Medicaid and Case Management to Promote Healthy Child Development

This policy brief presents options for financing and delivering case management services to low-income and special-needs children in Medicaid. The analysis builds on a literature review of case management, a review of the legal underpinnings of Medicaid case management, and consultation with experts in the fields of health care finance and program operations. It aims to inform the policy community about the importance of case management for assuring the health and development of our youngest and most vulnerable children

SURF IA Conflict Detection and Resolution Algorithm Evaluation

The Enhanced Traffic Situational Awareness on the Airport Surface with Indications and Alerts (SURF IA) algorithm was evaluated in a fast-time batch simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. SURF IA is designed to increase flight crew situation awareness of the runway environment and facilitate an appropriate and timely response to potential conflict situations. The purpose of the study was to evaluate the performance of the SURF IA algorithm under various runway scenarios, multiple levels of conflict detection and resolution (CD&R) system equipage, and various levels of horizontal position accuracy. This paper gives an overview of the SURF IA concept, simulation study, and results. Runway incursions are a serious aviation safety hazard. As such, the FAA is committed to reducing the severity, number, and rate of runway incursions by implementing a combination of guidance, education, outreach, training, technology, infrastructure, and risk identification and mitigation initiatives [1]. Progress has been made in reducing the number of serious incursions - from a high of 67 in Fiscal Year (FY) 2000 to 6 in FY2010. However, the rate of all incursions has risen steadily over recent years - from a rate of 12.3 incursions per million operations in FY2005 to a rate of 18.9 incursions per million operations in FY2010 [1, 2]. The National Transportation Safety Board (NTSB) also considers runway incursions to be a serious aviation safety hazard, listing runway incursion prevention as one of their most wanted transportation safety improvements [3]. The NTSB recommends that immediate warning of probable collisions/incursions be given directly to flight crews in the cockpit [4]

Program transformations using temporal logic side conditions

This paper describes an approach to program optimisation based on transformations, where temporal logic is used to specify side conditions, and strategies are created which expand the repertoire of transformations and provide a suitable level of abstraction. We demonstrate the power of this approach by developing a set of optimisations using our transformation language and showing how the transformations can be converted into a form which makes it easier to apply them, while maintaining trust in the resulting optimising steps. The approach is illustrated through a transformational case study where we apply several optimisations to a small program

Linezolid-Associated Thrombocytopenia in Children with Renal Impairment

Poster presented at ID Week, October 2013, San Francisco, California

Submillimetre observations of WISE-selected high-redshift, luminous, dusty galaxies

We present SCUBA-2 850um submillimetre (submm) observations of the fields of 10 dusty, luminous galaxies at z ~ 1.7 - 4.6, detected at 12um and/or 22um by the WISE all-sky survey, but faint or undetected at 3.4um and 4.6um; dubbed hot, dust-obscured galaxies (Hot DOGs). The six detected targets all have total infrared luminosities greater than 10^13 L_sun, with one greater than 10^14 L_sun. Their spectral energy distributions (SEDs) are very blue from mid-infrared to submm wavelengths and not well fitted by standard AGN SED templates, without adding extra dust extinction to fit the WISE 3.4um and 4.6um data. The SCUBA-2 850um observations confirm that the Hot DOGs have less cold and/or more warm dust emission than standard AGN templates, and limit an underlying extended spiral or ULIRG-type galaxy to contribute less than about 2% or 55% of the typical total Hot DOG IR luminosity, respectively. The two most distant and luminous targets have similar observed submm to mid-infrared ratios to the rest, and thus appear to have even hotter SEDs. The number of serendipitous submm galaxies (SMGs) detected in the 1.5-arcmin-radius SCUBA-2 850um maps indicates there is a significant over-density of serendipitous sources around Hot DOGs. These submm observations confirm that the WISE-selected ultra-luminous galaxies have very blue mid-infrared to submm SEDs, suggesting that they contain very powerful AGN, and are apparently located in unusual arcmin-scale overdensities of very luminous dusty galaxies.Comment: 12 pages, 8 figures, 3 tables, accepted for publication in MNRA

Reliability of measures of impairments associated with patellofemoral pain syndrome

BACKGROUND: The reliability and measurement error of several impairment measures used during the clinical examination of patients with patellofemoral pain syndrome (PFPS) has not been established. The purpose was to determine the inter-tester reliability and measurement error of measures of impairments associated with PFPS in patients with PFPS. METHODS: A single group repeated measures design was used. Two pairs of physical therapists participated in data collection. Examiners were blinded to each others' measurements. RESULTS: Thirty patients (age 29 +/- 8; 17 female) with PFPS participated in this study. Inter-tester reliability coefficients were substantial for measures of hamstrings, quadriceps, plantarflexors, and ITB/TFL complex length, hip abductors strength, and foot pronation (ICCs from .85 to .97); moderate for measures of Q-angle, tibial torsion, hip external rotation strength, lateral retinacular tightness, and quality of movement during a step down task (ICCs from .67 to .79); and poor for femoral anteversion (ICC of .45). Standard error of measurement (SEM) for measures of muscle length ranged from 1.6 degrees to 4.3 degrees. SEM for Q-angle, tibial torsion, and femoral anteversion were 2.4 degrees, 2.9 degrees, and 4.5 degrees respectively. SEM for foot pronation was 1 mm. SEM for measures of muscle strength was 1.8 Kg for abduction and 2.4 Kg for external rotation. CONCLUSION: Several of the impairments associated with PFPS had sufficient reliability and low measurement error. Further investigation is needed to test if these impairment measurements are related to physical function and whether or not they are useful for decision-making

Healthcare resource utilization and related financial costs associated with glucose lowering with either exenatide or basal insulin: a retrospective cohort study

Aims Type 2 diabetes is a major health problem placing increasing demands on healthcare systems. Our objective was to estimate healthcare resource use and related financial costs following treatment with exenatide‐based regimens prescribed as once‐weekly (EQW) or twice‐daily (EBID) formulations, compared with regimens based on basal insulin (BI). Materials and methods This retrospective cohort study used data from the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES). Patients with type 2 diabetes who received exenatide or BI between 2009 and 2014 as their first recorded exposure to injectable therapy were selected. Costs were attributed to primary care contacts, diabetes‐related prescriptions and inpatient admissions using standard UK healthcare costing methods (2014 prices). Frequency and costs were compared between cohorts before and after matching by propensity score using Poisson regression. Results Groups of 8723, 218 and 2180 patients receiving BI, EQW and EBID, respectively, were identified; 188 and 1486 patients receiving EQW and EBID, respectively, were matched 1:1 to patients receiving BI by propensity score. Among unmatched cohorts, total crude mean costs per patient‐year were £2765 for EQW, £2549 for EBID and £4080 for BI. Compared with BI, the adjusted annual cost ratio (aACR) was 0.92 (95% CI, 0.91‐0.92) for EQW and 0.82 (95% CI, 0.82‐0.82) for EBID. Corresponding costs for the propensity‐matched subgroups were £2646 vs £3283 (aACR, 0.80, 0.80‐0.81) for EQW vs BI and £2532 vs £3070 (aACR, 0.84, 0.84‐0.84) for EBID vs BI. Conclusion Overall, exenatide once‐weekly and twice‐daily‐based regimens were associated with reduced healthcare resource use and costs compared with basal‐insulin‐based regimens

Effect of Hydrologic Restoration on the Habitat of The Cape Sable Seaside Sparrow, Annual Report of 2003-2004

Following on our previous year’s work on ‘Effect of hydrologic restoration on the habitat of the Cape Sable seaside sparrow (CSSS)’, we presented first year results at the Cape Sable seaside sparrow – fire planning workshop at Everglades National Park in December 2003. Later, with almost the same set of crews as in the previous year, we started field work in the first week of January and continued till May 26, 2004. Protocols for sampling topography and vegetation in 2004 were identical to the previous year. In the early season, we completed topographic surveys along two remaining transects, B and E (~16.5 km), and vegetation surveys along three transects, D, E and F (~10.8 km), leaving only the vegetation sampling on transects B and C to be completed in 2005. During April and May, vegetation sampling was completed at 230 census sites, making the total of 409 CSSS census sites for which we have complete vegetation data. We updated data sets from both 2003 and 2004, and analyzed them together using cluster analysis, ordination, weighted-averaging regression and analysis of variance, as we had in 2003. Additionally, we used logistic regression to examine the effect of vegetation structural parameters on the recent occurrence of CSSS. We also analyzed vegetation observations recorded by the sparrow census team in 1981 and annually between 1992 and 2004 to assess historical patterns of vegetation change in CSSS habitat

Airport Traffic Conflict Detection and Resolution Algorithm Evaluation

Two conflict detection and resolution (CD&R) algorithms for the terminal maneuvering area (TMA) were evaluated in a fast-time batch simulation study at the National Aeronautics and Space Administration (NASA) Langley Research Center. One CD&R algorithm, developed at NASA, was designed to enhance surface situation awareness and provide cockpit alerts of potential conflicts during runway, taxi, and low altitude air-to-air operations. The second algorithm, Enhanced Traffic Situation Awareness on the Airport Surface with Indications and Alerts (SURF IA), was designed to increase flight crew awareness of the runway environment and facilitate an appropriate and timely response to potential conflict situations. The purpose of the study was to evaluate the performance of the aircraft-based CD&R algorithms during various runway, taxiway, and low altitude scenarios, multiple levels of CD&R system equipage, and various levels of horizontal position accuracy. Algorithm performance was assessed through various metrics including the collision rate, nuisance and missed alert rate, and alert toggling rate. The data suggests that, in general, alert toggling, nuisance and missed alerts, and unnecessary maneuvering occurred more frequently as the position accuracy was reduced. Collision avoidance was more effective when all of the aircraft were equipped with CD&R and maneuvered to avoid a collision after an alert was issued. In order to reduce the number of unwanted (nuisance) alerts when taxiing across a runway, a buffer is needed between the hold line and the alerting zone so alerts are not generated when an aircraft is behind the hold line. All of the results support RTCA horizontal position accuracy requirements for performing a CD&R function to reduce the likelihood and severity of runway incursions and collisions

Meeting report : 1st international functional metagenomics workshop May 7–8, 2012, St. Jacobs, Ontario, Canada

This report summarizes the events of the 1st International Functional Metagenomics Workshop. The workshop was held on May 7 and 8 in St. Jacobs, Ontario, Canada and was focused on building a core international functional metagenomics community, exploring strategic research areas, and identifying opportunities for future collaboration and funding. The workshop was initiated by researchers at the University of Waterloo with support from the Ontario Genomics Institute (OGI), Natural Sciences and Engineering Research Council of Canada (NSERC) and the University of Waterloo