Implementation of the Affordable Care Act in Physical Therapy

Introduction: With the implementation of the Affordable Care Act (ACA) in 2010, many medical specialties prepared to see reimbursement rates altered. Not impervious to this trend was the field of physical therapy (PT). This change in reimbursement structure could impact the effectiveness of PT treatment. Under this model, a patient may not be able to receive the appropriate number of visits to a physical therapist, resulting in a loss of utilization in the injured area and, possibly, a loss of independence. Methods: A literature review was performed to determine reimbursement rate impact on PT. A seven-item open-ended survey regarding various aspects of the ACA was sent to physical therapists in the area during November 2014. Interviews were also conducted with therapists from Kentucky. Results: Results from the survey indicated that, while a large portion of patients are gaining access to PT for the first time, the number of visits allowed have been drastically reduced. Kentucky’s poor health status makes the state more susceptible to decline in quality of PT. Discussion: These results indicate that the ACA may negatively impact the field of physical therapy as reimbursement rates and the number of allowed visits change

Power and Responsibility in Chinese Foreign Policy

The People’s Republic of China is now over fifty years old. Long considered an outsider, or a club of one, in international relations, China has recently become more active in international institutions. Is China becoming a responsible power in global and regional international relations? How accurate is the traditional perception of China? What factors may be motivating the changes in China’s approach to international institutions and its perceptions of its own role in the world? There is no certainty that China is becoming a more responsible power, recent developments may be just another manifestation of realpolitik. Power and Responsibility in Chinese Foreign Policy provides a vital insight into these issues, analysing the critical issues in China’s international relations– China’s regional and global diplomatic and security problems, the changing role of the People’s Liberation Army, human rights, religious and democratic movements, and the concept of responsibility. Power and Responsibility in Chinese Foreign Policy is an insightful and vital introduction to all sides of the current debate over China’s international relations

PHA Guidance for Correlating H2S Concentrations in Process Streams to Severity of Adverse Health Outcomes in the Event of a Leak

PresentationProcess hazard analysis (PHA) teams are responsible for determining and categorizing the potential impact of a loss of containment. For streams containing hydrogen sulfide (H2S), the health and safety consequences of a worker being exposed to H2S are a function of airborne concentration in the breathing zone and duration of exposure. PHA teams often do not have the technical knowledge to link the known concentration of H2S in the process stream to an adverse health outcome. This paper describes the methodology and the assumptions made in developing such guidance. H2S concentration in the stream was correlated to concentration of H2S in the breathing zone. Vapor releases used dispersion modeling, while liquid releases required additional modeling to determine the amount of H2S liberated from the released liquid. Modeling was done on different process streams under a variety of conditions. Concentration in the breathing zone was linked to the most probable health and safety outcome by surveying relevant literature published by private and government sources. This correlated the stream concentration of H2S directly to the consequence categorization used in the PHA. Results were summarized, providing simplified guidance that is valid over a wide range of process conditions and release scenarios

The Influence of Negative Affect on Self-Referent Sentence Processing and Memory Performance

The current study investigated how a negative mood state affects lexical and sentence processing in individuals that have never experienced depression. Specifically, the goal of this research was to investigate how an induced negative mood state affects the judgment of sentence plausibility and memory for lexical information in a self-referent context. This study also aims to further theories related to the processing of emotion that require more evidence to differentiate between the effect of a transient mood state and the experience of prolonged negative affect. Eighty-five Kansas University students performed 2 experimental blocks each containing 48 randomized sentences, including 18 self-referent sentences in each block. All sentences contained a final word that was chosen according to its negative, positive or neutral valence. The dependent variables were reading time for the sentence final word, reaction time for making the semantic plausibility judgment, and the response choice provided based on sentence content. The two experimental blocks of the reading task were separated by a mood induction procedure where participants were asked to consider a sad moment in their life while listening to Prokokiev's "Russia under the Mongolian yoke." Our results indicate that while in the negative mood state participants were much slower to reject the self-statements ending with a negative word. This effect occurred even though participants spent less time reading the sentence final words while in the negative mood. Overall, our response choice analyses indicated that participants were also less likely to judge the negative self-referent statements as implausible and more likely to accept the positive self-statements. Considering memory performance, we found that negative mood decreases overall memory performance. Valence analyses suggest a bias to recall positive self-referent targets regardless of mood state. Our findings support trait-specific models of emotion processing that have shown a positive cognitive processing bias in nondepressed populations

Effects of transition metals on thermal properties of ZrB2

Nominally phase pure zirconium diboride ceramics were synthesized to study their intrinsic thermal properties. Ceramics for this study were synthesized by reaction hot pressing of reactor grade ZrH2 and B to minimize impurities commonly found in commercial powders such as the natural abundance (1-4 wt%) of Hf. Starting powders contained \u3c200 ppm Hf. Previous results showed that Hf impurities present in quantities comparable to commercial powders masked the effect of other transition metal additions. For example, additions of 3 at% Ti and Y had no apparent effect on thermal conductivity of ceramics produced from commercial ZrB2. Lowering the Hf content to 0.4 at% increased thermal conductivity from ~90 W/m•K for ZrB2 ceramics prepared from commercial powders to ~100 W/m•K for low-Hf content ZrB2 at 25 °C. Lowering the Hf content also increased the thermal conductivity at 2000°C from ~70 W/m•K to ~80 W/m•K. For the low Hf ZrB2, adding 3 at% TiB2 decreased thermal conductivity ~15 W/m•K at 25°C while adding 3 at% MoB2 decreased thermal conductivity ~45 W/m•K at 25°C. For the present study, transition metals such as Hf, Ti, Y, Ta, and W were added individually to nominally phase pure ZrB2 to study the effects on thermal diffusivity, thermal conductivity and heat capacity at temperatures from 25°C to 2000°C. These properties will be compared to values obtained for ceramics prepared from commercial ZrB2 powders, which contained the natural abundance of Hf. Most previous reports have relied on heat capacity values from the NIST-JANAF thermodynamic tables to calculate thermal conductivity of ZrB2 ceramics. However, the heat capacity of ZrB2 with low Hf content was approximately 10% greater than widely accepted values. Due to this difference, heat capacity will be measured for each composition, and these values will be used to calculate thermal conductivity. The intrinsic thermal properties of ZrB2will be discussed as well as the effect of transition metal additions on the thermal properties of ZrB2 with low and naturally abundant quantities of Hf