A Flexible Health Care Workforce Requires a Flexible Regulatory Environment: Promoting Health Care Competition Through Regulatory Reform

Effective competition policy is critical to the success of U.S. health care reform, including efforts to reduce health care costs, increase quality of care, and expand access to health care services. While promoting competition is necessary at every level of the rapidly evolving health care system, it is particularly important with respect to licensed professionals who provide health care services. This Article argues that the current system of health care professional regulation, born of the last century, is in numerous respects an impediment to the kinds of changes needed to fully unleash the benefits of competition among different types of health care service providers. To the contrary, the current system of licensure and related regulations tends to artificially separate professionals in ways that not only insulate them from competition now, but also generate incentives to use regulation to perpetuate and fortify such insulation in the future. Drawing on analytic principles derived from antitrust law enforcement and other regulated industries, the Article argues that, although some regulation is necessary to protect public health and safety, the legacy regulatory system likely impedes the development of innovative, alternate service models that might facilitate enhanced competition by allowing all professionals to practice to the full extent of their education, licensure, and skill. The Article concludes by proposing a range of reforms that would re-conceptualize the core characteristics and methodology of traditional health care professional regulation

The SCR flare of 16 February 1984 as recorded by the Sayan spectrograph

The Sayan cosmic ray (CR) spectrograph recorded an SCR flare that occurred on 16 February 1984. Data from both 1-hour and 110-minute duration measurements in 10 channels with different energy sensitivity (of neutron monitors HM-64 located at different depths in the atmosphere, and of a neutron, multiple neutron and rigid mumeson component lead-less detector) is presented. The parameters of the SCR variation spectrum are evaluated and it is shown that the recording of multiple neutrons at the same geographic point and at the same level in the atmosphere provides information similar to that from a spectrographic complex of instruments

Hamiltonian dynamics and constrained variational calculus: continuous and discrete settings

The aim of this paper is to study the relationship between Hamiltonian dynamics and constrained variational calculus. We describe both using the notion of Lagrangian submanifolds of convenient symplectic manifolds and using the so-called Tulczyjew's triples. The results are also extended to the case of discrete dynamics and nonholonomic mechanics. Interesting applications to geometrical integration of Hamiltonian systems are obtained.Comment: 33 page

Quaternion Solution for the Rock'n'roller: Box Orbits, Loop Orbits and Recession

We consider two types of trajectories found in a wide range of mechanical systems, viz. box orbits and loop orbits. We elucidate the dynamics of these orbits in the simple context of a perturbed harmonic oscillator in two dimensions. We then examine the small-amplitude motion of a rigid body, the rock'n'roller, a sphere with eccentric distribution of mass. The equations of motion are expressed in quaternionic form and a complete analytical solution is obtained. Both types of orbit, boxes and loops, are found, the particular form depending on the initial conditions. We interpret the motion in terms of epi-elliptic orbits. The phenomenon of recession, or reversal of precession, is associated with box orbits. The small-amplitude solutions for the symmetric case, or Routh sphere, are expressed explicitly in terms of epicycles; there is no recession in this case

Reevaluating αE-catenin monomer and homodimer functions by characterizing E-cadherin/αE-catenin chimeras

As part of the E-cadherin–β-catenin–αE-catenin complex (CCC), mammalian αE-catenin binds F-actin weakly in the absence of force, whereas cytosolic αE-catenin forms a homodimer that interacts more strongly with F-actin. It has been concluded that cytosolic αE-catenin homodimer is not important for intercellular adhesion because E-cadherin/αE-catenin chimeras thought to mimic the CCC are sufficient to induce cell–cell adhesion. We show that, unlike αE-catenin in the CCC, these chimeras homodimerize, bind F-actin strongly, and inhibit the Arp2/3 complex, all of which are properties of the αE-catenin homodimer. To more accurately mimic the junctional CCC, we designed a constitutively monomeric chimera, and show that E-cadherin–dependent cell adhesion is weaker in cells expressing this chimera compared with cells in which αE-catenin homodimers are present. Our results demonstrate that E-cadherin/αE-catenin chimeras used previously do not mimic αE-catenin in the native CCC, and imply that both CCC-bound monomer and cytosolic homodimer αE-catenin are required for strong cell–cell adhesion

Distribution and ecology of Chaenocephalus aceratus (Channichthyidae) around South Georgia and Shag Rocks (Southern Ocean)

Chaenocephalus aceratus (Family Channicthyidae) is one of the dominant species of demersal fish living on the South Georgia shelf where it is caught in low numbers as by-catch in the mackerel icefish and Antarctic krill commercial fisheries. Data collected during 14 demersal fish surveys, from 1986 to 2006, are analysed to investigate biomass, distribution, growth and diet. Biomass estimates from a swept area method ranged from 4,462 to 28,740 tonnes on the South Georgia and Shag Rock shelves although few fish were caught at Shag Rocks. Analysis of length frequency data indicated that growth was fast in the first five years with males and females attaining lengths at first spawning of 440 mm TL and 520 mm TL. The diet was comprised of fish and crustaceans, with an ontogenetic shift in diet from Euphausia superba and mysids to benthic fish and decapods observed to begin at 250 mm TL. In larger fish (>500 mm TL) the diet was dominated by fish. C. aceratus diet is sufficiently different from the other species of channichthyids around South Georgia to suggest that these species have undergone resource partitioning

Detection and Discrimination of X-Ray Radiation Sources

International Telemetering Conference Proceedings / October 14-16, 1975 / Sheraton Inn, Silver Spring, MarylandWhile studying radiation sources in X-ray range by devices, carried to the near-Earth orbit, there appeares some problems, called by the necessity of uninterrupted scanning of the sky sphere and high speed of canals' test, which leads, consequently, to a considerable volume of data. Side by side with strong sources of radiation one shows great interest to the weak ones which may turn out to be unknown to the science stars. On detecting the source, it is necessary to get a number of parameters, characterizing its structure. Devices of the space station "Saljut 4", carried an enormous deposit into the study of sources in X-ray range. The analyses of results shows, that beside useful signal from X-ray telescopes, a considerable number of superfluous references enters the radioline. Highly effective algorythm of detection and discrimination of useful signals, allowing to raise the informational capability of radioline is represented in the work. Superfluous references, which are stipulated by a galactic background are excluded from the whole data stream. The use of this kind of algorythm allows to discriminate more legible the sources of radiation in on-board and on-Earth use. The effectiveness of this algorythm is shown in adaptation of experimental data, got from X-ray telescopes of the space station "Saljut-4".International Foundation for TelemeteringProceedings from the International Telemetering Conference are made available by the International Foundation for Telemetering and the University of Arizona Libraries. Visit http://www.telemetry.org/index.php/contact-us if you have questions about items in this collection

HYBRID REVASCULIZATION AS METHOD OF SURGICAL TREATMENT OF ISCHEMIC CORONARY DISEASE IN NUMEROUS LESIONS OF CORONARY BED

Hybrid revasculization of myocardium combined the advantages of mammary-coronary bypass surgery and coronary arteries stenting. It presented itself as a perspective direction in treatment of ischemic coronary disease. The article provides the results of comparison of usage of hybrid revasculization of myocardium and aortocoronary bypass in 71 patients with multivessel coronary artery disease. The data obtained indicated, that hybrid approach allowed complete revasculization of the myocardium (as in case of aortocoronary bypass), fast recovery of the patient, shortening a hospital stay due to decrease of intra- and postoperative complications