Comparing total expenditures by source of long-term services and supports.

This study compares total expenditures between beneficiaries enrolled in traditional Long-Term Care (LTC) and beneficiaries enrolled in Home and Community Based Services (HCBS) in a Quasi-Experimental Simple Ex Post Facto study utilizing multiple linear regression with inverted propensity score weighting. The results demonstrated, during the two years of the study period, that total expenditures were on average $14,565.03 (with a p-value oflessfor the total two years of the study, for HCBS beneficiaries when compared to their LTC counterparts. There remains today a belief that expenditures of elderly, dual beneficiaries electing to age-in-place for supported self-care expend less than that of elderly, dual beneficiaries electing traditional institutional LTC. Of forty-one peer reviewed periodicals, there is one that supports that belief, all other literature supports a counter-intuitive reality that LTC is less costly. In, Q4 of 2013 Florida’s Medicaid agency, the Agency for Health Care Administration (AHCA) in collaboration with the state’s Department of Elder Affairs (DOEA) consolidated its six aging/elderly programs[1] into their new Statewide Medicaid Managed Care (SMMC)-Long-Term Care (LTC) program. AHCA outsourced these programs through competitive procurement to managed care organizations. Compared to previous studies this study has three unique distinctions: Composition of expenditure categories–Nine of the eleven other studies compared only LTC costs directly to only HCBS costs. This study includes seven expenditure categories: Ancillary; Institutional–Acute; Institutional–Other; LTSS; Miscellaneous; Pharmaceutical; and, Professional. Managed care programs–Florida’s SMMC-LTC program is MLTSS with reimbursement methodologies including capitated payment schedules, FFS, pay-for-performance and risk/value agreements; and, Application of a Domicile Adjustment–In an attempt to adjust for Medicaid’s ‘room and board’ benefit differences between the two cohorts’, a domicile adjustment of -$831.00 was developed and applied to each month of enrollment for each LTC beneficiary. [1] The State of Florida had six different aging/elderly programs that were consolidated into the SMMC_LTC program, those six programs were: Nursing Facilities, Aged and Disabled Adult waiver, Assisted Living waiver, Nursing Home Diversion waiver, Channeling waiver and Frail Elder option

Fertilizer-Insecticide Mixtures on Tobacco Plant Beds and Fields

Fertility and insect control programs have a major influence on tobacco production. The proper amounts and kinds of fertilizers and insecticides properly placed will make production more economical on beds and fields if either or both are needed. Is a fertilizer-insecticide mix the best way to meet the fertility needs and t he insecticide needs on tobacco? The following questions and answers should help show how the decision was reached that this method is not recommended

Fertilizer-Insecticide Mixtures on Corn

Soil fertility and insects are major factors that affect corn yields. The proper kinds and amounts of fertilizers and insecticides properly placed will make corn production more economical on fields where either or both are needed

Fertilizer-Insecticide Mixtures on Corn

Soil fertility and insects are major factors that affect corn yields. The proper kinds and amounts of fertilizers and insecticides when used properly will make corn production more economical on fields where either or both are needed

Differences in physical activity and sedentary time in relation to weight in 8-9 year old children.

BACKGROUND: The health benefits of physical activity for children are well established. Although objective measures of physical activity are increasingly used there is still a lack of adequate data on physical activity in children. Sex differences in physical activity have been consistently demonstrated and lower levels of physical activity in obese than non-obese children have been shown. However, differences across the whole weight spectrum have not been examined in detail. The aim of this study was to assess associations between physical activity and sedentary time across the weight spectrum in children, and to determine whether the associations differed by sex. METHODS: Participants in the current study were 176 boys and 169 girls aged 8-9 years old taking part in a longitudinal study of associations between eating behaviours, physical activity and weight gain during childhood. Height, weight and waist circumference were measured, and physical activity data were collected using an Actigraph model GT1M worn for 5 consecutive days. Associations between sex, weight and physical activity were analysed using linear regression models. RESULTS: Boys had higher total activity (mean difference = 119, p < 0.001) and more minutes of moderate and vigorous physical activity (MVPA) (mean difference = 25, p < 0.001) than girls. A higher percentage of boys (72%) than girls (30%) met current physical activity guidelines of 60 minutes MVPA per day. In boys, weight status significantly predicted total activity (p = 0.001) and MVPA (p = 0.001) but there were no significant associations in girls. There was no significant difference in time spent sedentary between boys and girls, and weight status did not predict sedentary time. CONCLUSION: In boys, physical activity was progressively lower across the weight spectrum, but in girls physical activity was consistently low across all weight categories. Intervention is required prior to 8 years old to prevent weight-related declines in physical activity in boys and further research is required to determine at what age, if ever, weight related differences in physical activity are apparent in girls.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Heat dissipation during hovering and forward flight in hummingbirds

Flying animals generate large amounts of heat, which must be dissipated to avoid overheating. In birds, heat dissipation is complicated by feathers, which cover most body surfaces and retard heat loss. To understand how birds manage heat budgets during flight, it is critical to know how heat moves from the skin to the external environment. Hummingbirds are instructive because they fly at speeds from 0 to more than 12ms−1, during which they transit from radiative to convective heat loss. We used infrared thermography and particle image velocimetry to test the effects of flight speed on heat loss from specific body regions in flying calliope hummingbirds (Selasphorus calliope). We measured heat flux in a carcass with and without plumage to test the effectiveness of the insulation layer. In flying hummingbirds, the highest thermal gradients occurred in key heat dissipation areas (HDAs) around the eyes, axial region and feet. Eye and axial surface temperatures were 8◦C or more above air temperature, and remained relatively constant across speeds suggesting physiological regulation of skin surface temperature. During hovering, birds dangled their feet, which enhanced radiative heat loss. In addition, during hovering, near-body induced airflows from the wings were low except around the feet (approx. 2.5ms−1), which probably enhanced convective heat loss. Axial HDA and maximum surface temperature exhibited a shallow U-shaped pattern across speeds, revealing a localized relationship with power production in flight in the HDA closest to the primary flight muscles. We conclude that hummingbirds actively alter routes of heat dissipation as a function of flight speed

ALMA Cycle 1 Observations of the HH46/47 Molecular Outflow: Structure, Entrainment and Core Impact

We present ALMA Cycle 1 observations of the HH46/47 molecular outflow using combined 12m array and ACA observations. The improved angular resolution and sensitivity of our multi-line maps reveal structures that help us study the entrainment process in much more detail and allow us to obtain more precise estimates of outflow properties than previous observations. We use 13CO(1-0) and C18O(1-0) emission to correct for the 12CO(1-0) optical depth to accurately estimate the outflow mass, momentum and kinetic energy. This correction increases the estimates of the mass, momentum and kinetic energy by factors of about 9, 5 and 2, respectively, with respect to estimates assuming optically thin emission. The new 13CO and C18O data also allow us to trace denser and slower outflow material than that traced by the 12CO maps, and they reveal an outflow cavity wall at very low velocities (as low as 0.2km/s with respect to the cores central velocity). Adding with the slower material traced only by 13CO and C18O, there is another factor of 3 increase in the mass estimate and 50% increase in the momentum estimate. The estimated outflow properties indicate that the outflow is capable of dispersing the parent core within the typical lifetime of the embedded phase of a low-mass protostar, and that it is responsible for a core-to-star efficiency of 1/4 to 1/3. We find that the outflow cavity wall is composed of multiple shells associated with a series of jet bow-shock events. Within about 3000AU of the protostar the 13CO and C18O emission trace a circumstellar envelope with both rotation and infall motions, which we compare with a simple analytic model. The CS(2-1) emission reveals tentative evidence of a slowly-moving rotating outflow, which we suggest is entrained not only poloidally but also toroidally by a disk wind that is launched from relatively large radii from the source.Comment: Accepted for publication in ApJ. 26 pages, 20 figure

uvbyCa H beta CCD Photometry of Clusters. VII. The Intermediate-Age Anticenter Cluster Melotte 71

CCD photometry on the intermediate-band uvbyCa H beta system is presented for the anticenter, intermediate-age open cluster, Melotte 71. Restricting the data to probable single members of the cluster using the color-magnitude diagram and the photometric indices alone generates a sample of 48 F dwarfs on the unevolved main sequence. The average E(b-y) = 0.148 +/- 0.003 (s.e.m.) or E(B-V) = 0.202 +/- 0.004 (s.e.m.), where the errors refer to internal errors alone. With this reddening, [Fe/H] is derived from both m1 and hk, using H beta and b-y as the temperature index, with excellent agreement among the four approaches and a final weighted average of [Fe/H] = -0.17 +/- 0.02 (s.e.m.) for the cluster, on a scale where the Hyades has [Fe/H] = +0.12. When adjusted for the higher reddening estimate, the previous metallicity estimates from Washington photometry and from spectroscopy are now in agreement with the intermediate-band result. From comparisons to isochrones of appropriate metallicity, the cluster age and distance are determined as 0.9 +/- 0.1 Gyr and (m-M) = 12.2 +/- 0.1 or (m-M)_0 = 11.6 +/- 0.1. At this distance from the sun, Mel 71 has a galactocentric distance of 10.0 kpc on a scale where the sun is 8.5 kpc from the galactic center. Based upon its age, distance, and elemental abundances, Mel 71 appears to be a less populous analog to NGC 3960.Comment: Accepted for Astronomical Journal. 38 page latex file includes 11 figures and short version of data table. Full table will appear in online AJ or may be requested from author