Financing the U.S. Health System: Issues and Options for Change

Explores key issues of health reform and options for financing health care -- redirecting funds to more effective uses, rolling back tax cuts, modifying tax exclusions for health benefits, an employer play-or-pay model, and a value-added tax

Poziom poczucia koherencji wśród młodzieży zakładów poprawczych

Cel badań. Czy rzeczywiście jest tak, że współczesna oferta wychowawczo-resocjalizacyjna skierowana do młodzieży zakładów poprawczych buduje u nich poczucie zrozumienia, zaradności i sensowności, tak potrzebne w dorosłym życiu. Odpowiedzi poszukiwano poprzez ocenę poziomu poczucia koherencji wśród młodzieży zakładów poprawczych. Materiał i metoda. Dla oceny poziomu poczucia koherencji wśród młodzieży zakładów poprawczych, badaniom poddano 40 młodych ludzi tych zakładów. Użyto Kwestionariusza Poczucia Koherencji [SOC – 29], a uzyskane wyniki badań porównano ze zdrowymi osobnikami grupy kontrolnej. Wyniki i wnioski. Stwierdzono, że poziom poczucia koherencji wśród młodzieży zakładów poprawczych daleko odbiega od średniej wartości testu SOC-29 zarejestrowanej przez innych autorów u zdrowych mężczyzn naszej populacji, co może być istotnym czynnikiem niepowodzeń tej młodzieży w „dorosłym życiu”. Działalność resocjalizacyjna prowadzona w zakładach poprawczych nie przynosi jednakowego skutku w zmianach poczucia koherencji. Przede wszystkim skutkuje wzrostem liczebności nieletnich w przedziale 100-120 punków, głównie kosztem obniżenia liczebności grupy o zakresie punktacji 60 – 80 punktów. Istnieje taka wartość punktowa [jest to 58 pkt.] testu SOC-29, poniżej której pomimo prowadzonej starannej resocjalizacji istnieje u małoletnich znamiennie statystycznie wysokie ryzyko braku uzyskania sukcesu terapeutycznego, w postaci braku wzrostu poczucia koherencjiThe objective of the research: Is it actually the case that the modern educational and rehabilitation offer for approved school youth builds a sense of coherence, resourcefulness and meaningfulness among them, as these are factors very much essential to the adult life? To find an answer to this question, the sense of coherence level was measured among approved school youths. Material and method: In order to assess the approved school youth’s level of coherence, 40 of them were examined. The method used was The Sense of Coherence Questionnaire [SOC-29], and the results obtained were compared to those of the control group. Results and conclusions: It was established that the sense of coher-ence level among the approved school youth is largely discrepant from the result of SOC-29 test as indicated by the research on healthy men of our population conducted by other authors, which may be a significant factor to the youths’ failures in their “adult lives”. The rehabilitation process controlled by approved schools is not effective as far as the sense of coherence level is concerned. Above all, it re-sults in the increase in the number of juveniles within the range of 100-120 points, predominantly at the expense of the decrease in number within 60-80 points. Moreover, it was shown that in those cases where the result of the SOC questionnaire is lower than 58 points, the statistical risk of failing to achieve the therapeutic success [no increase in the sense of coherence level] is significantly high despite the on-going rehabilitation, even carefully supervised

Znaczenie komunikacji interpersonalnej w zawodzie pielęgniarskim

Wstęp. Komunikacja jest zjawiskiem wszechobecnym, towarzyszącym nam od samego początku naszego życia. Umiejętność komunikowania się z osobą chorą jest więc bardzo istotna, w tym również w zawodzie pielęgniarskim. Cel badań. Przekonanie to skłoniło autorów do podjęcia badań własnych mających na celu określenie aktywności komunikacyjnej w wybranej losowo grupie pielęgniarek. Materiał i metody. Grupę badawczą stanowiło 121 pielęgniarek. Ba-dania prowadzono w okresie od września 2010 roku do marca 2011 roku. Do określenie poziomu komunikacyjnej posłużono się Skalą Aktywności Komunikacyjnej Zb. Nęckiego Uzyskane wyniki odniesiono do wybranych cech takich jak wiek badanych, długość stażu pracy zawodowej oraz poziom wykształcenia. Wyniki i wnioski. Przeprowadzone badania pozwoliły stwierdzić, że zawód pielęgniarki nie podnosi w sposób charakterystyczny ( istotny statystycznie ) poziomu aktywności komunikacyjnej w porównaniu do przedstawicieli innych grup zawodowych np. informatyków. Średnia aktywność komunikacyjna wzrastała wraz z wiekiem badanych, przy czym w przedziale wieku 30-49 r.ż. znamiennie statystycznie w porównaniu do najmłodszej ankietowanej grupy pielęgniarek. Najniższy poziom aktywności komunikacyjnej wykazywały pielęgniarki o najkrótszym okresie pracy w zawodzie (do 5 lat). W miarę wydłużania stażu pracy średnia aktywność komunikacyjna badanych rosła. Średnia aktywność komunikacyjna wzrastała wraz ze stopniem wykształcenia zawodowego, przy czym wzrost ten miał cechy istotnie statystyczne, w porównaniu do niższych stopni wykształcenia, tylko w grupie pielęgniarek będących po studiach zawodowych II stopnia.Introduction. Communication is a universal phenomenon. It is essential to people at every stage of their lives. In it of utmost importance to be able to communicate with sick people, also as a nurse. The purpose of the study. The belief stated above has led the authors to undertake their own study, whose purpose was to assess communication activity in a randomly selected group of nurses. Materials and methods. The study group was 121 nurses. The re-search was conducted between September 2010 and March 2011. In order to assess the communication activity, the Communication Activity Scale introduced by Zbigniew Nęcki was used. The results obtained were compared with selected data such as the age of the nurses studied, their experience as professional nurses and their education. Results and conclusions. The research conducted allowed the authors to conclude that the nursing profession itself does not contribute to a statistically significant increase in the communication activity as compared to other professionals, e.g. IT specialists. The mean communication activity increased with the age of the interviewees – in the age groups of 30 to 49 years old, the increase was statistically signifi-cant in comparison with the youngest group interviewed. The lowest level of communication activity was characteristic of the least experienced nurses (no more than 5 years of experience). The mean communication activity of the interviewees increased along with the expe-rience. The increase in the mean communication activity was also observable with reference to their education; however, it was statistically significant only in relation to the those who completed professional postgraduate courses as compared to the lower levels of education

Simulations of the dynamic switching of vortex chirality in magnetic nanodisks by a uniform field pulse

We present a possibility to switch the chirality of a spin vortex occurring in a magnetic nanodisk by applying a uniform in-plane field pulse, based on optimizing its strength and duration. The related spin-dynamical process, investigated by micromagnetic simulations, consists of several stages. After applying the field, the original vortex is expelled from the disk, after which two C-shaped states oscillate between each other. The essence of the method is based on turning the field off at a suitably chosen moment for which the orientation of the C-state will evolve into the nucleation of a vortex with the desirable chirality. This idea simply uses the information about the original chirality present inside the nanodisk during the dynamic process before losing it in saturation, and can thus be regarded as analogous to the recent studies on the polarity switching.Comment: In this version only small formal changes are mad

Process behavior and product quality in fertilizer manufacturing using continuous hopper transfer pan granulation—Experimental investigations

Fertilizers are commonly used to improve the soil quality in both conventional and organic agriculture. One such fertilizer is dolomite for which soil application in granulated form is advantageous. These granules are commonly produced from ground dolomite powder in continuous pan transfer granulators. During production, the granulator’s operation parameters affect the granules’ properties and thereby also the overall performance of the fertilizer. To ensure product granules of certain specifications and an efficient overall production, process control and intensification approaches based on mathematical models can be applied. However, the latter require high-quality quantitative experimental data describing the effects of process operation parameters on the granule properties. Therefore, in this article, such data is presented for a lab-scale experimental setup. Investigations were carried out into how variations in binder spray rate, binder composition, feed powder flow rate, pan inclination angle, and angular velocity affect particle size distribution, mechanical stability, and humidity. Furthermore, in contrast to existing work samples from both, pan granules and product granules are analyzed. The influence of operation parameter variations on the differences between both, also known as trajectory separation, is described quantitatively. The results obtained indicate an increase in the average particle size with increasing binder flow rate to feed rate and increasing binder concentration and the inclination angle of the pan. Compressive strength varied significantly depending on the operating parameters. Significant differences in properties were observed for the product and the intermediate (pan) samples. In fact, for some operation parameters, e.g., binder feed rate, the magnitude of the separation effect strongly depends on the specific value of the operation parameter. The presented concise data will enable future mathematical modeling of the pan granulation process, e.g., using the framework of population balance equations

Local Policy Search in a Convex Space and Conservative Policy Iteration as Boosted Policy Search

International audienceLocal Policy Search is a popular reinforcement learning approach for handling large state spaces. Formally, it searches locally in a parameterized policy space in order to maximize the associated value function averaged over some pre-defined distribution. The best one can hope in general from such an approach is to get a local optimum of this criterion. The first contribution of this article is the following surprising result: if the policy space is convex, any (approximate) local optimum enjoys a global performance guarantee. Unfortunately, the convexity assumption is strong: it is not satisfied by commonly used parameterizations and designing a parameterization that induces this property seems hard. A natural so-lution to alleviate this issue consists in deriving an algorithm that solves the local policy search problem using a boosting approach (constrained to the convex hull of the policy space). The resulting algorithm turns out to be a slight generalization of conservative policy iteration; thus, our second contribution is to highlight an original connection between local policy search and approximate dynamic pro-gramming

Data production models for the CDF experiment

The data production for the CDF experiment is conducted on a large Linux PC farm designed to meet the needs of data collection at a maximum rate of 40 MByte/sec. We present two data production models that exploits advances in computing and communication technology. The first production farm is a centralized system that has achieved a stable data processing rate of approximately 2 TByte per day. The recently upgraded farm is migrated to the SAM (Sequential Access to data via Metadata) data handling system. The software and hardware of the CDF production farms has been successful in providing large computing and data throughput capacity to the experiment.Comment: 8 pages, 9 figures; presented at HPC Asia2005, Beijing, China, Nov 30 - Dec 3, 200

Learning near-optimal policies with Bellman-residual minimization based fitted policy iteration and a single sample path

We consider the problem of finding a near-optimal policy in continuous space, discounted Markovian Decision Problems given the trajectory of some behaviour policy. We study the policy iteration algorithm where in successive iterations the action-value functions of the intermediate policies are obtained by picking a function from some fixed function set (chosen by the user) that minimizes an unbiased finite-sample approximation to a novel loss function that upper-bounds the unmodified Bellman-residual criterion. The main result is a finite-sample, high-probability bound on the performance of the resulting policy that depends on the mixing rate of the trajectory, the capacity of the function set as measured by a novel capacity concept that we call the VC-crossing dimension, the approximation power of the function set and the discounted-average concentrability of the future-state distribution. To the best of our knowledge this is the first theoretical reinforcement learning result for off-policy control learning over continuous state-spaces using a single trajectory