1,621 research outputs found
McConnell v. Federal Election Commission: The Problem of Eradicating Campaign Finance Corruption
Immediately after the BCRA became law, its constitutionality was Supreme Court of the United States upheld all of the Act\u27s major provisions. This Article will examine four main empirical claims the Court makes in McConnell: (1) wealthy campaign donors are able to buy greater access to politicians with campaign contributions, (2) limits on freedom to associate within party committees are necessary in order to prevent campaign finance abuses, (3) reductions in campaign funding will not inhibit political campaigns, and (4) those who purchase campaign advertisements must be identified so voters are not misled by the advertisements\u27 messages. The first two claims are diagnostic; they identify problems with the pre-BCRA political system. The final two claims are predictive; they examine the BCRA\u27s potential to reform campaign finance. Analyzing these four claims will provide insight into the Court\u27s beliefs about money\u27s corruptive effect on politics and the BCRA\u27s role in remedying that corruption. challenged in McConnell v. Federal Election Commission, in which th
McConnell v. Federal Election Commission: The Problem of Eradicating Campaign Finance Corruption
Immediately after the BCRA became law, its constitutionality was Supreme Court of the United States upheld all of the Act\u27s major provisions. This Article will examine four main empirical claims the Court makes in McConnell: (1) wealthy campaign donors are able to buy greater access to politicians with campaign contributions, (2) limits on freedom to associate within party committees are necessary in order to prevent campaign finance abuses, (3) reductions in campaign funding will not inhibit political campaigns, and (4) those who purchase campaign advertisements must be identified so voters are not misled by the advertisements\u27 messages. The first two claims are diagnostic; they identify problems with the pre-BCRA political system. The final two claims are predictive; they examine the BCRA\u27s potential to reform campaign finance. Analyzing these four claims will provide insight into the Court\u27s beliefs about money\u27s corruptive effect on politics and the BCRA\u27s role in remedying that corruption. challenged in McConnell v. Federal Election Commission, in which th
Use of International Classification of Diseases, Ninth Revision Codes for Obesity: Trends in the United States from an Electronic Health Record-Derived Database.
Obesity is a potentially modifiable risk factor for many diseases, and a better understanding of its impact on health care utilization, costs, and medical outcomes is needed. The ability to accurately evaluate obesity outcomes depends on a correct identification of the population with obesity. The primary objective of this study was to determine the prevalence and accuracy of International Classification of Diseases, Ninth Revision (ICD-9) coding for overweight and obesity within a US primary care electronic health record (EHR) database compared against actual body mass index (BMI) values from recorded clinical patient data; characteristics of patients with obesity who did or did not receive ICD-9 codes for overweight/obesity also were evaluated. The study sample included 5,512,285 patients in the database with any BMI value recorded between January 1, 2014, and June 30, 2014. Based on BMI, 74.6% of patients were categorized as being overweight or obese, but only 15.1% of patients had relevant ICD-9 codes. ICD-9 coding prevalence increased with increasing BMI category. Among patients with obesity (BMI ≥30 kg/m2), those coded for obesity were younger, more often female, and had a greater comorbidity burden than those not coded; hypertension, dyslipidemia, type 2 diabetes mellitus, and gastroesophageal reflux disease were the most common comorbidities.
KEY FINDINGS: US outpatients with overweight or obesity are not being reliably coded, making ICD-9 codes undependable sources for determining obesity prevalence and outcomes. BMI data available within EHR databases offer a more accurate and objective means of classifying overweight/obese status
Impact of social complexity on outcomes in cystic fibrosis after transfer to adult care
Objective
This study evaluates the roles of medical and social complexity in health care use outcomes in cystic fibrosis (CF) after transfer from pediatric to adult care.
Methods
Retrospective cohort design included patients with CF who were transitioned into adult care at Indiana University from 2005 to 2015. Predictor variables included demographic and comorbidity data, age at transition, treatment complexity score (TCS), and an objective scoring measure of their social complexity (Bob's Level of Social Support, BLSS). Outcome variables included outpatient visit rates and hospitalization rates. Pearson's correlations and linear regression were used to analyze the data.
Results
The median age of the patients (N = 133) at the time of transition was 20 (IQR 19‐23) years. The mean FEV1 % predicted at transition was 69 ± 24%. TCS correlated with outpatient visit rates (r = 0.3, P = 0.003), as well as hospitalization rates (r = 0.4, P < 0.001); while the BLSS only correlated with hospitalization rates (r = 0.7, P < 0.001). After adjusting for covariates, the strongest predictors of post‐transfer hospitalizations are BLSS (P < 0.0001) and pre‐transfer hospitalization rate (P < 0.0001).
Conclusion
Greater treatment complexity is associated with greater healthcare utilization overall, while greater social complexity is associated with increased hospitalizations (but not outpatient visits). Screening young adults for social complexity may identify high‐risk subpopulations and allow for patient centered interventions to support them and prevent avoidable health care use
Pediatric Hand Surgery Training in Nicaragua: A Sustainable Model of Surgical Education in a Resource-Poor Environment.
Recent reports have demonstrated that nearly two-thirds of the world's population do not have access to adequate surgical care, a burden that is borne disproportionately by residents of resource-poor countries. Although the reasons for limited access to surgical care are complex and multi-factorial, among the most substantial barriers is the lack of trained surgical providers. This is particularly true in surgical subspecialties that focus on life-improving, rather than life-saving, treatments, such as pediatric hand and upper extremity surgery, which manages such conditions as congenital malformations, trauma and post-traumatic deformities including burns, and neuromuscular conditions (brachial plexus birth palsy, spinal cord injury, and cerebral palsy). Many models of providing surgical care in resource-limited environments have been described and implemented, but few result in sustainable models of health-care delivery. We present our experience developing a pediatric hand and upper extremity surgery training program in Nicaragua, a resource-limited nation, that grew out of a collaboration of American and Nicaraguan orthopedic surgeons. We compare this experience to that of surgeons undergoing subspecialty training in pediatric upper limb surgery in the US, highlighting the similarities and differences of these training programs. Finally, we assess the results of this training program and identify areas for further growth and development
Imaging Ultrafast Dynamics in Nanomaterials Using Spatially-Separated Pump-Probe Microscopy
Understanding the fundamental physics of nanomaterials is critical for the advancement and rational design of new nanotechnologies. On the nanoscale, differences between individual structures, and even variations between different spatial locations within the same structure, can have a significant impact on the functional properties of nanomaterials and the electronic performance of nanodevices; yet much of our knowledge of nanostructure function is inferred from measurements that average over entire structures or integrate over long times. The existence of multiple conformations or structures within an ensemble, which often exhibit different dynamical behaviors, shroud the underlying dynamics, making it difficult to reach meaningful and quantitative conclusions. These limitations are overcome with the development and implementation of an ultrafast pump-probe microscopy technique. With combined spatial and temporal resolution, the microscope is capable of collecting data from individual nanostructures at various spatially distinct locations with a high throughput. Additionally, the microscope’s ability to excite an object in one location and probe it in another, allows the direct visualization of charge carrier motion and acoustic lattice motion on the nanoscale without the need for physical contact or active electrical connection. In this work, the microscope has been used to image electron diffusion in intrinsically doped silicon nanowires as well as image a combination of electron diffusion and drift in silicon nanowire devices with built-in electric fields. Additionally, to demonstrate the versatility of the microscope, it has been employed to study the insulator to metal transition and coherent acoustic phonon mode propagation in vanadium (IV) oxide (VO2) nanowires in a contactless imaging mode.Doctor of Philosoph
BENZENE PRODUCTION FROM NATURAL GAS IN ARUN GAS FIELD: PROCESS DESIGN AND ECONOMIC EVALUATION
This study designs a benzene production plant from natural gas in the Arun Gas Field, Aceh, Indonesia, with a focus on sustainability and economics. The plant could support Indonesia's government efforts in achieving the Enhanced Nationally Determined Contribution and carbon credit objectives. Using DWSim simulation, the processes modeled consists of natural gas purification, dehydroaromatization reaction, and benzene separation. The results demonstrate high efficiency in producing benzene with a purity of 99.5%-wt. Economic analysis indicates that the investment in this plant is financially viable, with an internal rate of return of 12.2%, a payback period of 7.6 years, and an 8.93% return on investment. By combining sustainability and economic profitability, this research provides a foundation for the implementation of an environmentally friendly and sustainable benzene production plant in the Arun Gas Field
Statistical analysis of annual minimum air temperature trends in São Paulo State
Considerando que algumas investigações sobre o tema aquecimento global utilizam longas séries temporais de temperatura uma questão que deve ser levantada é relativa a influência de possíveis concentrações de fontes de calor urbano a que os postos meteorológicos possam estar submetidos. O primeiro passo para responder a essa questão é verificar se, em uma mesma região, ocorrem tendências concomitantes de elevação nos dados de temperatura em diversas localidades, possivelmente ligadas a fenômenos de escala global. Entretanto, se essa elevação tiver seu início em períodos bastante distintos entre as diversas localidades, o descarte de forçantes radioativas locais como principais responsáveis por esse aumento, dificilmente poderá ser realizado. O objetivo do trabalho foi detectar tendências de elevação nas séries anuais de temperatura mínima, bem como a data inicial dessas prováveis alterações, em seis localidades do Estado de São Paulo. A caracterização das séries foi realizada por meio da distribuição normal. O teste de Mann-Kendall não indicou tendências concomitantes nos dados anuais de temperatura mínima. Dessa forma, fatores de escala local parecem se sobrepor a fatores de escala global como principais forçantes radioativas causadoras do aumento médio dos valores da variável meteorológica sob investigação. Os resultados demonstram a necessidade de avaliar e/ou isolar fatores locais, como a urbanização, antes que investigações sobre os temas aquecimento global e zoneamento agrícola sejam realizadas com base em séries históricas no Estado de São Paulo.Considering that some global warming investigations are based on historical series of air temperature, a question that should be raised is about the influence of urban heat sources on the weather stations areas. The first approach to answering this question is to verify if different weather stations that are geographically close to each others, show elevation trends starting at the same time, possible related to global radiative forcing. However, if these trends start at quite different period among the several weather stations, the elimination of local radiative forcing as the main responsible for this trend is not possible. The aim of this work was to detect continuous trends in annual minimum air temperature series of six weather stations of the State of São Paulo, Brazil. The initial date of those trends was also evaluated. The series were fitted to the normal distribution. The Mann-Kendall test did not detected elevation trends starting at the same time among the analyzed series. Thus, local radiative forcing seems to be a more important factor, responsible for the average increase of the meteorological variable under investigation, than global radiative forcing. The results also indicate that local factors, such as urbanization influences, have to be evaluated and isolated in global warming or agricultural zoning investigations based on minimum air temperature series of the State of São Paulo, Brazil
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