An Investigation of the Implementation of Support Services in a Graduate Advising Center

A capstone submitted in partial fulfillment of the requirements for the degree of Doctor of Education in the College of Education at Morehead State University by Susan W. Maxey on April 10, 2014

Challenges and opportunities of low or zero carbon building: prospects of business models

Papers from the Designated Session TG66 - Energy and the Built EnvironmentCIB Publication 382: Selected papers presented at the CIB World Building Congres Construction and Society, Brisbane 5-9 May 2013There is an emerging consensus amongst governments, business sectors and civil societies regarding the urgent need to address the multiple challenges of climate change, environmental pollution, resource depletion and economic instability. The building and construction sector has been identified with the most opportunities for cost-effectively reducing carbon emissions. However, although business opportunities have been identified for low or zero carbon building (L/ZCB), L/ZCBs are generally perceived as more expensive and challenging than conventional buildings. Also, L/ZCBs are often addressed solely from their technological and environmental perspectives, while important economic and sociocultural aspects have been overlooked or examined implicitly. This paper aims to contribute to the knowledge of the challenges and opportunities of L/ZCB in a systems manner, and to explore how business models can help construction organisations address the former and maximise the latter. The research was carried out through the combination of a comprehensive literature review and case study with a large construction organisation which played a significant role in the UK and internationally. The examination of the challenges and opportunities employed the PESTEL analysis framework (Political, Economic, Sociocultural, Technological, Environmental and Legal). The case study included a desk study, observations, meetings and personal interviews with senior business and sustainability managers of the company. The results suggest the imperative role of business models for L/ZCB developments. Establishing and innovating business models were considered to present an opportunity for the company to sharpen their competitive edge in the market. A wide take-up of business models of L/ZCBs among construction firms was perceived to fit well the building industry's socio-technical system in addressing the multiple challenges.published_or_final_versio

Concentration fluctuations of large Stokes number particles in a one-dimensional random velocity field

We analyze the behavior of an ensemble of inertial particles in a one-dimensional smooth Gaussian velocity field, in the limit of large inertia, but considering a finite correlation time for the random field. We derive in this limit a perturbative scheme for the calculation of the concentration correlation and of the particle relative velocity distribution, providing analytical expressions for the concentration fluctuation amplitude, its correlation length, and the modification in the particle pair relative velocity variance. The amplitude of the concentration fluctuations is characterized by slow decay at large inertia and a much larger correlation length than that of the random field. The fluctuation structure in velocity space is very different from predictions from short-time correlated random velocity fields, with only few particle pairs crossing at sufficiently small relative velocity to produce correlations. Concentration fluctuations are associated with depletion of the relative velocity variance of colliding particles.Comment: 8 pages, 1 figure, revtex

Continuum description of finite-size particles advected by external flows. The effect of collisions

The equation of the density field of an assembly of macroscopic particles advected by a hydrodynamic flow is derived from the microscopic description of the system. This equation allows to recognize the role and the relative importance of the different microscopic processes implicit in the model: the driving of the external flow, the inertia of the particles, and the collisions among them. The validity of the density description is confirmed by comparisons of numerical studies of the continuum equation with Direct Simulation Monte Carlo (DSMC) simulations of hard disks advected by a chaotic flow. We show that the collisions have two competing roles: a dispersing-like effect and a clustering effect (even for elastic collisions). An unexpected feature is also observed in the system: the presence of collisions can reverse the effect of inertia, so that grains with lower inertia are more clusterized.Comment: Final (strongly modified) version accepted in PRE; 6 pages, 3 figure

State policy environment and the dental safety net: a case study of professional practice environments’ effect on dental service availability in Federally Qualified Health Centers

Objectives To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). Methods We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment. We then examined the influence of state policy environment on the availability of dental care through generalized linear mixed-effects models. Results Approximately 80% of FQHCs reported delivering dental services. We consistently observed that FQHCs with favorable levels of state support had the highest proportion of FQHCs that delivered dental services, even more so than FQHCs with extremely high support. FQHCs located in the most restrictive states had 0.28 the odds of delivering dental services as did those located in the most supportive states. Conclusions The state policy environment for the dental hygiene workforce is likely associated with the availability of dental services at FQHCs. The greatest proportion of FQHCs delivering dental services was found in states with policy provisions supporting professional independence in public health settings. Nevertheless, additional research is needed to understand the specific mechanism by which these policies affect FQHCs

Dental safety net capacity: An innovative use of existing data to measure dentists’ clinical engagement in state Medicaid programs

Background The demand for dentists available for state Medicaid populations has long outpaced the supply of such providers. To help understand the workforce dynamics, this study sought to develop a novel approach to measuring dentists’ relative contribution to the dental safety net and, using this new measurement, identify demographic and practice characteristics predictive of dentists’ willingness to participate in Indiana's Medicaid program. Methods We examined Medicaid claims data for 1,023 Indiana dentists. We fit generalized ordered logistic regression models to measure dentists’ level of clinical engagement with Medicaid. Using a partial proportional odds specification model, we estimated proportional adjusted odds ratios for covariates and separate estimates for each contrast of nonproportional covariates. Results Though 75% of Medicaid‐enrolled dentists were active providers, only 27% of them had 800 or more claims during fiscal year 2015. As has been shown in previous studies, our findings from the proportional odds model reinforced certain demographic and practice characteristics to be predictive of dentists’ participation in state Medicaid programs. Conclusions In addition to confirming predictive factors for Medicaid enrollment, this study validated the clinical engagement measure as a reliable method to assess the level of Medicaid participation. Prior studies have been limited by self‐reported data and variations in Medicaid claims reporting

Policy Report: 2012 Indiana Pharmacist Workforce

In order to fully leverage the pharmacist workforce in primary care delivery, which is focused more and more on cost-effective and team-based models, the pharmacist workforce must be clearly understood. Policymakers and health professionals must examine data that depicts the practice characteristics, demographics, capacity, and even the evolving role of pharmacists. Furthermore, these data must influence policy discussions that may lead to a more efficient health system. This report provides a ‘snapshot’ of the most recent data on Indiana’s pharmacist workforce, identifies emerging issues, and presents information pertinent to workforce planning and policy

Policy Report: 2013 Indiana's Nursing Workforce

As Indiana plans for the development of a strong nursing workforce, data should be used to inform decisions that are able to 1) accurately describe the current workforce and 2) identify challenges and emerging issues. Data informed decisions will result in workforce policies and planning efforts that closely align with the actual health workforce needs. This report provides a ‘snapshot’ of the most recent data on Indiana’s nursing workforce, identifies emerging issues, and presents information pertinent to workforce planning and policy

Recruitment, Retention, and Evaluation Associated with American Recovery and Reinvestment Act of 2009

Healthcare workforce shortages are central to healthcare reform discussions and are critical areas of interest for Indiana State Department of Health (ISDH). The National Health Service Corps (NHSC) is a financial incentive program that provides scholarship or loan repayment to primary healthcare providers in return for periods of obligation serving federally designated underserved communities. The American Recovery and Reinvestment Act of 2009 (ARRA) increased funding to the NHSC program with the intent of strengthening and expanding the NHSC program capacity. In addition to building workforce capacity, funding was made available to State Primary Care Offices (PCOs) for the coordination and implementation of activities to support NHSC participants, enhance recruitment and retention post-obligation, and evaluation of the impact of ARRA funding for the NHSC program. Indiana Area Health Education Centers (AHEC) Network entered into a contract with ISDH for the purpose of supporting current ARRA-funded NHSC scholars, clinicians, and obligation sites to improve retention and provider satisfaction. In addition, a team of researchers at the Center for Health Policy (CHP) in the Richard M. Fairbanks School of Public Health, Indiana University Purdue University Indianapolis (IUPUI) were subcontracted to perform an evaluation of activities outlined in the AHEC contract and evaluate the impact of ARRA funding on NHSC clinician retention, primary healthcare access, and primary care capacity. The NHSC project team, comprised of key personnel from AHEC and CHP, developed and administered surveys, conducted key informant interviews facilitated focus groups to gather data representing perspectives and experiences from ARRA-funded NHSC clinicians and obligation sites administrators to identify key issues and generate recommendations for the Indiana NHSC Program. The NHSC project team was comprised of key personnel from AHEC and CHP. The team developed and administered surveys, conducted key informant interviews, and facilitated focus groups. The activities were carried out to gather data on perspectives and experiences of ARRA-funded NHSC clinicians and site administrators in order to generate recommendations for the Indiana NHSC Program

Administrative Challenges to the Integration of Oral Health With Primary Care

Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce