An Overview Of The Home Health Prospective Payment System Rate Update For CY 2009

Beginning October 1, 2000, as required by the Balanced Budget Act (BBA) of 1997 and related amendments, Medicare began to reimburse home health agencies for home health services under the new Home Health Prospective Payment System (HHPPS). Under HHPPS, all home health costs for services including medical supplies are paid using a basic unit of payment known as the 60-Day Episode. The amount of the payment is calculated using a national standardized rate, adjusted for case mix and a wage index based on the site of service. For 60-Day Episodes beginning and ending in 2008, the Medicare HHPPS national standardized rate was updated by a new 153 case mix grouping and a new wage index value determined by the site of service for the patient.  The August 29,2008 ( 72 FR 49792) and November 30, 2008( 72 FR 67656) Federal Registers discuss the “Home Health Prospective Payment System Refinement and Rate Update For Calendar Year 2008” changes which include a rebasing and revising of the home health market basket resulting in new labor portion percentage of 77.082 and non-labor portion percentage of 22.918, the new LUPA (Low Utilization Payment Adjustments) per visit payment amounts, the inclusion of an  additional payment for NRS ( Non-Routine Supplies), elimination of the SCIC(Significant Change In Condition) payment, and adjustments to PEP ( Partial Episode Payment) and Outlier payments. This paper discusses an overview of the updated 2008 Medicare HHPPS national standardized rate for CY 2009

Using the Flipped Classroom Model in Your Library Instruction Course

In the flipped classroom model, the pedagogical paradigm is reversed and the students learn the class lesson at home and do homework in class. Although much of the focus of the flipped model has been on the secondary education level, this model could be a viable way to teach library instruction sessions to college-level students as well as a way to preserve scarce class time. This article examines a project that was done at LIU Post, where an instructor of the Library Competency Workshop course flipped the classroom and compared test results to sections where the class was run in a traditional lecture classroom model as well as the experiences on how the instructor flipped the classroom

An experimental study of tip shape effects on the flutter of aft-swept, flat-plate wings

The effects of tip chord orientation on wing flutter are investigated experimentally using six cantilever-mounted, flat-plate wing models. Experimentally determined flutter characteristics of the six models are presented covering both the subsonic and transonic Mach number ranges. While all models have a 60 degree leading edge sweep, a 40.97 degree trailing edge sweep, and a root chord of 34.75 inches, they are subdivided into two series characterized by a higher aspect ratio and a lower aspect ratio. Each series is made up of three models with tip chord orientations which are parallel to the free-stream flow, perpendicular to the model mid-chord line, and perpendicular to the free-stream flow. Although planform characteristics within each series of models are held constant, structural characteristics such as mode shapes and natural frequencies are allowed to vary

A vapor generator for transonic flow visualization

A vapor generator was developed for use in the NASA Langley Transonic Dynamics Tunnel (TDT). Propylene glycol was used as the vapor material. The vapor generator system was evaluated in a laboratory setting and then used in the TDT as part of a laser light sheet flow visualization system. The vapor generator provided satisfactory seeding of the air flow with visible condensate particles, smoke, for tests ranging from low subsonic through transonic speeds for tunnel total pressures from atmospheric pressure down to less than 0.1 atmospheric pressure

Hybrid NoHam

This proposal centers on the “NoHam” neighborhood in Detroit, Michigan. This neighborhood has been largely overlooked by Detroit city leaders; however, current residents have created a strong community where residents care for their homes and neighbors to their greatest ability. We seek to enhance the existing community while encouraging growth centered on the Detroit City Football Club. This project identifies existing bungalows for rehabilitation and proposes construction of new contextually appropriate bungalows along a neighborhood corridor. This corridor would anchor a newly developed community center and new soccer training grounds. These interventions seek not only to repopulate vacant lots with housing, but also to strengthen two communities by creating hybrid culture and place.http://deepblue.lib.umich.edu/bitstream/2027.42/120309/1/Davis-Rivera_HybridNoHam.pd

An experimental and analytical investigation of the effect of spanwise curvature on wing flutter at Mach number of 0.7

An experimental and analytical study was conducted at Mach 0.7 to investigate the effects of spanwise curvature on flutter. Two series of rectangular planform wings of aspect ration 1.5 and curvature ranging from zero (uncurved) to 1.04/ft were flutter tested in the NASA Langley Transonic Dynamics Tunnel (TDT). One series consisted of models with a NACA 65 A010 airfoil section and the other of flat plate cross section models. Flutter analyses were conducted for correlation with the experimental results by using structural finite element methods to perform vibration analysis and two aerodynamic theories to obtain unsteady aerodynamic load calculations. The experimental results showed that for one series of models the flutter dynamic pressure increased significantly with curvature while for the other series of models the flutter dynamic pressure decreased with curvature. The flutter analyses, which generally predicted the experimental results, indicated that the difference in behavior of the two series of models was primarily due to differences in their structural properties

HIV-1 Vpr Causes Synaptodendritic Damage in Neurons

HIV weakens the immune system by infecting and destroying T-cells, leaving the body vulnerable to infection and the development of AIDS. Conventional treatments for HIV, such as combined anti-rectroviral therapy (cART), fail to prevent the development of HIV-associated neurocognitive disorder (HAND). Neurological dysfunction has been directly related to the invasion of HIV in the central nervous system (CNS). HIV produces neurotoxic proteins, such as the Viral Protein R (Vpr), which contribute to HAND. Astrocytes are the most abundant cells in the brain and an important HIV target. We hypothesize that astrocytes expressing Vpr will cause neuronal damage in our co-culture system. Primary astrocytes were transfected with Vpr plasmid or control (pEGFP or mock) using electroporation. Astrocytes were then co-cultured with cortical neurons. At 48 and 72 hours we collected the primary astrocytes to confirm the Vpr expression via western blot analysis. We then measured structural damage in the neurons using immunofluorescence for cytoskeletal (MAP2, f-actin) and synaptic (synaptophysin) damage. Preliminary results showed strong staining of filamentous actin and MAP2 with weak detection of synaptophysin. The positive control for neurotoxicity (2.8µM acrylamide) showed substantial damage to the cellular structure. Results for Vpr expression are pending. After confirming that the immunofluorescence assays are working with our controls, we expect to detect any synaptodendritic damage in the neurons caused by Vpr in our upcoming experiments