510 research outputs found

    Lexical scaffolding in immersion classroom discourse

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    Adopting a sociocognitive perspective, this article presents a quantitative and qualitative analysis of interactional sequences of lexical scaffolding during read-aloud activities in a French immersion primary school in Montreal

    Addressing Tobacco in Managed Care: Results of the 2002 Survey

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    INTRODUCTION: In the United States, tobacco use is the leading preventable cause of death and disease. The health and cost consequences of tobacco dependence have made treatment and prevention of tobacco use a key priority among multiple stakeholders, including health plans, insurers, providers, employers, and policymakers. In 2002, the third survey of tobacco control practices and policies in health plans was conducted by America's Health Insurance Plans' technical assistance office as part of the Addressing Tobacco in Managed Care (ATMC) program. METHODS: The ATMC survey was conducted in the spring of 2002 via mail, e-mail, and fax. A 19-item survey instrument was developed and pilot-tested. Of the 19 items, 12 were the same as in previous years, four were modified to collect more detailed data on areas of key interest, and three were added to gain information about strategies to promote smoking cessation. The sample for the survey was drawn from the 687 plans listed in the national directory of member and nonmember health plans in America's Health Insurance Plans. RESULTS: Of the 246 plans in the sample, 152 plans (62%) representing more than 43.5 million health maintenance organization members completed the survey. Results show that health plans are using evidence-based programs and clinical guidelines to address tobacco use. Compared to ATMC survey data collected in 1997 and 2000, the 2002 ATMC survey results indicate that more health plans are providing full coverage for first-line pharmacotherapies and telephone counseling for smoking cessation. Plans have also shown improvement in their ability to identify at least some members who smoke. Similarly, a greater percentage of plans are employing strategies to address smoking cessation during the postpartum period to prevent smoking relapse and during pediatric visits to reduce or eliminate children's exposure to environmental tobacco smoke. CONCLUSION: The results of the 2002 ATMC survey reflect both tremendous accomplishments and important opportunities for health plans to collaborate in tobacco control efforts. With appropriate support, analytical tools, and resources, it is likely that health plans, clinicians, providers, and consumers will continue to evolve in their efforts to reduce the negative consequences of tobacco use

    1:1 AV Tachycardia: What is the Mechanism?

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    Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73730/1/j.1540-8159.2009.02516.x.pd

    Understanding Cultural Heritage Visitor Behavior: The Case of Melaka as World Heritage City

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    AbstractVisitors’ interests traveling to Melaka have increased recently and expected to continue. Melaka recorded one of the highest tourist arrivals ever in 2012 at 13.7 million tourists. Despite this trend, very little is known about individuals who visit cultural heritage sites. Evidence suggests many types of tourists who progress from general travelers to specialized tourists. This study investigates visitor behavior to cultural heritage sites in Melaka. Melaka as World Heritage City inscribed by UNESCO in July 2008 forms the scope and location of this study. Methodology utilized survey on 505 local and foreign tourists. The survey was aided by enumerators using Responsible Heritage Tourism Scale translated into four languages. Findings acknowledged that tourists displayed responsible tourism behavior and cultural significance towards heritage buildings and local culture. Visitors exhibited environmental concerns at the tourist surroundings. Memorable tourist and cultural heritage experiences were sought by these tourists. Heritage visitors were classified into memorable tourism experience seeker, cultural significant, responsible, willingness to pay and green tourist. Findings had practical implications for destination marketing of heritage sites

    Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy.

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    OBJECTIVES: The Emilia-Romagna region of Italy has reduced the number of available hospital beds and introduced financial incentives to curb hospital use. The goal of this study was to assess the impact of these policies on changes over time in the number of acute hospital admissions classified in diagnosis related groups (DRGs) that could be treated safely and effectively in alternative, less costly settings. METHODS: The assessment of the appropriate site of care was based on analysis of hospital discharge data for all hospitals for the selected diagnosis related groups in the Emilia-Romagna region for 2001 to 2005. The necessity for acute hospital admission was based on the severity of a patient\u27s principal diagnosis, co-morbid diseases and, for surgical admissions, procedure performed. RESULTS: From 2001 to 2005, potentially inappropriate medical admissions of more than one day decreased from 20,076 to 11,580, a 42% decrease. Inappropriate admissions decreased in both public and private hospitals but there remained a higher rate of inappropriate admissions to private hospitals. Potentially inappropriate medical admissions accounted for 128,319 bed-days in 2001 and 68,968 bed-days in 2005, a reduction of 59,351 bed-days. Potentially inappropriate surgical admissions decreased from 7383 in 2001 to 4349 in 2005, a 41% decrease. Bed-days consumed by inappropriate surgical admissions decreased from 23,181 in 2001 to 13,660 in 2005. CONCLUSIONS: The Emilia-Romagna region has succeeded in reducing the use of acute hospital beds for patients in selected diagnosis related groups. However, there are still substantial numbers of admissions that could potentially be treated in less costly settings

    Healthcare Utilization of Individuals with Opiate Use Disorders: An Analysis of Integrated Medicaid and State Mental Health/Substance Abuse Agency Data

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    Data from the Substance Abuse and Mental Health Services Administration’s Integrated Database (IDB) were used to examine the service use patterns of individuals with possible opiate use disorders in Washington State. Results indicate that regardless of Medicaid enrollment status, individuals who received mental health (MH) or substance abuse (SA) services only through state agencies received no inpatient substance abuse service. Furthermore, when compared with individuals who received at least one MH/SA service through Medicaid, those who received services only through the state agencies were less likely to have received any MH services and were more likely to have received residential SA services. This analysis highlights the importance of using integrated client data in providing a more comprehensive understanding of services to inform policy and raises significant questions about how regulatory requirements affecting different funding mechanisms might drive settings of care in ways not related to the care needed

    Recent Progress in the Management of Retroperitoneal Sarcoma

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    Retroperitoneal sarcomas (RPS) are rare tumours that typically present late and carry a poor prognosis even following grossly complete resection. In an attempt to improve the outlook for patients with RPS, sarcoma specialists have employed various adjuvant therapies, including extermal beam radiation, intraoperative radiation, brachyradiation and systemic chemotherapy. This article reviews the presentation and prognosis of RPS, and focuses on the results of new treatment strategies compared with conventional management
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