Fundamental Studies Relating to Systems Analysis of Solid Propellants

In this report the groundwork is laid for the proposed work scope which stressed the need for a greater understanding of the solid mechanics of grains. Particular emphasis will be directed toward the multi-axial behavior of thick walled configurations. The work falls naturally into three areas; (1) analysis procedures, (2) material properties, and (3) failure criteria. As a necessary preliminary to treating specific designs, certain material of general applicability must be developed, collected, and summarized. The following sections therefore deal with a general description of viscoelastic analysis and material representation, discussed by contrast with more conventional engineering analysis. By this means a background is established for the collection of elastic design formulas which are included in the second section of the report

Fundamental Studies Relating to Systems Analysis of Solid Propellants

The earlier progress reports presented some essentials of model representation and a summary of some elastic solutions as preliminary material for viscoelastic analyses of solid propellants under various loading conditions. The present report is a continuation of the above with a brief section on Thermal Distributions, a section called Engineering Analysis, and one on Failure Criteria. The thermal distributions, obtained from heat transfer theory, are required for the thermoelastic formulations of section II. The Engineering Analysis section includes several varied examples to assist in understanding the analysis techniques presented in the other sections. The final section relates to mechanical failure of propellants and presents some preliminary thoughts as to how the study of this important problem area will be conducted

Persistent disparities in cholesterol screening among immigrants to the United States

Background: This study compared differences in cholesterol screening among immigrant populations and US born race/ethnic groups and whether improving access to health care reduced differences in screening. Methods: Self-reported cholesterol screening for adults was calculated from multivariate logistic regression analysis of the 1988–2008 National Health and Nutrition Examination Surveys (N = 17,118). Immigrant populations were classified by place of birth and length of residency. Results: After adjusting for individual characteristics and access to health care, the multivariate adjusted probability of cholesterol screening is significantly lower for persons originating from Mexico (70.9%) compared to persons born in the US (80.1%) or compared to US born Hispanic persons (77.8%). Adjustment for access to care did significantly reduce the difference in screening rates between immigrants and natives because the rate for natives remained the same, but the rate for immigrants improved. For example, the difference in screening between US born persons and persons born in Mexico was reduced by nearly 10% after adjustment for access to care. Conclusions: There are persistent disparities in cholesterol screening for immigrants, particularly recent immigrants from Mexico, but improved access to health care may be a viable policy intervention to reduce disparities

Evaluation of a Competency-Based Health Policy Training Program

An academic and practice partnership was formed to create and implement a competency-based training program for local health departments in health policy. We evaluated if the training program improved the policy knowledge and competency of participants. Participants exhibited significant increases for self-assessed policy competency, including substantial improvements in “Critique the feasibility and expected outcomes of potential policy options”, “Identify and assess the strengths and motivations of key stakeholders and potential resistors”, and “Recommend a specific policy change”. The policy competency instrument developed in this report could be used to measure policy knowledge and competency in future training implementations.https://digitalcommons.unmc.edu/coph_policy_reports/1000/thumbnail.jp

Evaluation of a Competency-Based Health Policy Training Program

https://digitalcommons.unmc.edu/coph_policy_reports/1009/thumbnail.jp

Legal Mapping Analysis of State Telehealth Reimbursement Policies

Background: There exists rapid growth and inconsistency in the telehealth policy environment, which makes it difficult to quantitatively evaluate the impact of telehealth reimbursement and other policies without the availability of a legal mapping database. Introduction: We describe the creation of a legal mapping database of state-level policies related to telehealth reimbursement of healthcare services. Trends and characteristics of these policies are presented. Materials and Methods: Information provided by the Center for Connected Health Policy was used to identify state-wide laws and regulations regarding telehealth reimbursement. Other information was retrieved using: (1) LexisNexis database, (2) Westlaw database, and (3) retrieval from legislative websites, historical documents, and contacting state officials. We examined policies for live video, store and forward, and remote patient monitoring (RPM). Results: In the United States, there are 24 states with policies regarding reimbursement for live video transmission. Fourteen states have store and forward policies and 6 states have RPM related policies. Mississippi is the only state that requires reimbursement for all three types of telehealth transmission modes. Most states (47 states) have Medicaid policies regarding live video transmission, followed by 37 states for store and forward and 20 states for RPM. Only thirteen states require that live video will be reimbursed “consistent with” or at the “same rate” as in-person services in their Medicaid program. Discussion: There are no widely accepted telehealth reimbursement policies across states. They contain diverse restrictions and requirements that present complexities in policy evaluation and determining policy effectiveness across states

An Examination of Private Payer Reimbursements to Primary Care Providers for Healthcare Services Using Telehealth, United States 2009–2013

Half of telehealth-related state policies were implemented in the last five years. Although many states permit reimbursements for telehealth services, only seven states have passed statutes mandating parity with reimbursements for non-telehealth services. Despite an increasing number of telehealth policies, claims for telehealth services to private insurers are rare. Lower average reimbursements for telehealth billings may discourage adoption of telehealth technologies. Surveillance of claims data will help identify whether telehealth policies are having their intended impact on the healthcare system.https://digitalcommons.unmc.edu/coph_policy_reports/1026/thumbnail.jp

Rising gasoline prices increase new motorcycle sales and fatalities

Background: We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices. Methods: The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984–2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase. Results: New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase in gasoline prices would result in 295,000 new motorcycle sales and, consequently, 233 new motorcycle fatalities. Compared to crashes on older motorcycle models, those on new motorcycles were more likely to be young riders, occur in the afternoon, in clear weather, with a large engine displacement, and without alcohol involvement. Riders on new motorcycles were more likely to be in fatal crashes relative to older motorcycles (OR 1.14, 95 % confidence interval (CI) 1.02–1.28) when gasoline prices increase. Conclusions: Our findings suggest that, in response to increasing gasoline prices, people tend to purchase new motorcycles, and this is accompanied with significantly increased crash risk. There are several policy mechanisms that can be used to lower the risk of motorcycle crash injuries through the mechanism of gas prices and motorcycle sales such as raising awareness of motorcycling risks, enhancing licensing and testing requirements, limiting motorcycle power-to-weight ratios for inexperienced riders, and developing mandatory training programs for new riders

Fundamental Studies Relating to Systems Analysis of Solid Propellants

As in the previous progress reports, the contents in this report have been categorized so as to present a clear picture of their role in contributing to the problem of mechanical failure analysis. The subject of material representation by mechanical failure analysis. The subject of material representation by mechanical models is discussed in Section I, while Section II contains additions to the subject of Elastic Solutions for cylinders. The Engineering Analysis section includes an example of the strain response of an internal star grain to pressure. A damped sinusoid has been assumed for the pressure rise, and the use of stress concentration factors for a star grain is demonstrated. Section V on failure includes some preliminary test results which indicate the feasibility of the cumulative damage concept for composite (polyurethane) propellants, at least in the limited range tested. Recommendations are given which would expand this testing to show how damage accumulates under other conditions such as low temperatures, high strain-rates and with other types of propellant