Harmonic analysis of the stability of reverse routing in channels

International audienceNormal downstream routing of a flood flow is a highly stable process for Froude numbers less than 1 and hence the results are reliable. In contrast, reverse routing in an upstream direction, which may be required for flow control, is potentially unstable. This paper reports the results of a study of the practical limits on channel lengths for reverse routing. Harmonic analysis is applied to the full non-linear solution of the St. Venant equations for three different wave patterns and two different wave periods, for a particular channel with a Froude number of 0.5. Reverse routing can be done for prismatic channels longer than 100 km. For long periods (>10 hours) the shape of the upstream hydrograph is recovered well. However, when the wave period is short (<1 hour), the high frequency components of the upstream hydrograph and, thus, its shape, are not recovered. These limits are influenced by the channel morphology and shape of the wave. Further work is needed to determine how these factors interact

Children\u27s Use of Dental Care in Medicaid: Federal Fiscal Years 2000-2012

This report presents with national and state-specific analyses about dental services received by children ages 1 to 20 under Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in federal fiscal years (FFY) 2000-2012. These analyses are based on data reported by state Medicaid agencies using Form CMS-416 (Form 416); all data reflect updates received by CMS as of April 3, 2014. This report focuses on the number of children who received any dental service, any preventive dental service (e.g., dental cleaning or application of dental sealants) and any dental treatment service (e.g., filling a cavity). The national trend analyses at the beginning of this report focus on dental service trends for children ages 1 to 20 over the twelve-year period. (Data about children under 1 are excluded since teeth have just begun to erupt by that age and relatively little dental care is used before the first birthday.) To facilitate meaningful comparison over the study period, numbers reported by states for FFY 2010-2012 are adjusted to be more consistent with data from FFY 2000-2009, as described below. (Note: FFY 2012 data for Connecticut are not yet available as of April 3, 2014. We used FFY 2011 data as a conservative substitute, rather than omit that state.

Health Care Reform and Women\u27s Insurance Coverage for Breast and Cervical Cancer Screening

INTRODUCTION: The Patient Protection and Affordable Care Act of 2010 (ACA) will increase insurance coverage for US citizens and for breast and cervical cancer screening through insurance expansions and regulatory changes. The primary objective of this study was to estimate the number of low-income women who would gain health insurance after implementation of the ACA and thus be able to obtain cancer screening. A secondary objective was to estimate the size and characteristics of the uninsured low-income population and the number of women who would still need National Breast and Cervical Cancer Early Detection Program (NBCCEDP) services. METHODS: We used the nationally representative 2009 American Community Survey to estimate the determinants of insurance status for women in Massachusetts, assuming full implementation of the ACA. We extrapolated findings to simulate the effects of the ACA on each state. We used individual-level predicted probabilities of being uninsured to generate estimates of the number of women who would gain health insurance after implementation of the ACA and to predict demand for NBCCEDP services. RESULTS: Approximately 6.8 million low-income women would gain health insurance, potentially increasing the annual demand for NBCCEDP cancer screenings initially by about 500,000 mammograms and 1.3 million Papanicolaou tests. Despite a 60% decrease in the number of low-income uninsured women, the NBCCEDP would still serve fewer than one-third of the estimated number of women eligible for services. The NBCCEDP-eligible population would comprise a larger number of women with language and literacy-related barriers to care. CONCLUSION: Implementation of the ACA would increase insurance coverage and access to cancer screening for millions of women, but the NBCCEDP will remain essential for the millions who will remain uninsured

Increased use of dental services by children covered by Medicaid: 2000-2010

This report analyzes the use of dental services by children enrolled in Medicaid from federal fiscal years (FFY) 2000 to 2010. The number and percent of children receiving dental services under Medicaid climbed continuously over the decade. In FFY 2000, 6.3 million children ages 1 to 20 were reported to receive some form of dental care (either preventive or treatment); the number more than doubled to 15.4 million by FFY 2010. Part of the increase was because the overall number of children covered by Medicaid rose by 12 million (50%), but the percentage of children who received dental care climbed appreciably from 29.3% in FFY 2000 to 46.4% in FFY 2010. In that same time period, the number of children ages 1 to 20 receiving preventive dental services climbed from a reported 5.0 million to 13.6 million, while the percentage of children receiving preventive dental services rose from 23.2% to 40.8%. For children ages 1 to 20 who received dental treatment services, the reported number rose from 3.3 million in FFY 2000 to 7.6 million in FFY 2010. The percentage of children who obtained dental treatment services increased from 15.3% to 22.9%. In FFY 2010, about one sixth of children covered by Medicaid (15.7%) ages 6-14 had a dental sealant placed on a permanent molar. While most states have made steady progress in improving children’s access to dental care in Medicaid over the past decade, there is still substantial variation across states and more remains to be done

The Economic Stimulus: Gauging the Early Effects of ARRA Funding on Health Centers and Medically Underserved Populations and Communities

During times of economic crisis, community health centers and other health care safety net providers become even more vital to the communities they serve. The current downturn, with its high levels of unemployment and enormous impact on family incomes, carries major implications for health insurance coverage. The American Recovery and Reinvestment Act (ARRA), signed into law on February 17, 2009, provided slightly more than two billion dollars to community health centers for capital improvements, expansion (or retention) of personnel and services, and adoption of health information technology. All of these uses not only support health centers\u27 mission to serve populations with limited access to health care, such as the uninsured, low-income populations, minorities, and the homeless, but also generate new economic activities in communities hit hardest by the recession: More than 1,100 health centers throughout the United States have received ARRA funding to date. These centers are projected to serve 21 million persons in 2011, including nearly three million new patients as a direct result of ARRA funding. By targeting health centers, ARRA effectively provides needed health resources to populations at higher risk of poor health. Community health centers receiving ARRA funding tend to be located in areas with higher rates of unemployment and recent job losses. The average unemployment rate among counties with health center ARRA grantees was 9.6 percent compared to an average rate of 9.0 percent in all other counties; the average unemployment rate grew by 4.4 percent in counties with health centers compared to 4.0 percent in all other counties. The $1.85 billion invested to date in health centers under ARRA translates into$3.2 billion in new economic activity in these communities, suggesting that health centers are able to rapidly transform an infusion of funding into new services and expanded jobs. These findings indicate that ARRA has achieved its goal of directing resources into those communities that tend to bear the heaviest burden of an economic downturn, and have low community incomes, a disproportionate percentage of low wage workers, inadequate primary care access, and elevated health risks. However, the challenge lies in sustaining this expansion and assuring that the ability of health centers to respond to community needs is maintained even as overall economic circumstances begin to improve. Reforms contained in both the House and Senate bills, such as expanded Medicaid coverage for low income patients and direct investment in health center expansions, hold the greatest promise for operational sustainability and growth