A methodology for application design using active database technology

Issued as Status reports [nos. 1-5], Project C-36-X0

The Current State of Evidence on Bundled Payments

A review of the evidence shows that bundled payments for surgical procedures can generate savings without adversely affecting patient outcomes. Less is known about the effect of bundled payments for chronic medical conditions, but early evidence suggests that cost and quality improvements may be small or non-existent. There is little evidence that bundles reduce access and equity, but continued monitoring is required

Sex Offenders' Relationship Frames (SORF): A Qualitative Analysis of Value-laden Cognition in Child Sex Offenders

Over the past decades, sex offenders' cognition, specifically their cognitive distortions, have been the focus of extensive research. Traditionally, cognitive distortions have been described as any statements provided by the offender that justify, minimise, or excuse offending (Abel, et al., 1984). Recent research highlighted a need to expand current understanding of cognitive distortions with regards to value, affect and function. The Judgement Model of Cognitive Distortions (Ward, Gannon and Keown, 2006) argued for greater examination of beliefs, values, actions, and their interaction with each other. The current study examined the role played by values within the context of sex offenders' reasoning and decision-making processes. It also sought to understand the ways in which offenders' accounted for their offending, whether it was irrational, and if so, in what way. The research was qualitative, and used interviews gained from a sample of 27 adult, male, treated, child sexual offenders from within New Zealand. Grounded theory methodology (Strauss and Corbin, 1998) was used to create a data-driven model of offenders' reasoning and decision-making, within the context of offending. Results indicated that values were an important part of the offenders' cognition, central to their sense of self, and critical to their perception of the world around them. Values were closely related to how offenders framed their relationship with their victims. Based on the clustering of values, the Sexual Offender Relationship Frames Model (SORF) emerged. This was used to understand and illustrate different pathways to offending using case-studies from the sample. The results have been evaluated within the context of existing literature on the study of sexual offending. Clinical implications, limitations, and practical applications are discussed

Suitability of Various Substrates for Cultivation of Pleurotus Pulmonarius in Konkan Region of Maharashtra

Mild tropical humid climate persists in Konkan region throughout the year within a range of 23 - 35 0 C. This climate is conducive for the commercial cultivation of oyster mushroom. Locally available substrates such as paddy straw, arecanut husk, coconut husk, banana pseudostem, groundnut shells, sugarcane bagasse and wheat straw alone and in combination with rice bran and wheat bran were used. Maximum biological efficiency of P. pulmonarius was recorded on paddy straw (76.30%) followed by wheat straw (74. 53 %). In case of supplemented substrates, the maximum biological efficiency of the mushroom was recorded on paddy straw supplemented with wheat bran (85.40%). This was followed by paddy straw supplemented with rice bran (82.63%) and wheat straw supplemented with wheat bran (82.26)

Conceptual Clustering in Database Systems

Classes are an integral part of all semantic data models. Despite this, class formation in these data models is ad hoc due to the varied treatment of classes and because the issue of grouping instances into classes is considered an art rather than a science. It is the view of this paper that class formation be based on category theory through the use of an aJtribute-based purpose-dieected conceptual clustering technique. Several issues concerned with category theory, especially exception handling, are discussed. The emphasis in this approach is on reasoning at the instance level. Schema generation occurs as a result of conceptually clustering the underlying data instances and guiding this process by specifying a context in the form of a clustering seed. The use of this approach in the areas of schema integration, schema evolution and querying will be discussed. These facilities have been implemented on a database system based on the CANDIDE [3] semantic data model. CANDIDE is essentially an extended version of the tenn-subsumption languages known as the KL-ONE family of languages

The Future of Value-Based Payment

A decade of innovation and experimentation has failed to transform the health care system to one that pays for value rather than volume. It is now time to reconsider how value-based payment models can generate substantial savings and improve quality and health equity. Experts from the University of Pennsylvania, with input from a national panel of experts, reviewed the effectiveness of past payment reforms implemented by the Centers for Medicare and Medicaid Services (CMS) and made recommendations about how to accelerate and complete the nation’s transformation to value-based payment. This brief summarizes recommendations that provide a path toward widespread adoption and success of alternative payment models, producing better health outcomes for all Americans, reducing wasteful spending, improving health equity, and more effectively stewarding taxpayer funds to support other national priorities