Developing An Occupational Therapy Role In Pediatric Private Practice

Background An estimated 17.4% of children may be classified as children and youth with special health care needs (CYSHCN) (NSCH 2019 20: Children with Special Health Care Needs, Minnesota, n.d.). In MN there are an estimated 180,000 CYSHCN (Children and Youth with Special Health Needs (Cyshn) - Minnesota Department of Health, n.d.). These children are those with or at increased risk for a chronic physical, developmental, behavioral, or emotional condition (Children and Youth with Special Health Needs (Cyshn) - Minnesota Department of Health, n.d.). Occupational therapists’ scope of practice includes working with such children. Similarly, speech-language pathologists (SLPs) also provide a unique point-of-view when diagnosing and treating children with developmental disabilities. Together these two professions can collaborate to provide expanded holistic care to clients and their families. One such setting that these two professions collaborate in is private practice. Private practices fill a gap in access to therapy services for families who are experiencing distance-based barriers and limited provider availability (Carvalho, et. al., 2017). Therefore, a project was created to expand a current speech-language pathology private practice to potentially include an occupational therapist Purpose The purpose of this project was to assist a current MN private practice clinic, owned and operated by a SLP, to expand practice following a novel business proposal to include hiring an occupational therapy (OT) position. The intent behind the business proposal was to guide the recruiting, marking, and hiring process for an OT position. Methods A needs assessment, literature review, field observations and professional interviews were employed to compile data to create the business plan. The focus topics included: 1) collaborative healthcare approaches; 2) collaboration aiding professional growth; 3) collaboration supporting intervention planning; and 4) collaboration supporting client/family outcomes and therapy process understanding. The Person-Environment-Occupation (PEO) model was used to guide the literature review and development of the product (Law, et. al., 1996). Results The final business plan was constructed utilizing the known needs of the current practice, the results of the literature review and the PEO model. The business plan follows the lean startup plan model outlining: key partners, key activities, key resources, value propositions, customer relationships, customer segments, channels, cost structure, and revenue streams (Kanics, 2019). The occupational therapy process was analyzed and key components such as assessments and tools were identified along with costs and channels. Conclusion and Significance The business owner will be able to utilize the business plan for financial planning and expansion of the business and services. This expansion increases competitiveness and desirability to patients. Patients have reported higher levels of satisfaction, improved access to, quality of and coordination of health services and improved health outcomes following treatment by a collaborative team approach (Peabody, et. al., 2019; World Health Organization, 2011)

A Rational Expectations Model for Simulation and Policy Evaluation of the Spanish Economy

This paper describes a Rational Expectations Model of the Spanish economy, REMS, which is in the tradition of small open economy dynamic general equilibrium models, with a strongly microfounded system of equations. The model is built on standard elements, but incorporates some distinctive features to provide an accurate description of the Spanish economy. We contribute to the existing models of the Spanish economy by adding search and matching rigidities to a small open economy framework. Our model also incorporates habits in consumption and rule-of-thumb households. As Spain is a member of EMU, we model the interaction between a small open economy and monetary policy in a monetary union. The model is primarily constructed to serve as a simulation tool at the Spanish Ministry of Economic Affairs and Finance. As such, it provides a great deal of information regarding the transmission of policy shocks to economic outcomes. The paper describes the structure of the model in detail, as well as the estimation and calibration technique and some examples of simulations.general equilibrium, rigidities, policy simulations

The balance between fumarate and malate plays an important role in plant development and postharvest quality in tomato fruit

Organic acids, produced as intermediates of the tricarboxylic cycle, play a crucial role in the plant primary metabolism and are considered as being ones of the most important quality traits in edible fruits. Even if they are key metabolites in a multitude of cellular functions, little is known about their physiological relevance and regulation. Transgenic tomato (Solanum lycopersicum) plants expressing constitutively a bacterial maleate isomerase, which converts reversibly maleate to fumarate, were generated in order to improve our knowledge about the role of organic acids in the crop and fruit metabolism. Growth and reproduction were affected by the unbalance of tricarboxylic cycle intermediates, as a dwarf phenotype and a flowering delay were observed in the transgenic plants. In addition, a delay in chlorophyll synthesis, a decrease in the numbers of stomata and significant changes in some photosynthetic parameters indicated alterations in central primary metabolism. Postharvest was also impaired, as transgenic fruits showed increased water lost and deterioration, indicating a possible role of the organic acids in cell wall metabolism. Finally, preliminary metabolomics analysis pointed out important changes during fruit ripening in flavor-related metabolites, such as acids and sugars, revealing the importance of organic acids in fruit metabolism. Taken together, these data indicate a pivotal role of tricarboxylic cycle intermediates, such as malate or fumarate, as regulatory metabolites. Besides their role in quality fruit characteristics, they are involved in a multitude of functions including growth and photosynthesis.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

The REMSDB Macroeconomic Database of The Spanish Economy

This paper presents a new macroeconomic database for the Spanish economy, REMSDB. The construction of this database has been oriented to conducting medium-term simulations for policy evaluation with the REMS model, a large Rational Expectations macroeconomic Model for Spain. The paper provides a detailed description of the data and documents its main statistical properties. The database is thought to be of major interest to related applications,whether strictly associated with the REMS model or, rather, with empirical macroeconomic studies.Spanish Data, Growth Data, Business Cycle Data, REMS

Critical Temperature tuning of Ti/TiN multilayer films suitable for low temperature detectors

We present our current progress on the design and test of Ti/TiN Multilayer for use in Kinetic Inductance Detectors (KIDs). Sensors based on sub-stoichiometric TiN film are commonly used in several applications. However, it is difficult to control the targeted critical temperature $T_C$, to maintain precise control of the nitrogen incorporation process and to obtain a production uniformity. To avoid these problems we investigated multilayer Ti/TiN films that show a high uniformity coupled with high quality factor, kinetic inductance and inertness of TiN. These features are ideal to realize superconductive microresonator detectors for astronomical instruments application but also for the field of neutrino physics. Using pure Ti and stoichiometric TiN, we developed and tested different multilayer configuration, in term of number of Ti/TiN layers and in term of different interlayer thicknesses. The target was to reach a critical temperature $T_C$ around $(1\div 1.5)$ K in order to have a low energy gap and slower recombination time (i.e. low generation-recombination noise). The results prove that the superconductive transition can be tuned in the $(0.5\div 4.6)$ K temperature range properly choosing the Ti thickness in the $(0\div 15)$ nm range, and the TiN thickness in the $(5\div 100)$ nm rang

Efficient estimation of AUC in a sliding window

In many applications, monitoring area under the ROC curve (AUC) in a sliding window over a data stream is a natural way of detecting changes in the system. The drawback is that computing AUC in a sliding window is expensive, especially if the window size is large and the data flow is significant. In this paper we propose a scheme for maintaining an approximate AUC in a sliding window of length $k$. More specifically, we propose an algorithm that, given $\epsilon$, estimates AUC within $\epsilon / 2$, and can maintain this estimate in $O((\log k) / \epsilon)$ time, per update, as the window slides. This provides a speed-up over the exact computation of AUC, which requires $O(k)$ time, per update. The speed-up becomes more significant as the size of the window increases. Our estimate is based on grouping the data points together, and using these groups to calculate AUC. The grouping is designed carefully such that ($i$) the groups are small enough, so that the error stays small, ($ii$) the number of groups is small, so that enumerating them is not expensive, and ($iii$) the definition is flexible enough so that we can maintain the groups efficiently. Our experimental evaluation demonstrates that the average approximation error in practice is much smaller than the approximation guarantee $\epsilon / 2$, and that we can achieve significant speed-ups with only a modest sacrifice in accuracy