3,412 research outputs found
The Medicare Health Outcomes Survey program: Overview, context, and near-term prospects
In 1996, the Centers for Medicare & Medicaid Services (CMS) initiated the development of the Medicare Health Outcomes Survey (HOS). It is the first national survey to measure the quality of life and functional health status of Medicare beneficiaries enrolled in managed care. The program seeks to gather valid and reliable health status data in Medicare managed care for use in quality improvement activities, public reporting, plan accountability and improving health outcomes based on competition. The context that led to the development of the HOS was formed by the convergence of the following factors: 1) a recognized need to monitor the performance of managed care plans, 2) technical expertise and advancement in the areas of quality measurement and health outcomes assessment, 3) the existence of a tested functional health status assessment tool (SF-36(®))1, which was valid for an elderly population, 4) CMS leadership, and 5) political interest in quality improvement. Since 1998, there have been six baseline surveys and four follow up surveys. CMS, working with its partners, performs the following tasks as part of the HOS program: 1) Supports the technical/scientific development of the HOS measure, 2) Certifies survey vendors, 3) Collects Health Plan Employer Data and Information Set(HEDIS(®))(2 )HOS data, 4) Cleans, scores, and disseminates annual rounds of HOS data, public use files and reports to CMS, Quality Improvement Organizations (QIOs), Medicare+Choice Organizations (M+COs), and other stakeholders, 5) Trains M+COs and QIOs in the use of functional status measures and best practices for improving care, 6) Provides technical assistance to CMS, QIOs, M+COs and other data users, and 7) Conducts analyses using HOS data to support CMS and HHS priorities. CMS has recently sponsored an evaluation of the HOS program, which will provide the information necessary to enhance the future administration of the program. Information collected to date reveals that the HOS program is a valuable tool that provides a rich set of data that is useful for quality monitoring and improvement efforts. To enhance the future of the HOS program, many stakeholders recommend the implementation of incentives to encourage the use of the data, while others identify the need to monitor the health status of plan disenrollees. Overall, the HOS program represents an important vehicle for collecting outcomes data from Medicare beneficiaries. The new Medicare Prescription Drug, Improvement, and Modernization Act (2003) mandates the collection and use of data for quality, outcomes measurement, program administration, and facilitating consumer choice. Consequently, it is important that the HOS program effectively meet this mandate
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The Individuals with Disabilities Education Act: Schaffer v. Weast
This report discusses the Individuals with Disabilities Education Act (IDEA), which is the main federal
program concerning the education of children with disabilities. It authorizes state and
local aid for special education and related services for children with disabilities and
contains detailed due process protections for children with disabilities and their parents.
On December 3, 2004, President Bush signed “The Individuals with Disabilities
Education Act Improvement Act” (P.L. 108-446), a major reauthorization and revision
of IDEA. One issue which was not addressed in the reauthorization was whether the
parents or the school bears the burden of proof in special education due process
hearings. On November 14, 2005, the Supreme Court resolved a split in the circuits and
held that the burden of proof in an administrative hearing challenging a child’s
individualized education program is on the party seeking the relief
Ramanujan and Extensions and Contractions of Continued Fractions
If a continued fraction is known to converge
but its limit is not easy to determine, it may be easier to use an extension of
to find the limit. By an extension of
we mean a continued fraction whose odd or even part is . One can
then possibly find the limit in one of three ways:
(i) Prove the extension converges and find its limit;
(ii) Prove the extension converges and find the limit of the other
contraction (for example, the odd part, if is the
even part);
(ii) Find the limit of the other contraction and show that the odd and even
parts of the extension tend to the same limit.
We apply these ideas to derive new proofs of certain continued fraction
identities of Ramanujan and to prove a generalization of an identity involving
the Rogers-Ramanujan continued fraction, which was conjectured by Blecksmith
and Brillhart.Comment: 16 page
The expectations and aspirations of a late-career professional woman
NoThis article presents a powerful account of one late-career woman's lived experiences. Little is known about women who continue professional careers into their 50s and beyond. Here insights are offered into her aspirations and expectations, as she reflects upon a career fragmented by gendered caring responsibilities and the implications of ageism and sexism together with health and body for her late-career phase. The narrative enhances understanding of the intersection of age and gender in a context where masculine career norms dominate. It also offers a reflection upon the implications of these themes for late-career women and their employing organizations more generally
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The Individuals with Disabilities Education Act (IDEA): Overview of P.L. 108-446
The Individuals with Disabilities Education Act (IDEA) is the main federal
program concerning the education of children with disabilities. It authorizes state and
local aid for special education and related services for children with disabilities and
contains detailed due process protections for children with disabilities and their parents.
On December 3, 2004, President Bush signed “the Individuals with Disabilities
Education Act Improvement Act” (P.L. 108-446), a major reauthorization and revision
of IDEA. The new law preserves the basic structure and civil rights guarantees of IDEA
but also makes significant changes in the law. Most provisions of P.L. 108-446 go into
effect on July 1, 2005. This report will briefly discuss several of the major changes
made by the reauthorization
Growth of Lactobacillus reuteri NCIMB 30242 during yogurt fermentation and bile salt hydrolysis activity in the product
International audienceAbstractThe synthesis of bile salt hydrolase has been linked to the health benefit of Lactobacillus reuteri toward lowering blood cholesterol. The aim of this study was to examine the growth and bile salt hydrolysis activity (BSHA) of L. reuteri NCIMB 30242 during milk fermentation with a yogurt starter. There was little growth of L. reuteri during a 4-h co-fermentation with a yogurt culture, and an inoculation of 4.5 × 107 CFU.mL−1 was needed to obtain the 108 CFU.mL−1 target in the product. Enrichment of milk with sugars, minerals, or peptone-based ingredients did not improve growth of L. reuteri. Viable counts of L. reuteri above 1.5 × 108 CFU.mL−1 generated texture defects. Free and microencapsulated (ME) cultures were tested for BSHA in the yogurt drinks. L. reuteri cells which grew during the 4-h lactic fermentation had 40% less BSHA than L. reuteri added directly via the commercial culture. The BSHA of free cells was apparently three times higher than in the ME culture. This study adds data showing that the yogurt production process could affect the functionality of probiotic bacteria
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The Individuals with Disabilities Education Act (IDEA): Overview of Major Provisions
The Individuals with DisabilitiesEducation Act (IDEA) providesfundsto statesfor
the education of children with disabilities. It contains detailed requirements for the
receipt of these funds, including the core requirement of the provision of a free
appropriate public education (FAPE). IDEA was comprehensively revised in 1997 by
P.L. 105-17, but Congress has continued to grapple with issuesrelating to the Act. This
report provides a brief overview of the Act with particular attention paid to issues of
recent congressional concern, such as funding and the provision of FAPE for children
with disabilities found to have brought a weapon to school
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The 2009 Influenza Pandemic: Selected Legal Issues
This report provides a brief overview of selected legal issues regarding the H1N1 influenza, including emergency measures, civil rights, liability issues, and employment issues
Health Communication as a Public Health Training and Workforce Development Issue
Effective communication is one of the core competencies for public health professionals and is required for local health department (LHD) accreditation. Public health communication specialists play a critical role as conduits of health information, particularly with regard to managing relationships with media and the message that is ultimately represented by news outlets. However, capacity for engagement with traditional media in community health improvement at the local level has not been well-described. As part of a larger study examining the use and impact of the County Health Rankings in North Carolina, LHD media staffing and interaction with traditional media were examined through a cross-sectional, online survey, administered to North Carolina LHDs. Results indicate that most LHDs in North Carolina have staff designated to work with media, but few have dedicated staff or staff with an educational background in mass communication. Most communication staff enter their position with less than one year of experience, though almost all receive some training once on the job. Press releases are issued relatively infrequently, which implies that media engagement and message management are underdeveloped at the local level. These results suggest that health communication specialists are underutilized in LHDs and these skills should be emphasized in LHD hiring practices and in public health workforce development
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