Three Large-Scale Changes To The Medicare Program Could Curb Its Costs But Also Reduce Enrollment

With Medicare spending projected to increase to 24 percent of all federal spending and to equal 6 percent of the gross domestic product by 2037, policy makers are again considering ways to curb the program's spending growth. We used a microsimulation approach to estimate three scenarios: imposing a means-tested premium for Part A hospitalinsurance, introducing a premium support credit to purchase health insurance, and increasing the eligibility age to sixty-seven.We found thatthe scenarios would lead to reductions in cumulative Medicare spending in 2012 -- 36 of 2.4 -- 24.0 percent. However, the scenarios also would increase out-of-pocket spending for enrollees and, in some cases, causemillions of seniors not to enroll in the program and to be left without coverage. To achieve substantial cost savings without causing substantial lack of coverage among seniors, policy makers should consider benefitchanges in combination with other options, such as some of those now being contemplated by the Obama administration and Congress

Material Ecocriticism: Dirt, Waste, Bodies, Food, and other Matter

Chunks of walls and flooring crash in mangled heaps as an enormous orange crane smashes apart the science building. Fueled in part by energy funds, Trinity University is updating its campus. Several hundred feet away, purple martins swoop down to feed squawking chicks nestled in white plastic gourds dangling from an angular metallic pole. In the university\u27s community garden, ripe tomatoes are going to waste. Beyond the demolition site, a grackle lands on the neatly mown grass, where he puffs up and struts while other grackles watch him

Effectiveness of Rectangular Rapid Flashing Beacons (RRFBs) in Small and Rural Communities

Ensuring the safety of pedestrians and cyclists in rural and small communities is becoming increasingly important as planners seek to encourage active travel and eliminate traffic-related injuries and fatalities, consistent with Vision Zero. One area of focus is the protection of vulnerable road users such as pedestrians, who face a significant risk of injury or death in a traffic collision. The risks to pedestrians are particularly high when crossing roadways in high-risk areas such as high-speed and low pedestrian-volume rural roads and between intersections where drivers may not expect them. One concern in rural communities is that pedestrians may face a heightened risk in rural transition zones as they approach the boundary of a city, town, or village from a higher-speed rural highway. In these settings drivers’ perceptions may lag behind their changing surroundings, and their awareness of reduced speed limits and the presence of pedestrians may be diminished. This report addresses the need to evaluate the effectiveness of RRFBs in rural and small communities. We first review prior literature on RRFB effectiveness to synthesize research insights that provide contextspecific guidance for their use as well as gaps in this literature. To supplement this body of research, we use a rigorous observational research design to evaluate the effectiveness of RRFBs within the unique context of small and rural communities in Vermont. Our results are used to provide recommendations for updating Vermont\u27s RRFB guidelines

Promoting Positive Family Interactions: Evaluating a Free Early Childhood Book Distribution Program

The Dolly Parton Imagination Library (DPIL) program encourages reading among families of preschool children by mailing age-appropriate books, once per month, until the age of five. An evaluation of a DPIL program in a southern state in the U.S. was conducted to assess the impact on enrolled children. Focus groups were conducted and a survey was administered to over 100 parents of children in the program to determine parents’ satisfaction with – and assessment of – the program relative to its activities and stated outcomes. To what extent the program promoted reading in the family, and children’s enjoyment of reading and school readiness was explored. In addition, family communication styles and relationships were assessed relative to these outcomes. The parents reported that the program introduced more diverse reading choices, fostered their children’s love of reading, promoted cognitive development and readiness for school, increased use of public libraries, and encouraged family interaction although some differences in reading activities based on family communication styles were found. As well, parents provided recommendations for outreaching to underserved children. Implications of these findings for groups that sponsor this program and for further research are presented

Connecting the Dots: Families and Children with Special Needs in a Rural Community

Due to the rising number of children with disabilities, the needs of these families must be addressed. This article describes the development and implementation of a regional forum in a rural community to address education and training needs of families and professionals. The Special Needs Summit provided workshops, information, and activities for parents and professionals. Participants were invited to participate in a study through a survey soliciting feedback regarding the importance and effectiveness of the training and information received through the Summit, gaps in resources, and future educational and training needs. Overall, participants gave satisfactory ratings regarding the training and education provided during the forum, and gave direction for future programming

Research to Practice: Community-Based Non-Work Services: Findings from the National Survey of Day and Employment Programs for People with Developmental Disabilities

As community-based services for adults with developmental disabilities develop, one category remains underexplored: community-based non-work (CBNW). Findings from an ICI survey show that while CBNW is a growing part of the service mix, its definitions and requirements remain fuzzy

Research to Practice: Collaboration Between Medicaid and Other State Agencies- Findings from the National Survey of State Systems and Employment for People with Disabilities

Many state Medicaid agencies are playing a greater role in multi-agency efforts to promote employment for people with disabilities. This brief uses data from the National Survey of State Systems and Employment for People with Disabilities to explore the varieties of collaboration Medicaid agencies are using and the agencies they are collaborating with

Research to Practice: The National Survey of Community Rehabilitation Providers, FY2002-2003, Report 2: Non-Work Services

The second in a series exploring the services people with developmental disabilities receive from community rehabilitation providers (CRPs). Despite recent ideological emphasis on work, the majority of CRPs continued to offer non-work programs and a substantial proportion of the people they served were involved in those programs. Overall, the findings raise questions about CRP commitment to community integration

Considerations with using unmanned aircraft systems in turfgrass

In recent years, small unmanned aircraft systems (sUAS) and advancements in remote sensing technology have provided alternative and more affordable means for monitoring crop health and stress than ground-based (hand-held or vehicle-mounted) or other aerial-based platforms (manned aircraft or satellites). However, few scientific studies have evaluated the application of sUAS in turfgrass systems. The use of sUAS in monitoring turfgrass requires an understanding of basic remote sensing principles; identifying the target of interest and the various sUAS platforms and sensors that provide the necessary resolution and frequencies to measure and monitor that target; calibration of sensors in the field; and data processing considerations. Those topics are discussed, followed by reviews of recent turfgrass field studies conducted to predict and manage drought stress and pest outbreaks, and improve phenotyping capabilities in turfgrass breeding programs. The use of sUAS remote sensing in turfgrass offers unique possibilities and challenges, which are addressed herein