GP Reimbursement and Visiting Behaviour in Ireland

In Ireland, approximately 30 per cent of the population (“medical cardholders”) receive free GP services while the remainder (“non-medical cardholders”) must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical cardholder patients was changed from fee-for-service to capitation while other patients continued to pay on a fee-for-service basis. Concerns about supplier-induced demand were in part responsible for this policy change. The purpose of this paper is to examine the extent to which the utilisation of GP services is influenced by the reimbursement system facing GPs, by comparing visiting rates for the two groups before and after this change. Using a difference-in-differences approach on pooled micro-data from 1987, 1995 and 2000, we find that medical card eligibility exerts a consistently positive and significant effect on the utilisation of GP services. However, the differential in visiting rates between medical cardholders and others did not narrow between 1987 and 1995 or 2000, as might have been anticipated if supplier-induced demand played a major role prior to the change in reimbursement system.GP Utilisation; Reimbursement; Supplier-Induced Demand; Difference-in-Differences

Extended Intensity Range Imaging

A single composite image with an extended intensive range is generated by combining disjoining regions from different images of the same scene. The set of images is obtained with a charge-couple device (CCD) set for different flux integration times. By limiting differences in the integration times so that the ranges of output pixel values overlap considerably, individual pixels are assigned the value measured at each spatial location that is in the most sensitive range where the values are both below saturation and are most precisely specified. Integration times are lengthened geometrically from a minimum where all pixel values are below saturation until all dark regions emerge from the lowest quantization level. the method is applied to an example scene and the effect the composite images have on traditional low-level imaging methods also is examined

Belmore

Belmore, in the City of Canterbury, is part of the traditional land of the Bediagal people. The area was once covered by a forest of Sydney blue gum, blackbutt, red mahogany and ironbark trees, growing on clay soils derived from Wianamatta shales. Water came from three small creeks, which flowed in a north-easterly direction into Cooks River.The earliest colonial surveyors followed an Aboriginal pathway (which became Punchbowl Road/Milperra Road) which led from Cooks River to Georges River. Before 1810, this pathway became a convenient access road from Sydney through Canterbury Farm, crossing Cooks River at the 'Punch Bowl' ford, and land grants were surveyed along the route. Once over the ford, travellers could turn south on a track, now Burwood Road at Belfield, and pass through country which is today's suburb of Belmore, south-east to King's Grove Farm and the land grants beyond. Canterbury Road was not formed as an access road into Sydney until after the 1830s, and it was not gazetted until 1856

Hurlstone Park

Hurlstone Park, in the City of Canterbury, is part of the traditional land of the Wangal people. Hawkesbury sandstone outcrops form cliffs above Cooks River at the southern edge of the suburb, and two small creeks once ran down the hill from the Canterbury Road ridge, ending in wetlands along the river bank

GP Reimbursement And Visiting Behaviour In Ireland. ESRI Working Paper No. 9, 2005

In Ireland, approximately 30 per cent of the population (“medical cardholders”) receive free GP services while the remainder (“non-medical cardholders”) must pay for each visit. In 1989, the manner in which GPs were reimbursed by the State for their medical cardholder patients was changed from fee-for-service to capitation while other patients continued to pay on a fee-for-service basis. Concerns about supplier-induced demand were in part responsible for this policy change. The purpose of this paper is to examine the extent to which the utilisation of GP services is influenced by the reimbursement system facing GPs, by comparing visiting rates for the two groups before and after this change. Using a difference-in-differences approach on pooled micro-data from 1987, 1995 and 2000, we find that medical card eligibility exerts a consistently positive and significant effect on the utilisation of GP services. However, the differential in visiting rates between medical cardholders and others did not narrow between 1987 and 1995 or 2000, as might have been anticipated if supplier-induced demand played a major role prior to the change in reimbursement system

Augmented control of hands free voice prostheses

Laryngectomy patients often use an electrolarynx to facilitate speech following a tracheotomy. Devices of this type provide the most intelligible means of communication for tracheotomy patients. However, the electro-larynx has inherent drawbacks such as the buzzing monotonic sound emitted, the need for a free hand to operate the device, and the difficulty experienced by many tracheotomy patients in adapting to use it. The most effective means of addressing the shortcomings of existing electro-larynges is to provide the user with a hands-free facility. This allows the user to perform other manual tasks whilst speaking, or simply to communicate more effectively through body language. Hands-free devices do exist but require a considerable amount of patient training as they involve the use of the shoulder muscles to control pitch. Furthermore, they are not suitable for all patients as the hands-free is suitable only for users with a certain type of tracheotomy. Goldstein et al in 2004 [1] produced a working prototype of a hands-free device that employed electromyographic signals to activate the device. However, it was quite cumbersome in design and failed to alleviate the monotonous sound produced. The goal of this research is to research the implementation of a hands-free electrolarynx, using various activation methods including electromyographic signals to vary parameters of the output signal. Once a satisfactory system of initiation has been devised and tested, a method of pitch variation shall be developed

Damselfish and their Effect on the Biodiversity of Algal Species: A Continuation of Research in the Galápagos Islands

Algal diversity is important in the Galápagos Islands’ littoral ecosystems because it is part of the photosynthetic role in the food web. Male damselfish (Stegastes sps.) may play a key role in the maintenance of algal diversity due to their territorial behavior; they actively clean territories and thereby, open up niches for algal growth. We investigated the damselfish role in algal coverage and diversity and predicted that there will be greater mean coverage and number of species within territories. Results from this study will contribute to the knowledge base concerning natural diversity maintenance. Data collection occurred during low tide between 20 and 26 July, 2015 at two beaches on Isla San Cristόbal. Using 50cm x 50cm PVC quadrants, we compared algal coverage and species diversity on damselfish territories and on randomly selected areas (“non-territories”) within 7 meters of the focal territory (N = 50 for each category at each beach). Using a chi-square goodness of fit analysis protocol, we found a significant difference between the mean number of algal species within a territory as compared to non-territories at both beaches (Playa Mann: 2.5 vs. 2.0, respectively and La Loberίa: 3.0 and 2.5, respectively). At La Loberίa, there was significantly less algal coverage in non-territories (P \u3c 0.001). There was no difference in mean algal coverage at Playa Mann (P = 0.94). Reduced algal coverage within non-territories at La Loberίa may be a function of a generally shallower area and high snorkeling activities. Lower algal coverage may be explained by daily abrasion of the bottom by the public. In terms of mean algal diversity, results are in agreement with our prediction and damselfish appear to play an important role in the maintenance of higher algal diversity. This research provides valuable insight into the biodiversity of algal species in marine ecosystems, as well as further supports the importance of Damselfish in regards to upkeep of these marine ecosystems

Environmental factors influencing conidial release and sporulation of Paronospora manshurica

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Bibliography: leaves 42-44.Not availabl

Intelligibility of Electrolarynx Speech using a Novel Hands-Free Actuator

During voiced speech, the larynx provides quasi-periodic acoustic excitation of the vocal tract. In most electrolarynxes, mechanical vibrations are produced by a linear electromechanical actuator, the armature of which percusses against a metal or plastic plate at a frequency within the range of glottal excitation. In this paper, the intelligibility of speech produced using a novel hands-free actuator is compared to speech produced using a conventional electrolarynx. Two able-bodied speakers (one male, one female) performed a closed response test containing 28 monosyllabic words, once using a conventional electrolarynx and a second time using the novel design. The resulting audio recordings were randomized and replayed to ten listeners who recorded each word that they heard. The results show that the speech produced using the hands-free actuator was substantially more intelligible to the majority of listeners than that produced using the conventional electrolarynx. The new actuator has properties (size, weight, shape, cost) which lends itself as a suitable candidate for possible hands-free operation. This is one of the research ideals for the group and this test methodology presented as a means of testing intelligibility. This paper outlines the procedure for the possible testing of intelligibility of electrolarynx designs

Sunmaster: An SEP cargo vehicle for Mars missions

Options are examined for an unmanned solar powered electric propulsion cargo vehicle for Mars missions. The 6 prime areas of study include: trajectory, propulsion system, power system, supporting structure, control system, and launch consideration. Optimization of the low thrust trajectory resulted in a total round trip mission time just under 4 years. The argon propelled electrostatic ion thruster system consists of seventeen 5 N engines and uses a specific impulse of 10,300 secs. At Earth, the system uses 13 engines to produce 60 N of thrust; at Mars, five engines are used, producing 25 N thrust. The thrust of the craft is varied between 60 N at Earth and 24 N at Mars due to reduced solar power available. Solar power is collected by a Fresnel lens concentrator system using a multistacked cell. This system provides 3.5 MW to the propulsion system after losses. Control and positioning to the craft are provided by a system of three double gimballed control moment gyros. Four shuttle 'C' launches will be used to transport the unassembled vehicle in modular units to low Earth orbit where it will be assembled using the Mobile Transporter of the Space Station Freedom