The Medicare Physician Group Practice Demonstration: Lessons Learned on Improving Quality and Efficiency in Health Care

Discusses the experiences of ten large practices earning performance payments for improving the quality and cost-efficiency of health care delivered to Medicare fee-for-service beneficiaries

Geology field trip 1976

Originally presented as the author's Thesis (M.S.) Miami Universit

Relations between Townspeople and Rural Nobles in late medieval Germany: A Study of Nuremberg in the 1440s

In the 1440s all levels of society in the imperial city of Nuremberg were strongly differentiated as social groups from almost all groups within the rural nobility. Townspeople and nobles nonetheless interacted in many ways, and this thesis examines: the presence of the nobility in the town; burghers as rural landowners; cooperation and conflict between town and nobility over questions of rural security; communication practices and common membership of regional and imperial political communities; nobles as allies and servitors of Nuremberg; and nobles as feud opponents of Nuremberg. The objective is to locate within this interaction influences upon and consequences of fifteenth-century discourses about town and nobility which emphasized antagonism between the two, and which seem to have been increasingly influential over the course of the century. The thesis finds that, whereas townspeople and nobles have traditionally been seen as opposing forces in German history, the actual points of tension between Nuremberg and rural nobles were closely focused on security in the countryside, and a clash of interests arising from the often unintended consequences of nobles’ feuding activity for the city’s long-distance trade. But we also see that although the urban elite had much in common with the rural nobility, Nuremberg had weak (and weakening) connections to communities amongst the nobility in the 1440s, and that the city council’s policy within the walls placed obstacles in the way of nobles’ engagement with the town. The resulting social and political distance between town and nobility was exploited for political gain by certain regional princes, who (in the 1440s at least) were the principal promoters of antagonistic models of town-noble relations, though events during the 1440s may have helped to establish these ideas in wider debates about the fundamental order of society

Discrete event simulation Model of the Ground Maintenance Operations Cycle of a Reusable Launch Vehicle

The Air Force uses a family of expendable launch vehicles to meet its spacelift needs. Unfortunately, this method is not responsive: months of preparation are typically required and launch costs are high. Consequently, the Air Force seeks a reusable military launch vehicle that can be launched inexpensively and quickly regenerated between flights. Air Force Research Laboratory personnel desire a tool to help evaluate candidate designs and perform tradeoff studies necessary to acquire a launch vehicle that will achieve Air Force goals. The objective of this research was first to develop a conceptual model of maintenance operations needed to regenerate a launch vehicle between flights, and then to translate this conceptual model into a discrete event simulation tool. This research was accomplished concurrently with Stiegelmeier, who focused on vehicle prelaunch operations