiation oncology practice's operations and results against guidelines defined by accreditation and professional organizations and regulatory agencies.

Improving the design of competitive bidding in Medicare Advantage.

PubMed

Cawley, John H; Whitford, Andrew B

2007-04-01

In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act, which required that in 2006 the Centers for Medicare and Medicaid Services (CMS) implement a system of competitive bids to set payments for the Medicare Advantage program. Managed care plans now bid for the right to enroll Medicare beneficiaries. Data from the first year of bidding suggest that imperfect competition is limiting the success of the bidding system. This article offers suggestions to improve this system based on findings from auction theory and previous government-run auctions. In particular, CMS can benefit by adjusting its system of competitive bids in four ways: credibly committing to regulations governing bidding; limiting the scope for collusion, entry deterrence, and predatory behavior among bidders; adjusting how benchmark reimbursement rates are set; and accounting for asymmetric information among bidders.

76 FR 47835 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-05

...This final rule will implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This final rule will also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also consolidating, clarifying, and revising existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled ``Improving Regulation and Regulatory Review,'' we are amending existing regulatory provisions regarding ''new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.

Insulin analogs with improved pharmacokinetic profiles.

PubMed

Brange; Vølund

1999-02-01

The aim of insulin replacement therapy is to normalize blood glucose in order to reduce the complications of diabetes. The pharmacokinetics of the traditional insulin preparations, however, do not match the profiles of physiological insulin secretion. The introduction of the rDNA technology 20 years ago opened new ways to create insulin analogs with altered properties. Fast-acting analogs are based on the idea that an insulin with less tendency to self-association than human insulin would be more readily absorbed into the systemic circulation. Protracted-acting analogs have been created to mimic the slow, steady rate of insulin secretion in the fasting state. The present paper provides a historical review of the efforts to change the physicochemical and pharmacological properties of insulin in order to improve insulin therapy. The available clinical studies of the new insulins are surveyed and show, together with modeling results, that new strategies for optimal basal-bolus treatment are required for utilization of the new fast-acting analogs.

AVIATION SECURITY: Terrorist Acts Demonstrate Urgent Need to Improve Security at the Nation’s Airports

DTIC Science & Technology

2001-09-20

what actually occurred or what all the weaknesses in the nation’s aviation security apparatus are that contributed to the horrendous events of last week...it is clear that serious weaknesses exist in our aviation security system and that their impact can be far more devastating than previously imagined...offer some observations about improving aviation security in these various areas.

Daily Management System of the Henry Ford Production System: QTIPS to Focus Continuous Improvements at the Level of the Work.

PubMed

Zarbo, Richard J; Varney, Ruan C; Copeland, Jacqueline R; D'Angelo, Rita; Sharma, Gaurav

2015-07-01

To support our Lean culture of continuous improvement, we implemented a daily management system designed so critical metrics of operational success were the focus of local teams to drive improvements. We innovated a standardized visual daily management board composed of metric categories of Quality, Time, Inventory, Productivity, and Safety (QTIPS); frequency trending; root cause analysis; corrective/preventive actions; and resulting process improvements. In 1 year (June 2013 to July 2014), eight laboratory sections at Henry Ford Hospital employed 64 unique daily metrics. Most assessed long-term (>6 months), monitored process stability, while short-term metrics (1-6 months) were retired after successful targeted problem resolution. Daily monitoring resulted in 42 process improvements. Daily management is the key business accountability subsystem that enabled our culture of continuous improvement to function more efficiently at the managerial level in a visible manner by reviewing and acting based on data and root cause analysis. Copyright© by the American Society for Clinical Pathology.

Local application of an ibandronate/collagen sponge improves femoral fracture healing in ovariectomized rats

PubMed Central

Liu, Yansong; Hou, Zhiyong; Chen, Wei; Jin, Lin; Tian, Ye; Ju, Linlin; Liu, Bo; Dong, Tianhua; Zhang, Fei

2017-01-01

Non-union is a major clinical problem in the healing of fractures, especially in patients with osteoporosis. The systemic administration of drugs is time consuming and large doses are demanding and act slowly, whereas local release acts rapidly, increases the quality and quantity of the bone tissue. We hypothesize that local delivery demonstrates better therapeutic effects on an osteoporotic fracture. The aim of this paper is to investigate the effect of the local application of ibandronate loaded with a collagen sponge on regulating bone formation and remodeling in an osteoporotic rat model of fracture healing. We found that the local delivery of ibandronate exhibited excellent effects on improving the bone microarchitecture and suppressed effects on bone remodeling. At 4 weeks, more callus formation and improvement of mechanical character and microstructure were observed in a local delivery via μCT, mechanical test, histological research and serum analysis. The suppression of bone remodeling was compared with a systemic treatment at 12 weeks, and the structural mechanical properties and microarchitecture were also improved with local delivery. This research identifies an earlier, safer and integrated approach for local delivery of ibandronate with collagen and provides a better strategy for the treatment of osteoporotic fracture in rats. PMID:29108027

Restoration of motor function following spinal cord injury via optimal control of intraspinal microstimulation: toward a next generation closed-loop neural prosthesis

PubMed Central

Grahn, Peter J.; Mallory, Grant W.; Berry, B. Michael; Hachmann, Jan T.; Lobel, Darlene A.; Lujan, J. Luis

2014-01-01

Movement is planned and coordinated by the brain and carried out by contracting muscles acting on specific joints. Motor commands initiated in the brain travel through descending pathways in the spinal cord to effector motor neurons before reaching target muscles. Damage to these pathways by spinal cord injury (SCI) can result in paralysis below the injury level. However, the planning and coordination centers of the brain, as well as peripheral nerves and the muscles that they act upon, remain functional. Neuroprosthetic devices can restore motor function following SCI by direct electrical stimulation of the neuromuscular system. Unfortunately, conventional neuroprosthetic techniques are limited by a myriad of factors that include, but are not limited to, a lack of characterization of non-linear input/output system dynamics, mechanical coupling, limited number of degrees of freedom, high power consumption, large device size, and rapid onset of muscle fatigue. Wireless multi-channel closed-loop neuroprostheses that integrate command signals from the brain with sensor-based feedback from the environment and the system's state offer the possibility of increasing device performance, ultimately improving quality of life for people with SCI. In this manuscript, we review neuroprosthetic technology for improving functional restoration following SCI and describe brain-machine interfaces suitable for control of neuroprosthetic systems with multiple degrees of freedom. Additionally, we discuss novel stimulation paradigms that can improve synergy with higher planning centers and improve fatigue-resistant activation of paralyzed muscles. In the near future, integration of these technologies will provide SCI survivors with versatile closed-loop neuroprosthetic systems for restoring function to paralyzed muscles. PMID:25278830

City of El Monte Stormwater System Improvement Project FONSI and EA

EPA Pesticide Factsheets

The U.S. Environmental Protection Agency (EPA) Region 9 intends to award a grant to the City of El Monte, California, in accordance with the in accordance with the Consolidated Appropriations Act of FY2009 for the Garvey Storm Drain Reconstruction Project.

Strategic plan for deployment of intelligent transportation systems in the Interstate 71 corridor (Columbus to Cleveland) : final report

DOT National Transportation Integrated Search

1998-04-01

The Intermodal Surface Transportation Efficiency Act (ISTEA} signed by the U.S. Congress in December of 199 1 called for improvements in surface transportation through technological advancements. The U.S. Department of Transportation subsequently lau...

75 FR 6215 - Agency Information Collection Activity

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-08

.... SUPPLEMENTARY INFORMATION: I. Abstract During FY10, the Volcano Hazards Program (VHP) will provide funding under the American Recovery and Reinvestment Act (ARRA) for improvement of the volcano and other monitoring systems and other monitoring- related activities that contribute to mitigation of volcano hazards. This...

BCG Approaches for Improved Management of Estuaries

EPA Science Inventory

Estuaries and other complex aquatic systems are exposed to a variety of stressors that act at several scales, but are managed piecemeal - - often resulting in a “death by 1000 cuts” caused by cumulative impacts to these valued resources. To address this, managers need tools that...

17 CFR 256.305 - Structures and improvements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... provided for machinery, apparatus, or other equipment of the company shall be charged to the same account... (CONTINUED) UNIFORM SYSTEM OF ACCOUNTS FOR MUTUAL SERVICE COMPANIES AND SUBSIDIARY SERVICE COMPANIES, PUBLIC UTILITY HOLDING COMPANY ACT OF 1935 Service Company Property Accounts § 256.305 Structures and...

76 FR 58840 - Central Valley Project Improvement Act; Refuge Water Management Plans

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-22

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Central Valley Project Improvement Act; Refuge Water Management Plans AGENCY: Bureau of Reclamation, Interior. ACTION: Notice of availability. SUMMARY: To meet the requirements of the Central Valley Project Improvement Act of 1992 (CVPIA) and subsequent...

Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project

PubMed Central

O’Suilleabhain, Padraig E.; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H.; Chitnis, Shilpa; Whitworth, Louis A.; Dewey, Richard B.

2016-01-01

Objective To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. Methods We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. Results The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Conclusions Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring. PMID:27711133

Developing a Deep Brain Stimulation Neuromodulation Network for Parkinson Disease, Essential Tremor, and Dystonia: Report of a Quality Improvement Project.

PubMed

Dewey, Richard B; O'Suilleabhain, Padraig E; Sanghera, Manjit; Patel, Neepa; Khemani, Pravin; Lacritz, Laura H; Chitnis, Shilpa; Whitworth, Louis A; Dewey, Richard B

2016-01-01

To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring.

Integrated Application of Active Controls (IAAC) technology to an advanced subsonic transport project: Wing planform study and final configuration selection

NASA Technical Reports Server (NTRS)

1981-01-01

The Wing Planform Study and Final Configuration Selection Task of the Integrated Application of Active Controls (IAAC) Technology Project within the Energy Efficient Transport Program is documented. Application of Active Controls Technology (ACT) in combination with increased wing span resulted in significant improvements over the Conventional Baseline Configuration (Baseline) and the Initial ACT Configuration previously established. The configurations use the same levels of technology, takeoff gross weight, and payload as the Baseline. The Final ACT Configuration (Model 768-107) incorporates pitch-augmented stability (which enabled an approximately 10% aft shift in cruise center of gravity and a 44% reduction in horizontal tail size), lateral/directional-augmented stability, an angle-of-attack limiter, and wing-load alleviation. Flutter-mode control was not beneficial for this configuration. This resulted in an 890 kg (1960 lb) reduction in airplane takeoff gross weight and a 9.8% improvement in cruise lift/drag. At the Baseline mission range (3589 km 1938 nmi), this amounts to 10% block-fuel reduction. Results of this task strongly indicate that the IAAC Project should proceed with the Final ACT evaluation, and begin the required control system development and test.

76 FR 18581 - Correction; Central Valley Project Improvement Act, Standard Criteria for Agricultural and Urban...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-04

... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Correction; Central Valley Project Improvement Act, Standard Criteria for Agricultural and Urban Water Management Plans AGENCY: Bureau of Reclamation... notice in the Federal Register at 76 FR 16818 on the Central Valley Project Improvement Act Standard...

76 FR 44289 - Amendment to Standard for All-Terrain Vehicles; Notice of Proposed Rulemaking

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-25

.... ACTION: Notice of proposed rulemaking. SUMMARY: The Consumer Product Safety Improvement Act of 2008.... Background The Consumer Product Safety Improvement Act of 2008 (``CPSIA'') directed the Commission to... and the Consumer Product Safety Improvement Act's (CPSIA) lead content requirements on ATVs intended...

July 2011 Memorandum: Improving EPA Review of Appalachian Surface Coal Mining Operations Under the Clean Water Act, National Environmental Policy Act, and the Environmental Justice Executive Order

EPA Pesticide Factsheets

Memorandum: Improving EPA Review of Appalachian Surface Coal Mining Operations Under the Clean Water Act, National Environmental Policy Act, and the Environmental Justice Executive Order, July 21, 2011

'Second generation' Internet e-health: the gladiator for HIPAA compliance?

PubMed

Korpman, R A; Rose, J S

2001-01-01

The Health Insurance Portability and Accountability Act (HIPAA) is intended to simplify administrative processes and improve health information security. There are a number of traditional ways to address the expense and complexities of simplification, but none of them are bargains or beauties to behold: (1) Do-it-yourself encryption; (2) new back-end system purchases; (3) legacy system re-programming; or (4) onerous paper documentation. The good news is that 'second generation' e-health solutions are emerging that act as internal "wrappers" for health plan or provider data systems. They provide both an interface for end-users and a layer of security for organizational information and allow detailed patient-related data to remain at the system owner's physical location. These second generation solutions don't just 'connect,' data, they actually 'understand' the information, and can use data elements to invoke necessary rules, processing pathways, or personalization for specific stakeholders as required by HIPAA.

Expanding the domain of drug delivery for HIV prevention: exploration of the transdermal route.

PubMed

Puri, Ashana; Sivaraman, Arunprasad; Zhang, Wei; Clark, Meredith R; Banga, Ajay K

2017-01-01

Constant efforts for HIV prevention using antiretroviral drugs, pre- and postexposure prophylactic agents, and microbicides are being made by researchers. Drug-delivery systems such as oral tablets and coitally dependent vaginal gels are short acting, require daily application, and are associated with user adherence issues, whereas the coitally independent systems such as injectables and biodegradable implants are long acting, lasting several months, during which time the termination of prophylaxis is impractical in case of adverse effects. An effective drug-delivery system to be used for an intermediate duration, if available, would be an attractive alternative option for users in terms of adherence. Transdermal delivery systems, overcoming most of the limitations of the other routes of administration and aiming to provide sustained delivery of drugs through skin, may be explored for HIV prevention. Passive and physical enhancement techniques may be designed strategically to improve the transdermal delivery of HIV preventive agents.

Mine Improvement and New Emergency Response Act of 2006. Public Law 109-236, S2803

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

NONE

2006-06-15

This Act may be cited as the 'Mine Improvement and New Emergency Response Act of 2006' or the 'MINER Act'. It amends the Federal Mine Safety and Health Act of 1977 to improve the safety of mines and mining. The Act requires operators of underground coal mines to improve accident preparedness. The legislation requires mining companies to develop an emergency response plan specific to each mine they operate, and requires that every mine has at least two rescue teams located within one hour. S. 2803 also limits the legal liability of rescue team members and the companies that employ them.more » The act increases both civil and criminal penalties for violations of federal mining safety standards and gives the Mine Safety and Health Administration (MSHA) the ability to temporarily close a mine that fails to pay the penalties or fines. In addition, the act calls for several studies into ways to enhance mine safety, as well as the establishment of a new office within the National Institute for Occupational Safety and Health devoted to improving mine safety. Finally, the legislation establishes new scholarship and grant programs devoted to training individuals with respect to mine safety.« less

Student, Teacher, and School Performance 1995. Tenth Annual Report Submitted to the Governor and the General Assembly of the State of Tennessee.

ERIC Educational Resources Information Center

Tennessee State Board of Education, Nashville.

This report describes the performance goals established for Tennessee school systems in accordance with the Education Improvement Act (EIA) adopted in 1992. The report also describes the initiatives undertaken to assist school systems in achieving those goals. Prepared by the State Board of Education and the Commissioner of Education, this report…

Challenges around Capability Improvements in a System of Self-Managed Schools in New Zealand. Case Study

ERIC Educational Resources Information Center

Wylie, Cathy

2012-01-01

New Zealand (NZ), a small country of 4.3 million people, has a single national education system. Local authorities have no role in education in NZ, nor are there any school districts. There are four national government education agencies: (1) The Ministry of Education (MOE), established under the Education Act of 1989, is responsible for education…

Access to artemisinin-based anti-malarial treatment and its related factors in rural Tanzania

PubMed Central

2013-01-01

Background Artemisinin-based combination treatment (ACT) has been widely adopted as one of the main malaria control strategies. However, its promise to save thousands of lives in sub-Saharan Africa depends on how effective the use of ACT is within the routine health system. The INESS platform evaluated effective coverage of ACT in several African countries. Timely access within 24 hours to an authorized ACT outlet is one of the determinants of effective coverage and was assessed for artemether-lumefantrine (Alu), in two district health systems in rural Tanzania. Methods From October 2009 to June 2011we conducted continuous rolling household surveys in the Kilombero-Ulanga and the Rufiji Health and Demographic Surveillance Sites (HDSS). Surveys were linked to the routine HDSS update rounds. Members of randomly pre-selected households that had experienced a fever episode in the previous two weeks were eligible for a structured interview. Data on individual treatment seeking, access to treatment, timing, source of treatment and household costs per episode were collected. Data are presented on timely access from a total of 2,112 interviews in relation to demographics, seasonality, and socio economic status. Results In Kilombero-Ulanga, 41.8% (CI: 36.6–45.1) and in Rufiji 36.8% (33.7–40.1) of fever cases had access to an authorized ACT provider within 24 hours of fever onset. In neither of the HDSS site was age, sex, socio-economic status or seasonality of malaria found to be significantly correlated with timely access. Conclusion Timely access to authorized ACT providers is below 50% despite interventions intended to improve access such as social marketing and accreditation of private dispensing outlets. To improve prompt diagnosis and treatment, access remains a major bottle neck and new more innovative interventions are needed to raise effective coverage of malaria treatment in Tanzania. PMID:23651521

Accelerating Research Impact in a Learning Health Care System

PubMed Central

Elwy, A. Rani; Sales, Anne E.; Atkins, David

2017-01-01

Background: Since 1998, the Veterans Health Administration (VHA) Quality Enhancement Research Initiative (QUERI) has supported more rapid implementation of research into clinical practice. Objectives: With the passage of the Veterans Access, Choice and Accountability Act of 2014 (Choice Act), QUERI further evolved to support VHA’s transformation into a Learning Health Care System by aligning science with clinical priority goals based on a strategic planning process and alignment of funding priorities with updated VHA priority goals in response to the Choice Act. Design: QUERI updated its strategic goals in response to independent assessments mandated by the Choice Act that recommended VHA reduce variation in care by providing a clear path to implement best practices. Specifically, QUERI updated its application process to ensure its centers (Programs) focus on cross-cutting VHA priorities and specify roadmaps for implementation of research-informed practices across different settings. QUERI also increased funding for scientific evaluations of the Choice Act and other policies in response to Commission on Care recommendations. Results: QUERI’s national network of Programs deploys effective practices using implementation strategies across different settings. QUERI Choice Act evaluations informed the law’s further implementation, setting the stage for additional rigorous national evaluations of other VHA programs and policies including community provider networks. Conclusions: Grounded in implementation science and evidence-based policy, QUERI serves as an example of how to operationalize core components of a Learning Health Care System, notably through rigorous evaluation and scientific testing of implementation strategies to ultimately reduce variation in quality and improve overall population health. PMID:27997456

78 FR 23920 - Application for New Awards; Education Research and Special Education Research Grant Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-23

... Act of 2002. The Institute's purpose in awarding these grants is to provide national leadership in...: Policies, Organization, Management, and Leadership Mathematics and Science Education Postsecondary and......... [dec222] Improving Education Systems: Policies, Organization, Management, and Leadership. [dec222...

28 CFR 42.207 - Compliance information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Compliance information. 42.207 Section 42...) of the Justice System Improvement Act of 1979 § 42.207 Compliance information. (a) Each recipient shall: (1) Keep such records, and submit to OJARS such timely, complete, and accurate information as...

75 FR 62542 - Agency Information Collection Request. 30-Day Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

... Public Health Service Act, as amended. The funding opportunity focuses on two categories of activities: Category A: Obesity prevention through improved nutrition and increased physical activity Category B.../enactment of MAPPS-related policy, systems, and environmental change in physical activity, nutrition, and...

Improving Airline Safety

NASA Technical Reports Server (NTRS)

1998-01-01

Under a NASA-Ames Space Act Agreement, Coryphaeus Software and Simauthor, Inc., developed an Aviation Performance Measuring System (APMS). This software, developed for the aerospace and airline industry, enables the replay of Digital Flight Data Recorder (DFDR) data in a flexible, user-configurable, real-time, high fidelity 3D (three dimensional) environment.

28 CFR 42.203 - Discrimination prohibited.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Discrimination prohibited. 42.203 Section...) of the Justice System Improvement Act of 1979 § 42.203 Discrimination prohibited. (a) No person in... participation in, be denied the benefits of, be subjected to discrimination under, or denied employment in...

28 CFR 42.203 - Discrimination prohibited.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Discrimination prohibited. 42.203 Section...) of the Justice System Improvement Act of 1979 § 42.203 Discrimination prohibited. (a) No person in... participation in, be denied the benefits of, be subjected to discrimination under, or denied employment in...

28 CFR 42.203 - Discrimination prohibited.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Discrimination prohibited. 42.203 Section...) of the Justice System Improvement Act of 1979 § 42.203 Discrimination prohibited. (a) No person in... participation in, be denied the benefits of, be subjected to discrimination under, or denied employment in...

28 CFR 42.203 - Discrimination prohibited.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Discrimination prohibited. 42.203 Section...) of the Justice System Improvement Act of 1979 § 42.203 Discrimination prohibited. (a) No person in... participation in, be denied the benefits of, be subjected to discrimination under, or denied employment in...

ACTS broadband aeronautical experiment

NASA Technical Reports Server (NTRS)

Abbe, Brian S.; Jedrey, Thomas C.; Estabrook, Polly; Agan, Martin J.

1993-01-01

In the last decade, the demand for reliable data, voice, and video satellite communication links between aircraft and ground to improve air traffic control, airline management, and to meet the growing demand for passenger communications has increased significantly. It is expected that in the near future, the spectrum required for aeronautical communication services will grow significantly beyond that currently available at L-band. In anticipation of this, JPL is developing an experimental broadband aeronautical satellite communications system that will utilize NASA's Advanced Communications Technology Satellite (ACTS) as a satellite of opportunity and the technology developed under JPL's ACTS Mobile Terminal (AMT) Task to evaluate the feasibility of using K/Ka-band for these applications. The application of K/Ka-band for aeronautical satellite communications at cruise altitudes is particularly promising for several reasons: (1) the minimal amount of signal attenuation due to rain; (2) the reduced drag due to the smaller K/Ka-band antennas (as compared to the current L-band systems); and (3) the large amount of available bandwidth. The increased bandwidth available at these frequencies is expected to lead to significantly improved passenger communications - including full-duplex compressed video and multiple channel voice. A description of the proposed broadband experimental system will be presented including: (1) applications of K/Ka-band aeronautical satellite technology to U.S. industry; (2) the experiment objectives; (3) the experiment set-up; (4) experimental equipment description; and (5) industrial participation in the experiment and the benefits.

Oregon's ACTs, cross-jurisdictional collaboration, and improved transportation planning.

DOT National Transportation Integrated Search

2009-01-01

The Oregon Transportation Commission (OTC) created Area Commissions on Transportation (ACTs) to improve : coordination, help prioritize infrastructure investment, and provide input on statewide transportation issues. The structure of : the ACTs is de...

Oregon's ACTs, cross-jurisdictional collaboration and improved transportation planning.

DOT National Transportation Integrated Search

2009-01-01

The Oregon Transportation Commission (OTC) created Area Commissions on Transportation (ACTs) to improve coordination, help prioritize infrastructure investment, and provide input on statewide transportation issues. The structure of the ACTs is design...

5 CFR 842.107 - Employees covered under the National Capital Revitalization and Self-Government Improvement Act...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Employees covered under the National Capital Revitalization and Self-Government Improvement Act of 1997. 842.107 Section 842.107 Administrative... Revitalization and Self-Government Improvement Act of 1997. The following categories of employees of the District...

5 CFR 842.107 - Employees covered under the National Capital Revitalization and Self-Government Improvement Act...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 2 2012-01-01 2012-01-01 false Employees covered under the National Capital Revitalization and Self-Government Improvement Act of 1997. 842.107 Section 842.107 Administrative... Revitalization and Self-Government Improvement Act of 1997. The following categories of employees of the District...

5 CFR 842.107 - Employees covered under the National Capital Revitalization and Self-Government Improvement Act...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 2 2013-01-01 2013-01-01 false Employees covered under the National Capital Revitalization and Self-Government Improvement Act of 1997. 842.107 Section 842.107 Administrative... Revitalization and Self-Government Improvement Act of 1997. The following categories of employees of the District...

5 CFR 842.107 - Employees covered under the National Capital Revitalization and Self-Government Improvement Act...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 2 2014-01-01 2014-01-01 false Employees covered under the National Capital Revitalization and Self-Government Improvement Act of 1997. 842.107 Section 842.107 Administrative... Revitalization and Self-Government Improvement Act of 1997. The following categories of employees of the District...

5 CFR 842.107 - Employees covered under the National Capital Revitalization and Self-Government Improvement Act...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Employees covered under the National Capital Revitalization and Self-Government Improvement Act of 1997. 842.107 Section 842.107 Administrative... Revitalization and Self-Government Improvement Act of 1997. The following categories of employees of the District...

16 CFR 1500.89 - Procedures and requirements for determinations regarding lead content of materials or products...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Safety Improvement Act. 1500.89 Section 1500.89 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION... materials or products under section 101(a) of the Consumer Product Safety Improvement Act. (a) The Consumer Product Safety Improvement Act provides for specific lead limits in children's products. Section 101(a) of...

Student Financial Aid Systems: Absence of Guiding Architecture Reduces Efficiency, Ease of Use. Testimony before the Subcommittee on Postsecondary Education, Training, and Life-Long Learning, House Committee on Education and the Workforce.

ERIC Educational Resources Information Center

Willemssen, Joel C.

This testimony is an evaluation of the U.S. Department of Education's progress in integrating its National Student Loan Data System (NSLDS) with other student financial aid systems, as required by law. NSLDS was authorized under the 1986 Higher Education Act amendments as a means to improve compliance with repayment and loan-limitation provisions,…

75 FR 49029 - Medicare Program; End-Stage Renal Disease Prospective Payment System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

...This final rule implements a case-mix adjusted bundled prospective payment system (PPS) for Medicare outpatient end-stage renal disease (ESRD) dialysis facilities beginning January 1, 2011 (ESRD PPS), in compliance with the statutory requirement of the Medicare Improvements for Patients and Providers Act (MIPPA), enacted July 15, 2008. This ESRD PPS also replaces the current basic case-mix adjusted composite payment system and the methodologies for the reimbursement of separately billable outpatient ESRD services.

[Acceptance and commitment therapy (ACT) and improving chess performance in promising young chess-players].

PubMed

Ruiz, Francisco J; Luciano, Carmen

2009-08-01

Acceptance and Commitment Therapy (ACT) is shown to be effective in relatively distant fields from the so-called psychological disorders. One of these areas is sport performance improvement. The aim of the current study is to expand the application of brief ACT protocols to improve chess-players' performance. In a previous study, a brief protocol was applied to international-level adult chess-players that was effective. The current study aims to apply an equivalent brief ACT protocol, but in this case, applied in a group format to promising young chess-players. In addition, this brief protocol is compared to a non-intervention control condition. Results show that the ACT brief protocol improved the performance in 5 out of 7 participants, and that none of the chess-players in the control condition reached the established change criterion. The differences between the conditions in chess performance were statistically significant. The results are discussed, emphasizing the replicated impact of a brief ACT protocol on the improvement of chess-players' performance.

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

PubMed

DiPietro, Barbara; Klingenmaier, Lisa

2013-12-01

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

Merit-Based Incentive Payment System: Meaningful Changes in the Final Rule Brings Cautious Optimism.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Calodney, Aaron K; Hirsch, Joshua A

2017-01-01

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) eliminated the flawed Sustainable Growth Rate (SGR) act formula - a longstanding crucial issue of concern for health care providers and Medicare beneficiaries. MACRA also included a quality improvement program entitled, "The Merit-Based Incentive Payment System, or MIPS." The proposed rule of MIPS sought to streamline existing federal quality efforts and therefore linked 4 distinct programs into one. Three existing programs, meaningful use (MU), Physician Quality Reporting System (PQRS), value-based payment (VBP) system were merged with the addition of Clinical Improvement Activity category. The proposed rule also changed the name of MU to Advancing Care Information, or ACI. ACI contributes to 25% of composite score of the four programs, PQRS contributes 50% of the composite score, while VBP system, which deals with resource use or cost, contributes to 10% of the composite score. The newest category, Improvement Activities or IA, contributes 15% to the composite score. The proposed rule also created what it called a design incentive that drives movement to delivery system reform principles with the inclusion of Advanced Alternative Payment Models (APMs).Following the release of the proposed rule, the medical community, as well as Congress, provided substantial input to Centers for Medicare and Medicaid Services (CMS),expressing their concern. American Society of Interventional Pain Physicians (ASIPP) focused on 3 important aspects: delay the implementation, provide a 3-month performance period, and provide ability to submit meaningful quality measures in a timely and economic manner. The final rule accepted many of the comments from various organizations, including several of those specifically emphasized by ASIPP, with acceptance of 3-month reporting period, as well as the ability to submit non-MIPS measures to improve real quality and make the system meaningful. CMS also provided a mechanism for physicians to avoid penalties for non-reporting with reporting of just a single patient. In summary, CMS has provided substantial flexibility with mechanisms to avoid penalties, reporting for 90 continuous days, increasing the low volume threshold, changing the reporting burden and data thresholds and, finally, coordination between performance categories. The final rule has made MIPS more meaningful with bonuses for exceptional performance, the ability to report for 90 days, and to report on 50% of the patients in 2017 and 60% of the patients in 2018. The final rule also reduced the quality measures to 6, including only one outcome or high priority measure with elimination of cross cutting measure requirement. In addition, the final rule reduced the burden of ACI, improved the coordination of performance, reduced improvement activities burden from 60 points to 40 points, and finally improved coordination between performance categories. Multiple concerns remain regarding the reduction in scoring for quality improvement in future years, increase in proportion of MIPS scoring for resource use utilizing flawed, claims based methodology and the continuation of the disproportionate importance of ACI, an expensive program that can be onerous for providers which in many ways has not lived up to its promise. Key words: Medicare Access and CHIP Reauthorization Act of 2015, merit-based incentive payment system, quality performance measures, resource use, improvement activities, advancing care information performance category.

Design of Flow Systems for Improved Networking and Reduced Noise in Biomolecular Signal Processing in Biocomputing and Biosensing Applications

PubMed Central

Verma, Arjun; Fratto, Brian E.; Privman, Vladimir; Katz, Evgeny

2016-01-01

We consider flow systems that have been utilized for small-scale biomolecular computing and digital signal processing in binary-operating biosensors. Signal measurement is optimized by designing a flow-reversal cuvette and analyzing the experimental data to theoretically extract the pulse shape, as well as reveal the level of noise it possesses. Noise reduction is then carried out numerically. We conclude that this can be accomplished physically via the addition of properly designed well-mixing flow-reversal cell(s) as an integral part of the flow system. This approach should enable improved networking capabilities and potentially not only digital but analog signal-processing in such systems. Possible applications in complex biocomputing networks and various sense-and-act systems are discussed. PMID:27399702

Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.

PubMed

Russell, Mark C; Figley, Charles R

2014-01-01

On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems.

76 FR 41246 - Pesticide Program Dialogue Committee, Pesticide Registration Improvement Act Process Improvement...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-13

... Committee, Pesticide Registration Improvement Act Process Improvement Workgroup; Notice of Public Meeting...) Process Improvement Work Group. EPA plans to meet its ESA consultation obligations through the pesticide... a pesticide during the registration review process. This meeting of the PRIA Process Improvement...

78 FR 39295 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-01

... standardized and readily accessible source of data, the CDC EHDI program developed a survey to be used annually... Detection and Intervention (EHDI) programs with quality improvement activities and provide information that... or the current system from the Directors of Speech and Language Programs in State Health and Welfare...

75 FR 63183 - Notice of Meeting of the Consumer Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-14

... in Lending Act, to enhance consumer protection and improve disclosures for reverse mortgage... FEDERAL RESERVE SYSTEM Notice of Meeting of the Consumer Advisory Council The Consumer Advisory..., will take place at the Federal Reserve Board's offices in Washington, DC, in Dining Room E on the...

Critical Issues in Reauthorization. Issue Paper.

ERIC Educational Resources Information Center

Buzzell, Charles H.

H.R. 7, the Applied Technology Education Amendments of 1989, would reauthorize the Carl D. Perkins Vocational Education Act through fiscal year 1995. Among other improvements, H.R. 7 strengthens support for personnel development, articulation, career guidance and counseling, consumer and homemaking education, and the national data system. However,…

32 CFR 32.21 - Standards for financial management systems.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... For awards that support research, it should be noted that it is generally not appropriate to develop... that support research. (5) Written procedures to minimize the time elapsing between the transfer of... Cash Management Improvement Act (CMIA) (Pub. L. 101-453) govern, payment methods of State agencies...

Effect of sorghum biofuel production systems on soil characteristics in Souteastern U.S.

USDA-ARS?s Scientific Manuscript database

According Energy Policy Act of 2005, the U.S. must to produce 36 billion gallons of oil equivalent in 2022.Cellulosic material is considered a renewable and environmental improved alternative source for energy production. Sorghum (Sorghum bicolor L.) could provide food and cellulosic feedstock produ...

A Collaborative Planning Framework for Teachers Implementing Tiered Instruction

ERIC Educational Resources Information Center

Stuart, Shannon K.; Rinaldi, Claudia

2009-01-01

The recent reauthorization and regulations of the Individuals With Disabilities Education Improvement Act (IDEA 2004) encourage the use of school-wide interventions including response to intervention (RTI; Bradley, Danielson, & Doolittle, 2007). RTI refers to a multi-tiered system that addresses the academic needs of all students by using…

78 FR 72818 - Electronic Reporting Under the Toxic Substances Control Act

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-04

... methods of information gathering. EPA's Chemical Information Submission System (CISS) Web-based reporting... respond to a collection of information unless it displays a currently valid OMB control number. The... disposition of information. This action will also improve the quality and use of information to strengthen...

Assessing Students' Technical Skill Attainment

ERIC Educational Resources Information Center

Jorgensen, Haley

2010-01-01

The Wisconsin Technical College System (WTCS) is working to comply with the Carl D. Perkins Career and Technical Education Improvement Act of 2006 (Perkins) to ensure that its graduates have mastered the technical skills needed by business and industry. The legislation requires that each state identify and approve program assessment strategies…

The Promise of Baldrige for K-12 Education. ACT Policy Report.

ERIC Educational Resources Information Center

Walpole, MaryBeth.; Noeth, Richard J.

This report examines the evidence available on improving school quality through implementation of the Malcolm Baldrige Education Criteria for Performance Excellence. The Baldrige criteria address many issues other failed educational efforts have not, including leadership, systems thinking, changes in school culture, and data-driven decision…

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2012 CFR

2012-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2013 CFR

2013-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2014 CFR

2014-04-01

... ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do... to improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a...

NCLB--Year for Change

ERIC Educational Resources Information Center

Odland, Jerry

2007-01-01

Much debate continues about whether the 2001 No Child Left Behind Act (NCLB) has actually improved the academic achievement level of poorly performing students or only created yet another layer of government oversight to an already heavily burdened public school system. Drafted in 2001 and signed into law in January 2002, NCLB provided the…

77 FR 26522 - Proposed Priority; Technical Assistance on State Data Collection, Analysis, and Reporting...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

..., parents of individuals with disabilities, data system experts, representatives of other early learning and... to improve their capacity to meet the Individuals with Disabilities Education Act (IDEA) data... data for infants, toddlers, and young children with disabilities (birth through age 5) served through...

Phase II Recommendations by the Air Quality Management Subcommittee to the Clean Air Act Advisory Committee

EPA Pesticide Factsheets

The primary charge of the AQM Subcommittee was to develop recommendations to improve the air quality management system and address the air quality challenges in this country expected over the next 10 to 20 years. This report addresses those challenges.

Bill spurs efforts to improve forecasting of inland flooding from tropical storms

NASA Astrophysics Data System (ADS)

Showstack, Randy

Newly-enacted U.S. legislation to reduce the threat of inland flooding from tropical storms could provide a "laser beam" focus to dealing with this natural hazard, according to Rep. Bob Etheridge (D-N.C.), the chief sponsor of the bill.The Tropical Cyclone Inland Forecasting Improvement and Warning System Development Act, (PL. 107-253), signed into law on 29 October, authorizes the National Oceanic and Atmospheric Administration's U.S. Weather Research Program (USWRP) to improve the capability to accurately forecast inland flooding from tropical storms through research and modeling.

Design and Implementation of Improved Electronic Load Controller for Self-Excited Induction Generator for Rural Electrification

PubMed Central

Kathirvel, C.; Porkumaran, K.; Jaganathan, S.

2015-01-01

This paper offers an alternative technique, namely, Improved Electronic Load Controller (IELC), which is proposal to improve power quality, maintaining voltage at frequency desired level for rural electrification. The design and development of IELC are considered as microhydroenergy system. The proposed work aims to concentrate on the new schemes for rural electrification with the help of different kinds of hybrid energy systems. The objective of the proposed scheme is to maintain the speed of generation against fluctuating rural demand. The Electronic Load Controller (ELC) is used to connect and disconnect the dump load during the operation of the system, and which absorbs the load when consumer are not in active will enhance the lifestyle of the rural population and improve the living standards. Hydroelectricity is a promising option for electrification of remote villages in India. The conventional methods are not suitable to act as standalone system. Hence, the designing of a proper ELC is essential. The improved electronic load control performance tested with simulation at validated through hardware setup. PMID:26783553

Design and Implementation of Improved Electronic Load Controller for Self-Excited Induction Generator for Rural Electrification.

PubMed

Kathirvel, C; Porkumaran, K; Jaganathan, S

2015-01-01

This paper offers an alternative technique, namely, Improved Electronic Load Controller (IELC), which is proposal to improve power quality, maintaining voltage at frequency desired level for rural electrification. The design and development of IELC are considered as microhydroenergy system. The proposed work aims to concentrate on the new schemes for rural electrification with the help of different kinds of hybrid energy systems. The objective of the proposed scheme is to maintain the speed of generation against fluctuating rural demand. The Electronic Load Controller (ELC) is used to connect and disconnect the dump load during the operation of the system, and which absorbs the load when consumer are not in active will enhance the lifestyle of the rural population and improve the living standards. Hydroelectricity is a promising option for electrification of remote villages in India. The conventional methods are not suitable to act as standalone system. Hence, the designing of a proper ELC is essential. The improved electronic load control performance tested with simulation at validated through hardware setup.

Patient Safety and Quality Improvement Act of 2005.

PubMed

Fassett, William E

2006-05-01

To review Public Law (PL) 109-41-the Patient Safety and Quality Improvement Act of 2005 (PSQIA)-and summarize key medication error research that contributed to congressional recognition of the need for this legislation. Relevant publications related to medication error research, patient safety programs, and the legislative history of and commentary on PL 109-41, published in English, were identified by MEDLINE, PREMEDLINE, Thomas (Library of Congress), and Internet search engine-assisted searches using the terms healthcare quality, medication error, patient safety, PL 109-41, and quality improvement. Additional citations were identified from references cited in related publications. All relevant publications were reviewed. Summarization of the PSQIA was carried out by legal textual analysis. PL 109-41 provides privilege and confidentiality for patient safety work product (PSWP) developed for reporting to patient safety organizations (PSOs). It does not establish federal mandatory reporting of significant errors; rather, it relies on existing state reporting systems. The Act does not preempt stronger state protections for PSWP. The Agency for Healthcare Research and Quality is directed to certify PSOs and promote the establishment of a national network of patient safety databases. Whistleblower protection and penalties for unauthorized disclosure of PSWP are among its enforcement mechanisms. The Act protects clinicians who report minor errors to PSOs and protects the information from disclosure, but providers must increasingly embrace a culture of interdisciplinary concern for patient safety if this protection is to have real impact on patient care.

Barriers to the success of an electronic pharmacovigilance reporting system in Kenya: an evaluation three years post implementation.

PubMed

Agoro, Oscar O; Kibira, Sarah W; Freeman, Jenny V; Fraser, Hamish S F

2018-06-01

Electronic pharmacovigilance reporting systems are being implemented in many developing countries in an effort to improve reporting rates. This study sought to establish the factors that acted as barriers to the success of an electronic pharmacovigilance reporting system in Kenya 3 years after its implementation. Factors that could act as barriers to using electronic reporting systems were identified in a review of literature and then used to develop a survey questionnaire that was administered to pharmacists working in government hospitals in 6 counties in Kenya. The survey was completed by 103 out of the 115 targeted pharmacists (89.5%) and included free-text comments. The key factors identified as barriers were: unavailable, unreliable, or expensive Internet access; challenges associated with a hybrid system of paper and electronic reporting tools; and system usability issues. Coordination challenges at the national pharmacovigilance center and changes in the structure of health management in the country also had an impact on the success of the electronic reporting system. Different personal, organizational, infrastructural, and reporting system factors affect the success of electronic reporting systems in different ways, depending on the context. Context-specific formative evaluations are useful in establishing the performance of electronic reporting systems to identify problems and ensure that they achieve the desired objectives. While several factors hindered the optimal use of the electronic pharmacovigilance reporting system in Kenya, all were considered modifiable. Effort should be directed toward tackling the identified issues in order to facilitate use and improve pharmacovigilance reporting rates.

Structure and Function of the Mucus Clearance System of the Lung

PubMed Central

Button, Brenda M.; Button, Brian

2013-01-01

In cystic fibrosis (CF), a defect in ion transport results in thick and dehydrated airway mucus, which is difficult to clear, making such patients prone to chronic inflammation and bacterial infections. Physiotherapy using a variety of airway clearance techniques (ACTs) represents a key treatment regime by helping clear the airways of thickened, adhered, mucus and, thus, reducing the impact of lung infections and improving lung function. This article aims to bridge the gap between our understanding of the physiological effects of mechanical stresses elicited by ACTs on airway epithelia and the reported effectiveness of ACTs in CF patients. In the first part of this review, the effects of mechanical stress on airway epithelia are discussed in relation to changes in ion transport and stimulation in airway surface layer hydration. The second half is devoted to detailing the most commonly used ACTs to stimulate the removal of mucus from the airways of patients with CF. PMID:23751214

Terrorism in Mexico.

PubMed

Nordin, Yannick; Cruz-Vega, Felipe; Roman, Fernando

2003-01-01

Even though Mexico is considered internationally as a pacifist country, its economic, social, and geopolitical characteristics during the last half of the 20th century have resulted in internal events that can be considered acts of terrorism. Most of the acts of terrorism during the last 15 years have had to do either with political movements or drug-dealing actions. After the 11 September 2001 attacks in the United States, Mexican Health Authorities have strengthened the epidemiological surveillance system. More than 1,372 calls asking for information or reporting suspicious envelopes were received between 16 October and 21 October 2001. Following the earthquake in 1985 that caused great damage and many deaths in Mexico, the National Civil Protection System was created in 1986. This protection system is led by the President and the Secretary of Government. It was developed to improve preparedness for disaster coordination more than for terrorism responses. In addition, the emergency medical systems continue to lack organization, even though some states have shown significant progress in their emergency medical system.

Medicare Postacute Care Payment Reforms Have Potential to Improve Efficiency, but May Need Changes to Cut Costs

PubMed Central

Grabowski, David C.; Huckfeldt, Peter J.; Sood, Neeraj; Escarce, José J; Newhouse, Joseph P.

2012-01-01

The Affordable Care Act mandates changes in payment policies for Medicare postacute care services intended to contain spending in the long run and help ensure the program’s financial sustainability. In addition to reducing annual payment increases to providers under the existing prospective payment systems, the act calls for demonstration projects of bundled payment, accountable care organizations, and other strategies to promote care coordination and reduce spending. Experience with the adoption of Medicare prospective payment systems in postacute care settings approximately a decade ago suggests that current reforms could, but need not necessarily, produce such undesirable effects as decreased access for less profitable patients, poorer patient outcomes, and only short-lived curbs on spending. Policy makers will need to be vigilant in monitoring the impact of the Affordable Care Act reforms and be prepared to amend policies as necessary to ensure that the reforms exert persistent controls on spending without compromising the delivery of patient-appropriate postacute services. PMID:22949442

75 FR 3468 - Revised Jurisdictional Thresholds For Section 7A of the Clayton Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-21

... revised thresholds for the Hart-Scott-Rodino Antitrust Improvements Act of 1976 required by the 2000... Hart-Scott-Rodino Antitrust Improvements Act of 1976, Pub. L. 94-435, 90 Stat. 1390 (``the Act... product, in accordance with Section 8(a)(5). The new thresholds, which take effect 30 days after...

Wyoming's industrial siting permit process and environmental impact assessment

NASA Astrophysics Data System (ADS)

Hyman, Eric L.

1982-01-01

The problem of management of industrial residuals can be reduced through a rational system for siting and planning major industrial facilities. In the United States, Wyoming has moved in the direction of establishing a one-stop permitting system that provides important information for air and water quality planning and solid waste management with a minimum of regulatory overlap. This paper describes Wyoming's Industrial Development Information and Siting Act of 1975 and suggests ways in which the Wyoming permitting system can be improved and applied elsewhere.

32 CFR 644.554 - Insurance against loss or damages to buildings and improvements by fire or acts of God.

Code of Federal Regulations, 2012 CFR

2012-07-01

... and improvements by fire or acts of God. 644.554 Section 644.554 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Sale Procedure § 644.554 Insurance against loss or damages to buildings and improvements by fire or acts of God...

32 CFR 644.554 - Insurance against loss or damages to buildings and improvements by fire or acts of God.

Code of Federal Regulations, 2013 CFR

2013-07-01

... and improvements by fire or acts of God. 644.554 Section 644.554 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Sale Procedure § 644.554 Insurance against loss or damages to buildings and improvements by fire or acts of God...

32 CFR 644.554 - Insurance against loss or damages to buildings and improvements by fire or acts of God.

Code of Federal Regulations, 2014 CFR

2014-07-01

... and improvements by fire or acts of God. 644.554 Section 644.554 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) REAL PROPERTY REAL ESTATE HANDBOOK Disposal Sale Procedure § 644.554 Insurance against loss or damages to buildings and improvements by fire or acts of God...

Plan, do, study, act model to improve an orientation program.

PubMed

Ragsdale, Mary Alice; Mueller, John

2005-01-01

The Franciscan Health System has designed a new employee orientation program that is both interactive and thought-provoking. The program has transitioned from a predominantly lecture-based format to one that consists of group discussion, role playing, lunch with senior leaders in the organization, and the utilization of adult learning principles. This article describes the shortcomings of the previous program, gaps identified in the needs assessment, and performance improvement methodology used to enhance the program.

Treating uncomplicated malaria in children: comparing artemisinin-based combination therapies.

PubMed

Yeka, Adoke; Harris, Jamal C

2010-12-01

In response to increased resistance to conventional drugs, the WHO is promoting artemisinin-based combination therapy (ACT) for treating uncomplicated malaria. The objective of this report is to review the available evidence on the efficacy and effectiveness, acceptability, and deployment of ACT in resource-limited settings with a focus on sub-Saharan Africa. ACTs are very effective in the treatment of uncomplicated Plasmodium falciparum malaria in children. ACTs are relatively safe and tolerable with no reported resistance in sub-Saharan Africa despite indications of delayed clearance of infections in south-east Asia. The major challenges to the widespread use of ACT include its high cost, availability, and inefficient delivery due to, among other things, weak healthcare systems. ACTs are an essential tool in the fight to control and eliminate malaria. They are currently the most effective drugs against P. falciparum malaria. They should be deployed through programs that address availability, cost, adherence, and quality assurance. Initiatives including home-based management of malaria, improving public sector procurement and supply chains, and reducing private sector pricing should make ACTs more accessible for sub-Saharan African children who bear the brunt of the burden of malarial disease.

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice.

PubMed

Wiler, Jennifer L; Granovsky, Michael; Cantrill, Stephen V; Newell, Richard; Venkatesh, Arjun K; Schuur, Jeremiah D

2016-03-01

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician's to focus on quality of care measures and report quality performance for the first time. Initially termed "The Physician Voluntary Reporting Program," various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the "traditional PQRS" reporting program and the newer "Value Modifier" program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians.

You are what you eat: influence of type and amount of food consumed on central dopamine systems and the behavioral effects of direct- and indirect-acting dopamine receptor agonists

PubMed Central

Baladi, Michelle G; Daws, Lynette C; France, Charles P

2012-01-01

The important role of dopamine (DA) in mediating feeding behavior and the positive reinforcing effects of some drugs is well recognized. Less widely studied is how feeding conditions might impact the sensitivity of drugs acting on DA systems. Food restriction, for example, has often been the focus of aging and longevity studies; however, other studies have demonstrated that mild food restriction markedly increases sensitivity to direct- and indirect-acting DA receptor agonists. Moreover, it is becoming clear that not only the amount of food, but the type of food, is an important factor in modifying the effects of drugs. Given the increased consumption of high fat and sugary foods, studies are exploring how consumption of highly palatable food impacts DA neurochemistry and the effects of drugs acting on these systems. For example, eating high fat chow increases sensitivity to some behavioral effects of direct- as well as indirect-acting DA receptor agonists. A compelling mechanistic possibility is that the central DA pathways that mediate the effects of some drugs are regulated by one or more of the endocrine hormones (e.g. insulin) that undergo marked changes during food restriction or after consuming high fat or sugary foods. Although traditionally recognized as an important signaling molecule in regulating energy homeostasis, insulin can also regulate DA neurochemistry. Because direct- and indirect-acting DA receptor drugs are used therapeutically and some are abused, a better understanding of how food intake impacts response to these drugs would likely facilitate improved treatment of clinical disorders and provide information that would be relevant to the causes of vulnerability to abuse drugs. PMID:22710441

Column-Integrated CO2 Concentrations Measured by MFLL During ACT-America Flight Campaigns

NASA Astrophysics Data System (ADS)

Erxleben, W. H.; McGregor, D.; Kooi, S. A.; Campbell, J.; Dobler, J. T.; Pal, S.; Lin, B.; Browell, E. V.; O'Dell, C.; DiGangi, J. P.; Bell, E.

2017-12-01

The Multifunction Fiber Laser Lidar (MFLL), designed, built, and operated by Harris Space and Intelligence Systems, is a key instrument aboard the NASA Earth Venture Suborbital mission known as Atmospheric Carbon and Transport - America (ACT-America). The mission's goals include improving estimates of atmospheric transport and fluxes of CO2 and CH4, and evaluating sensitivity of the OCO-2 satellite to regional CO2 variability. ACT-America includes five flight campaigns on two NASA aircraft between 2016 and 2019. The MFLL instrument has been under evaluation in collaboration with NASA Langley Research Center since 2005 and installed on one of NASA's C-130s for ACT-America campaigns since 2016. MFLL measures the integrated path differential absorption in the atmospheric column between the airplane and the ground caused by atmospheric gases (primarily CO2 and H2O). From the differential absorption, the integrated differential optical depth is obtained. The waveforms used to encode and identify the individual wavelengths of light also enable the instrument to determine range to the surface. The measured range and optical depth, together with spectroscopic and meteorological information, enable the column-integrated concentration of CO2 to be retrieved. Through the first two flight campaigns, MFLL has performed 47 flight sorties totaling 170 hours with zero critical failures. Improvements were implemented after the first campaign to reduce harmonic crosstalk and to eliminate both a short-period etalon effect and a longer-period oscillation. MFLL will be flying on the third ACT-America campaign in Fall 2017. We will present a brief review of the measurement method, the instrument performance, and the improvements made over the course of ACT-America. We will also present the most recent results from the first two campaigns covering various altitudes and scenarios: frontal crossings, fair-weather patterns, and OCO-2 underflights. These results will be compared with model predictions generated from in situ instruments and meteorological data sources.

Improving Access to Military Aircraft During Civilian Wildfires

DTIC Science & Technology

2015-12-01

Stafford acts ; DOD doctrine and instruction, such as Defense Support to (of) Civil Authorities and Immediate Response Authority; and civilian...civilian wildfires, and that (2) the Economy and Stafford acts be modified to improve the efficiency with which military aircraft respond to civilian...wildfires. 14. SUBJECT TERMS wildfire, aircraft, The Economy Act , The Stafford Act , Department of Defense, National Interagency Fire Center

The Library Systems Act and Rules for Administering the Library Systems Act.

ERIC Educational Resources Information Center

Texas State Library, Austin. Library Development Div.

This document contains the Texas Library Systems Act and rules for administering the Library Systems Act. Specifically, it includes the following documents: Texas Library Systems Act; Summary of Codes;Texas Administrative Code: Service Complaints and Protest Procedure; Criteria For Texas Library System Membership; and Certification Requirements…

Using HFACS-Healthcare to Identify Systemic Vulnerabilities During Surgery.

PubMed

Cohen, Tara N; Francis, Sarah E; Wiegmann, Douglas A; Shappell, Scott A; Gewertz, Bruce L

2018-03-01

The Human Factors Analysis and Classification System for Healthcare (HFACS-Healthcare) was used to classify surgical near miss events reported via a hospital's event reporting system over the course of 1 year. Two trained analysts identified causal factors within each event narrative and subsequently categorized the events using HFACS-Healthcare. Of 910 original events, 592 could be analyzed further using HFACS-Healthcare, resulting in the identification of 726 causal factors. Most issues (n = 436, 60.00%) involved preconditions for unsafe acts, followed by unsafe acts (n = 257, 35.39%), organizational influences (n = 27, 3.72%), and supervisory factors (n = 6, 0.82%). These findings go beyond the traditional methods of trending incident data that typically focus on documenting the frequency of their occurrence. Analyzing near misses based on their underlying contributing human factors affords a greater opportunity to develop process improvements to reduce reoccurrence and better provide patient safety approaches.

Analytical investigation of thermal barrier coatings for advanced power generation combustion turbines

NASA Technical Reports Server (NTRS)

Amos, D. J.

1977-01-01

An analytical evaluation was conducted to determine quantitatively the improvement potential in cycle efficiency and cost of electricity made possible by the introduction of thermal barrier coatings to power generation combustion turbine systems. The thermal barrier system, a metallic bond coat and yttria stabilized zirconia outer layer applied by plasma spray techniques, acts as a heat insulator to provide substantial metal temperature reductions below that of the exposed thermal barrier surface. The study results show the thermal barrier to be a potentially attractive means for improving performance and reducing cost of electricity for the simple, recuperated, and combined cycles evaluated.

32 CFR 644.554 - Insurance against loss or damages to buildings and improvements by fire or acts of God.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Insurance against loss or damages to buildings and improvements by fire or acts of God. 644.554 Section 644.554 National Defense Department of... Procedure § 644.554 Insurance against loss or damages to buildings and improvements by fire or acts of God...

Post-9/11 Veterans Educational Assistance Improvements Act of 2010 (Public Law 111-377)

ERIC Educational Resources Information Center

US Congress, 2011

2011-01-01

The Post-9/11 Veterans Educational Assistance Improvements Act of 2010 (Public Law 111-377) was put in place to amend title 38, United States Code, to improve educational assistance for veterans who served in the Armed Forces after September 11, 2001, and for other purposes. The table of contents for this Act is as follows: (1) Sec. 1. Short…

32 CFR 644.554 - Insurance against loss or damages to buildings and improvements by fire or acts of God.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Insurance against loss or damages to buildings and improvements by fire or acts of God. 644.554 Section 644.554 National Defense Department of... Procedure § 644.554 Insurance against loss or damages to buildings and improvements by fire or acts of God...

Think Systemically, Act Systematically

ERIC Educational Resources Information Center

Parsley, Danette; Galvin, Mike

2008-01-01

In an effort to be comprehensive, schools often outline sweeping plans for improvement in multiple goal areas. Although well-intended, the efforts may be either too diffuse to have much impact, or so overwhelming that staff become immobilized. A school that chooses to proceed in too limited a manner, on the other hand, may run the risk of…

Air Force Internal Control Systems: A Proposal for Improvement.

DTIC Science & Technology

1986-09-01

Wrong. Idea Paper, LD 51636A, PMCS 82-C, August 1982. 66. Marler , Kenneth E. Implementation of the Federal Managers’ Financial Integrity Act of 1982 in... Eric V. Can Internal Review Support A Manage- ment Development Program? Idea Paper, LD 47951A, PMCS 81-A, December 1980. 91. Trimble, Robert C., Jr

National ESEA Chapter 1 Schoolwide Projects Conference.

ERIC Educational Resources Information Center

Cleveland Public Schools, OH.

This document is a collection of schoolwide compensatory education project plans for 22 elementary schools in the Cleveland (Ohio) Public Schools system, with funding provided by Chapter 1 of the Education Consolidation and Improvement Act. Chapter 1 project plans are included for the following schools: (1) Alfred A. Benesch; (2) Andrew J.…

California WIC and Proposition 10: Made for Each Other. Building Community Systems for Young Children.

ERIC Educational Resources Information Center

Whaley, Shannon; True, Laurie

The federal government's WIC program, the Special Supplemental Nutrition Program for Women, Infants and Children, is designed to improve the health and development of low-income women and young children. California's passage of Proposition 10, the "Children and Families First Act," has created a climate that encourages collaborative…

A Spatial Analysis of Contextual Effects on Educational Accountability in Kentucky.

ERIC Educational Resources Information Center

Pitts, Timothy C.; Reeves, Edward B.

A cornerstone of the Kentucky Education Reform Act of 1990 was the creation of a high-stakes performance assessment program called the Kentucky Instructional Results Information System (KIRIS). KIRIS test results were the basis for granting monetary rewards to schools and school districts where student test performance improved significantly and…

Transition and Beyond...Now What? Guide for Parents of Youth with Disabilities.

ERIC Educational Resources Information Center

Johnson, Jane; Goldberg, Paula

This guide on transition services for Minnesota students with disabilities provides parents with information on student's rights and responsibilities under the Individuals with Disabilities Education Act (IDEA) that is available, how to obtain it, and how to improve the system to provide for transition needs that are not being met. Separate…

Early Intervening for Students with Speech Sound Disorders: Lessons from a School District

ERIC Educational Resources Information Center

Mire, Stephen P.; Montgomery, Judy K.

2009-01-01

The concept of early intervening services was introduced into public school systems with the implementation of the Individuals With Disabilities Education Improvement Act (IDEA) of 2004. This article describes a program developed for students with speech sound disorders that incorporated concepts of early intervening services, response to…

Quality in Student Financial Aid Programs. A New Approach.

ERIC Educational Resources Information Center

Fecso, Ronald S., Ed.

This report of the Panel on Quality Improvement in Student Financial Aid Programs examines the quality control of federal student financial aid programs covered by Title IV of the Higher Education Act of 1965 and offers recommendations calling for sweeping revisions of the present system. The report explores: (1) the quality control practices…

20 CFR 663.620 - How do the Welfare-to-Work program and the TANF program relate to the One-Stop delivery system?

Code of Federal Regulations, 2011 CFR

2011-04-01

... TITLE I OF THE WORKFORCE INVESTMENT ACT Priority and Special Populations § 663.620 How do the Welfare-to... improve the quality of services to the WtW and TANF-eligible populations. In addition, becoming a One-Stop...

Interactive Whiteboard Use: The Catalyst of Student Achievement

ERIC Educational Resources Information Center

Lamberth, Tenneille Terrell

2012-01-01

The No Child Left Behind (NCLB) Act of 2001 forced school districts to become more accountable by requiring all students to read on grade level by the year 2014. However, President Obama's educational policy shift is allowing states to develop their own accountability and improvement system. This study examined fourth and eighth grade math…

Guidelines for Successful Parent Involvement: Working with Parents of Students with Disabilities

ERIC Educational Resources Information Center

Staples, Kelli E.; Diliberto, Jennifer A.

2010-01-01

According to the Individuals With Disabilities Education Improvement Act (IDEA), school systems must ensure that the individualized education program (IEP) team includes the parent of the child with a disability. Teachers often report the challenges of getting parents to attend IEP meetings often assuming parents' lack of interest with involvement…

The March to Accountable Care Organizations--How Will Rural Fare?

ERIC Educational Resources Information Center

MacKinney, A. Clinton; Mueller, Keith J.; McBride, Timothy D.

2011-01-01

Purpose: This article describes a strategy for rural providers, communities, and policy makers to support or establish accountable care organizations (ACOs). Methods: ACOs represent a new health care delivery and provider payment system designed to improve clinical quality and control costs. The Patient Protection and Affordable Care Act (ACA)…

Assistive and Instructional Technology: Understanding the Differences to Enhance Programming and Teaching

ERIC Educational Resources Information Center

Shepley, Collin; Lane, Justin D.; Ayres, Kevin; Douglas, Karen H.

2017-01-01

The Assistive Technology Act of 2004 (29 U.S.C. Sec 2202(2)) defines AT as "any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." Instructional Technology (IT), a term not…

The Health Care Strengthening Act: The next level of integrated care in Germany.

PubMed

Milstein, Ricarda; Blankart, Carl Rudolf

2016-05-01

The lack of integration of health-care sectors and specialist groups is widely accepted as a necessity to effectively address the most urgent challenges in modern health care systems. Germany follows a more decentralized approach that allows for many degrees of freedom. With its latest bill, the German government has introduced several measures to explicitly foster the integration of health-care services. This article presents the historic development of integrated care services and offers insights into the construction of integrated care programs in the German health-care system. The measures of integrated care within the Health Care Strengthening Act are presented and discussed in detail from the perspective of the provider, the payer, and the political arena. In addition, the effects of the new act are assessed using scenario technique based on an analysis of the effects of previously implemented health policy reforms. Germany now has a flourishing integrated care scene with many integrated care programs being able to contain costs and improve quality. Although it will be still a long journey for Germany to reach the coordination of care standards set by leading countries such as the United Kingdom, New Zealand or Switzerland, international health policy makers may deliberately and selectively adopt elements of the German approach such as the extensive freedom of contract, the strong patient-focus by allowing for very need-driven and regional solutions, or the substantial start-up funding allowing for more unproven and progressive endeavors to further improve their own health systems. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

The scope and specific criteria of compensation for occupational diseases in Korea.

PubMed

Song, Jaechul; Kim, Inah; Choi, Byung-Soon

2014-06-01

The range of diseases covered by workers' compensation is constantly expanding. However, new regulations are required for the recognition of occupational diseases (ODs) because OD types evolve with changes in industrial structures and working conditions. OD criteria are usually based on medical relevance, but they vary depending on the social security system and laws of each country. In addition, the proposed range and extent of work-relatedness vary depending on the socio-economic conditions of each country. The Labor Standards Act (LSA) and the Industrial Accident Compensation Insurance Act (IACIA) of Korea employ lists based on their requirements without listing causes and diseases separately. Despite a considerable reshuffle in 2003, the basic framework has been maintained for 50 yr, and many cases do not fit into the international disease classification system. Since July 1, 2013, Korea has expanded the range of occupational accidents to include occupational cancers and has implemented revised LSA and IACIA enforcement decrees. There have been improvements to OD recognition standards with the inclusion of additional or modified criteria, a revised and improved classification scheme for risk factors and ODs, and so on.

Anticoagulation therapy advisor: a decision-support system for heparin therapy during ECMO.

PubMed Central

Peverini, R. L.; Sale, M.; Rhine, W. D.; Fagan, L. M.; Lenert, L. A.

1992-01-01

We present a case study describing our development of a mathematical model to control a clinical parameter in a patient--in this case, the degree of anticoagulation during extracorporeal membrane oxygenation (ECMO) support. During ECMO therapy, an anticoagulant agent (heparin) is administered to prevent thrombosis. Under- or over-coagulation can have grave consequences. To improve control of anticoagulation, we developed a pharmacokinetic-pharmacodynamic (PK-PD) model that predicts activated clotting times (ACT) using the NONMEM program. We then integrated this model into a decision-support system, and validated it with an independent data set. The population model had a mean absolute error of prediction for ACT values of 33.5 seconds, with a mean bias in estimation of -14.3 seconds. Individualization of model-parameter estimates using nonlinear regression improved the absolute error prediction to 25.5 seconds, and lowered the mean bias to -3.1 seconds. The PK-PD model is coupled with software for heuristic interpretation of model results to provide a complete environment for the management of anticoagulation. PMID:1482937

The vascular endothelium in diabetes--a therapeutic target?

PubMed

Mather, Kieren J

2013-03-01

Insulin resistance affects the vascular endothelium, and contributes to systemic insulin resistance by directly impairing the actions of insulin to redistribute blood flow as part of its normal actions driving muscle glucose uptake. Impaired vascular function is a component of the insulin resistance syndrome, and is a feature of type 2 diabetes. On this basis, the vascular endothelium has emerged as a therapeutic target where the intent is to improve systemic metabolic state by improving vascular function. We review the available literature presenting studies in humans, evaluating the effects of metabolically targeted and vascular targeted therapies on insulin action and systemic metabolism. Therapies that improve systemic insulin resistance exert strong concurrent effects to improve vascular function and vascular insulin action. RAS-acting agents and statins have widely recognized beneficial effects on vascular function but have not uniformly produced the hoped-for metabolic benefits. These observations support the notion that systemic metabolic benefits can arise from therapies targeted at the endothelium, but improving vascular insulin action does not result from all treatments that improve endothelium-dependent vasodilation. A better understanding of the mechanisms of insulin's actions in the vascular wall will advance our understanding of the specificity of these responses, and allow us to better target the vasculature for metabolic benefits.

Multiphysics Application Coupling Toolkit

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

Campbell, Michael T.

2013-12-02

This particular consortium implementation of the software integration infrastructure will, in large part, refactor portions of the Rocstar multiphysics infrastructure. Development of this infrastructure originated at the University of Illinois DOE ASCI Center for Simulation of Advanced Rockets (CSAR) to support the center's massively parallel multiphysics simulation application, Rocstar, and has continued at IllinoisRocstar, a small company formed near the end of the University-based program. IllinoisRocstar is now licensing these new developments as free, open source, in hopes to help improve their own and others' access to infrastructure which can be readily utilized in developing coupled or composite software systems;more » with particular attention to more rapid production and utilization of multiphysics applications in the HPC environment. There are two major pieces to the consortium implementation, the Application Component Toolkit (ACT), and the Multiphysics Application Coupling Toolkit (MPACT). The current development focus is the ACT, which is (will be) the substrate for MPACT. The ACT itself is built up from the components described in the technical approach. In particular, the ACT has the following major components: 1.The Component Object Manager (COM): The COM package provides encapsulation of user applications, and their data. COM also provides the inter-component function call mechanism. 2.The System Integration Manager (SIM): The SIM package provides constructs and mechanisms for orchestrating composite systems of multiply integrated pieces.« less

Infrastructure to support learning health systems: are we there yet? Innovative solutions and lessons learned from American Recovery and Reinvestment Act CER investments.

PubMed

Holve, Erin; Segal, Courtney

2014-11-01

The 11 big health data networks participating in the AcademyHealth Electronic Data Methods Forum represent cutting-edge efforts to harness the power of big health data for research and quality improvement. This paper is a comparative case study based on site visits conducted with a subset of these large infrastructure grants funded through the Recovery Act, in which four key issues emerge that can inform the evolution of learning health systems, including the importance of acknowledging the challenges of scaling specialized expertise needed to manage and run CER networks; the delicate balance between privacy protections and the utility of distributed networks; emerging community engagement strategies; and the complexities of developing a robust business model for multi-use networks.

42 CFR 136.301 - Policy and applicability.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Indian Health Care Improvement Act Programs Subdivision... intended to be consistent with principles of Indian self-determination and to supplement the... Improvement Act: (1) The award of health professions recruitment grants under section 102 of the Act to...

42 CFR 136.301 - Policy and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Indian Health Care Improvement Act Programs Subdivision... intended to be consistent with principles of Indian self-determination and to supplement the... Improvement Act: (1) The award of health professions recruitment grants under section 102 of the Act to...

42 CFR 136.301 - Policy and applicability.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Indian Health Care Improvement Act Programs Subdivision... intended to be consistent with principles of Indian self-determination and to supplement the... Improvement Act: (1) The award of health professions recruitment grants under section 102 of the Act to...

42 CFR 136.301 - Policy and applicability.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Indian Health Care Improvement Act Programs Subdivision... intended to be consistent with principles of Indian self-determination and to supplement the... Improvement Act: (1) The award of health professions recruitment grants under section 102 of the Act to...

42 CFR 136.301 - Policy and applicability.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Indian Health Care Improvement Act Programs Subdivision... intended to be consistent with principles of Indian self-determination and to supplement the... Improvement Act: (1) The award of health professions recruitment grants under section 102 of the Act to...

Short Duration Base Heating Test Improvements

NASA Technical Reports Server (NTRS)

Bender, Robert L.; Dagostino, Mark G.; Engel, Bradley A.; Engel, Carl D.

1999-01-01

Significant improvements have been made to a short duration space launch vehicle base heating test technique. This technique was first developed during the 1960's to investigate launch vehicle plume induced convective environments. Recent improvements include the use of coiled nitrogen buffer gas lines upstream of the hydrogen / oxygen propellant charge tubes, fast acting solenoid valves, stand alone gas delivery and data acquisition systems, and an integrated model design code. Technique improvements were successfully demonstrated during a 2.25% scale X-33 base heating test conducted in the NASA/MSFC Nozzle Test Facility in early 1999. Cost savings of approximately an order of magnitude over previous tests were realized due in large part to these improvements.

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

PubMed

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

2015-04-01

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

An assessment of patient sign-outs conducted by University at Buffalo internal medicine residents.

PubMed

Wheat, Deirdre; Co, Christopher; Manochakian, Rami; Rich, Ellen

2012-01-01

Internal medicine residents were surveyed regarding patient sign-outs at shift change. Data were used to design and implement interventions aimed at improving sign-out quality. This quasi-experimental project incorporated the Plan, Do, Study, Act methodology. Residents completed an anonymous electronic survey regarding experiences during sign-outs. Survey questions assessed structure, process, and outcome of sign-outs. Analysis of qualitative and quantitative data was performed; interventions were implemented based on survey findings. A total of 120 surveys (89% response) and 115 surveys (83% response) were completed by residents of 4 postgraduate years in response to the first (2008) and second (2009) survey requests, respectively. Approximately 79% of the respondents to the second survey indicated that postintervention sign-out systems were superior to preintervention systems. Results indicated improvement in specific areas of structure, process, and outcome. Survey-based modifications to existing sign-out systems effected measurable quality improvement in structure, process, and outcome.

Progress toward improving regional atmospheric inversions using airborne measurements: Results from ACT-America

NASA Astrophysics Data System (ADS)

Davis, K. J.; Baier, B.; Baker, D.; Barkley, Z.; Bell, E.; Bowman, K. W.; Browell, E. V.; Campbell, J.; Chen, H. W.; Choi, Y.; DiGangi, J. P.; Dobler, J. T.; Erxleben, W. H.; Fan, T. F.; Feng, S.; Fried, A.; Gaudet, B. J.; Jacobson, A. R.; Keller, K.; Kooi, S. A.; Lauvaux, T.; Lin, B.; McGill, M. J.; McGregor, D.; Michalak, A.; Obland, M. D.; O'Dell, C.; Pal, S.; Parazoo, N.; Pauly, R.; Randazzo, N. A.; Samaddar, A.; Schuh, A. E.; Sweeney, C.; Wesloh, D.; Williams, C. A.; Zhang, F.; Zhou, Y.

2017-12-01

The Atmospheric Carbon and Transport (ACT) - America mission aims to improve our understanding of transport and fluxes of greenhouse gases (GHGs) via airborne campaigns spanning a range of mid-latitude weather conditions, and thus to improve the accuracy and precision of regional inverse flux estimates of GHGs. ACT-America has conducted three field campaigns with two aircraft across three regions of the eastern United States during summer 2016, winter 2017 and fall 2017. Simulations of atmospheric GHGs have been conducted for a subset of these campaigns. We present progress from these campaigns. Mid-summer observations suggest a net biological source of CO2 to the atmosphere in the Gulf Coast states. These results contradict those terrestrial biosphere models that show net uptake of CO2 in this region in summer. Methane observations downwind of major sources in the MidAtlantic suggest that these sources are represented fairly well by existing emissions inventories. Flux estimation in other regions is underway. Spatially-coherent differences in GHGs extend throughout the depth of the troposphere are observed at frontal boundaries in summer and winter. These spatial structures are captured in global and mesoscale simulations, though the simulated GHG mole fractions are sometimes biased with respect to observations, suggesting potential biases in synoptic transport. Mesoscale simulations overestimate spatial differences in ABL CO2 mole fractions in fair weather conditions as compared to observations and the CarbonTracker global inverse modeling system. ABL depths are simulated fairly well by both mesoscale and global modeling systems, suggesting that either weather-scale flux amplitudes are overestimated by CarbonTracker, or the mesoscale model lacks parameterized transport above the ABL. Measurements of OCS, 14CO2, and CO are being used to attribute CO2 variability to biogenic and anthropogenic processes and to expand the evaluation of GHG simulation systems. Cross-evaluation of OCO-2 and airborne lidar XCO2 observations against in situ measurements is defining the regional precision and accuracy of these observations. These findings are moving us toward improved regional GHG inverse flux estimates via better understanding of prior fluxes, atmospheric transport, and satellite CO2 observations.

An Act to extend expiring provisions of the USA PATRIOT Improvement and Reauthorization Act of 2005 and Intelligence Reform and Terrorism Prevention Act of 2004 until February 28, 2011.

THOMAS, 111th Congress

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

2009-10-29

02/27/2010 Became Public Law No: 111-141. (TXT | PDF) (All Actions) Notes: Title on passage: To extend expiring provisions of the USA PATRIOT Improvement and Reauthorization Act of 2005 and Intelligence Reform and Terrorism Prevention Act of 2004 until February 28, 2011. Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:

Inferring Fitness Effects from Time-Resolved Sequence Data with a Delay-Deterministic Model

PubMed Central

Nené, Nuno R.; Dunham, Alistair S.; Illingworth, Christopher J. R.

2018-01-01

A common challenge arising from the observation of an evolutionary system over time is to infer the magnitude of selection acting upon a specific genetic variant, or variants, within the population. The inference of selection may be confounded by the effects of genetic drift in a system, leading to the development of inference procedures to account for these effects. However, recent work has suggested that deterministic models of evolution may be effective in capturing the effects of selection even under complex models of demography, suggesting the more general application of deterministic approaches to inference. Responding to this literature, we here note a case in which a deterministic model of evolution may give highly misleading inferences, resulting from the nondeterministic properties of mutation in a finite population. We propose an alternative approach that acts to correct for this error, and which we denote the delay-deterministic model. Applying our model to a simple evolutionary system, we demonstrate its performance in quantifying the extent of selection acting within that system. We further consider the application of our model to sequence data from an evolutionary experiment. We outline scenarios in which our model may produce improved results for the inference of selection, noting that such situations can be easily identified via the use of a regular deterministic model. PMID:29500183

Risk management and measuring productivity with POAS--Point of Act System--a medical information system as ERP (Enterprise Resource Planning) for hospital management.

PubMed

Akiyama, M

2007-01-01

The concept of our system is not only to manage material flows, but also to provide an integrated management resource, a means of correcting errors in medical treatment, and applications to EBM (evidence-based medicine) through the data mining of medical records. Prior to the development of this system, electronic processing systems in hospitals did a poor job of accurately grasping medical practice and medical material flows. With POAS (Point of Act System), hospital managers can solve the so-called, "man, money, material, and information" issues inherent in the costs of healthcare. The POAS system synchronizes with each department system, from finance and accounting, to pharmacy, to imaging, and allows information exchange. We can manage Man (Business Process), Material (Medical Materials and Medicine), Money (Expenditure for purchase and Receipt), and Information (Medical Records) completely by this system. Our analysis has shown that this system has a remarkable investment effect - saving over four million dollars per year - through cost savings in logistics and business process efficiencies. In addition, the quality of care has been improved dramatically while error rates have been reduced - nearly to zero in some cases.

Troubleshooting crude vacuum tower overhead ejector systems

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

Lines, J.R.; Frens, L.L.

1995-03-01

Routinely surveying tower overhead vacuum systems can improve performance and product quality. These vacuum systems normally provide reliable and consistent operation. However, process conditions, supplied utilities, corrosion, erosion and fouling all have an impact on ejector system performance. Refinery vacuum distillation towers use ejector systems to maintain tower top pressure and remove overhead gases. However, as with virtually all refinery equipment, performance may be affected by a number of variables. These variables may act independently or concurrently. It is important to understand basic operating principles of vacuum systems and how performance is affected by: utilities, corrosion and erosion, fouling, andmore » process conditions. Reputable vacuum-system suppliers have service engineers that will come to a refinery to survey the system and troubleshoot performance or offer suggestions for improvement. A skilled vacuum-system engineer may be needed to diagnose and remedy system problems. The affect of these variables on performance is discussed. A case history is described of a vacuum system on a crude tower in a South American refinery.« less

On the RAC. CIOs must work to make their organization's time with CMS Recovery Audit Contractors as painless as possible.

PubMed

Lawrence, Daphne

2009-01-01

CIOs should act as a team with HIM and Finance to prepare for RAC audits. CIOs can take the lead in looking at improved coding systems, and can be involved in creating policies and procedures for the hospital's RAC team. RAC is an opportunity to improve documentation, coding and data analysis. RAC appeals will become more common as states share lessons learned. Follow the money and check on claims that are frequently returned.

Analysis of Fade Detection and Compensation Experimental Results in a Ka-Band Satellite System. Degree awarded by Akron Univ., May 2000

NASA Technical Reports Server (NTRS)

Johnson, Sandra

2001-01-01

The frequency bands being used for new satellite communication systems are constantly increasing to accommodate the requirements for additional capacity. At these higher frequencies, propagation impairments that did not significantly affect the signal at lower frequencies begin to have considerable impact. In Ka-band, the next logical commercial frequency band to be used for satellite communication, attenuation of the signal due to rain is a primary concern. An experimental satellite built by NASA, the Advanced Communication Technology Satellite (ACTS), launched in September 1993, is the first US communication satellite operating in the Ka-band. In addition to higher carrier frequencies, a number of other new technologies, including onboard baseband processing, multiple beam antennas, and rain fade detection and compensation techniques, were designed into the ACTS. Verification experiments have been conducted since the launch to characterize the new technologies. The focus of this thesis is to describe and validate the method used by the ACTS Very Small Aperture Terminal (VSAT) ground stations in detecting the presence of fade in the communication signal and to adaptively compensate for it by the addition of burst rate reduction and forward error correction. Measured data obtained from the ACTS program is used to validate the compensation technique. In this thesis, models in MATLAB are developed to statistically characterize the increased availability achieved by the compensation techniques in terms of the bit error rate time enhancement factor. Several improvements to the ACTS technique are discussed and possible implementations for future Ka-band systems are also presented.

Parallel and orthogonal stimulus in ultradiluted neural networks

NASA Astrophysics Data System (ADS)

Sobral, G. A., Jr.; Vieira, V. M.; Lyra, M. L.; da Silva, C. R.

2006-10-01

Extending a model due to Derrida, Gardner, and Zippelius, we have studied the recognition ability of an extreme and asymmetrically diluted version of the Hopfield model for associative memory by including the effect of a stimulus in the dynamics of the system. We obtain exact results for the dynamic evolution of the average network superposition. The stimulus field was considered as proportional to the overlapping of the state of the system with a particular stimulated pattern. Two situations were analyzed, namely, the external stimulus acting on the initialization pattern (parallel stimulus) and the external stimulus acting on a pattern orthogonal to the initialization one (orthogonal stimulus). In both cases, we obtained the complete phase diagram in the parameter space composed of the stimulus field, thermal noise, and network capacity. Our results show that the system improves its recognition ability for parallel stimulus. For orthogonal stimulus two recognition phases emerge with the system locking at the initialization or stimulated pattern. We confront our analytical results with numerical simulations for the noiseless case T=0 .

Stimulus bill implementation: expanding meaningful use of health IT.

PubMed

Cunningham, Rob

2009-08-25

The American Recovery and Reinvestment Act authorizes an estimated $38 billion in incentives and supports for health information technology (IT) from 2009 to 2019. After years of sluggish HIT adoption, this crisis-driven investment of public funds creates a unique opportunity for rapid diffusion of a technology that is widely expected to improve care, save money, and facilitate transformation of the troubled U.S. health system. Achieving maximal effect from the stimulus funds is nevertheless a difficult challenge. The Recovery Act strengthens the federal government's leadership role in promoting HIT. But successful adoption and utilization across the health system will also require development of a supportive infrastructure and broad-based efforts by providers, vendors, state-based agencies, and other health system stakeholders. Optimal use of IT for health care may require extensive reengineering of medical practice and of existing systems of payment. The future course of HIT adoption will also be subject to the effects of any health care reform legislation and of technological innovation in the fast-changing world of electronic communications

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

Sobral, G. A. Jr.; Vieira, V. M.; Lyra, M. L.

Extending a model due to Derrida, Gardner, and Zippelius, we have studied the recognition ability of an extreme and asymmetrically diluted version of the Hopfield model for associative memory by including the effect of a stimulus in the dynamics of the system. We obtain exact results for the dynamic evolution of the average network superposition. The stimulus field was considered as proportional to the overlapping of the state of the system with a particular stimulated pattern. Two situations were analyzed, namely, the external stimulus acting on the initialization pattern (parallel stimulus) and the external stimulus acting on a pattern orthogonalmore » to the initialization one (orthogonal stimulus). In both cases, we obtained the complete phase diagram in the parameter space composed of the stimulus field, thermal noise, and network capacity. Our results show that the system improves its recognition ability for parallel stimulus. For orthogonal stimulus two recognition phases emerge with the system locking at the initialization or stimulated pattern. We confront our analytical results with numerical simulations for the noiseless case T=0.« less

Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings

PubMed Central

Al-Najar, Amr; Kaufmann, Sascha; Boy, Soenke; Naumann, Carsten Maik; Jünemann, Peter-Klaus; van der Horst, Christof

2011-01-01

Objective: Our objective was to establish the feasibility of combining 2 minimally invasive procedures in patients with failed primary treatment (male sling) in post-prostatectomy incontinence (PPI) patients. Methods: From January 2007 to July 2008, 40 men with PPI were implanted with a suburethral tape (2 patients with Seratim, 3 with I-Stop and 35 with Advance). The median preoperative pad count was 4 (range 2–10). Prior to sling placement, 6 patients had undergone ProACT implantation. Of these, 4 patients required explantation due to balloon migration and 2 patients had their balloons kept in situ, with the balloons deflated. Results: Twenty-five patients were socially continent at this time. Fifteen patients (37.5%) did not improve or their improvement was not significant. These patients had a preoperative pad count between 7 and 10. Two of these patients had prostate adjustable continence therapy (ProACT) systems still in place. By gradually filling the balloons to 3 mL, both of these patients achieved complete continence, which was maintained at a mean follow-up of 8.5 months. Three patients with prior pelvic irradiation received an artificial urinary sphincter and achieved continence at mean follow-up of 8.3 months. The remaining 10 patients received a ProACT system in addition to the already implanted sling. After appropriate healing and filling of the balloons (average balloon volume 5 mL), all 10 patients reached complete continence; they were pad-free at a mean follow-up of 6 months (range 3–9). Conclusions: The combination of ProACT and a suburethral tape was demonstrated to be a possible treatment option in recurrent or persistent PPI. PMID:21470536

Terrorism in South Africa.

PubMed

MacFarlane, Campbell

2003-01-01

The Republic of South Africa lies at the southern tip of the African continent. The population encompasses a variety of races, ethnic groups, religions, and cultural identities. The country has had a turbulent history from early tribal conflicts, colonialisation, the apartheid period, and post-apartheid readjustment. Modern terrorism developed mainly during the apartheid period, both by activities of the state and by the liberation movements that continued to the time of the first democratic elections in 1994, which saw South Africa evolve into a fully representative democratic state with equal rights for all. Since 1994, terrorist acts have been criminal-based, evolving in the Cape Town area to political acts, largely laid at the feet of a predominantly Muslim organisation, People against Gangsterism and Drugs, a vigilant organisation allegedly infiltrated by Muslim fundamentalists. Along with this, has been terrorist activities, mainly bombings by disaffected members of white, right-wing groups. In the apartheid era, a Draconian series of laws was enacted to suppress liberation activities. After 1994, most of these were repealed and new legislation was enacted, particularly after the events of 11 September 2001; this legislation allows the government to act against terrorism within the constraints of a democratic system. Disaster management in South Africa has been largely local authority-based, with input from provincial authorities and Civil Defence. After 1994, attempts were made to improve this situation, and national direction was provided. After 11 September 2001, activity was increased and the Disaster Management Act 2002 was brought into effect. This standardized disaster management system at national, provincial, and local levels, also facilites risk assessment and limitation as well as disaster mitigation. The potential still exists for terrorism, mainly from right-wing and Muslim fundamentalist groups, but the new legislation should stimulate disaster management in South Africa to new and improved levels.

South Carolina's Education Improvement Act: Is It Working?

ERIC Educational Resources Information Center

Richardson, Mike; And Others

South Carolina's response to the excellence literature of the early 1980s is called the Education Improvement Act (EIA). This act increased high school graduation requirements, required basic skills testing and standardized observation of teacher candidates, and mandated extensive competency testing and remediation of students. The EIA, like most…

Transportation Improvement Program of the Mid-Ohio Regional Planning Commission

DOT National Transportation Integrated Search

1996-06-20

The MORPC Transportation Improvement program (TIP) is a staged, multi-year schedule of regionally significant transportation improvements in the Columbus area. The Federal-aid Highway Act of 1962 and the federal Urban Mass Transportation Act of 1964 ...

76 FR 64115 - Privacy Act of 1974; Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-092)] Privacy Act of 1974; Privacy Act... retirement of one Privacy Act system of records notice. SUMMARY: In accordance with the Privacy Act of 1974, NASA is giving notice that it proposes to cancel the following Privacy Act system of records notice...

How Academic Health Systems Can Achieve Population Health in Vulnerable Populations Through Value-Based Care: The Critical Importance of Establishing Trusted Agency.

PubMed

Wesson, Donald E; Kitzman, Heather E

2018-01-16

Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve. Health systems will need the help of community entities and individuals who have the trust of the population being served to act on behalf of the health system if they are to achieve this effective working partnership. The need for these trusted agents is particularly pertinent for vulnerable and historically underserved segments of the population. In this Invited Commentary, the authors discuss ways by which health systems might identify, engage, and leverage trusted agents to improve the health of the population through value-based care.

32 CFR 505.3 - Privacy Act systems of records.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Privacy Act systems of records. 505.3 Section 505... AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems of... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute or...

32 CFR 505.3 - Privacy Act systems of records.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 3 2014-07-01 2014-07-01 false Privacy Act systems of records. 505.3 Section... AUTHORITIES AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute or...

32 CFR 505.3 - Privacy Act systems of records.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 3 2013-07-01 2013-07-01 false Privacy Act systems of records. 505.3 Section... AUTHORITIES AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute or...

32 CFR 505.3 - Privacy Act systems of records.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 3 2012-07-01 2009-07-01 true Privacy Act systems of records. 505.3 Section 505... AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems of... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute or...

Improved Oversight, but No Invoice Reviews and Potential Antideficiency Act Violation May Have Occurred on the Kuwait Observer Controller Team Task Orders

DTIC Science & Technology

2012-08-02

Contracting, Program Executive Office for Simulation, Training, and Instrumentation; the Resident Auditor, Raytheon Network Centric Systems, Defense...Router Network (SIPRNET). We appreciate the courtesies extended to the staff. Please direct questions to Mr. Tim Moore at (703) 604-9068 (DSN 664...Raytheon Network Centric System Resident Office, DCAA, should develop and implement procedures to verify that the Army does not reimburse the contractor

Tautomerism in chemical information management systems

NASA Astrophysics Data System (ADS)

Warr, Wendy A.

2010-06-01

Tautomerism has an impact on many of the processes in chemical information management systems including novelty checking during registration into chemical structure databases; storage of structures; exact and substructure searching in chemical structure databases; and depiction of structures retrieved by a search. The approaches taken by 27 different software vendors and database producers are compared. It is hoped that this comparison will act as a discussion document that could ultimately improve databases and software for researchers in the future.

7 CFR 63.1 - Act.

Code of Federal Regulations, 2011 CFR

2011-01-01

... ACT OF 1946 AND THE EGG PRODUCTS INSPECTION ACT (CONTINUED) NATIONAL SHEEP INDUSTRY IMPROVEMENT CENTER... Development Act, 7 U.S.C. 2008j, as amended by section 11009 of the Food, Conservation, and Energy Act of 2008...

42 CFR 480.107 - Limitations on redisclosure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... the Act or for CMS to process sanctions under section 1156 of the Act; (d) If the health care services...

75 FR 71353 - Office of the Attorney General; Certification Process for State Capital Counsel Systems; Removal...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-23

... DEPARTMENT OF JUSTICE 28 CFR Part 26 [Docket No. OJP 1464; AG Order No.] RIN 1121-AA76 Office of... AGENCY: Department of Justice. ACTION: Final rule. SUMMARY: Pursuant to the USA PATRIOT Improvement and Reauthorization Act of 2005, the Department of Justice promulgated a final rule to implement certification...

Identity Crisis: Multiple Measures and the Identification of Schools under ESSA. Policy Memo 16-3

ERIC Educational Resources Information Center

Hough, Heather; Penner, Emily; Witte, Joe

2016-01-01

The Every Student Succeeds Act (ESSA) makes sweeping changes to the way school performance is measured. Using the innovative measurement system developed by the CORE Districts in California, the authors explore how schools can be identified for support and improvement using a multiple measures framework. They show that 1) Different academic…

77 FR 46781 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving a...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-06

... rules. See id. A. SAL SAL is a feature within CBOE's Hybrid System designed to provide price improvement... before being booked in the electronic complex order book (``COB'') or on a PAR workstation.\\22\\ To the... rules of a national securities exchange be designed to prevent fraudulent and manipulative acts and...

To amend the National Flood Insurance Act of 1968 to require the Administrator of the Federal Emergency Management Agency to consider reconstruction and improvement of flood protection systems when establishing flood insurance rates.

THOMAS, 112th Congress

Rep. Matsui, Doris O. [D-CA-5

2011-03-03

House - 04/04/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Interim Report on the Evaluation of the Growth Model Pilot Project

ERIC Educational Resources Information Center

Hoffer, Thomas B.; Hedberg, E. C.; Brown, Kevin L.; Halverson, Marie L.; McDonald, Sarah-Kathryn

2010-01-01

The Growth Model Pilot Project (GMPP) was initiated to allow states to experiment with adjustments to the No Child Left Behind Act (NCLB) status accountability system in order to improve the validity of AYP determinations by giving schools credit for students who are making significant growth. The pilot allowed states, districts, and schools to…

Los Angeles OneSource System Youth Participant Customer Satisfaction Survey, 2010-2011

ERIC Educational Resources Information Center

Heisley, Deborah D.; Moore, Richard W.; Patch, Robin N.

2012-01-01

As part of the Workforce Investment Act of 1998, Los Angeles OneSource Centers offer low-income youth ages 14-21 services aimed at improving educational achievement, enhancing job skills, and preparing for college. The primary purpose of this study was to evaluate the youths' satisfaction with services received at 14 OneSource Centers throughout…

7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

Code of Federal Regulations, 2014 CFR

2014-01-01

... (33 U.S.C. 1251 et seq.); (iii) Safe Drinking Water Act, as amended (42 U.S.C. 300f et seq.); (iv... Innovation Center Demonstration program (note to 7 U.S.C. 1621). (30) Administer the Renewable Energy Systems and Energy Efficiency Improvements program (7 U.S.C. 8106). (30) Administer the renewable energy...

Teaching English Language Learners in Mainstream Science Classrooms: Teacher Practice and Educational Opportunity

ERIC Educational Resources Information Center

Schroeder, Carlotta Dorothy

2011-01-01

Equal educational opportunity for English language learners (ELLs) has been a goal of the public educational system in the United States. Language policy reforms have increased accountability in order for schools to improve student achievement and measure the progress of ELLs. The No Child Left Behind Act (NCLB) requires assessment and…

77 FR 68751 - Privacy Act of 1974; System of Records-Impact Evaluation of Race to the Top and School...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

... Top and School Improvement Grants AGENCY: Institute of Education Sciences, Department of Education. ACTION: Notice; correction. SUMMARY: On October 12, 2012, the Institute of Education Sciences in the U.S... Evaluation and Regional Assistance, Institute of Education Sciences, U.S. Department of Education, 555 New...

Avoid the Pitfalls: Benefits of Formal Part C Data System Governance. Revised

ERIC Educational Resources Information Center

Mauzy, Denise; Bull, Bruce; Gould, Tate

2016-01-01

Since the initial authorizing legislation for Part C of the Individuals with Disabilities Education Act (IDEA) in 1986, the scope and complexity of data collected by Part C programs have significantly increased. Formal governance establishes responsibility for Part C data and enables program staff to improve the effectiveness of data processes and…

Incentives and Test-Based Accountability in Education

ERIC Educational Resources Information Center

Hout, Michael, Ed.; Elliott, Stuart W., Ed.

2011-01-01

In recent years there have been increasing efforts to use accountability systems based on large-scale tests of students as a mechanism for improving student achievement. The federal No Child Left Behind Act (NCLB) is a prominent example of such an effort, but it is only the continuation of a steady trend toward greater test-based accountability in…

Responsiveness-to-Intervention and School-Wide Positive Behavior Supports: Integration of Multi-Tiered System Approaches

ERIC Educational Resources Information Center

Sugai, George; Horner, Robert H.

2009-01-01

The Individuals with Disabilities Education Act and No Child Left Behind emphasize the use of scientifically based research to improve outcomes for students. From this emphasis, response-to-intervention has evolved. We present one perspective on the defining features of response-to-intervention and application of those features to school-wide…

Implementing Statewide Longitudinal Student Data Systems: Lessons from the States. Working Paper #22

ERIC Educational Resources Information Center

Anagnostopoulos, Dorothea; Bali, Valentina A.

2011-01-01

Providing accurate and useful information on student achievement is a rising challenge for state educational agencies. With the passage of the No Child Left Behind Act (NCLB) in 2001, such challenges have become more pressing. A centerpiece of the educational accountability movement, NCLB has prompted states to improve their reporting on student…

75 FR 30025 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-28

... FEDERAL COMMUNICATIONS COMMISSION Privacy Act System of Records AGENCY: Federal Communications Commission (FCC or Commission). ACTION: Notice; one altered Privacy Act system of records; revision of one... Act of 1974, as amended (``Privacy Act''), 5 U.S.C. 552a, the FCC proposes to alter one system of...

Organic electrochemical transistor based immunosensor for prostate specific antigen (PSA) detection using gold nanoparticles for signal amplification.

PubMed

Kim, Duck-Jin; Lee, Nae-Eung; Park, Joon-Shik; Park, In-Jun; Kim, Jung-Gu; Cho, Hyoung J

2010-07-15

We demonstrated a highly sensitive organic electrochemical transistor (OECT) based immunosensor with a low detection limit for prostate specific antigen/alpha1-antichymotrypsin (PSA-ACT) complex. The poly(styrenesulfonate) doped poly(3,4-ethylenedioxythiophene) (PEDOT:PSS) based OECT with secondary antibody conjugated gold nanoparticles (AuNPs) provided a detection limit of the PSA-ACT complex as low as 1pg/ml, as well as improved sensitivity and a dynamic range, due to the role of AuNPs in the signal amplification. The sensor performances were particularly improved in the lower concentration range where the detection is clinically important for the preoperative diagnosis and screening of prostate cancer. This result shows that the OECT-based immunosensor can be used as a transducer platform acceptable to the point-of-care (POC) diagnostic systems and demonstrates adaptability of organic electronics to clinical applications. Copyright (c) 2010 Elsevier B.V. All rights reserved.

Numerical and experimental analysis of a vibration isolator equipped with a negative stiffness system

NASA Astrophysics Data System (ADS)

Palomares, E.; Nieto, A. J.; Morales, A. L.; Chicharro, J. M.; Pintado, P.

2018-02-01

This paper presents a Negative Stiffness System (NSS) based on a set of two double-acting pneumatic linear actuators (PLA). The NSS is added to a system with a single degree of freedom, which consists of a sprung mass and a pneumatic spring. One end of each PLA is jointed to the sprung mass while the other end is jointed to the vibrating frame. In addition, the PLAs are symmetrically arranged so that they remain horizontal while the sprung mass is in static conditions. When the rear chamber is pressurised, the vertical component of the force applied by the PLAs will work against the pneumatic spring reducing the dynamic resonance frequency of the overall system. Experimental tests and simulations showed improvements regarding sprung mass isolation in comparison to the passive system without NSS, decreasing the resonance frequency by up to 58 % and improving the vibration attenuation for different experimental excitations.

Improvements in manual dexterity relate to improvements in cognitive planning after assisted cycling therapy (ACT) in adolescents with down syndrome.

PubMed

Holzapfel, Simon D; Ringenbach, Shannon D R; Mulvey, Genna M; Sandoval-Menendez, Amber M; Cook, Megan R; Ganger, Rachel O; Bennett, Kristen

2015-01-01

We have previously reported beneficial effects of acute (i.e., single session) Assisted Cycling Therapy (ACT) on manual dexterity and cognitive planning ability in adolescents with Down syndrome (DS). In the present study, we report the chronic effects of eight weeks of ACT, voluntary cycling (VC), and no cycling (NC), on the same measures in adolescents with DS. Participants completed 8 weeks of ACT, VC, or NC. Those in the ACT and VC groups completed 30min sessions three times per week on a stationary bicycle. During ACT, the mechanical motor of the bicycle augmented the cadence to a rate which was on average 79% faster than the voluntary cadence. During VC, the participants pedaled at a self-selected rate. Unimanual dexterity scores as measured with the Purdue Pegboard test (PPT) improved significantly more for the ACT and VC groups compared to the NC group. ACT lead to greater improvements than VC and NC in the assembly sub-test, which is a task that requires more advanced temporal and spatial processing. The ACT group improved significantly more than the VC group and non-significantly more than the NC group in cognitive planning ability as measured by the Tower of London test (ToL). There were also significant correlations between the assembly subtest of the PPT and all measures of the ToL. These correlations were stronger during post-testing than pre-testing. Pre-post changes in the combined PPT score and ToL number of correct moves correlated positively in the ACT group. These results support the efficacy of the salutary effects of ACT on global fine motor function and executive function in DS. Additionally, the performance on complex bimanual dexterity tasks appears to be related to the capacity of cognitive planning ability. This research has important implications for persons with movement deficits that affect activities of daily living. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effects of assisted cycling therapy (ACT) and voluntary cycling on reaction time and measures of executive function in adolescents with Down syndrome.

PubMed

Ringenbach, S D R; Holzapfel, S D; Mulvey, G M; Jimenez, A; Benson, A; Richter, M

2016-11-01

Reports of positive effects of aerobic exercise on cognitive function in persons with Down syndrome are extremely limited. However, a novel exercise intervention, termed assisted cycling therapy (ACT), has resulted in acutely improved cognitive planning ability and reaction times as well as improved cognitive planning after 8 weeks of ACT in adolescents and young adults with Down syndrome. Here, we report the effects of 8 weeks of ACT on reaction time, set-shifting, inhibition and language fluency in adolescents with Down syndrome. Adolescents with Down syndrome (age: ~18 years) were randomly assigned to 8 weeks of ACT (n = 17) or voluntary cycling (VC: n = 16), and a convenience sample (n = 11) was assigned to be an inactive comparison group (NC: n = 11). During ACT, the cycling cadence of the participants was augmented to an average cadence that was 80% faster than the voluntary cadence of the VC group. The increase in cadence was achieved with an electric motor in the stationary bicycle. Reaction time, set-shifting, inhibition and language fluency were assessed before and after 8 weeks of intervention. Power output and heart rates of the ACT and VC groups were almost identical, but the ACT cadence was significantly faster. The ACT group, but not the VC or NC groups, showed significantly improved reactions times (Hedges' g = -0.42) and inhibitory control (g = 0.18). Only the VC group showed improved set-shifting ability (g = 0.57). The ACT and VC groups displayed improved semantic language fluency (g = 0.25, g = 0.22, respectively). These and previous results support the hypothesis of increased neuroplasticity and prefrontal cortex function following ACT and, to a smaller extent, following VC. Both ACT and VC appear to be associated with cortical benefits, but based on current and previous results, ACT seems to maximize the benefits. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Preparedness and Emergency Response Research Centers: Using a Public Health Systems Approach to Improve All-Hazards Preparedness and Response

PubMed Central

Leinhos, Mary; Williams-Johnson, Mildred

2014-01-01

In 2008, at the request of the Centers for Disease Control and Prevention (CDC), the Institute of Medicine (IOM) prepared a report identifying knowledge gaps in public health systems preparedness and emergency response and recommending near-term priority research areas. In accordance with the Pandemic and All-Hazards Preparedness Act mandating new public health systems research for preparedness and emergency response, CDC provided competitive awards establishing nine Preparedness and Emergency Response Research Centers (PERRCs) in accredited U.S. schools of public health. The PERRCs conducted research in four IOM-recommended priority areas: (1) enhancing the usefulness of public health preparedness and response (PHPR) training, (2) creating and maintaining sustainable preparedness and response systems, (3) improving PHPR communications, and (4) identifying evaluation criteria and metrics to improve PHPR for all hazards. The PERRCs worked closely with state and local public health, community partners, and advisory committees to produce practice-relevant research findings. PERRC research has generated more than 130 peer-reviewed publications and nearly 80 practice and policy tools and recommendations with the potential to significantly enhance our nation's PHPR to all hazards and that highlight the need for further improvements in public health systems. PMID:25355970

Better Evidence, Better Choices, Better Schools: State Supports for Evidence-Based School Improvement and the Every Student Succeeds Act. Series on Implementation of the Every Student Succeeds Act

ERIC Educational Resources Information Center

Fleischman, Steve; Scott, Caitlin; Sargrad, Scott

2016-01-01

Signed into law in December 2015, the Every Student Suceeds Act (ESSA) offers state education agencies significant opportunities to use evidence to support the improvement of schools and ensure better outcomes for all students. ESSA replaces the law, regulations, and guidance established through the 2001 No Child Left Behind Act (NCLB), but two…

Embedding the Mental Capacity Act 2005 in clinical practice: an audit review.

PubMed

Dunlop, Claudia; Sorinmade, Oluwatoyin

2014-12-01

Aims and method An audit cycle assessed compliance of healthcare professionals within Oxleas NHS Foundation Trust with the statutory requirements of the Mental Capacity Act 2005 in patient care. Each stage involved a retrospective review of relevant patient electronic records. The additional purpose of the audit was to make recommendations to improve compliance with the requirement of the Act by healthcare professionals and improve patient understanding of its provisions. Results The audit cycle demonstrated some improvement in clinical practice as well as the need for further efforts at raising the understanding and compliance of clinicians and the public with provisions of the Act. Clinical Implications Healthcare professionals need further understanding of the provisions of the Act and their responsibilities. There is also the need to enhance public awareness to provisions of the Act in relation to their decision-making autonomy. Stakeholders need to put strategies in place for these to be achieved.

The 20-year history of the evolution of air pollution control legislation in the U.S.A.

NASA Astrophysics Data System (ADS)

Schulze, Richard H.

Over the past 20 years, the U.S. Congress has passed four acts relating to clean air. The 1970 act set out a comprehensive plan for federal-state partnership to require all areas in the country to meet National Ambient Air Quality Standards. In 1977, the act was amended and expanded, both to address many of the problems encountered in the 1970 act and to reorient the law to limit significantly emissions of any sort, even if there were no currently identified health-related reasons. In 1986, the Emergency Planning and Community Right-to-know Act was passed, as an amendment to a solid waste law, in response to the desire to prevent chemical release tragedies. After 10 years of effort, Congress finally passed the 1990 Clean Air Act amendments which require a number of new programs aimed at curbing urban ozone, rural acid rain, stratospheric ozone, toxic air pollutant emissions and vehicle emissions, and establishing a new, uniform national permit system. This paper discusses some of the consequences of the various acts and suggests ways that others might learn from our 20 years of experience. Certain programs have worked quite well, while some alternatives could have improved other programs.

78 FR 40625 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-08

..., Hunger-Free Kids Act of 2010; Approval of Information Collection Request AGENCY: Food and Nutrition... Continuous Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010'' on February 22, 2013... Program (NSLP) regulations to incorporate provisions of the Healthy, Hunger-Free Kids Act of 2010 designed...

The Spanish long-term care system in transition: Ten years since the 2006 Dependency Act.

PubMed

Peña-Longobardo, Luz María; Oliva-Moreno, Juan; García-Armesto, Sandra; Hernández-Quevedo, Cristina

2016-10-01

At the end of 2006, a new System for Promotion of Personal Autonomy and Assistance for Persons in a Situation of Dependency (SAAD) was established in Spain through the approval of the Act 39/2006 of 14th December (the Dependency Act, DA). The DA acknowledged the universal entitlement of Spanish citizens to social services. The recent economic crisis added degrees of uncertainty to several dimensions of the SAAD implementation process. Firstly, the political consensus on which its foundation rested upon has weakened. Secondly, implementation of the SAAD was hampered by several challenges that emerged in the context of the economic crisis. Thirdly, the so-called "dependency limbo" (i.e. the existence of a large number of people eligible for benefits but who do not receive them) has become a structural feature of the system. Finally, contrary to the spirit of the DA, monetary benefits have become the norm rather than a last resort. High heterogeneity across regions regarding the number of beneficiaries covered and services provided reveal the existence of regional inequity in access to long-term care services in the country. Broadly, the current evidence on the state of the SAAD suggests the need to improve the quality of governance, to enhance coordination between health and social systems, to increase the system's transparency, to foster citizens' participation in decision-making and to implement a systematic monitoring of the system. Copyright © 2016 The Author(s). Published by Elsevier Ireland Ltd.. All rights reserved.

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection. Final Rule.

PubMed

2015-08-04

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.

Affiliation and Its Benefits to the Hospital and Community.

PubMed

Schneider, Maureen

2016-01-01

As a result of the Affordable Care Act, innovative strategies must be developed and initiated to work with the Affordable Care Act in order to diminish fragmentation of care delivery and thereby improve quality and reduce costs. It is imperative for health care organizations to explore options from mergers and acquisitions to affiliation agreements in order to prepare for business transformation. Since financial strength combined with independent governance and retention of cultural identity may be optimal, a legal transactional structure such as an affiliation is sometimes the best course of action for a health system. This article explores the affiliation process for health care organizations.

Rebalancing the Addicted Brain: Oxytocin Interference with the Neural Substrates of Addiction.

PubMed

Bowen, Michael T; Neumann, Inga D

2017-12-01

Drugs that act on the brain oxytocin (OXT) system may provide a much-needed treatment breakthrough for substance-use disorders. Targeting the brain OXT system has the potential to treat addiction to all major classes of addictive substance and to intervene across all stages of the addiction cycle. Emerging evidence suggests that OXT is able to interfere with such a wide range of addictive behaviours for such a wide range of addictive substances by rebalancing core neural systems that become dysregulated over the course of addiction. By improving our understanding of these interactions between OXT and the neural substrates of addiction, we will not only improve our understanding of addiction, but also our ability to effectively treat these devastating disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

Multi-Family Pediatric Pain Group Therapy: Capturing Acceptance and Cultivating Change.

PubMed

Huestis, Samantha E; Kao, Grace; Dunn, Ashley; Hilliard, Austin T; Yoon, Isabel A; Golianu, Brenda; Bhandari, Rashmi P

2017-12-07

Behavioral health interventions for pediatric chronic pain include cognitive-behavioral (CBT), acceptance and commitment (ACT), and family-based therapies, though literature regarding multi-family therapy (MFT) is sparse. This investigation examined the utility and outcomes of the Courage to Act with Pain: Teens Identifying Values, Acceptance, and Treatment Effects (CAPTIVATE) program, which included all three modalities (CBT, ACT, MFT) for youth with chronic pain and their parents. Program utility, engagement, and satisfaction were evaluated via quantitative and qualitative feedback. Pain-specific psychological, behavioral, and interpersonal processes were examined along with outcomes related to disability, quality of life, pain interference, fatigue, anxiety, and depressive symptoms. Participants indicated that CAPTIVATE was constructive, engaging, and helpful for social and family systems. Clinical and statistical improvements with large effect sizes were captured for pain catastrophizing, acceptance, and protective parenting but not family functioning. Similar effects were found for functional disability, pain interference, fatigue, anxiety, and depression. Given the importance of targeting multiple systems in the management of pediatric chronic pain, preliminary findings suggest a potential new group-based treatment option for youth and families. Next steps involve evaluating the differential effect of the program over treatment as usual, as well as specific CBT, ACT, and MFT components and processes that may affect outcomes.

Physician Quality Reporting System Program Updates and the Impact on Emergency Medicine Practice

PubMed Central

Wiler, Jennifer L.; Granovsky, Michael; Cantrill, Stephen V.; Newell, Richard; Venkatesh, Arjun K.; Schuur, Jeremiah D.

2016-01-01

In 2007, the Centers for Medicaid and Medicare Services (CMS) created a novel payment program to create incentives for physician’s to focus on quality of care measures and report quality performance for the first time. Initially termed “The Physician Voluntary Reporting Program,” various Congressional actions, including the Tax Relief and Health Care Act of 2006 (TRHCA) and Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) further strengthened and ensconced this program, eventually leading to the quality program termed today as the Physician Quality Reporting System (PQRS). As a result of passage of the Affordable Care Act of 2010, the PQRS program has expanded to include both the “traditional PQRS” reporting program and the newer “Value Modifier” program (VM). For the first time, these programs were designed to include pay-for-performance incentives for all physicians providing care to Medicare beneficiaries and to measure the cost of care. The recent passage of the Medicare Access and Children’s Health Insurance Program (CHIP) Reauthorization Act in March of 2015 includes changes to these payment programs that will have an even more profound impact on emergency care providers. We describe the implications of these important federal policy changes for emergency physicians. PMID:26973757

The ARM Climate Research Facility - New Capabilities and the Expected Impacts on Climate Science and Modeling

NASA Astrophysics Data System (ADS)

Voyles, J.; Mather, J. H.

2010-12-01

The ARM Climate Research Facility is a Department of Energy national scientific user facility. Research sites include fixed and mobile facilities, which collect research quality data for climate research. Through the American Recovery and Reinvestment Act of 2009, the U.S. Department of Energy’s Office of Science allocated $60 million to the ARM Climate Research Facility for the purchase of instruments and improvement of research sites. With these funds, ARM is in the process of deploying a broad variety of new instruments that will greatly enhance the measurement capabilities of the facility. New instruments being purchased include dual-frequency scanning cloud radars, scanning precipitation radars, Doppler lidars, a mobile Aerosol Observing System and many others. A list of instruments being purchased is available at http://www.arm.gov/about/recovery-act. Orders for all instruments have now been placed and activities are underway to integrate these new systems with our research sites. The overarching goal is to provide instantaneous and statistical measurements of the climate that can be used to advance the physical understanding and predictive performance of climate models. The Recovery Act investments enable the ARM Climate Research Facility to enhance existing and add new measurements, which enable a more complete understanding of the 3-dimensional evolution of cloud processes and related atmospheric properties. Understanding cloud processes are important globally, to reduce climate-modeling uncertainties and help improve our nation’s ability to manage climate impacts. Domer Plot of W-Band Reflectivity

Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders

PubMed Central

Arch, Joanna; Eifert, Georg H.; Davies, Carolyn; Plumb Vilardaga, Jennifer C.; Rose, Raphael D.; Craske, Michelle G.

2016-01-01

Objective Randomized comparisons of acceptance-based treatments with traditional cognitive behavioral therapy (CBT) for anxiety disorders are lacking. To address this research gap, we compared acceptance and commitment therapy (ACT) to CBT for heterogeneous anxiety disorders. Method One hundred twenty eight individuals (52% female, mean age = 38, 33% minority) with one or more DSM-IV anxiety disorders began treatment following randomization to 12 sessions of CBT or ACT; both treatments included behavioral exposure. Assessments at pre-treatment, post-treatment, 6-month, and 12-month follow-up measured anxiety specific (principal disorder Clinical Severity Ratings [CSR], Anxiety Sensitivity Index, Penn State Worry Questionnaire, Fear Questionnaire avoidance) and non-anxiety specific (Quality of Life Index [QOLI], Acceptance and Action Questionnaire-16 [AAQ]) outcomes. Treatment adherence and therapist competency ratings, treatment credibility, and co-occurring mood and anxiety disorders were investigated. Results CBT and ACT improved similarly across all outcomes from pre- to post-treatment. During follow-up, ACT showed steeper CSR improvements than CBT (p < .05, d = 1.33) and at 12-month follow-up, ACT showed lower CSRs than CBT among completers (p < .05, d = 1.05). At 12-month follow-up, ACT reported higher AAQ than CBT (p = .08, d = .42; Completers: p < .05, d = .59) whereas CBT reported higher QOLI than ACT (p < .05, d = .43). Attrition and comorbidity improvements were similar, although ACT utilized more non-study psychotherapy at 6-month follow-up. Therapist adherence and competency were good; treatment credibility was higher in CBT. Conclusions Overall improvement was similar between ACT and CBT, indicating that ACT is a highly viable treatment for anxiety disorders. PMID:22563639

Critical Care Implications of the Affordable Care Act

PubMed Central

Dogra, Anjali P.; Dorman, Todd

2015-01-01

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

Exploring Systems That Support Good Clinical Care in Indigenous Primary Health-care Services: A Retrospective Analysis of Longitudinal Systems Assessment Tool Data from High-Improving Services.

PubMed

Woods, Cindy; Carlisle, Karen; Larkins, Sarah; Thompson, Sandra Claire; Tsey, Komla; Matthews, Veronica; Bailie, Ross

2017-01-01

Continuous Quality Improvement is a process for raising the quality of primary health care (PHC) across Indigenous PHC services. In addition to clinical auditing using plan, do, study, and act cycles, engaging staff in a process of reflecting on systems to support quality care is vital. The One21seventy Systems Assessment Tool (SAT) supports staff to assess systems performance in terms of five key components. This study examines quantitative and qualitative SAT data from five high-improving Indigenous PHC services in northern Australia to understand the systems used to support quality care. High-improving services selected for the study were determined by calculating quality of care indices for Indigenous health services participating in the Audit and Best Practice in Chronic Disease National Research Partnership. Services that reported continuing high improvement in quality of care delivered across two or more audit tools in three or more audits were selected for the study. Precollected SAT data (from annual team SAT meetings) are presented longitudinally using radar plots for quantitative scores for each component, and content analysis is used to describe strengths and weaknesses of performance in each systems' component. High-improving services were able to demonstrate strong processes for assessing system performance and consistent improvement in systems to support quality care across components. Key strengths in the quality support systems included adequate and orientated workforce, appropriate health system supports, and engagement with other organizations and community, while the weaknesses included lack of service infrastructure, recruitment, retention, and support for staff and additional costs. Qualitative data revealed clear voices from health service staff expressing concerns with performance, and subsequent SAT data provided evidence of changes made to address concerns. Learning from the processes and strengths of high-improving services may be useful as we work with services striving to improve the quality of care provided in other areas.

Medicare program; hospital outpatient prospective payment system and CY 2007 payment rates; CY 2007 update to the ambulatory surgical center covered procedures list; Medicare administrative contractors; and reporting hospital quality data for FY 2008 inpatient prospective payment system annual payment update program--HCAHPS survey, SCIP, and mortality. Final rule with comment period and final rule.

PubMed

2006-11-24

This final rule with comment period revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement certain related provisions of the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 and the Deficit Reduction Act (DRA) of 2005. In this final rule with comment period, we describe changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2007. In addition, this final rule with comment period implements future CY 2009 required reporting on quality measures for hospital outpatient services paid under the prospective payment system. This final rule with comment period revises the current list of procedures that are covered when furnished in a Medicare-approved ambulatory surgical center (ASC), which are applicable to services furnished on or after January 1, 2007. This final rule with comment period revises the emergency medical screening requirements for critical access hospitals (CAHs). This final rule with comment period supports implementation of a restructuring of the contracting entities responsibilities and functions that support the adjudication of Medicare fee-for-service (FFS) claims. This restructuring is directed by section 1874A of the Act, as added by section 911 of the MMA. The prior separate Medicare intermediary and Medicare carrier contracting authorities under Title XVIII of the Act have been replaced with the Medicare Administrative Contractor (MAC) authority. This final rule continues to implement the requirements of the DRA that require that we expand the "starter set" of 10 quality measures that we used in FY 2005 and FY 2006 for the hospital inpatient prospective payment system (IPPS) Reporting Hospital Quality Data for the Annual Payment Update (RHQDAPU) program. We began to adopt expanded measures effective for payments beginning in FY 2007. In this rule, we are finalizing additional quality measures for the expanded set of measures for FY 2008 payment purposes. These measures include the HCAHPS survey, as well as Surgical Care Improvement Project (SCIP, formerly Surgical Infection Prevention (SIP)), and Mortality quality measures.

Test Rig for Active Turbine Blade Tip Clearance Control Concepts: An Update

NASA Technical Reports Server (NTRS)

Taylor, Shawn; Steinetz, Bruce; Oswald, Jay; DeCastro, Jonathan; Melcher, Kevin

2006-01-01

The objective is to develop and demonstrate a fast-acting active clearance control system to improve turbine engine performance, reduce emissions, and increase service life. System studies have shown the benefits of reducing blade tip clearances in modern turbine engines. Minimizing blade tip clearances throughout the engine will contribute materially to meeting NASA's Ultra-Efficient Engine Technology (UEET) turbine engine project goals. NASA GRC is examining two candidate approaches including rub-avoidance and regeneration which are explained in subsequent slides.

ACTS 118x Final Report High-Speed TCP Interoperability Testing

NASA Technical Reports Server (NTRS)

Ivancic, William D.; Zernic, Mike; Hoder, Douglas J.; Brooks, David E.; Beering, Dave R.; Welch, Arun

1999-01-01

With the recent explosion of the Internet and the enormous business opportunities available to communication system providers, great interest has developed in improving the efficiency of data transfer using the Transmission Control Protocol (TCP) of the Internet Protocol (IP) suite. The satellite system providers are interested in solving TCP efficiency problems associated with long delays and error-prone links. Similarly, the terrestrial community is interested in solving TCP problems over high-bandwidth links. Whereas the wireless community is interested in improving TCP performance over bandwidth constrained, error-prone links. NASA realized that solutions had already been proposed for most of the problems associated with efficient data transfer over large bandwidth-delay links (which include satellite links). The solutions are detailed in various Internet Engineering Task Force (IETF) Request for Comments (RFCs). Unfortunately, most of these solutions had not been tested at high-speed (155+ Mbps). Therefore, the NASA's ACTS experiments program initiated a series of TCP experiments to demonstrate scalability of TCP/IP and determine how far the protocol can be optimized over a 622 Mbps satellite link. These experiments were known as the 118i and 118j experiments. During the 118i and 118j experiments, NASA worked closely with SUN Microsystems and FORE Systems to improve the operating system, TCP stacks. and network interface cards and drivers. We were able to obtain instantaneous data throughput rates of greater than 520 Mbps and average throughput rates of 470 Mbps using TCP over Asynchronous Transfer Mode (ATM) over a 622 Mbps Synchronous Optical Network (SONET) OC12 link. Following the success of these experiments and the successful government/industry collaboration, a new series of experiments. the 118x experiments. were developed.

Clinical decision support: effectiveness in improving quality processes and clinical outcomes and factors that may influence success.

PubMed

Murphy, Elizabeth V

2014-06-01

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the "meaningful use" of electronic medical record systems. An important component of the "Meaningful Use" legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledge and evidence-based guidance to the physician at the point of care. As reimbursement is increasingly tied to process and clinical outcomes, CDSS will be integral to future medical practice. Studies of CDSS indicate improvement in preventive services, appropriate care, and clinical and cost outcomes with strong evidence for CDSS effectiveness in process measures. Increasing provider adherence to CDSS recommendations is essential in improving CDSS effectiveness, and factors that influence adherence are currently under study.

Texas Library Systems Act and Rules for Administering the Library Systems Act.

ERIC Educational Resources Information Center

Texas State Library, Austin. Dept. of Library Development.

This booklet presents the Texas State Library Systems Act and some supporting documents to help in the operation of a library under the Texas system. The State Library Systems Act establishes and defines the state library system, allowing for its operation and management and defining the member libraries. Information on state grants is provided,…

21 CFR 21.20 - Procedures for notice of Food and Drug Administration Privacy Act Record Systems.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Administration Privacy Act Record Systems. 21.20 Section 21.20 Food and Drugs FOOD AND DRUG ADMINISTRATION... Act Record Systems § 21.20 Procedures for notice of Food and Drug Administration Privacy Act Record... of each year a notice concerning each Privacy Act Record System as defined in § 21.3(c) that is not...

21 CFR 21.20 - Procedures for notice of Food and Drug Administration Privacy Act Record Systems.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Administration Privacy Act Record Systems. 21.20 Section 21.20 Food and Drugs FOOD AND DRUG ADMINISTRATION... Act Record Systems § 21.20 Procedures for notice of Food and Drug Administration Privacy Act Record... of each year a notice concerning each Privacy Act Record System as defined in § 21.3(c) that is not...

21 CFR 21.20 - Procedures for notice of Food and Drug Administration Privacy Act Record Systems.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Administration Privacy Act Record Systems. 21.20 Section 21.20 Food and Drugs FOOD AND DRUG ADMINISTRATION... Act Record Systems § 21.20 Procedures for notice of Food and Drug Administration Privacy Act Record... of each year a notice concerning each Privacy Act Record System as defined in § 21.3(c) that is not...

21 CFR 21.20 - Procedures for notice of Food and Drug Administration Privacy Act Record Systems.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Administration Privacy Act Record Systems. 21.20 Section 21.20 Food and Drugs FOOD AND DRUG ADMINISTRATION... Act Record Systems § 21.20 Procedures for notice of Food and Drug Administration Privacy Act Record... of each year a notice concerning each Privacy Act Record System as defined in § 21.3(c) that is not...

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

PubMed Central

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

2015-01-01

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

Inferring Fitness Effects from Time-Resolved Sequence Data with a Delay-Deterministic Model.

PubMed

Nené, Nuno R; Dunham, Alistair S; Illingworth, Christopher J R

2018-05-01

A common challenge arising from the observation of an evolutionary system over time is to infer the magnitude of selection acting upon a specific genetic variant, or variants, within the population. The inference of selection may be confounded by the effects of genetic drift in a system, leading to the development of inference procedures to account for these effects. However, recent work has suggested that deterministic models of evolution may be effective in capturing the effects of selection even under complex models of demography, suggesting the more general application of deterministic approaches to inference. Responding to this literature, we here note a case in which a deterministic model of evolution may give highly misleading inferences, resulting from the nondeterministic properties of mutation in a finite population. We propose an alternative approach that acts to correct for this error, and which we denote the delay-deterministic model. Applying our model to a simple evolutionary system, we demonstrate its performance in quantifying the extent of selection acting within that system. We further consider the application of our model to sequence data from an evolutionary experiment. We outline scenarios in which our model may produce improved results for the inference of selection, noting that such situations can be easily identified via the use of a regular deterministic model. Copyright © 2018 Nené et al.

A Study on Design and Analysis of Hybrid Vibration Damper with Energy Harvesting and Optimal Damping Effect

NASA Astrophysics Data System (ADS)

Hanumantha Rao, T. V.; Srinivasa Rao, M. S. S.; Apparao, B. V.; Satyanarayana, K.

2014-04-01

The basic purpose of a damper is to reduce the vibration and to have a better ride comfort, road handling and safety to the rider. Recent developments show that an active vibration damper can effectively work much better than a passive damper. The effectiveness and reliability can be further enhanced by using hybrid dampers, which is a combination of active and passive dampers. But the need to have energy optimization in any field need not be stressed. Consequently, novel suspension concepts are required, not only to improve the vehicle's dynamic performance, but also to see that the energy generated during vibration can be harvested by utilizing regeneration functions. Hence if a hybrid damper with energy harvesting capability be designed, it would serve both purposes. In the hybrid damper a combination of hydraulic damper to act as a passive damper and an electromagnetic (EM) damper to act as an active damper is considered. The hydraulic system has more reliability and is time tested and the EM system acts as a dynamic vibration system as well as energy harvester. In this study a hybrid EM damper is modeled, analyzed and validity is shown for frequency response functions and energy balance for its active use. It is also shown how the effectiveness of the suspension system can be enhanced by using a hybrid damper.

Increase in transmission loss of single panels by addition of mass inclusions to a poro-elastic layer: Experimental investigation

NASA Astrophysics Data System (ADS)

Kidner, M. R. F.; Fuller, C. R.; Gardner, B.

2006-06-01

The insertion loss of standard acoustic blankets can be significantly improved at low frequencies by the addition of randomly placed mass inclusions to the poro-elastic layers. The improvement is much greater than that due to the mass effect alone. The mass inclusions act as resonant systems and so increase the structure impedance. This paper reports the results of experimental investigations into this phenomenon. Increases in insertion loss of 15 dB in the 100 Hz third octave band are reported.

[The adaptive pharmacological correction of functional disorders in young recruits with hypotrophy].

PubMed

Buchnov, A D; Grechko, A T; Murga, Ia T

2000-04-01

Low level of physical development, physiologic reserves, signs of psychical disadaptation, frequent functional disorders in cardiovascular system and gastrointestinal tract are noted in recruits with hypotrophy. Using of rapidly acting adaptogenes during 1 month (phytopreparation elixir "Altai" and "Vitavis" in tablets) significantly improves body state: increase in the level of physiologic reserves, physical working capacity, IMT, body unspecific resistance; improvement in indices of hemodynamics, metabolism and immunity; decrease in asthenization and psychical disadaptation. The state of adaptation and increased resistance in this recruit group remains during the following months of service.

Veterans' Employment and Education. Hearing on S. 2515, Veterans' Employment and Training Act of 1992 and S. 2647, Veterans' Readjustment Benefits Improvement Act of 1992 before the Committee on Veterans' Affairs. United States Senate, One Hundred Second Congress, Second Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Veteran's Affairs.

This document records the oral and written testimony of witnesses who testified concerning the Veterans' Employment and Training Act of 1992 and the Veterans' Readjustment Benefits Improvement Act of 1992. It also includes the texts of the bills. Witnesses included representatives of veterans' organizations, disabled veterans' groups, the U.S.…

Evaluation of the Library Aide Program, 1967-68. Research and Development Report, Volume II, Number 8.

ERIC Educational Resources Information Center

Ireland, Vera M.

As an integral part of the library improvement program of the Atlanta Public School System, the library aide program, funded under Title I of the Elementary and Secondary Education Act, was developed to relieve librarians of routine clerical and nonprofessional duties. In order to evaluate the inservice training and library aide activities,…

Neuroprosthetics and Solutions for Restoring Sensorimotor Functions

DTIC Science & Technology

2009-12-01

system can load drug molecules in the polymer backbones and inside the nanoholes respectively. Electrical stimulation can release drugs from both the...polymer backbones and the 13 nanoholes , which significantly improves the drug load and release efficiency. Furthermore, with one drug incorporated...in the polymer backbone during electrochemical polymerization, the nanoholes inside the polymer can act as containers to store a different drug, and

What's Missing from No Child Left Behind? A Policy Analysis from a Social Work Perspective

ERIC Educational Resources Information Center

Lagana-Riordan, Christine; Aguilar, Jemel P.

2009-01-01

The No Child Left Behind Act of 2001 (NCLB) initiated sweeping changes to the U.S. educational system. However, many have argued that NCLB is not accomplishing its stated purposes of improving education for disadvantaged students and closing the achievement gap. This policy analysis sheds light on the social and emotional risk factors that prevent…

A bill to amend the National Flood Insurance Act of 1968 to require the Administrator of the Federal Emergency Management Agency to consider reconstruction and improvement of flood protection systems when establishing flood insurance rates.

THOMAS, 112th Congress

Sen. Feinstein, Dianne [D-CA

2011-06-28

Senate - 06/28/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The USDA Feed the Future Initiative for genetic improvement of African goats: an update on genomic resources and genetic characterization of indigenous breeds

USDA-ARS?s Scientific Manuscript database

Food production systems in Africa depend heavily on the use of locally adapted animals such as goats which are critical to small-scale farmers as they are easier to acquire, maintain, and act as scavengers in sparse pasture and marginal crop regions. Indigenous goat ecotypes have undergone generatio...

77 FR 32135 - Notice of Lodging of Consent Decree Under the Clean Air Act and the Emergency Planning and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-31

... flare gas recovery systems and improved flaring efficiency, and enhanced controls for leak detection and... the monitoring data to a publicly available Web site on a weekly basis. The Consent Decree also... Department of Justice Web site: http://www.usdoj.gov/enrd/Consent_Decrees.html . A copy of the Decree may...

Providing System Compliance Training to Accountants of a Global Pharmaceutical Company: The Switzerland Case

ERIC Educational Resources Information Center

Leschinsky, Maribeth; Messemer, Jonathan E.

2010-01-01

On July 30, 2002, President George W. Bush signed the Sarbanes-Oxley Act of 2002 into law. The legislation was crafted by the United States Congress to address issues related to accounting improprieties which came to light during the Enron scandal. The specific purpose of the legislation was "To protect investors by improving the accuracy and…

Grants Management: Grants.gov Has Systemic Weaknesses That Require Attention. Report to Congressional Requesters. GAO-09-589

ERIC Educational Resources Information Center

Czerwinski, Stanley J.

2009-01-01

In response to the Federal Financial Assistance Management Improvement Act of 1999, the Office of Management and Budget (OMB), among other things, developed Grants.gov as the central grant identification and application portal for federal grant programs. OMB oversees the initiative and named the Department of Health and Human Services (HHS) its…

A Multimedia over IP Integrated System for Military Communications

DTIC Science & Technology

2006-12-01

stressed how communications requirements raise dramatically now, either in quantity either in quality, in order to effectively improve sensor...admission control based on network resources availability. We will stress the role of SIT and the characteristic of the Gatekeeper to act as the...considered: • Telecommuting - Telecommuting is a broad term referring to corporate employees who interact electronically with corporate resources

When Does Accountability Work? Texas System Had Mixed Effects on College Graduation Rates and Future Earnings

ERIC Educational Resources Information Center

Deming, David J.; Cohodes, Sarah; Jennings, Jennifer; Jencks, Christopher

2016-01-01

When congress passed the No Child Left Behind Act of 2001 (NCLB), standardized testing in public schools became the law of the land. The ambitious legislation identified test-based accountability as the key to improving schools and, by extension, the long-term prospects of American schoolchildren. Thirteen years later, the debate over the federal…

Schools as Sites of Socio-Economic Inclusion: Improving the Fabric of Indian Society

ERIC Educational Resources Information Center

Rani, Bhavana

2016-01-01

This article examines the Right of Children to Free and Compulsory Education Act (RTE, 2009) in India, including its origin, the system of schools to which it gave rise, and its importance against the backdrop of the larger Indian society. This article further assesses the progress made in the implementation of the RTE, the roadblocks, and the…

Serving the Nation's Students with Disabilities: Progress and Prospects. A Report to the President and the Congress of the United States.

ERIC Educational Resources Information Center

National Council on Disability, Washington, DC.

This study was commissioned to determine how the Individuals with Disabilities Education Act is working, what outcomes children and youth with disabilities are achieving, and how the system can be improved in the context of current education reform initiatives. Key policy themes addressed include individualized education programs, least…

Mobile User Connectivity in Relay-Assisted Visible Light Communications.

PubMed

Pešek, Petr; Zvanovec, Stanislav; Chvojka, Petr; Bhatnagar, Manav R; Ghassemlooy, Zabih; Saxena, Prakriti

2018-04-07

In this paper, we investigate relay-assisted visible light communications (VLC) where a mobile user acts as a relay and forwards data from a transmitter to the end mobile user. We analyse the utilization of the amplify-and-forward (AF) and decode-and-forward (DF) relaying schemes. The focus of the paper is on analysis of the behavior of the mobile user acting as a relay while considering a realistic locations of the receivers and transmitters on a standard mobile phone, more specifically with two photodetectors on both sides of a mobile phone and a transmitting LED array located upright. We also investigate dependency of the bit error rate (BER) performance on the azimuth and elevation angles of the mobile relay device within a typical office environment. We provide a new analytical description of BER for AF and DF-based relays in VLC. In addition we compare AF and DF-based systems and show that DF offers a marginal improvement in the coverage area with a BER < 10 -3 and a data rate of 100 Mb/s. Numerical results also illustrate that relay-based systems offer a significant improvement in terms of the coverage compared to direct non-line of sight VLC links.

Mobile User Connectivity in Relay-Assisted Visible Light Communications

PubMed Central

Pešek, Petr; Zvanovec, Stanislav; Chvojka, Petr; Bhatnagar, Manav R.; Ghassemlooy, Zabih; Saxena, Prakriti

2018-01-01

In this paper, we investigate relay-assisted visible light communications (VLC) where a mobile user acts as a relay and forwards data from a transmitter to the end mobile user. We analyse the utilization of the amplify-and-forward (AF) and decode-and-forward (DF) relaying schemes. The focus of the paper is on analysis of the behavior of the mobile user acting as a relay while considering a realistic locations of the receivers and transmitters on a standard mobile phone, more specifically with two photodetectors on both sides of a mobile phone and a transmitting LED array located upright. We also investigate dependency of the bit error rate (BER) performance on the azimuth and elevation angles of the mobile relay device within a typical office environment. We provide a new analytical description of BER for AF and DF-based relays in VLC. In addition we compare AF and DF-based systems and show that DF offers a marginal improvement in the coverage area with a BER < 10–3 and a data rate of 100 Mb/s. Numerical results also illustrate that relay-based systems offer a significant improvement in terms of the coverage compared to direct non-line of sight VLC links. PMID:29642432

32 CFR 505.3 - Privacy Act systems of records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems of... Register in a system of records notice, which will provide the public an opportunity to comment before DA... Register on new, amended, altered, or deleted systems of records to inform the public of the Privacy Act...

48 CFR 3052.209-74 - Limitations on contractors acting as lead system integrators.

Code of Federal Regulations, 2010 CFR

2010-10-01

... acting as lead system integrators. 3052.209-74 Section 3052.209-74 Federal Acquisition Regulations System... contractors acting as lead system integrators. As prescribed in (HSAR) 48 CFR 3009.570-4(a), use the following provision: LIMITATIONS ON CONTRACTORS ACTING AS LEAD SYSTEM INTEGRATORS (JUL 2010) (a) Definitions. “Direct...

48 CFR 3052.209-74 - Limitations on contractors acting as lead system integrators.

Code of Federal Regulations, 2011 CFR

2011-10-01

... acting as lead system integrators. 3052.209-74 Section 3052.209-74 Federal Acquisition Regulations System... contractors acting as lead system integrators. As prescribed in (HSAR) 48 CFR 3009.570-4(a), use the following provision: LIMITATIONS ON CONTRACTORS ACTING AS LEAD SYSTEM INTEGRATORS (JUL 2010) (a) Definitions. “Direct...

29 CFR 71.50 - General exemptions pursuant to subsection (j) of the Privacy Act.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (Investigative Case Tracking Systems/Audit Information Reporting Systems, USDOL/OIG), a system of records... ACCESS TO RECORDS UNDER THE PRIVACY ACT OF 1974 Exemption of Records Systems Under the Privacy Act § 71.50 General exemptions pursuant to subsection (j) of the Privacy Act. (a) The following systems of...

In-flight simulation of high agility through active control: Taming complexity by design

NASA Technical Reports Server (NTRS)

Padfield, Gareth D.; Bradley, Roy

1993-01-01

The motivation for research into helicopter agility stems from the realization that marked improvements relative to current operational types are possible, yet there is a dearth of useful criteria for flying qualities at high performance levels. Several research laboratories are currently investing resources in developing second generation airborne rotorcraft simulators. The UK's focus has been the exploitation of agility through active control technology (ACT); this paper reviews the results of studies conducted to date. The conflict between safety and performance in flight research is highlighted and the various forms of safety net to protect against system failures are described. The role of the safety pilot, and the use of actuator and flight envelope limiting are discussed. It is argued that the deep complexity of a research ACT system can only be tamed through a requirement specification assembled using design principles and cast in an operational simulation form. Work along these lines conducted at DRA is described, including the use of the Jackson System Development method and associated Ada simulation.

Resonant tunneling modulation in quasi-2D Cu(2)O/SnO(2) p-n horizontal-multi-layer heterostructure for room temperature H(2)S sensor application.

PubMed

Cui, Guangliang; Zhang, Mingzhe; Zou, Guangtian

2013-01-01

Heterostructure material that acts as resonant tunneling system is a major scientific challenge in applied physics. Herein, we report a resonant tunneling system, quasi-2D Cu(2)O/SnO(2) p-n heterostructure multi-layer film, prepared by electrochemical deposition in a quasi-2D ultra-thin liquid layer. By applying a special half-sine deposition potential across the electrodes, Cu(2)O and SnO(2) selectively and periodically deposited according to their reduction potentials. The as-prepared heterostructure film displays excellent sensitivity to H(2)S at room temperature due to the resonant tunneling modulation. Furthermore, it is found that the laser illumination could enhance the gas response, and the mechanism with laser illumination is discussed. It is the first report on gas sensing application of resonant tunneling modulation. Hence, heterostructure material act as resonant tunneling system is believed to be an ideal candidate for further improvement of room temperature gas sensing.

77 FR 2721 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

... FEDERAL COMMUNICATIONS COMMISSION Privacy Act System of Records AGENCY: Federal Communications Commission (FCC, Commission, or Agency). ACTION: Notice; one new Privacy Act system of records. SUMMARY: Pursuant to subsection (e)(4) of the Privacy Act of 1974, as amended (``Privacy Act''), 5 U.S.C. 552a, the...

Applications of systems approaches in the study of rheumatic diseases.

PubMed

Kim, Ki-Jo; Lee, Saseong; Kim, Wan-Uk

2015-03-01

The complex interaction of molecules within a biological system constitutes a functional module. These modules are then acted upon by both internal and external factors, such as genetic and environmental stresses, which under certain conditions can manifest as complex disease phenotypes. Recent advances in high-throughput biological analyses, in combination with improved computational methods for data enrichment, functional annotation, and network visualization, have enabled a much deeper understanding of the mechanisms underlying important biological processes by identifying functional modules that are temporally and spatially perturbed in the context of disease development. Systems biology approaches such as these have produced compelling observations that would be impossible to replicate using classical methodologies, with greater insights expected as both the technology and methods improve in the coming years. Here, we examine the use of systems biology and network analysis in the study of a wide range of rheumatic diseases to better understand the underlying molecular and clinical features.

Integrating conflict detection and attentional control mechanisms.

PubMed

Walsh, Bong J; Buonocore, Michael H; Carter, Cameron S; Mangun, George R

2011-09-01

Human behavior involves monitoring and adjusting performance to meet established goals. Performance-monitoring systems that act by detecting conflict in stimulus and response processing have been hypothesized to influence cortical control systems to adjust and improve performance. Here we used fMRI to investigate the neural mechanisms of conflict monitoring and resolution during voluntary spatial attention. We tested the hypothesis that the ACC would be sensitive to conflict during attentional orienting and influence activity in the frontoparietal attentional control network that selectively modulates visual information processing. We found that activity in ACC increased monotonically with increasing attentional conflict. This increased conflict detection activity was correlated with both increased activity in the attentional control network and improved speed and accuracy from one trial to the next. These results establish a long hypothesized interaction between conflict detection systems and neural systems supporting voluntary control of visual attention.

Flexible solution for interoperable cloud healthcare systems.

PubMed

Vida, Mihaela Marcella; Lupşe, Oana Sorina; Stoicu-Tivadar, Lăcrămioara; Bernad, Elena

2012-01-01

It is extremely important for the healthcare domain to have a standardized communication because will improve the quality of information and in the end the resulting benefits will improve the quality of patients' life. The standards proposed to be used are: HL7 CDA and CCD. For a better access to the medical data a solution based on cloud computing (CC) is investigated. CC is a technology that supports flexibility, seamless care, and reduced costs of the medical act. To ensure interoperability between healthcare information systems a solution creating a Web Custom Control is presented. The control shows the database tables and fields used to configure the two standards. This control will facilitate the work of the medical staff and hospital administrators, because they can configure the local system easily and prepare it for communication with other systems. The resulted information will have a higher quality and will provide knowledge that will support better patient management and diagnosis.

Baffled duckweed pond system for treatment of agricultural drainage water containing pharmaceuticals.

PubMed

Bassuney, Doaa; Tawfik, Ahmed

2017-08-03

The aim of the study is to assess the efficiency of a novel bioremediation system namely baffled duckweed pond (BDWP) system for the treatment of agricultural drainage water containing pharmaceuticals at different hydraulic retention times (HRTs). The removal efficiencies of acetaminophen (ACT), amoxicillin (AMX), and ampicillin (AMP) increased from 69.3 ± 8.6 to 87.3 ± 3.5%, from 52.9 ± 9.4 to 82.9 ± 5.2%, and from 55.3 ± 7.9 to 90.6 ± 2.8% at increasing the HRT from 6 to 8 days, respectively. However, ACT, AMX, and AMP removal efficiencies were slightly improved at increasing the HRT from 8 to 12 days. Diclofenac (DFC) removal efficiencies amounted to 56.6 ± 11.6, 55.7 ± 11.9, and 28.3 ± 12.9% at an HRTs of 12, 8, and 6 days, respectively. The results showed no relationship between the uptake/absorption of pharmaceuticals fractions and BOD 5 /chemical oxygen demand (COD) ratio except ACT where R 2 was 0.84. The effect of COD/N ratio on the removal efficiency of pharmaceuticals fractions was slight. Additional removal of pharmaceuticals fractions and nitrification occurred in carrier sponge media situated in the last compartment of the BDWP.

You are what you eat: influence of type and amount of food consumed on central dopamine systems and the behavioral effects of direct- and indirect-acting dopamine receptor agonists.

PubMed

Baladi, Michelle G; Daws, Lynette C; France, Charles P

2012-07-01

The important role of dopamine (DA) in mediating feeding behavior and the positive reinforcing effects of some drugs is well recognized. Less widely studied is how feeding conditions might impact the sensitivity of drugs acting on DA systems. Food restriction, for example, has often been the focus of aging and longevity studies; however, other studies have demonstrated that mild food restriction markedly increases sensitivity to direct- and indirect-acting DA receptor agonists. Moreover, it is becoming clear that not only the amount of food, but the type of food, is an important factor in modifying the effects of drugs. Given the increased consumption of high fat and sugary foods, studies are exploring how consumption of highly palatable food impacts DA neurochemistry and the effects of drugs acting on these systems. For example, eating high fat chow increases sensitivity to some behavioral effects of direct- as well as indirect-acting DA receptor agonists. A compelling mechanistic possibility is that central DA pathways that mediate the effects of some drugs are regulated by one or more of the endocrine hormones (e.g. insulin) that undergo marked changes during food restriction or after consuming high fat or sugary foods. Although traditionally recognized as an important signaling molecule in regulating energy homeostasis, insulin can also regulate DA neurochemistry. Because direct- and indirect-acting DA receptor drugs are used therapeutically and some are abused, a better understanding of how food intake impacts response to these drugs would likely facilitate improved treatment of clinical disorders and provide information that would be relevant to the causes of vulnerability to abuse drugs. This article is part of a Special Issue entitled 'Central Control of Food Intake'. Copyright © 2012 Elsevier Ltd. All rights reserved.

What Is the Penny Buying for South Carolina? Assessment of the South Carolina Education Improvement Act of 1984.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Div. of Public Accountability.

South Carolina's Education Improvement Act (EIA) of 1984 was a comprehensive piece of reform legislation providing for 60 new educational policies and programs. These new activities were funded by a one-cent increase in the state sales tax. The Act requires annual reports that present information concerning the benefits of EIA, provide additional…

Improving America's Schools Act, Conference Report (To Accompany H.R. 6). House of Representatives, 103D Congress, 2d Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House.

This report from the United States House of Representatives presents the complete amended version of the House bill to extend for 5 years the authorizations of appropriations for the programs under the Elementary and Secondary Education Act. The current reauthorization bill is known as the "Improving America's Schools Act." The first…

78 FR 12221 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-22

..., Hunger-Free Kids Act of 2010 AGENCY: Food and Nutrition Service, USDA. ACTION: Final rule. SUMMARY: This... Healthy, Hunger-Free Kids Act of 2010 designed to encourage States to improve direct certification efforts.../CNP/cnp.htm .) Section 101(b) of Public Law 111-296, the Healthy, Hunger-Free Kids Act of 2010 (HHFKA...

77 FR 4688 - National School Lunch Program: Direct Certification Continuous Improvement Plans Required by the...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

... Improvement Plans Required by the Healthy, Hunger-Free Kids Act of 2010 AGENCY: Food and Nutrition Service... (NSLP) regulations to incorporate provisions of the Healthy, Hunger- Free Kids Act of 2010 designed to..., the Healthy, Hunger-Free Kids Act of 2010 (HHFKA), amended section 9(b)(4) of the NSLA (42 U.S.C. 1758...

77 FR 35961 - Notice of Public Information Collection(s) Approved by the Office of Management and Budget

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-15

...) to fulfill its continuing obligations under the New and Emerging Technologies 911 Improvement Act of 2008, Public Law 110-283, 122 Stat. 2620 (2008) (NET 911 Act) to submit an annual ``Fee Accountability... or Charges for Enhanced 911 (E911) Services Under the NET 911 Improvement Act of 2008. Form No.: Not...

One to Grow On. Chapter One in Ohio: Education Consolidation and Improvement Act.

ERIC Educational Resources Information Center

Douthitt, Frieda

Since 1965, first through Title I of the Elementary and Secondary Education Act and now through Chapter 1 of the Education Consolidation and Improvement Act, funds have been allocated to supplement regular classroom instruction for children achieving below grade level. Together, Title I and Chapter 1 form a 20-year continuum of a concentrated,…

Chapter One in Ohio: Education Consolidation and Improvement Act. 21st Annual Evaluation Report, Fiscal 1986.

ERIC Educational Resources Information Center

Young, Eileen, Ed.

Recent activities provided in Ohio through Chapter 1 of the Education Consolidation and Improvement Act and its predecessor, Title I of the Elementary and Secondary Education Act are summarized in this annual report. Specific information contained in the report includes statistics for fiscal 1986 (the 1985-86 school year and the summer that…

Improving detection sensitivity for partial discharge monitoring of high voltage equipment

NASA Astrophysics Data System (ADS)

Hao, L.; Lewin, P. L.; Swingler, S. G.

2008-05-01

Partial discharge (PD) measurements are an important technique for assessing the health of power apparatus. Previous published research by the authors has shown that an electro-optic system can be used for PD measurement of oil-filled power transformers. A PD signal generated within an oil-filled power transformer may reach a winding and then travel along the winding to the bushing core bar. The bushing, acting like a capacitor, can transfer the high frequency components of the partial discharge signal to its earthed tap point. Therefore, an effective PD current measurement can be implemented at the bushing tap by using a radio frequency current transducer around the bushing-tap earth connection. In addition, the use of an optical transmission technique not only improves the electrical noise immunity and provides the possibility of remote measurement but also realizes electrical isolation and enhances safety for operators. However, the bushing core bar can act as an aerial and in addition noise induced by the electro-optic modulation system may influence overall measurement sensitivity. This paper reports on a machine learning technique, namely the use of a support vector machine (SVM), to improve the detection sensitivity of the system. Comparison between the signal extraction performances of a passive hardware filter and the SVM technique has been assessed. The results obtained from the laboratory-based experiment have been analysed and indicate that the SVM approach provides better performance than the passive hardware filter and it can reliably detect discharge signals with apparent charge greater than 30 pC.

77 FR 18205 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... DEPARTMENT OF COMMERCE [Docket No. 111115680-2197-02] Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of amended Privacy Act System of Records: COMMERCE... date of an amended Privacy Act System of Records titled, ``COMMERCE/CENSUS-6, Population Census Records...

75 FR 27294 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-14

... DEPARTMENT OF COMMERCE [Docket No. 100427198-2060-01] Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of amended Privacy Act System of Records: COMMERCE... effective date of a Privacy Act System of Records notice entitled COMMERCE/CENSUS-5, Decennial Census...

A clinical nurse specialist-led intervention to enhance medication adherence using the plan-do-check-act cycle for continuous self-improvement.

PubMed

Russell, Cynthia L

2010-01-01

A clinical nurse specialist-led intervention to improve medication adherence in chronically ill adults using renal transplant recipients as an exemplar population is proposed. Meta-analyses and systematic reviews of chronically ill and transplant patients indicate that patient-specific characteristics not only are poor and inconsistent predictors for medication nonadherence but also are not amenable to intervention. Adherence has not meaningfully improved, despite meta-analyses and systematic narrative reviews of randomized controlled trials (RCTs) dealing with medication nonadherence in acutely and chronically ill persons and RCTs dealing with transplant patients. Interventions with a superior potential to enhance medication adherence must be developed. Use of a clinical nurse specialist-led continuous self-improvement intervention with adult renal transplant recipients is proposed. Continuous self-improvement focuses on improving personal systems thinking and behavior using the plan-do-check-act process. Electronic medication monitoring reports, one of several objective measures of medication adherence, are used by the clinician to provide patient feedback during the check process on medication-taking patterns. Continuous self-improvement as an intervention holds promise in supporting patient self-management and diminishing the blame that clinicians place on patients for medication nonadherence. Using an objective measure of medication adherence such as an electronic monitoring report fosters collaborative patient-clinician discussions of daily medication-taking patterns. Through collaboration, ideas for improving medication taking can be explored. Changes can be followed and evaluated for effectiveness through the continuous self-improvement process. Future studies should include RCTs comparing educational and/or behavioral interventions to improve medication adherence.

Implementation of integrated heterogeneous electronic electrocardiography data into Maharaj Nakorn Chiang Mai Hospital Information System.

PubMed

Khumrin, Piyapong; Chumpoo, Pitupoom

2016-03-01

Electrocardiography is one of the most important non-invasive diagnostic tools for diagnosing coronary heart disease. The electrocardiography information system in Maharaj Nakorn Chiang Mai Hospital required a massive manual labor effort. In this article, we propose an approach toward the integration of heterogeneous electrocardiography data and the implementation of an integrated electrocardiography information system into the existing Hospital Information System. The system integrates different electrocardiography formats into a consistent electrocardiography rendering by using Java software. The interface acts as middleware to seamlessly integrate different electrocardiography formats. Instead of using a common electrocardiography protocol, we applied a central format based on Java classes for mapping different electrocardiography formats which contains a specific parser for each electrocardiography format to acquire the same information. Our observations showed that the new system improved the effectiveness of data management, work flow, and data quality; increased the availability of information; and finally improved quality of care. © The Author(s) 2014.

Texas Library Systems Act and Rules for Administering the Library Systems Act.

ERIC Educational Resources Information Center

Texas State Library, Austin. Dept. of Library Development.

This guide to the administration of the Library Systems Act for the State of Texas begins by presenting the text of the Library Systems Act. The relevant regulations from the Texas Administrative Code are then provided, covering such topics as standards for accreditation of a major resource system of libraries, minimum standards for accreditation…

A MultiAir®/MultiFuel Approach to Enhancing Engine System Efficiency

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

Reese, Ronald

2015-05-20

FCA US LLC (formally known as Chrysler Group LLC, and hereinafter “Chrysler”) was awarded an American Recovery and Reinvestment Act (ARRA) funded project by the Department of Energy (DOE) titled “A MultiAir®/MultiFuel Approach to Enhancing Engine System Efficiency” (hereinafter “project”). This award was issued after Chrysler submitted a proposal for Funding Opportunity Announcement DE-FOA- 0000079, “Systems Level Technology Development, Integration, and Demonstration for Efficient Class 8 Trucks (SuperTruck) and Advanced Technology Powertrains for Light-Duty Vehicles (ATP-LD).” Chrysler started work on this project on June 01, 2010 and completed testing activities on August 30, 2014. Overall objectives of this project were;more » Demonstrate a 25% improvement in combined Federal Test Procedure (FTP) City and Highway fuel economy over a 2009 Chrysler minivan; Accelerate the development of highly efficient engine and powertrain systems for light-duty vehicles, while meeting future emissions standards; and Create and retain jobs in accordance with the American Recovery and Reinvestment Act of 2009« less

A new method to evaluate human-robot system performance

NASA Technical Reports Server (NTRS)

Rodriguez, G.; Weisbin, C. R.

2003-01-01

One of the key issues in space exploration is that of deciding what space tasks are best done with humans, with robots, or a suitable combination of each. In general, human and robot skills are complementary. Humans provide as yet unmatched capabilities to perceive, think, and act when faced with anomalies and unforeseen events, but there can be huge potential risks to human safety in getting these benefits. Robots provide complementary skills in being able to work in extremely risky environments, but their ability to perceive, think, and act by themselves is currently not error-free, although these capabilities are continually improving with the emergence of new technologies. Substantial past experience validates these generally qualitative notions. However, there is a need for more rigorously systematic evaluation of human and robot roles, in order to optimize the design and performance of human-robot system architectures using well-defined performance evaluation metrics. This article summarizes a new analytical method to conduct such quantitative evaluations. While the article focuses on evaluating human-robot systems, the method is generally applicable to a much broader class of systems whose performance needs to be evaluated.

76 FR 58786 - Privacy Act of 1974; Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-22

... National Security Agency/Central Security System systems of records notices subject to the Privacy Act of... inquiries to the National Security Agency/Central Security Service, Freedom of Information Act/Privacy Act...; Systems of Records AGENCY: National Security Agency/Central Security Service, Department of Defense (DoD...

75 FR 67697 - Privacy Act of 1974; Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-03

... National Security Agency's record system notices for records systems subject to the Privacy Act of 1974 (5... National Security Agency/Central Security Service, Freedom of Information Act (FOIA)/Privacy Act Office...; Systems of Records AGENCY: National Security Agency/Central Security Service, DoD. ACTION: Notice to add a...

75 FR 43494 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-26

... National Security Agency's record system notices for records systems subject to the Privacy Act of 1974 (5... National Security Agency/Central Security Service, Freedom of Information Act and Privacy Act Office, 9800...; System of Records AGENCY: National Security Agency/Central Security Service, DoD. ACTION: Notice to...

75 FR 78211 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... DEPARTMENT OF COMMERCE [Docket No. 101207607-0607-02] Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of amended Privacy Act System of Records: COMMERCE... notice to announce the effective date of a Privacy Act System of Records notice entitled COMMERCE/CENSUS...

77 FR 18205 - Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-27

... DEPARTMENT OF COMMERCE [Docket No. 111115679-2197-02] Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of amended Privacy Act System of Records: COMMERCE... Commerce publishes this notice to announce the effective date of a Privacy Act System of Records notice...

Oregon's acts, cross-jurisdictional collaboration and improved transportation planning : final report : appendices.

DOT National Transportation Integrated Search

2009-01-01

This appendix summarizes interviews completed as part of an Oregon Department of : Transportation (ODOT) research study titled, Oregons ACTs, Cross-Jurisdictional : Collaboration and Improved Transportation Planning. The research was conduct...

The Food Safety Modernization Act: a barrier to trade? Only if the science says so.

PubMed

McNeill, Naomi

2012-01-01

The Food Safety Modernization Act improves oversight of America's food safety system. Title III, which regulates imported food, may create extra burdens for importers and therefore act as a barrier to trade. What will be on trial before the World Trade Organization (WTO), however, is not the law's content, but the science supporting it. Under the WTO regime, food safety laws that could restrict the free movement of food commodities must be sufficiently justified by scientific evidence. Member states must engage in risk assessments and regulate food imports in a manner that is "no more restrictive than necessary" to protect against the health risks identified by scientific evidence. This article examines the requirements of the WTO to evaluate the FSMA's legality under WTO rules. It analyzes the case law of the WTO Panel and Appellate Body and compares the FMSA to the EU's General Food Law.

Initiation and continuation of long-acting reversible contraception in the United States military healthcare system.

PubMed

Chiles, Daniel P; Roberts, Timothy A; Klein, David A

2016-09-01

Long-acting reversible contraception is more effective for pregnancy prevention than shorter-acting contraceptive methods and has the potential to reduce healthcare disparities and costs. However, long-acting reversible contraception is underused in the United States. One population of interest is beneficiaries of the United States military healthcare system who have access to universal healthcare, including no-cost, no-copay contraception with unlimited method switching, and comprise a large, actual use cohort. Efforts to increase long-acting reversible contraception initiation and continuation in this population may improve health outcomes and mitigate the profound consequences of unintended or mistimed pregnancy on readiness and cost to the military. We aimed to determine long-acting reversible contraception initiation and continuation rates among the diverse population with universal healthcare who are enrolled in the US military healthcare system. This study is a retrospective cohort of >1.7 million women, aged 14-40 years, who were enrolled in the US military healthcare system, TRICARE Prime, between October 2009 and September 2014. Individuals were assessed for long-acting reversible contraception initiation and continuation with the use of medical billing records. Method continuation and factors that were associated with early method discontinuation were evaluated with the Kaplan-Meier estimator and Cox proportional hazard models. During the study dates, 188,533 women initiated long-acting reversible contraception. Of these, 74.6% women selected intrauterine contraceptives. Method initiation rates remained relatively stable (41.7-50.1/1000 women/year) for intrauterine methods, although the rate for subdermal implants increased from 6.1-23.0/1000 women/year. In analysis of women who selected intrauterine contraceptives, 61.2% continued their method at 36 months, and 48.8% continued at 60 months. Among women who selected the implant, 32.0% continued their method at 36 months; however, 45.8% continued until 33 months (ie, 3 months before the currently recommended expiration date). Compared with intrauterine contraceptive users, implant users were more likely to discontinue their method during the 36 months after insertion (hazard ratio, 1.59; 95% confidence interval, 1.56-1.62; P < .001). Adolescents aged 14-19 years were the least likely age group to discontinue the implant before 36 months; women aged 35-40 years were the least likely to discontinue an intrauterine contraceptive before 60 months. In multivariable analysis that controlled for demographic factors and contraceptive type, early contraceptive method discontinuation was most likely among women aged 20-24 years, implant users, and women with method initiation in military clinics. In the US military healthcare system, TRICARE Prime, the initiation of long-acting reversible contraception is low but increasing, and continuation rates are high. This evidence supports long-acting reversible contraception as first-line recommendations for women of all ages who seek contraception. Published by Elsevier Inc.

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

PubMed Central

Klingenmaier, Lisa

2013-01-01

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

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

PubMed Central

Wise, Paul H.; Halfon, Neal

2014-01-01

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

Health Reforms as Examples of Multilevel Interventions in Cancer Care

PubMed Central

Fennell, Mary L.; Devers, Kelly J.

2012-01-01

To increase access and improve system quality and efficiency, President Obama signed the Patient Protection and Affordable Care Act with sweeping changes to the nation’s health-care system. Although not intended to be specific to cancer, the act's implementation will profoundly impact cancer care. Its components will influence multiple levels of the health-care environment including states, communities, health-care organizations, and individuals seeking care. To illustrate these influences, two reforms are considered: 1) accountable care organizations and 2) insurance-based reforms to gather evidence about effectiveness. We discuss these reforms using three facets of multilevel interventions: 1) their intended and unintended consequences, 2) the importance of timing, and 3) their implications for cancer. The success of complex health reforms requires understanding the scientific basis and evidence for carrying out such multilevel interventions. Conversely and equally important, successful implementation of multilevel interventions depends on understanding the political setting and goals of health-care reform. PMID:22623600

Health reforms as examples of multilevel interventions in cancer care.

PubMed

Flood, Ann B; Fennell, Mary L; Devers, Kelly J

2012-05-01

To increase access and improve system quality and efficiency, President Obama signed the Patient Protection and Affordable Care Act with sweeping changes to the nation's health-care system. Although not intended to be specific to cancer, the act's implementation will profoundly impact cancer care. Its components will influence multiple levels of the health-care environment including states, communities, health-care organizations, and individuals seeking care. To illustrate these influences, two reforms are considered: 1) accountable care organizations and 2) insurance-based reforms to gather evidence about effectiveness. We discuss these reforms using three facets of multilevel interventions: 1) their intended and unintended consequences, 2) the importance of timing, and 3) their implications for cancer. The success of complex health reforms requires understanding the scientific basis and evidence for carrying out such multilevel interventions. Conversely and equally important, successful implementation of multilevel interventions depends on understanding the political setting and goals of health-care reform.

Competitive advantage in the ERP system's value-chain and its influence on future development

NASA Astrophysics Data System (ADS)

Johansson, Björn; Newman, Mike

2010-02-01

Using the resource-based view, we present a set of propositions related to enterprise resource planning (ERP) development, reflections on competitive advantage and the different roles that stakeholders play in the value-chain. This has the goal of building a foundation for future research on ERPs and how stakeholders' desire to achieve competitive advantage influence ERP development, especially when it comes to development of a more standardised or pre-customised ERP system. The propositions also act as a foundation for increasing our knowledge concerning the difficulty in developing improved ERP systems.

The School Improvement Grant Rollout in America's Great City Schools: School Improvement Grants

ERIC Educational Resources Information Center

Lachlan-Hache, Jonathon; Naik, Manish; Casserly, Michael

2012-01-01

The School Improvement Grant (SIG) program, initially enacted as part of the "No Child Left Behind" amendments to the Elementary and Secondary Education Act, underwent a substantial transformation under the American Recovery and Reinvestment Act of 2009. Under the new program, states identified 2,172 persistently low-achieving schools…

An Analysis of Five Years of the Education Improvement Act on the Fiscal Capacity of South Carolina Schools To Deliver Equal Education Opportunity.

ERIC Educational Resources Information Center

Flanigan, J. L.; Richardson, M. D.

The first 5 years of South Carolina's 1984 Educational Improvement Act (EIA), a major educational reform program to deliver equal education opportunity and improve academic performance, are analyzed in this paper. A review of South Carolina's per-capita disposable income as compared with other states reveals an improvement in South Carolina's rank…

What Is the Penny Buying for South Carolina? Assessment of the Third Year of the South Carolina Education Improvement Act of 1984.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia. Div. of Public Accountability.

This assessment report examines the impact of the South Carolina Educational Improvement Act (EIA) by focusing on six specific areas relevant to improving education in South Carolina during the school year 1986-87. The report is divided into six areas that show the following improvements: (1) Academic Achievement: performance on standardized tests…

Individuals with Disabilities Education Improvement Act of 2004 and IDEA Regulations of 2006: Implications for Educators, Administrators, and Teacher Trainers

ERIC Educational Resources Information Center

Yell, Mitchell L.; Shriner, James G.; Katsiyannis, Antonis

2006-01-01

The Individuals with Disabilities Education Improvement Act of 2004 (hereafter IDEIA) was signed into law by President George W. Bush on December 3, 2004. The law reauthorized and made important changes to the Individuals with Disabilities Education Act (IDEA). On August 3, 2006, the U.S. Department of Education released the Regulations…

Implementation of "New Directions" in Development Assistance: Report to the Committee on International Relations on Implementation of Legislative Reforms in the Foreign Assistance Act of 1973.

ERIC Educational Resources Information Center

Agency for International Development (Dept. of State), Washington, DC.

This report discusses the many policy and procedural issues of the Agency for International Development (AID) in implementing the reforms included in the congressional Foreign Assistance Act of 1973. The act concentrated aid efforts on food and nutrition improvement, population control, health improvement, education, and human resource…

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

PubMed

Jha, Saurabh; Baker, Tom

2012-12-01

The Patient Protection and Affordable Care Act is a comprehensive and multipronged reform of the US health care system. The legislation makes incremental changes to Medicare, Medicaid, and the market for employer-sponsored health insurance. However, it makes substantial changes to the market for individual and small-group health insurance. The purpose of this article is to introduce the key regulatory reforms in the market for individual and small-group health insurance and explain how these reforms tackle adverse selection and risk classification and improve access to health care for the hitherto uninsured or underinsured population. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Pediatric aspects of inpatient health information technology systems.

PubMed

Lehmann, Christoph U

2015-03-01

In the past 3 years, the Health Information Technology for Economic and Clinical Health Act accelerated the adoption of electronic health records (EHRs) with providers and hospitals, who can claim incentive monies related to meaningful use. Despite the increase in adoption of commercial EHRs in pediatric settings, there has been little support for EHR tools and functionalities that promote pediatric quality improvement and patient safety, and children remain at higher risk than adults for medical errors in inpatient environments. Health information technology (HIT) tailored to the needs of pediatric health care providers can improve care by reducing the likelihood of errors through information assurance and minimizing the harm that results from errors. This technical report outlines pediatric-specific concepts, child health needs and their data elements, and required functionalities in inpatient clinical information systems that may be missing in adult-oriented HIT systems with negative consequences for pediatric inpatient care. It is imperative that inpatient (and outpatient) HIT systems be adapted to improve their ability to properly support safe health care delivery for children. Copyright © 2015 by the American Academy of Pediatrics.

75 FR 18500 - Guidance on Improving EPA Review of Appalachian Surface Coal Mining Operations under the Clean...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-12

... of Appalachian Surface Coal Mining Operations under the Clean Water Act, National Environmental... Appalachian Surface Coal Mining Operations under the Clean Water Act, National Environmental Policy Act, and... coal mining operations under the Clean Water Act, National Environmental Policy Act, and the...

Annual Adaptive Management Report for Compensatory Mitigation at Keyport Lagoon: Mitigation of Pier B Development at the Bremerton Naval Facilities - Compensatory Mitigation at Keyport Lagoon - Naval Underwater Warfare Center Division - Keyport, Washington

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

Vavrinec, John; Borde, Amy B.; Woodruff, Dana L.

Unites States Navy capital improvement projects are designed to modernize and improve mission capacity. Such capital improvement projects often result in unavoidable environmental impacts by increasing over-water structures, which results in a loss of subtidal habitat within industrial areas of Navy bases. In the Pacific Northwest, compensatory mitigation often targets alleviating impacts to Endangered Species Act-listed salmon species. The complexity of restoring large systems requires limited resources to target successful and more coordinated mitigation efforts to address habitat loss and improvements in water quality that will clearly contribute to an improvement at the site scale and can then be linkedmore » to a cumulative net ecosystem improvement.« less

13 CFR 102.39 - SBA's exempt Privacy Act systems of records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false SBA's exempt Privacy Act systems... DISCLOSURE AND PRIVACY Protection of Privacy and Access to Individual Records Under the Privacy Act of 1974 § 102.39 SBA's exempt Privacy Act systems of records. (a) Systems of records subject to investigatory...

4 CFR 200.12 - Notification of systems of Privacy Act records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Notification of systems of Privacy Act records. 200.12 Section 200.12 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200.12 Notification of systems of Privacy Act records. (a) Public notice. The Board periodically reviews its systems...

77 FR 2710 - Privacy Act of 1974; System of Records; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-19

... DEPARTMENT OF DEFENSE Office of the Secretary [Docket ID: DOD-2012-OS-0001] Privacy Act of 1974... intent to add a new Privacy Act System of Records. The Categories of Records in the System paragraph was... inventory of Privacy Act System of Records: FSTRATCOM 01, Command Data Records. Subsequent to the...

4 CFR 200.12 - Notification of systems of Privacy Act records.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 4 Accounts 1 2011-01-01 2011-01-01 false Notification of systems of Privacy Act records. 200.12 Section 200.12 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200.12 Notification of systems of Privacy Act records. (a) Public notice. The Board periodically reviews its systems...

4 CFR 200.12 - Notification of systems of Privacy Act records.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 4 Accounts 1 2013-01-01 2013-01-01 false Notification of systems of Privacy Act records. 200.12 Section 200.12 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200.12 Notification of systems of Privacy Act records. (a) Public notice. The Board periodically reviews its systems...

4 CFR 200.12 - Notification of systems of Privacy Act records.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 4 Accounts 1 2012-01-01 2012-01-01 false Notification of systems of Privacy Act records. 200.12 Section 200.12 Accounts RECOVERY ACCOUNTABILITY AND TRANSPARENCY BOARD PRIVACY ACT OF 1974 § 200.12 Notification of systems of Privacy Act records. (a) Public notice. The Board periodically reviews its systems...

Beneficial Properties of Probiotics.

PubMed

Shi, Lye Huey; Balakrishnan, Kunasundari; Thiagarajah, Kokila; Mohd Ismail, Nor Ismaliza; Yin, Ooi Shao

2016-08-01

Probiotics are live microorganisms that can be found in fermented foods and cultured milk, and are widely used for the preparation of infant food. They are well-known as "health friendly bacteria", which exhibit various health beneficial properties such as prevention of bowel diseases, improving the immune system, for lactose intolerance and intestinal microbial balance, exhibiting antihypercholesterolemic and antihypertensive effects, alleviation of postmenopausal disorders, and reducing traveller's diarrhoea. Recent studies have also been focused on their uses in treating skin and oral diseases. In addition to that, modulation of the gut-brain by probiotics has been suggested as a novel therapeutic solution for anxiety and depression. Thus, this review discusses on the current probiotics-based products in Malaysia, criteria for selection of probiotics, and evidences obtained from past studies on how probiotics have been used in preventing intestinal disorders via improving the immune system, acting as an antihypercholesterolemic factor, improving oral and dermal health, and performing as anti-anxiety and anti-depressive agents.

Clinical Decision Support: Effectiveness in Improving Quality Processes and Clinical Outcomes and Factors That May Influence Success

PubMed Central

Murphy, Elizabeth V.

2014-01-01

The use of electronic health records has skyrocketed following the 2009 HITECH Act, which provides financial incentives to health care providers for the “meaningful use” of electronic medical record systems. An important component of the “Meaningful Use” legislation is the integration of Clinical Decision Support Systems (CDSS) into the computerized record, providing up-to-date medical knowledge and evidence-based guidance to the physician at the point of care. As reimbursement is increasingly tied to process and clinical outcomes, CDSS will be integral to future medical practice. Studies of CDSS indicate improvement in preventive services, appropriate care, and clinical and cost outcomes with strong evidence for CDSS effectiveness in process measures. Increasing provider adherence to CDSS recommendations is essential in improving CDSS effectiveness, and factors that influence adherence are currently under study. PMID:24910564

Using Evaluation Systems for Teacher Improvement: Are School Districts Ready to Meet New Federal Goals?

ERIC Educational Resources Information Center

Rosen, Rachel; Parise, Leigh M.

2017-01-01

The Every Student Succeeds Act (ESSA--the main federal education law) was signed into law at the end of 2015, but schools and districts have until the 2017-2018 school year to begin implementing their plans to comply with it. ESSA represents a substantial shift from prior law in how it addresses teacher professional growth and evaluation, and as…

Demand Forecasting: An Evaluation of DODs Accuracy Metric and Navys Procedures

DTIC Science & Technology

2016-06-01

inventory management improvement plan, mean of absolute scaled error, lead time adjusted squared error, forecast accuracy, benchmarking, naïve method...Manager JASA Journal of the American Statistical Association LASE Lead-time Adjusted Squared Error LCI Life Cycle Indicator MA Moving Average MAE...Mean Squared Error xvi NAVSUP Naval Supply Systems Command NDAA National Defense Authorization Act NIIN National Individual Identification Number

Strategic Planning and Management in Defense Systems Acquisition

DTIC Science & Technology

2013-10-01

to Dr. John Bryson (2010), offers many benefits to public-sector organizations: • Promotes strategic thinking, acting, and learning; • Improves...and with strategic planning in particular—and has proven its value (Barzelay & Campbell, 2003; Berman & West, 1998; Berry & Wechsler, 1995; Boyne ...national survey. Public Administration Review, 55(2), 159–68. Boyne , G. A., & Gould-Williams, J. (2003). Planning and performance in public organizations

Continuous improvement of the quality reporting system of a medium-size company

NASA Astrophysics Data System (ADS)

Hawkins, Anthony; Onuh, Spencer

2001-10-01

Many companies are faced with quality improvement issues on a daily basis but their response to this problem varies. This paper discusses the improvement in the defect reporting system at a medium sized manufacturing company following the appointment of an experienced, motivated, design engineer to be dedicated to that task. It sets out the situation that the engineer inherited and details the changes that were incorporated; it assesses which were successful and which failed. Following a survey of current literature, it was seen that there is little written specifically on the subject of audited defect reporting. It is felt that this study goes some way to filling that void. A successful survey of engineering companies in Southern Hampshire reinforces the principle findings, that the emphasising of the Check part of Demming's Plan-Do-Check-Act cycle is a novel approach to the Quality Improvement Process, and that it has reduced the cost of rework by an audited 80% in a period of two years.

Individuals with bipolar disorder and their relationship with the criminal justice system: a critical review.

PubMed

Fovet, Thomas; Geoffroy, Pierre Alexis; Vaiva, Guillaume; Adins, Catherine; Thomas, Pierre; Amad, Ali

2015-04-01

Bipolar disorder is a severe and prevalent psychiatric disease. Poor outcomes include a high frequency of criminal acts, imprisonments, and repeat offenses. This critical review of the international literature examined several aspects of the complex relationship between individuals with bipolar disorder and the criminal justice system: risk factors for criminal acts, features of bipolar patients' incarceration, and their postrelease trajectories. Publications were obtained from the PubMed and Google Scholar electronic databases by using the following MeSH headings: prison, forensic psychiatry, criminal law, crime, and bipolar disorder. Among patients with bipolar disorder, the frequency of violent criminal acts is higher than in the general population (odds ratio [OR]=2.8, 95% confidence interval [CI]=1.8-4.3). The frequency is higher among patients with bipolar disorder and a comorbid substance use disorder than among those without either disorder (OR=10.1, CI=5.3-19.2). As a result, the prevalence of bipolar disorder among prisoners is high (2%-7%). In prison, patients' bipolar disorder symptoms can complicate their relationship with prison administrators, leading to an increased risk of multiple incarcerations. Moreover, the risk of suicide increases for these prisoners. Criminal acts are common among patients with bipolar disorder and are often associated with problems such as addiction. Thus it is important to improve the diagnosis and treatment of inmates with bipolar disorder.

Guaranteed Ride Home: Taking the Worry Out of Ridesharing

DOT National Transportation Integrated Search

1986-07-01

The Highway Safety Acts of 1973 and 1976 and the Surface Transportation Acts of 1978 and 1982 provide funding authorizations for individual states to improve safety at public rail-highway crossings. Safety improvements frequently consist of the insta...

How did a Housing First intervention improve health and social outcomes among homeless adults with mental illness in Toronto? Two-year outcomes from a randomised trial

PubMed Central

O'Campo, Patricia; Stergiopoulos, Vicky; Nir, Pam; Levy, Matthew; Misir, Vachan; Chum, Antony; Arbach, Bouchra; Nisenbaum, Rosane; To, Matthew J; Hwang, Stephen W

2016-01-01

Objectives We studied the impact of a Housing First (HF) intervention on housing, contact with the justice system, healthcare usage and health outcomes among At Home/Chez Soi randomised trial participants in Toronto, a city with an extensive service network for social and health services for individuals who are experiencing homelessness and mental illness. Methods Participants identified as high needs were randomised to receive either the intervention which provided them with housing and supports by an assertive community treatment team (HF+ACT) or treatment as usual (TAU). Participants (N=197) had in-person interviews every 3 months for 2 years. Results The HF+ACT group spent more time stably housed compared to the TAU group with the mean difference between the groups of 45.8% (95% CI 37.1% to 54.4%, p<0.0001). Accounting for baseline differences, HF+ACT group showed significant improvements over TAU group for community functioning, selected quality-of-life subscales and arrests at some time points during follow-up. No differences between HF+ACT and TAU groups over the follow-up were observed for health service usage, community integration and substance use. Conclusions HF for individuals with high levels of need increased housing stability and selected health and justice outcomes over 2 years in a city with many social and health services. Trial registration number ISRCTN42520374. PMID:27619826

76 FR 3098 - Privacy Act of 1974; Systems of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-19

...: National Security Agency/Central Security Service, Freedom of Information Act and Privacy Act Office, 9800..., Privacy Act and Mandatory Declassification Review Records. System Location: National Security Agency... Information Act; 5 U.S.C. 552a, The Privacy Act of 1974 (as amended); E.O. 13526, Classified National Security...

36 CFR 1202.8 - How does NARA handle records that are in Government-wide Privacy Act systems?

Code of Federal Regulations, 2011 CFR

2011-07-01

... that are in Government-wide Privacy Act systems? 1202.8 Section 1202.8 Parks, Forests, and Public... ACT OF 1974 General Information About the Privacy Act § 1202.8 How does NARA handle records that are in Government-wide Privacy Act systems? Records in the custody of NARA in a Government-wide Privacy...

36 CFR 1202.8 - How does NARA handle records that are in Government-wide Privacy Act systems?

Code of Federal Regulations, 2010 CFR

2010-07-01

... that are in Government-wide Privacy Act systems? 1202.8 Section 1202.8 Parks, Forests, and Public... ACT OF 1974 General Information About the Privacy Act § 1202.8 How does NARA handle records that are in Government-wide Privacy Act systems? Records in the custody of NARA in a Government-wide Privacy...

Multiple-input multiple-output visible light communication system based on disorder dispersion components

NASA Astrophysics Data System (ADS)

Yang, Tao; Zhang, Qi; Hao, Yue; Zhou, Xin-hui; Yi, Ming-dong; Wei, Wei; Huang, Wei; Li, Xing-ao

2017-10-01

A multiple-input multiple-output visible light communication (VLC) system based on disorder dispersion components is presented. Instead of monochromatic sources and large size photodetectors used in the traditional VLC systems, broadband sources with different spectra act as the transmitters and a compact imaging chip sensor accompanied by a disorder dispersion component and a calculating component serve as the receivers in the proposed system. This system has the merits of small size, more channels, simple structure, easy integration, and low cost. Simultaneously, the broadband sources are suitable to act as illumination sources for their white color. A regularized procedure is designed to solve a matrix equation for decoding the signals at the receivers. A proof-of-concept experiment using on-off keying modulation has been done to prove the feasibility of the design. The experimental results show that the signals decoded by the receivers fit well with those generated from the transmitters, but the bit error ratio is increased with the number of the signal channels. The experimental results can be further improved using a high-speed charge-coupled device, decreasing noises, and increasing the distance between the transmitters and the receivers.

One-day behavioral intervention in depressed migraine patients: effects on headache.

PubMed

Dindo, Lilian; Recober, Ana; Marchman, James; O'Hara, Michael W; Turvey, Carolyn

2014-03-01

To determine whether a 1-day behavioral intervention, aimed at enhancing psychological flexibility, improves headache outcomes of migraine patients with comorbid depression. Migraine is often comorbid with depression, with each disorder increasing the risk for onset and exacerbation of the other. Managing psychological triggers, such as stress and depression, may result in greater success of headache management. Sixty patients with comorbid migraine and depression were assigned to a 1-day Acceptance and Commitment Training plus Migraine Education workshop (ACT-ED; N = 38) or to treatment as usual (TAU; N = 22). Patients completed a daily headache diary prior to, and for 3 months following, the intervention. Clinical variables examined included headache frequency/severity, medication use, disability, and visit to a health care professional. Comparisons were made between baseline findings and findings at the 3-month follow up. Participants assigned to the ACT-ED condition exhibited significant improvements in headache frequency, headache severity, medication use, and headache-related disability. In contrast, the TAU group did not exhibit improvements. The difference in headache outcomes between ACT-ED and TAU was not statistically significant over time (ie, the treatment by time interaction was nonsignificant). These results complement those of a previous report showing effects of ACT-ED vs TAU on depression and disability. A 1-day ACT-ED workshop targeting psychological flexibility may convey benefit for patients with comorbid migraine and depression.These pilot study findings merit further investigation using a more rigorously designed large-scale trial.

Second Evaluation of the Improving Literacy through School Libraries Program

ERIC Educational Resources Information Center

Michie, Joan S.; Chaney, Bradford W.

2009-01-01

The Improving Literacy through School Libraries (LSL) program was established under Title I, Part B, Subpart 4 of the Elementary and Secondary Education Act (ESEA) by the No Child Left Behind Act of 2001 (NCLB). The purpose of the program is to improve the literacy skills and academic achievement of students by providing them with increased…

14 CFR 16.1 - Applicability and description of part.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) The assurances contained in grant-in-aid agreements issued under the Airport and Airway Improvement...(a) and (b). (6) Section 505(d) of the Airport and Airway Improvement Act of 1982, as amended, 49 U.S... (49 U.S.C. 1723), or section 516 of the Airport and Airway Improvement Act (49 U.S.C. 47125). (8...

48 CFR 3009.570 - Limitations on contractors acting as lead system integrators.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Limitations on contractors acting as lead system integrators. 3009.570 Section 3009.570 Federal Acquisition Regulations System... contractors acting as lead system integrators. ...

Fastener load tests and retention systems tests for cryogenic wind-tunnel models

NASA Technical Reports Server (NTRS)

Wallace, J. W.

1984-01-01

A-286 stainless steel screws were tested to determine the tensile load capability and failure mode of various screw sizes and types at both cryogenic and room temperature. Additionally, five fastener retention systems were tested by using A-286 screws with specimens made from the primary metallic alloys that are currently used for cryogenic models. The locking system effectiveness was examined by simple no-load cycling to cryogenic temperatures (-275 F) as well as by dynamic and static loading at cryogenic temperatures. In general, most systems were found to be effective retention devices. There are some differences between the various devices with respect to ease of application, cleanup, and reuse. Results of tests at -275 F imply that the cold temperatures act to improve screw retention. The improved retention is probably the result of differential thermal contraction and/or increased friction (thread-binding effects). The data provided are useful in selecting screw sizes, types, and locking devices for model systems to be tested in cryogenic wind tunnels.

Behavioral Health Integration in Large Multi-group Pediatric Practice.

PubMed

Schlesinger, Abigail Boden

2017-03-01

There is increasing interest in methods to improve access to behavioral health services for children and adolescents. Children's Community Pediatric Behavioral Health Service (CCPBHS) is an integrated behavioral health service whose method of (a) creating a leadership team with empowered administrative and clinical stakeholders who can act on a commitment to change and (b) having a clear mission statement with integrated administrative and clinical care processes can serve as a model for implementing integration efforts within the medical home. Community Pediatrics Behavioral Health Service (CPBHS) is a sustainable initiative that improved the utilization of physical health and behavioral health systems for youth and improved the utilization of evidence-based interventions for youth served in primary care.

Airborne lidar mapping of vertical ozone distributions in support of the 1990 Clean Air Act Amendments

NASA Technical Reports Server (NTRS)

Uthe, Edward E.; Nielsen, Norman B.; Livingston, John M.

1992-01-01

The 1990 Clean Air Act Amendments mandated attainment of the ozone standard established by the U.S. Environmental Protection Agency. Improved photochemical models validated by experimental data are needed to develop strategies for reducing near surface ozone concentrations downwind of urban and industrial centers. For more than 10 years, lidar has been used on large aircraft to provide unique information on ozone distributions in the atmosphere. However, compact airborne lidar systems are needed for operation on small aircraft of the type typically used on regional air quality investigations to collect data with which to develop and validate air quality models. Data presented in this paper will consist of a comparison between airborne differential absorption lidar (DIAL) and airborne in-situ ozone measurements. Also discussed are future plans to improve the airborne ultraviolet-DIAL for ozone and other gas observations and addition of a Fourier Transform Infrared (FTIR) emission spectrometer to investigate the effects of other gas species on vertical ozone distribution.

Influence of the dietary supplement health and education act on consumer beliefs about the safety and effectiveness of dietary supplements.

PubMed

Dodge, Tonya; Litt, Dana; Kaufman, Annette

2011-03-01

The authors conducted two studies to examine the influence of the U.S. Dietary Supplement Health and Education Act (DSHEA) on consumer beliefs about the safety and effectiveness of dietary supplements. Study 1 manipulated information about Food and Drug Administration (FDA) approval in the context of a dietary supplement designed to improve immune system functioning. Study 2 tested the effect of an educational intervention designed to improve knowledge about the DSHEA. Results of Study 1 highlighted deficits in consumer knowledge about FDA regulation of dietary supplements. Results also showed that information about FDA approval failed to have a statistically significant effect on beliefs about safety or effectiveness of the dietary supplement. Results of Study 2 showed that participants who were educated about the regulation of dietary supplements under the DSHEA rated dietary supplements as less safe and less effective than did participants in the control condition. The authors discuss the implications for consumers in the United States and for public policy.

Drafting and acting on feedback supports student learning when writing essay assignments.

PubMed

Freestone, Nicholas

2009-06-01

A diverse student population is a relatively recent feature of the higher education system in the United Kingdom. Consequently, it may be thought that more "traditional" types of assessment based around essay writing skills for science undergraduates may be of decreasing value and relevance to contemporary students. This article describes a study in which the process of feedback on, and associated redrafting of, an essay was closely supervised to improve essay writing skills and subsequent exam performance. The results of this study show that students can significantly improve their learning and academic performance, as assessed by final examination mark, by a process that more closely mimics a "real-world" situation of review and redrafting. Additionally, the data show that students benefit from feedback only when this is used appropriately by the student. The article also discusses the continuing importance and relevance of essay writing skills so that writing, and acting upon feedback to do with that writing, remains an integral part of the process of learning.

Health Education Careers in a Post-Health Reform Era.

PubMed

Auld, M Elaine

2017-09-01

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law's provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

UNC-16 (JIP3) Acts Through Synapse-Assembly Proteins to Inhibit the Active Transport of Cell Soma Organelles to Caenorhabditis elegans Motor Neuron Axons

PubMed Central

Edwards, Stacey L.; Morrison, Logan M.; Yorks, Rosalina M.; Hoover, Christopher M.; Boominathan, Soorajnath; Miller, Kenneth G.

2015-01-01

The conserved protein UNC-16 (JIP3) inhibits the active transport of some cell soma organelles, such as lysosomes, early endosomes, and Golgi, to the synaptic region of axons. However, little is known about UNC-16’s organelle transport regulatory function, which is distinct from its Kinesin-1 adaptor function. We used an unc-16 suppressor screen in Caenorhabditis elegans to discover that UNC-16 acts through CDK-5 (Cdk5) and two conserved synapse assembly proteins: SAD-1 (SAD-A Kinase), and SYD-2 (Liprin-α). Genetic analysis of all combinations of double and triple mutants in unc-16(+) and unc-16(−) backgrounds showed that the three proteins (CDK-5, SAD-1, and SYD-2) are all part of the same organelle transport regulatory system, which we named the CSS system based on its founder proteins. Further genetic analysis revealed roles for SYD-1 (another synapse assembly protein) and STRADα (a SAD-1-interacting protein) in the CSS system. In an unc-16(−) background, loss of the CSS system improved the sluggish locomotion of unc-16 mutants, inhibited axonal lysosome accumulation, and led to the dynein-dependent accumulation of lysosomes in dendrites. Time-lapse imaging of lysosomes in CSS system mutants in unc-16(+) and unc-16(−) backgrounds revealed active transport defects consistent with the steady-state distributions of lysosomes. UNC-16 also uses the CSS system to regulate the distribution of early endosomes in neurons and, to a lesser extent, Golgi. The data reveal a new and unprecedented role for synapse assembly proteins, acting as part of the newly defined CSS system, in mediating UNC-16’s organelle transport regulatory function. PMID:26354976

Ceramic membrane ultrafiltration of natural surface water with ultrasound enhanced backwashing.

PubMed

Boley, A; Narasimhan, K; Kieninger, M; Müller, W-R

2010-01-01

Ultrafiltration membrane cleaning with ultrasound enhanced backwashing was investigated with two ceramic membrane systems in parallel. One of them was subjected to ultrasound during backwashing, the other acted as a reference system. The feed water was directly taken from a creek with a sedimentation process as only pre-treatment. The cleaning performance was improved with ultrasound but after 3 weeks of operation damages occurred on the membranes. These effects were studied with online measurements of flux, trans-membrane-pressure and temperature, but also with integrity tests, turbidity measurements and visual examination.

Perfect discretization of path integrals

NASA Astrophysics Data System (ADS)

Steinhaus, Sebastian

2012-05-01

In order to obtain a well-defined path integral one often employs discretizations. In the case of General Relativity these generically break diffeomorphism symmetry, which has severe consequences since these symmetries determine the dynamics of the corresponding system. In this article we consider the path integral of reparametrization invariant systems as a toy example and present an improvement procedure for the discretized propagator. Fixed points and convergence of the procedure are discussed. Furthermore we show that a reparametrization invariant path integral implies discretization independence and acts as a projector onto physical states.

New ergonomic headset for Tongue-Drive System with wireless smartphone interface.

PubMed

Park, Hangue; Kim, Jeonghee; Huo, Xueliang; Hwang, In-O; Ghovanloo, Maysam

2011-01-01

Tongue Drive System (TDS) is a wireless tongue-operated assistive technology (AT), developed for people with severe physical disabilities to control their environment using their tongue motion. We have developed a new ergonomic headset for the TDS with a user-friendly smartphone interface, through which users will be able to wirelessly control various devices, access computers, and drive wheelchairs. This headset design is expected to act as a flexible and multifunctional communication interface for the TDS and improve its usability, accessibility, aesthetics, and convenience for the end users.

77 FR 61275 - Privacy Act of 1974: Implementation

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-09

... (FBI) Privacy Act system of records titled FBI Data Warehouse System, JUSTICE/FBI- 022. This system is...)(G), (H), and (I), (5), and (8); (f); and (g) of the Privacy Act: (1) FBI Data Warehouse System...

76 FR 58007 - Privacy Act of 1974; Report of a New System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... Social Security Act (the Act). The system of records will contain personally identifiable information... and Medicaid Innovation, Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Mailstop... Social Security Act (the Act) (42 U.S.C. 1395 et seq.) by adding new section 1899 to the Act to establish...

76 FR 67763 - Privacy Act of 1974; Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-02

... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (11-109)] Privacy Act of 1974; Privacy Act... proposed revisions to an existing Privacy Act system of records. SUMMARY: Pursuant to the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), the National Aeronautics and Space Administration is issuing public...

77 FR 69442 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-19

... in its existing inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as... of the Secretary of Defense systems of records notices subject to the Privacy Act of 1974 (5 U.S.C... of records notice in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C...

76 FR 19307 - Privacy Act of 1974; Amendment of Privacy Act System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... accordance with the Privacy Act of 1974, as amended, the U.S. Department of Agriculture (USDA) is amending an existing Forest Service Privacy Act system of records, USDA/FS-3, Uniform Allowance System. DATES: Comments must be received in writing, on or before May 9, 2011. The System of Records USDA/FS-3 Uniform...

Protection of human cultured cells against oxidative stress by Rhodiola rosea without activation of antioxidant defenses.

PubMed

Schriner, Samuel E; Avanesian, Agnesa; Liu, Yanxia; Luesch, Hendrik; Jafari, Mahtab

2009-09-01

Rhodiola rosea root has been long used in traditional medical systems in Europe and Asia as an adaptogen to increase an organism's resistance to physical stress. Recent research has demonstrated its ability to improve mental and physical stamina, to improve mood, and to help alleviate high-altitude sickness. We have also recently found that R. rosea is able to extend the life span of Drosophila melanogaster. The mode of action of R. rosea is currently unknown; it has been suggested by some to act as an antioxidant, whereas others have argued that it may actually be a pro-oxidant and act through a hormetic mechanism. We found that R. rosea supplementation could protect cultured cells against ultraviolet light, paraquat, and H(2)O(2). However, it did not alter the levels of the major antioxidant defenses nor did it markedly activate the antioxidant response element or modulate heme-oxygenase-1 expression levels at relevant concentrations. In addition, R. rosea extract was not able to significantly degrade H(2)O(2) in vitro. These results suggest that in human cultured cells R. rosea does not act as an antioxidant and that its mode of action cannot be sufficiently explained through a pro-oxidant hormetic mechanism.

Reinforcement learning improves behaviour from evaluative feedback

NASA Astrophysics Data System (ADS)

Littman, Michael L.

2015-05-01

Reinforcement learning is a branch of machine learning concerned with using experience gained through interacting with the world and evaluative feedback to improve a system's ability to make behavioural decisions. It has been called the artificial intelligence problem in a microcosm because learning algorithms must act autonomously to perform well and achieve their goals. Partly driven by the increasing availability of rich data, recent years have seen exciting advances in the theory and practice of reinforcement learning, including developments in fundamental technical areas such as generalization, planning, exploration and empirical methodology, leading to increasing applicability to real-life problems.