Medicaid Managed Care Contracting for Childhood Lead Poisoning Prevention Services

This study reports on provisions relating to childhood lead poisoning prevention services in Medicaid managed care contract documents (service agreements and requests for proposals, RFPS). The provisions were extracted from the managed care contracts data base of the Center for Health Policy Research of the George Washington University Medical Center. The data base was constructed and is updated as part of the Center\u27s ongoing analytic studies.\u27 As with other Center studies of the contract documents, this is a descriptive study of how state Medicaid agencies addressed a series of contracting issues at a specific point in time.* In brief, we found that a substantial number of the 42 contract documents in the data base addressed screening enrolled children for elevated blood lead levels (EBLLS) as a duty of managed care organizations (MCOs) serving Medicaid beneficiaries. However, very few documents addressed either medical followup for children for whom screening showed EBLL or integration of medical followup with public health agency activities to identify and reduce lead hazards in the homes of enrollees with EBLL. This last finding is consistent with a major finding of our larger studies, that at the time the contract documents we analyzed were drafted, state Medicaid agencies were just beginning to consider interactions between MCOs enrolling Medicaid beneficiaries and other public agencies with health-related duties toward enrollees. We also found that the contract documents rarely identified lead-related services in either quality assurance or as a specific MCO reporting duty. Thus, while managed care is viewed as a means of providing medical homes for Medicaid children and creating administrative systems for tracking and assuring provision of care, the contract documents suggest that many states have yet to really grasp the potential of managed care to provide a tool for improving the quality of leadrelated treatment services. After setting out our methods, findings and discussion of findings, we provide the contract language excerpts on which the analysis is based

An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies

This study represents a descriptive, point-in-time examination of the structure and content of provider network agreements between managed care organizations (MCOs) and community mental health and substance abuse (MH/SA) treatment and prevention agencies. This is not a study of the quality of managed care systems. Instead, this analysis is designed to assess provider contracts (one of the basic legal instruments on which the managed care system rests) and to identify the meaning of these instruments for MH/SA service providers, group purchasers, MCOs, individual consumers and their families, and public policy

Organización de recursos tecnológicos y uso de las tecnologías de información y comunicación de los docentes en las instituciones educativas estatales de José Gálvez - Villa María del Triunfo, 2013

Actualmente, la organización de los recursos tecnológicos y el uso de las TIC en cualquier institución educativa representan un elemento competitivo que puede repercutir en la población estudiantil con que cuentan las Instituciones es por ello que el presente trabajo de investigación tuvo como problema general: ¿Cuál es la relación que existe entre la organización de recursos tecnológicos y el uso de las TICs en los docentes en las instituciones Educativas estatales de José Gálvez de- V.M.T. 2013? se basa en un estudio descriptivo- correlacional, que tiene como objetivo Determinar cuál es la relación que existe entre la organización de recursos tecnológicos y el uso de las TIC de los docentes en las instituciones Educativas estatales de José Gálvez de- V.M.T. 2013. Dentro de la organización de recursos tecnológicos se abordan temas administrativos relacionados con la parte pedagógica, infraestructura, capacitación, software, en referencia a las TIC se establecen conceptos de tics las formas de uso, los conocimientos y formas de inserción en la enseñanza. Se diseñaron dos (2) Cuestionarios cerrado tipo escala de Likert, que sirvieron de instrumento para la recolección de información y fueron aplicados a los docentes de las diversas instituciones educativas. Los datos obtenidos se analizaron mediante el programa estadístico SPSS versión 20 en español. En la investigación, se ha encontrado que entre los principales resultados Se puede afirmar que hay evidencias suficientes para concluir que no existe una relación positiva y significativa (p – valor= .091 > .05) entre las variables organización de recursos tecnológicos y el uso de las Tics de los docente en las instituciones Educativas estatales de José Gálvez de- V.M.T. 2013, cabe destacar que si existe relación significativa entre las variables organización de recursos tecnológicos y la dimensión práctica docente de la variable uso de las Tics de los docente en las instituciones Educativas estatales de José Gálvez de- V.M.T. 2013. Lo que se demuestra con la prueba de Spearman (Rho = 0,236; p-valor = 0,006 < 0,05)

Programa “Cienciatic” para fortalecer las competencias científicas en estudiantes de segundo grado de secundaria de una institución educativa de Lima

Esta tesis tiene el objetivo de determinar la existencia de la existencia de diferencias significativas en el desarrollo de competencias científicas luego de aplicarse el programa Cienciatic. Se trata de una investigación de tipo aplicada, de enfoque cuantitativo, de diseño experimental del tipo cuasi experimental, se trabajó con una muestra de 102 estudiantes del segundo grado de educación secundaria. La unidad de análisis fue una institución educativa escolar ubicada en Villa María del Triunfo. Su técnica fue la encuesta, mientras que el instrumento ha sido el cuestionario. La hipótesis general fue aceptada luego de la prueba de hipótesis (p<0,05). En cuanto a los resultados de la hipótesis general se evidencia que el promedio en el postest (61,31) es mayor que el promedio en el pretest (50.90). Por tanto, se concluyó afirmando que el programa en cuestión es eficaz y que cumple los objetivos formativos, por lo que debe evaluarse su aplicación en otros contextos socioeducativos similares

Can People Sleep Too Much? Effects of Extended Sleep Opportunity on Sleep Duration and Timing

Many people are concerned about whether they are getting “enough” sleep, and if they can “sleep too much.” These concerns can be approached scientifically using experiments probing long-term (i.e., multi-night) sleep homeostatic processes, since homeostatic processes move the system toward its physiological setpoint (i.e., between “not enough” and “too much”). We analyzed sleep data from two human studies with sleep opportunities much longer than people usually stay in bed (i.e., conditions in which sleep homeostatic responses could be documented): sleep opportunities were 14–16 h per day for 3–28 days. Across the nights of the extended sleep opportunities, total sleep duration, Rapid Eye Movement (REM) sleep duration and non-REM sleep durations decreased and sleep latency increased. Multiple nights were required to reach approximately steady-state values. These results suggest a multi-day homeostatic sleep process responding to self-selected insufficient sleep duration prior to the study. Once steady state-values were reached, there were large night-to-night variations in total sleep time and other sleep metrics. Our results therefore answer these concerns about sleep amount and are important for understanding the basic physiology of sleep and for two sleep-related topics: (i) the inter-individual and intra-individual variability are relevant to understanding “normal” sleep patterns and for people with insomnia and (ii) the multiple nights of sleep required for recovery from insufficient sleep from self-selected sleep loss is important for public health and other efforts for reducing the adverse effects of sleep loss on multiple areas of physiology

Detecting forest response to droughts with global observations of vegetation water content

Droughts in a warming climate have become more common and more extreme, making understanding forest responses to water stress increasingly pressing. Analysis of water stress in trees has long focused on water potential in xylem and leaves, which influences stomatal closure and water flow through the soil-plant-atmosphere continuum. At the same time, changes of vegetation water content (VWC) are linked to a range of tree responses, including fluxes of water and carbon, mortality, flammability, and more. Unlike water potential, which requires demanding in situ measurements, VWC can be retrieved from remote sensing measurements, particularly at microwave frequencies using radar and radiometry. Here, we highlight key frontiers through which VWC has the potential to significantly increase our understanding of forest responses to water stress. To validate remote sensing observations of VWC at landscape scale and to better relate them to data assimilation model parameters, we introduce an ecosystem-scale analog of the pressure-volume curve, the non-linear relationship between average leaf or branch water potential and water content commonly used in plant hydraulics. The sources of variability in these ecosystem-scale pressure-volume curves and their relationship to forest response to water stress are discussed. We further show to what extent diel, seasonal, and decadal dynamics of VWC reflect variations in different processes relating the tree response to water stress. VWC can also be used for inferring belowground conditions-which are difficult to impossible to observe directly. Lastly, we discuss how a dedicated geostationary spaceborne observational system for VWC, when combined with existing datasets, can capture diel and seasonal water dynamics to advance the science and applications of global forest vulnerability to future droughts

Global data on earthworm abundance, biomass, diversity and corresponding environmental properties

Publisher Copyright: © 2021, The Author(s).Earthworms are an important soil taxon as ecosystem engineers, providing a variety of crucial ecosystem functions and services. Little is known about their diversity and distribution at large spatial scales, despite the availability of considerable amounts of local-scale data. Earthworm diversity data, obtained from the primary literature or provided directly by authors, were collated with information on site locations, including coordinates, habitat cover, and soil properties. Datasets were required, at a minimum, to include abundance or biomass of earthworms at a site. Where possible, site-level species lists were included, as well as the abundance and biomass of individual species and ecological groups. This global dataset contains 10,840 sites, with 184 species, from 60 countries and all continents except Antarctica. The data were obtained from 182 published articles, published between 1973 and 2017, and 17 unpublished datasets. Amalgamating data into a single global database will assist researchers in investigating and answering a wide variety of pressing questions, for example, jointly assessing aboveground and belowground biodiversity distributions and drivers of biodiversity change.Peer reviewe

Global data on earthworm abundance, biomass, diversity and corresponding environmental properties

Earthworms are an important soil taxon as ecosystem engineers, providing a variety of crucial ecosystem functions and services. Little is known about their diversity and distribution at large spatial scales, despite the availability of considerable amounts of local-scale data. Earthworm diversity data, obtained from the primary literature or provided directly by authors, were collated with information on site locations, including coordinates, habitat cover, and soil properties. Datasets were required, at a minimum, to include abundance or biomass of earthworms at a site. Where possible, site-level species lists were included, as well as the abundance and biomass of individual species and ecological groups. This global dataset contains 10,840 sites, with 184 species, from 60 countries and all continents except Antarctica. The data were obtained from 182 published articles, published between 1973 and 2017, and 17 unpublished datasets. Amalgamating data into a single global database will assist researchers in investigating and answering a wide variety of pressing questions, for example, jointly assessing aboveground and belowground biodiversity distributions and drivers of biodiversity change

SNAPSHOT USA 2019 : a coordinated national camera trap survey of the United States

This article is protected by copyright. All rights reserved.With the accelerating pace of global change, it is imperative that we obtain rapid inventories of the status and distribution of wildlife for ecological inferences and conservation planning. To address this challenge, we launched the SNAPSHOT USA project, a collaborative survey of terrestrial wildlife populations using camera traps across the United States. For our first annual survey, we compiled data across all 50 states during a 14-week period (17 August - 24 November of 2019). We sampled wildlife at 1509 camera trap sites from 110 camera trap arrays covering 12 different ecoregions across four development zones. This effort resulted in 166,036 unique detections of 83 species of mammals and 17 species of birds. All images were processed through the Smithsonian's eMammal camera trap data repository and included an expert review phase to ensure taxonomic accuracy of data, resulting in each picture being reviewed at least twice. The results represent a timely and standardized camera trap survey of the USA. All of the 2019 survey data are made available herein. We are currently repeating surveys in fall 2020, opening up the opportunity to other institutions and cooperators to expand coverage of all the urban-wild gradients and ecophysiographic regions of the country. Future data will be available as the database is updated at eMammal.si.edu/snapshot-usa, as well as future data paper submissions. These data will be useful for local and macroecological research including the examination of community assembly, effects of environmental and anthropogenic landscape variables, effects of fragmentation and extinction debt dynamics, as well as species-specific population dynamics and conservation action plans. There are no copyright restrictions; please cite this paper when using the data for publication.Publisher PDFPeer reviewe

Synaptic and circuit mechanisms promoting broadband transmission of olfactory stimulus dynamics

Sensory stimuli fluctuate on many timescales. However, short-term plasticity causes synapses to act as temporal filters, limiting the range of frequencies they can transmit. How synapses in vivo might transmit a range of frequencies in spite of short-term plasticity is poorly understood. The first synapse in the Drosophila olfactory system exhibits short-term depression, and yet can transmit broadband signals. Here we describe two mechanisms that broaden the frequency characteristics of this synapse. First, two distinct excitatory postsynaptic currents transmit signals on different timescales. Second, presynaptic inhibition dynamically updates synaptic properties to promote accurate transmission of signals across a wide range of frequencies. Inhibition is transient but grows slowly, and simulations show that these two features of inhibition promote broadband synaptic transmission. Dynamic inhibition is often thought to restrict the temporal patterns that a neuron responds to, but our results illustrate a different idea: inhibition can expand the bandwidth of neural coding