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Crashworthy Seats Would Afford Superior Protection
NASA Technical Reports Server (NTRS)
Gohmert, Dustin
Seats to prevent or limit crash injuries to astronauts aboard the crew vehicle of the Orion spacecraft are undergoing development. The design of these seats incorporates and goes beyond crash-protection concepts embodied in prior spacecraft and racing-car seats to afford superior protection against impacts. Although the seats are designed to support astronauts in a recumbent, quasi-fetal posture that would likely not be suitable for non-spacecraft applications, parts of the design could be adapted to military and some civilian aircraft seats and to racing car seats to increase levels of protection. The main problem in designing any crashworthy seat is to provide full support of the occupant against anticipated crash and emergency-landing loads so as to safely limit motion, along any axis, of any part of the occupant s body relative to (1) any other part of the occupant s body, (2) the spacecraft or other vehicle, and (3) the seat itself. In the original Orion spacecraft application and in other applications that could easily be envisioned, the problem is complicated by severe limits on space available for the seat, a requirement to enable rapid egress by the occupant after a crash, and a requirement to provide for fitting of the seat to a wide range of sizes and shapes of a human body covered by a crash suit, space suit, or other protective garment. The problem is further complicated by other Orion-application-specific requirements that must be omitted here for the sake of brevity. To accommodate the wide range of crewmember body lengths within the limits on available space in the original Orion application, the design provides for taller crewmembers to pull their legs back closer toward their chests, while shorter crewmembers can allow their legs to stretch out further. The range of hip-support seat adjustments needed to effect this accommodation, as derived from NASA s Human Systems Integration Standard, was found to define a parabolic path along which the knees
Patient Protection and Affordable Care Act
Rep. Rangel, Charles B. [D-NY-15
03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:
Patient Protection and Affordable Care Act
Rep. Rangel, Charles B. [D-NY-15
03/23/2010 Became Public Law No: 111-148. (PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:
Patient Protection and Affordable Care Act
Rep. Rangel, Charles B. [D-NY-15
03/23/2010 Became Public Law No: 111-148. (TXT | PDF) (All Actions) Notes: H.R.4872 makes a number of health-related financing and revenue changes to this bill. Read together, this bill and the health care-related provisions of H.R.4872 are commonly referred to as the Affordable Care Act (ACA). Tracker: This bill has the status Became LawHere are the steps for Status of Legislation:
Measuring the skin dose protection afforded by protective apparel with a beta spectrometer
Martz, D.E.; Rich, B.L.; Johnson, L.O. )
This paper reports that the protective apparel worn by radiation workers to avoid skin contamination also provides measurable protection against external beta sources. The beta contribution to the skin dose rate depends on the residual energy spectrum of the beta particles after they have penetrated the protective apparel. The shift in the beta energy spectra and consequent reduction in the shallow dose rates afforded by various items of protective apparel were investigated for a few laboratory beta sources using a beta spectrometer that is capable of dose calculations. The results presented here indicate that significant dose rates to the skin can occur despite the presence of protective apparel if high energy beta emitting isotopes are present.
Assessment of Thermal Protection Afforded by Hot Water Diving Suits
Assessment of Thermal Protect! " Afforded by Hot Water Diving Suits A AA L. A. Kuehn Diver thermal comfort in cold water is presently only...with proper control oj inlet suit water flow% and temperature, as well as heating of inspired gas, this suit technology suffices for thermal comfort for...technology provides in part to the convective heat loss that it prpsents, sustained long-term thermal comfort in cold water, Webb (W) has defined a
New affordable options for infrastructure and asset protection
Securitas is one of the leaders evolving with technology and delivering new forms of affordable security for mining facilities. It was called in to protect a large mothballed coal mine in the central USA, the victim of repeated thefts. First, Mobile Surveillance Units (MSUs) were installed but thefts continued. Later, a new wireless video security system called Videofied which used MotionViewers which use infrared detectors to detect movement and send a 10 second clip of the intrusion to an operator. This led to the thieves being caught. 2 photos.
78 FR 15553 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...
Federal Register 2010, 2011, 2012, 2013, 2014
... 45 CFR Parts 155 and 156 RIN 0938-AR76 Patient Protection and Affordable Care Act; Establishment of... of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business...
78 FR 20581 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...
Federal Register 2010, 2011, 2012, 2013, 2014
... HUMAN SERVICES 45 CFR Part 155 RIN 0938-AR75 Patient Protection and Affordable Care Act; Exchange... state or Exchange must not prevent the application of the provisions of title I of the Affordable Care.... Introduction The Patient Protection and Affordable Care Act (Pub. L. 111-148) was enacted on March 23,...
77 FR 18309 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...
Federal Register 2010, 2011, 2012, 2013, 2014
...This final rule will implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for individuals and small employers to directly......
76 FR 41865 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans
Federal Register 2010, 2011, 2012, 2013, 2014
...This proposed rule would implement the new Affordable Insurance Exchanges (``Exchanges''), consistent with title I of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148) as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), referred to collectively as the Affordable Care Act. The Exchanges will provide competitive marketplaces for......
77 FR 28790 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act
Federal Register 2010, 2011, 2012, 2013, 2014
... Protection and Affordable Care Act AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Final... Care Act (Pub. L. 111-148) was enacted on March 23, 2010; the Health Care and Education Reconciliation... collectively as the Affordable Care Act. The Affordable Care Act reorganizes, amends, and adds to...
78 FR 65045 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...
Federal Register 2010, 2011, 2012, 2013, 2014
...This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, this final rule outlines financial integrity and oversight standards with respect to Affordable Insurance Exchanges, qualified health plan (QHP) issuers in Federally-facilitated......
77 FR 29235 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors, and...
Federal Register 2010, 2011, 2012, 2013, 2014
... HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards... ] entitled, ``Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors... section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C. 553(b)). However, we can waive...
78 FR 4093 - Extension of Comment Period for the Rulemaking Enhancing Protections Afforded Customers and...
Federal Register 2010, 2011, 2012, 2013, 2014
..., risk management programs, internal monitoring and controls, capital and liquidity standards, customer... Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants and...'') published in the Federal Register a notice of proposed rulemaking (the ``Customer Protection Proposal'')...
How the Patient Protection and Affordable Care Act affects Texas dentists.
Oneacre, Lee P
President Barack Obama signed the Patient Protection and Affordable Care Act (PPACA) into law March 23, 2010 (P.L. 111-148), as arguably the most significant legislative health reform since the creation of Medicare and Medicaid in 1965 (1). Several PPACA provisions will impact dentists as both health care providers and small business owners and employers (2). Overall, the law significantly changes health care financing and facilitates competition in the health insurance market place through the creation of health insurance exchanges (HIX).
78 FR 13405 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review
Federal Register 2010, 2011, 2012, 2013, 2014
...This final rule implements provisions related to fair health insurance premiums, guaranteed availability, guaranteed renewability, single risk pools, and catastrophic plans, consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. The final rule......
76 FR 41929 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...
Federal Register 2010, 2011, 2012, 2013, 2014
... July 15, 2011 Part III Department of Health and Human Services 45 CFR Part 153 Patient Protection and... OF HEALTH AND HUMAN SERVICES 45 CFR Part 153 RIN 0938-AR07 Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and Risk Adjustment AGENCY: Department of Health and...
Contribution of epithelial innate immunity to systemic protection afforded by prolyl hydroxylase inhibition in murine colitis
Keely, Simon; Campbell, Eric L.; Baird, Alan W.; Hansbro, Philip M.; Shalwitz, Robert A.; Kotsakis, Anna; McNamee, Eoin N.; Eltzschig, Holger K.; Kominsky, Douglas J.; Colgan, Sean P.
Pharmacological stabilization of hypoxia-inducible factor (HIF) through prolyl hydroxylase (PHD) inhibition limits mucosal damage associated with models of murine colitis. However, little is known about how PHD inhibitors (PHDi) influence systemic immune function during mucosal inflammation or the relative importance of immunological changes to mucosal protection. We hypothesized that PHDi enhances systemic innate immune responses to colitis-associated bacteremia. Mice with colitis induced by TNBS were treated with AKB-4924, a new HIF-1 isoform-predominant PHDi and clinical, immunological and biochemical endpoints were assessed. Administration of AKB-4924 led to significantly reduced weight loss and disease activity compared to vehicle controls. Treated groups were pyrexic, but did not become subsequently hypothermic. PHDi treatment augmented epithelial barrier function and led to an approximately 50-fold reduction in serum endotoxin during colitis. AKB-4924 also decreased cytokines involved in pyrogenesis and hypothermia, significantly reducing serum levels of IL-1β, IL-6 and TNF-α, while increasing IL-10. Treatment offered no protection against colitis in epithelial-specific HIF-1α deficient mice, strongly implicating epithelial HIF-1α as the tissue target for AKB-4924-mediated protection. Taken together, these results indicate that inhibition of prolyl hydroxylase with AKB-4924 enhances innate immunity and identifies the epithelium is a central site of inflammatory protection afforded by PHDi in murine colitis. PMID:23695513
The Patient Protection and Affordable Care Act: The Role of the School Nurse. Position Statement
ERIC Educational Resources Information Center
Combe, Laurie G.; Sharpe, Susan; Feeser, Cynthia Jo; Ondeck, Lynnette; Fekaris, Nina
It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) serves a vital role in the delivery of health care to our nation's students within the healthcare system reshaped by the Patient Protection and Affordable Care Act of 2010, commonly known as…
76 FR 51201 - Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market...
Federal Register 2010, 2011, 2012, 2013, 2014
... From the Federal Register Online via the Government Publishing Office ] Vol. 76 Wednesday, No. 159 August 17, 2011 Part III Department of Health and Human Services 45 CFR Parts 155 and 157 Patient Protection and Affordable Care Act; Exchange Functions in the Individual Market: Eligibility...
Affordance of Braille Music as a Mediational Means: Significance and Limitations
ERIC Educational Resources Information Center
Park, Hyu-Yong; Kim, Mi-Jung
Affordance refers to the properties or designs of a thing that offer the function of the thing. This paper discusses the affordance of Braille music in terms of three notions: mediational means, mastery and appropriation, and focuses on answering the following three questions: (i) How do musicians with visual impairments (MVI) perceive Braille…
Patient Protection and Affordable Care Act of 2010: a primer for neurointerventionalists.
Manchikanti, Laxmaiah; Hirsch, Joshua A
The Patient Protection and Affordable Care Act (the ACA, for short) became law on 23 March 2010. It represents the most significant transformation of the American healthcare system since Medicare and Medicaid. Essentials of ACA include: (1) a mandate for individuals and businesses requiring as a matter of law that nearly every American has an approved level of health insurance or pay a penalty; (2) a system of federal subsidies to completely or partially pay for the now required health insurance for ∼34 million Americans who are currently uninsured-subsidized through Medicaid and Exchanges; (3) extensive new requirements on the health insurance industry and (4) changes in the practice of medicine. The Act is divided into 10 titles. It contains provisions that went into effect starting on 21 June 2010 with many of the provisions going into effect in 2014 and later. The ACA goes well beyond insurance and payment reform. Practicing physicians will potentially be impacted by the Independent Payment Advisory Board and the Patient Centered Outcomes Research Institute.
The Patient Protection and Affordable Care Act: opportunities for prevention and public health.
Shaw, Frederic E; Asomugha, Chisara N; Conway, Patrick H; Rein, Andrew S
The Patient Protection and Affordable Care Act, which was enacted by the US Congress in 2010, marks the greatest change in US health policy since the 1960s. The law is intended to address fundamental problems within the US health system, including the high and rising cost of care, inadequate access to health insurance and health services for many Americans, and low health-care efficiency and quality. By 2019, the law will bring health coverage--and the health benefits of insurance--to an estimated 25 million more Americans. It has already restrained discriminatory insurance practices, made coverage more affordable, and realised new provisions to curb costs (including tests of new health-care delivery models). The new law establishes the first National Prevention Strategy, adds substantial new funding for prevention and public health programmes, and promotes the use of recommended clinical preventive services and other measures, and thus represents a major opportunity for prevention and public health. The law also provides impetus for greater collaboration between the US health-care and public health systems, which have traditionally operated separately with little interaction. Taken together, the various effects of the Patient Protection and Affordable Care Act can advance the health of the US population.
78 FR 75581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...
Federal Register 2010, 2011, 2012, 2013, 2014
...This document announces the effective date of a regulatory provision published in the Federal Register by OPM on March 11, 2013 (78 FR 15559), entitled ``Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the Affordable Insurance...
Public health law: the constitutionality of the Patient Protection and Affordable Care Act.
De Ville, Kenneth
Congress of the Patient Protection and Affordable Care Act (PPACA) was immediately challenged by lawsuits attacking the constitutionality of the legislation. The lawsuits, joined by over 2 dozen state's attorney generals, contend that PPACA is an unconstitutional exercise of federal power. Specifically, the suits argue that the individual insurance mandate portion of the law is justified by neither the "Commerce Power" nor Congress' authority to "tax" and provide for "the general welfare." This essay outlines and analyzes the constitutional arguments for, and against, PPACA forecasting the likely resolution of the debate if the suits reach the US Supreme Court.
Implementing the Patient Protection and Affordable Care Act: the time is now.
Wojcik, Steven E
Employers all across the country should be in full swing as they prepare to implement the tougher parts of the Patient Protection and Affordable Care Act's (ACA) employer provisions, which are about to come online and take effect in 2014. This article reviews these more challenging requirements and their complications, including how employer calculations over whether to continue to offer coverage might vary by industry characteristics. The author then looks further ahead to the "Cadillac" tax and discusses how this liability may affect every employer's decision about its health care strategy leading up to 2018.
The Patient Protection and Affordable Care Act and the regulation of the health insurance industry.
Jha, Saurabh; Baker, Tom
The Patient Protection and Affordable Care Act is a comprehensive and multipronged reform of the US health care system. The legislation makes incremental changes to Medicare, Medicaid, and the market for employer-sponsored health insurance. However, it makes substantial changes to the market for individual and small-group health insurance. The purpose of this article is to introduce the key regulatory reforms in the market for individual and small-group health insurance and explain how these reforms tackle adverse selection and risk classification and improve access to health care for the hitherto uninsured or underinsured population.
Expansion of Coverage under the Patient Protection and Affordable Care Act and Primary Care Utilization
Hofer, Adam N; Abraham, Jean Marie; Moscovice, Ira
Context: Provisions of the Patient Protection and Affordable Care Act of 2010 (PPACA) expand Medicaid to all individuals in families earning less than 133 percent of the federal poverty level (FPL) and make available subsidies to uninsured lower-income Americans (133 to 400 percent of FPL) without access to employer-based coverage to purchase insurance in new exchanges. Since primary care physicians typically serve as the point of entry into the health care delivery system, an adequate supply of them is critical to meeting the anticipated increase in demand for medical care resulting from the expansion of coverage. This article provides state-level estimates of the anticipated increases in primary care utilization given the PPACA's provisions for expanded coverage. Methods: Using the Medical Expenditure Panel Survey, this article estimates a multivariate regression model of annual primary care utilization. Using the model estimates and state-level information regarding the number of uninsured, it predicts, by state, the change in primary care visits expected from the expanded coverage. Finally, the article predicts the number of primary care physicians needed to accommodate this change in utilization. Findings: This expanded coverage is predicted to increase by 2019 the number of annual primary care visits between 15.07 million and 24.26 million. Assuming stable levels of physicians' productivity, between 4,307 and 6,940 additional primary care physicians would be needed to accommodate this increase. Conclusions: The PPACA's health insurance expansion parameters are expected to significantly increase the use of primary care. Two strategies that policymakers may consider are creating stronger financial incentives to attract medical school students to primary care and changing the delivery of care in ways that lead to operational improvements, higher throughput, and better quality of care. PMID:21418313
Candida albicans infection affords protection against reinfection via functional reprogramming of monocytes.
Quintin, Jessica; Saeed, Sadia; Martens, Joost H A; Giamarellos-Bourboulis, Evangelos J; Ifrim, Daniela C; Logie, Colin; Jacobs, Liesbeth; Jansen, Trees; Kullberg, Bart-Jan; Wijmenga, Cisca; Joosten, Leo A B; Xavier, Ramnik J; van der Meer, Jos W M; Stunnenberg, Hendrik G; Netea, Mihai G
Immunological memory in vertebrates is often exclusively attributed to T and B cell function. Recently it was proposed that the enhanced and sustained innate immune responses following initial infectious exposure may also afford protection against reinfection. Testing this concept of "trained immunity," we show that mice lacking functional T and B lymphocytes are protected against reinfection with Candida albicans in a monocyte-dependent manner. C. albicans and fungal cell wall β-glucans induced functional reprogramming of monocytes, leading to enhanced cytokine production in vivo and in vitro. The training required the β-glucan receptor dectin-1 and the noncanonical Raf-1 pathway. Monocyte training by β-glucans was associated with stable changes in histone trimethylation at H3K4, which suggests the involvement of epigenetic mechanisms in this phenomenon. The functional reprogramming of monocytes, reminiscent of similar NK cell properties, supports the concept of "trained immunity" and may be employed for the design of improved vaccination strategies.
Right-wing conspiracy? Socialist plot? The origins of the Patient Protection and Affordable Care Act.
Quadagno, Jill
On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). Did the ACA signify a government takeover of the health care system, a first step on the road to socialism, as conservative critics charged? Or was it, rather, a sellout to the right wing, as liberal single-payer advocates proclaimed? The ACA's key provisions, the employer mandate and the individual mandate, were Republican policy ideas, and its fundamental principles were nearly identical to the Health Equity and Access Reform Today Act of 1993 (HEART), a bill promoted by Republican senators to deflect support for President Bill Clinton's Health Security plan. Yet the ACA was also a policy legacy of the Clinton administration in important ways that rarely are acknowledged, notably Medicaid expansion and insurance company regulation. Although the ACA departed from the liberal vision of a single-payer plan and adhered closely to the objectives of those who believed that the health care system should encourage the free market, it included provisions that will make coverage more affordable, reliable, and accessible.
The Patient Protection and Affordable Care Act: what every provider of gynecologic oncology care should know.
Duska, Linda R; Engelhard, Carolyn L
The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama in 2010. While initial implementation of the law began shortly thereafter, the full implementation will take place over the next few years. With respect to cancer care, the act was intended to make care more accessible, affordable, and comprehensive across different parts of the country. For our cancer patients and our practices, the ACA has implications that are both positive and negative. The Medicaid expansion and access to insurance exchanges are intended to increase the number of insured patients and thus improve access to care, but many states have decided to opt out of the Medicaid program and in these states access problems will persist. Screening programs will be put in place for insured patients but may supplant federally funded programs that are currently in place for uninsured patients and may not follow current screening guidelines. Both hospice and home health providers will be asked to provide more services with less funding, and quality measures, including readmission rates, will factor into reimbursement. Insured patients will have access to all phases of clinical trial research. There is a need for us as providers of Gynecologic Oncology care to be active in the implementation of the ACA in order to ensure that our patients and our practices can survive and benefit from the changes in health care reimbursement, with the ultimate goals of improving access to care and quality while reducing unsustainable costs.
Patient Protection and Affordable Care Act; establishment of exchanges and qualified health plans; Small Business Health Options Program. Final rule.
This final rule implements provisions of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) related to the Small Business Health Options Program (SHOP). Specifically, this final rule amends existing regulations regarding triggering events and special enrollment periods for qualified employees and their dependents and implements a transitional policy regarding employees' choice of qualified health plans (QHPs) in the SHOP.
77 FR 72581 - Patient Protection and Affordable Care Act; Establishment of the Multi-State Plan Program for the...
Federal Register 2010, 2011, 2012, 2013, 2014
...The U.S. Office of Personnel Management (OPM) is issuing a proposed rule to implement the Multi-State Plan Program (MSPP). OPM is establishing the MSPP pursuant to the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Through contracts with OPM, health insurance issuers will......
Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act
Corman, Juliane; Levin, David
Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans' support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA's implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination. PMID:27257309
Integrating Community Health Workers Within Patient Protection and Affordable Care Act Implementation
Islam, Nadia; Nadkarni, Smiti Kapadia; Zahn, Deborah; Skillman, Megan; Kwon, Simona C.; Trinh-Shevrin, Chau
Context The Patient Protection and Affordable Care Act's (PPACA) emphasis on community-based initiatives affords a unique opportunity to disseminate and scale up evidence-based community health worker (CHW) models that integrate CHWs within health care delivery teams and programs. Community health workers have unique access and local knowledge that can inform program development and evaluation, improve service delivery and care coordination, and expand health care access. As a member of the PPACA-defined health care workforce, CHWs have the potential to positively impact numerous programs and reduce costs. Objective This article discusses different strategies for integrating CHW models within PPACA implementation through facilitated enrollment strategies, patient-centered medical homes, coordination and expansion of health information technology (HIT) efforts, and also discusses payment options for such integration. Results Title V of the PPACA outlines a plan to improve access to and delivery of health care services for all individuals, particularly low-income, underserved, uninsured, minority, health disparity, and rural populations. Community health workers' role as trusted community leaders can facilitate accurate data collection, program enrollment, and provision of culturally and linguistically appropriate, patient- and family-centered care. Because CHWs already support disease management and care coordination services, they will be critical to delivering and expanding patient-centered medical homes and Health Home services, especially for communities that suffer disproportionately from multiple chronic diseases. Community health workers' unique expertise in conducting outreach make them well positioned to help enroll people in Medicaid or insurance offered by Health Benefit Exchanges. New payment models provide opportunities to fund and sustain CHWs. Conclusion Community health workers can support the effective implementation of PPACA if the capacity
Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.
Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R
The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment.
A systems thinking approach to analysis of the Patient Protection and Affordable Care Act.
Williams, John C
The public health community is challenged with understanding the many complexities presented by systems thinking and its applications in systems modeling. The model presented encompasses multiple variables needed (eg, model building) for the construction of a conceptual system model of the Patient Protection and Affordable Care Act (ACA). The model tracks the ACA from inception, through passage, March 2010, to its current state. Justification for the need to reform the current health care system rests, in part, on the heels of social justice. Proponents of the ACA have long argued that health reform was needed by the millions of uninsured person who suffered from health disparities, took little advantage of health prevention advice, and faced issues of access to providers as well as insurers. In addition the ACA seeks to address our uncontrollable spending on health care delivery. This article highlights the ACA from a systems perspective. The conceptual model presented encompasses both health reform variables (eg, health care provisions, key legislative components, system environment) and system variables (eg, inputs, outputs, feedback, and throughput) needed to understand current health care reform efforts from a systems perspective. The model presented shows how the interrelationships and interconnections of elements of a system come together to achieve its purpose or goal.
The Patient Protection and Affordable Care Act: impact on mental health services demand and provider availability.
Pearlman, Shoshannah A
The Patient Protection and Affordable Care Act (ACA) will greatly increase the demand for mental health (MH) services, as 62.5 million Americans from relatively high-need populations will be newly eligible for MH benefits. Consequently, the supply of MH care provider services is expected to proportionately decrease by 18% to 21% in 2014. ACA funding does not demonstrate the ability to increase turnout of psychiatrists sufficiently to meet the need. Available data indicate that the numbers of advanced practice psychiatric nurses (APPNs) continue to increase at a much greater rate, but information from either a clinical perspective or a market perspective is complicated by the weak distinctions that are made between nurse practitioners (NPs) and other nonphysician care professionals. The following recommendations are made: (a) some of the ACA funding for research into efficient and effective care delivery systems should be allocated to acquiring data on APPNs in leadership roles or clinical settings in which they are ultimately responsible for management of MH care, as differentiated from settings in which they provide support for psychiatrists; and (b) since the available data indicate nurse practitioners achieve good outcomes and are more economically viable than psychiatrists, placement of psychiatric-mental health nurse practitioners in community settings should be recognized as a realistic solution to the shortfall of MH services.
The Patient Protection and Affordable Care Act: the victory of unorthodox lawmaking.
Beaussier, Anne-Laure
The 2010 Patient Protection and Affordable Care Act was a major legislative achievement of the 111th Congress. This law structurally reforms the US health care system by encouraging universal health care coverage through regulated competition among private insurance companies. When looking at the process for reform, what strikes an observer of US health care policy in the first place is that the Democratic majority was able to enact something in a political field characterized by strong resistance to change. This article builds on that observation. Arguments concentrate on the legislative process of the reform and support the idea that it may be partly explained by considering an evolution of US legislative institutions, mostly in the sense of a more centralized legislative process. Based on approximately one hundred semidirected interviews, I argue that the Democratic majority, building on lessons from both President Bill Clinton's health care reform attempt and the Republicans' strategy of using strong congressional leadership to pass social reforms, was able to overcome institutional constraints that have long prevented comprehensive change. A more centralized legislative process, which has been described as "unorthodox lawmaking," enabled the Democratic leadership to overcome multiple institutional and political veto players.
Racial and Ethnic Disparities in Services and the Patient Protection and Affordable Care Act
Abdus, Salam; Mistry, Kamila B.
Objectives. We examined prereform patterns in insurance coverage, access to care, and preventive services use by race/ethnicity in adults targeted by the coverage expansions of the Patient Protection and Affordable Care Act (ACA). Methods. We used pre-ACA household data from the Medical Expenditure Panel Survey to identify groups targeted by the coverage provisions of the Act (Medicaid expansions and subsidized Marketplace coverage). We examined racial/ethnic differences in coverage, access to care, and preventive service use, across and within ACA relevant subgroups from 2005 to 2010. The study took place at the Agency for Healthcare Research and Quality in Rockville, Maryland. Results. Minorities were disproportionately represented among those targeted by the coverage provisions of the ACA. Targeted groups had lower rates of coverage, access to care, and preventive services use, and racial/ethnic disparities were, in some cases, widest within these targeted groups. Conclusions. Our findings highlighted the opportunity of the ACA to not only to improve coverage, access, and use for all racial/ethnic groups, but also to narrow racial/ethnic disparities in these outcomes. Our results might have particular importance for states that are deciding whether to implement the ACA Medicaid expansions. PMID:26447920
Patient Protection and Affordable Care Act; standards related to essential health benefits, actuarial value and accreditation. Final rule.
This final rule sets forth standards for health insurance issuers consistent with title I of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, referred to collectively as the Affordable Care Act. Specifically, this final rule outlines Exchange and issuer standards related to coverage of essential health benefits and actuarial value. This rule also finalizes a timeline for qualified health plans to be accredited in Federally-facilitated Exchanges and amends regulations providing an application process for the recognition of additional accrediting entities for purposes of certification of qualified health plans.
Protection against Acute Hepatocellular Injury Afforded by Liver Fibrosis Is Independent of T Lymphocytes
Lacoste, Benoit; Raymond, Valérie-Ann; Lapierre, Pascal; Bilodeau, Marc
Collagen produced during the process of liver fibrosis can induce a hepatocellular protective response through ERK1 signalling. However, the influence of T cells and associated cytokine production on this protection is unknown. In addition, athymic mice are frequently used in hepatocellular carcinoma xenograft experiments but current methods limit our ability to study the impact of liver fibrosis in this setting due to high mortality. Therefore, a mouse model of liver fibrosis lacking T cells was developed using Foxn1 nu/nu mice and progressive oral administration of thioacetamide (TAA) [0.01–0.02%] in drinking water. Fibrosis developed over a period of 16 weeks (alpha-SMA positive area: 20.0 ± 2.2%, preCol1a1 mRNA expression: 11.7 ± 4.1 fold changes, hydroxyproline content: 1041.2 ± 77μg/g of liver) at levels comparable to that of BALB/c mice that received intraperitoneal TAA injections [200 μg/g of body weight (bw)] (alpha-SMA positive area: 20.9 ± 2.9%, preCol1a1 mRNA expression: 13.1 ± 2.3 fold changes, hydroxyproline content: 931.6 ± 14.8μg/g of liver). No mortality was observed. Athymic mice showed phosphorylation of ERK1/2 during fibrogenesis (control 0.03 ± 0.01 vs 16 weeks 0.22 ± 0.06AU; P<0.05). The fibrosis-induced hepatoprotection against cytotoxic agents, as assessed histologically and by serum AST levels, was not affected by the absence of circulating T cells (anti-Fas JO2 [0.5μg/g bw] for 6h (fibrotic 4665 ± 2596 vs non-fibrotic 13953 ± 2260 U/L; P<0.05), APAP [750 mg/kg bw] for 6 hours (fibrotic 292 ± 66 U/L vs non-fibrotic 4086 ± 2205; P<0.01) and CCl4 [0.5mL/Kg bw] for 24h (fibrotic 888 ± 268 vs non-fibrotic 15673 ± 2782 U/L; P<0.001)). In conclusion, liver fibrosis can be induced in athymic Foxn1 nu/nu mice without early mortality. Liver fibrosis leads to ERK1/2 phosphorylation. Finally, circulating T lymphocytes and associated cytokines are not involved in the hepatocellular protection afforded by liver fibrosis. PMID
78 FR 39493 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...
Federal Register 2010, 2011, 2012, 2013, 2014
... requested translation of the requisite materials in non-English languages, and suggested that HHS refer to... applicable language in the Affordable Care Act. Upon publication of the Treasury final rule, we intend to... proposed to amend Sec. 155.200(a) to add a reference to indicate that, consistent with existing language...
78 FR 37031 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, Premium...
Federal Register 2010, 2011, 2012, 2013, 2014
...This proposed rule sets forth financial integrity and oversight standards with respect to Affordable Insurance Exchanges; Qualified Health Plan (QHP) issuers in Federally-facilitated Exchanges (FFEs); and States with regard to the operation of risk adjustment and reinsurance programs. It also proposes additional standards with respect to agents and brokers. These standards, which include......
76 FR 77392 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...
Federal Register 2010, 2011, 2012, 2013, 2014
... and other business cooperatives provide possible models for the successful development of CO-OPs... to promote integrated models of care and enhance competition in the Affordable Insurance Exchanges... met. Starting in 2014, individuals and small businesses will be able to purchase private...
The Patient Protection and Affordable Care Act: A Primer for Hand Surgeons
Adkinson, Joshua M.; Chung, Kevin C.
The Affordable Care Act is the largest and most comprehensive overhaul of the United States healthcare industry since the inception of the Medicare and Medicaid. Contained within the 10 Titles are a multitude of provisions that will change how hand surgeons practice medicine and how they are reimbursed. It is imperative that surgeons are equipped with the knowledge of how this law will affect all physician practices and hospitals. PMID:25066853
Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.
This document contains amendments to the interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding preventive health services.
Patient Protection and Affordable Care Act of 2010 and Children and Youth With Special Health Care Needs
Buysse, Christina A.; Hubner, Lauren M.; Huffman, Lynne C.; Loe, Irene M.
ABSTRACT: The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN. PMID:25793891
Patient Protection and Affordable Care Act of 2010 and children and youth with special health care needs.
Feldman, Heidi M; Buysse, Christina A; Hubner, Lauren M; Huffman, Lynne C; Loe, Irene M
The Patient Protection and Affordable Care Act (ACA) was designed to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system. During the design of ACA, children in general and children and youth with special health care needs and disabilities (CYSHCN) were not a priority because before ACA, a higher proportion of children than adults had insurance coverage through private family plans, Medicaid, or the State Children's Health Insurance Programs (CHIP). ACA benefits CYSHCN through provisions designed to make health insurance coverage universal and continuous, affordable, and adequate. Among the limitations of ACA for CYSHCN are the exemption of plans that had been in existence before ACA, lack of national standards for insurance benefits, possible elimination or reductions in funding for CHIP, and limited experience with new delivery models for improving care while reducing costs. Advocacy efforts on behalf of CYSHCN must track implementation of ACA at the federal and the state levels. Systems and payment reforms must emphasize access and quality improvements for CYSHCN over cost savings. Developmental-behavioral pediatrics must be represented at the policy level and in the design of new delivery models to assure high quality and cost-effective care for CYSHCN.
Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act
Huntoon, Kristin M.; McCluney, Colin J.; Scannell, Christopher A.; Wiley, Elizabeth A.; Bruno, Richard; Andrews, Allen; Gorman, Paul
Context Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. Objective To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. Design, Setting, and Participants An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October–December 2010, with 1232 students responding and a response rate of 18%. Main Outcome Measures Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. Results Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. Conclusion The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment. PMID:21931604
Patient Protection and Affordable Care Act of 2010: Summary, Analysis, and Opportunities for Advocacy for the Academic Emergency Physician
Kline, Jeffrey A.; Walthall, Jennifer D.H.
The Patient Protection and Affordable Care Bill, commonly referred to as the "Health Care Bill" or the "Health Care Reform Bill," became enacted in March, 2010. This article is a review and analysis of the sections of this Act that are relevant to researchers and teachers of emergency care. The purpose of this document is to serve as a citable reference for interested parties and a reference to quickly locate the sections of the Bill relevant to academic emergency physicians. When appropriate, text was copied verbatim from the bill. The source of the downloaded Act, and the page numbers of the text sections, are provided to help the reader to find the sections described. This review is presented in two parts. Part 1 presents 11 sections extirpated from the Act, with short interpretations of the significance of each section. Part II presents an analysis of the sections that the authors believe represent opportunities for emergency care researchers and teachers to make the most impact, through active involvement with the various departments and agencies of the federal government that will be charged with interpreting and implementing this Act. The Act contains sections that could lead to new funding opportunities for research in emergency care, especially for comparative clinical trials and clinical studies that focus on integration and efficiency of health care delivery. The Act will establish several new institutes, centers, and committees that will create policies highly relevant to emergency care. The authors conclude that this Act can be expected to have a profound influence on research and training in emergency care. PMID:20653573
Biochemical analysis of plant protection afforded by a nonpathogenic endophytic mutant of Colletotrichum magna
Redman, R.S.; Rodriguez, R.J. Univ. of Washington, Seattle, WA . Dept. of Botany); Clifton, D.R.; Morrel, J.; Brown, G. ); Freeman, S. . Dept. of Plant Pathology)
A nonpathogenic mutant of Colletotrichum magna (path-1) was previously shown to protect watermelon (Citrullus lanatus) and cucumber (Cucumis sativus) seedlings from anthracnose disease elicited by wild-type C. magna. Disease protection was observed in stems of path-1-colonized cucurbits but not in cotyledons, indicating that path-1 conferred tissue-specific and/or localized protection. Plant biochemical indicators of a localized and systemic (peroxidase, phenylalanine ammonia-lyase, lignin, and salicylic acid) plant-defense response were investigated in anthracnose-resistant and-susceptible cultivars of cucurbit seedlings exposed to four treatments: (1) water (control), (2) path-1 conidia, (3) wild-type conidia, and (4) challenge conditions (inoculation into path-1 conidia for 48 h and then exposure to wild-type conidia). Collectively, these analyses indicated that disease protection in path-1-colonized plants was correlated with the ability of these plants to mount a defense response more rapidly and to equal or greater levels than plants exposed to wild-type C. magna alone. Watermelon plants colonized with path-1 were also protected against disease caused by Colletotrichum orbiculare and Fusarium oxysporum. A model based on the kinetics of plant-defense activation is presented to explain the mechanism of path-1-conferred disease protection.
Biochemical analysis of plant protection afforded by a nonpathogenic endophytic mutant of Colletotrichum magna
Redman, R.S.; Freeman, S.; Clifton, D.R.; Morrel, J.; Brown, G.; Rodriguez, R.J.
A nonpathogenic mutant of Colletotrichum magna (path-1) was previously shown to protect watermelon (Citrullus lanatus) and cucumber (Cucumis sativus) seedlings from anthracnose disease elicited by wild-type C. magna. Disease protection was observed in stems of path-1-colonized cucurbits but not in cotyledons, indicating that path-1 conferred tissue-specific and/or localized protection. Plant biochemical indicators of a localized and systemic (peroxidase, phenylalanine ammonia-lyase, lignin, and salicylic acid) 'plant-defense' response were investigated in anthracnose-resistant and -susceptible cultivars of cucurbit seedlings exposed to four treatments: (1) water (control), (2) path-1 conidia, (3) wild-type conidia, and (4) challenge conditions (inoculation into path-1 conidia for 48 h and then exposure to wild-type conidia). Collectively, these analyses indicated that disease protection in path-1 colonized plants was correlated with the ability of these plants to mount a defense response more rapidly and to equal or greater levels than plants exposed to wild-type C. magna alone. Watermelon plants colonized with path-1 were also protected against disease caused by Colletotrichum orbiculare and Fusarium oxysporum. A model based on the kinetics of plant-defense activation is presented to explain the mechanism of path-1-conferred disease protection.
Patient Protection and Affordable Care Act; exchange and insurance market standards for 2015 and beyond. Final rule.
This final rule addresses various requirements applicable to health insurance issuers, Affordable Insurance Exchanges (``Exchanges''), Navigators, non-Navigator assistance personnel, and other entities under the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). Specifically, the rule establishes standards related to product discontinuation and renewal, quality reporting, non-discrimination standards, minimum certification standards and responsibilities of qualified health plan (QHP) issuers, the Small Business Health Options Program, and enforcement remedies in Federally-facilitated Exchanges. It also finalizes: A modification of HHS's allocation of reinsurance collections if those collections do not meet our projections; certain changes to allowable administrative expenses in the risk corridors calculation; modifications to the way we calculate the annual limit on cost sharing so that we round this parameter down to the nearest $50 increment; an approach to index the required contribution used to determine eligibility for an exemption from the shared responsibility payment under section 5000A of the Internal Revenue Code; grounds for imposing civil money penalties on persons who provide false or fraudulent information to the Exchange and on persons who improperly use or disclose information; updated standards for the consumer assistance programs; standards related to the opt-out provisions for self-funded, non-Federal governmental plans and related to the individual market provisions under the Health Insurance Portability and Accountability Act of 1996 including excepted benefits; standards regarding how enrollees may request access to non-formulary drugs under exigent circumstances; amendments to Exchange appeals standards and coverage enrollment and termination standards; and time-limited adjustments to the standards relating to the medical loss ratio
78 FR 68505 - Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants...
Federal Register 2010, 2011, 2012, 2013, 2014
...The Commodity Futures Trading Commission (``Commission'' or ``CFTC'') is adopting new regulations and amending existing regulations to require enhanced customer protections, risk management programs, internal monitoring and controls, capital and liquidity standards, customer disclosures, and auditing and examination programs for futures commission merchants (``FCMs''). The regulations also......
78 FR 79619 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, Premium Stabilization...
Federal Register 2010, 2011, 2012, 2013, 2014
...] [Pages 79619-79620] [FR Doc No: 2013-31319] DEPARTMENT OF HEALTH AND HUMAN SERVICES 45 CFR Part 155 [CMS.... Background In FR Doc. 2013-25326 of October 30, 2013 (78 FR 65046), final rule entitled ``Patient Protection... Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014 (78 FR 65046), there...
Patient protection and Affordable Care Act; data collection to support standards related to essential health benefits; recognition of entities for the accreditation of qualified health plans. Final rule.
This final rule establishes data collection standards necessary to implement aspects of section 1302 of the Patient Protection and Affordable Care Act (Affordable Care Act), which directs the Secretary of Health and Human Services to define essential health benefits. This final rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health benefits. This final rule also establishes a process for the recognition of accrediting entities for purposes of certification of qualified health plans.
Creatine affords protection against glutamate-induced nitrosative and oxidative stress.
Cunha, Mauricio P; Lieberknecht, Vicente; Ramos-Hryb, Ana Belén; Olescowicz, Gislaine; Ludka, Fabiana K; Tasca, Carla I; Gabilan, Nelson H; Rodrigues, Ana Lúcia S
Creatine has been reported to exert beneficial effects in several neurodegenerative diseases in which glutamatergic excitotoxicity and oxidative stress play an etiological role. The purpose of this study was to investigate the protective effects of creatine, as compared to the N-Methyl-d-Aspartate (NMDA) receptor antagonist dizocilpine (MK-801), against glutamate or hydrogen peroxide (H2O2)-induced injury in human neuroblastoma SH-SY5Y cells. Exposure of cells to glutamate (60-80 mM) or H2O2 (200-300 μM) for 24 h decreased cellular viability and increased dichlorofluorescein (DCF) fluorescence (indicative of increased reactive oxygen species, ROS) and nitric oxide (NO) production (assessed by mono-nitrogen oxides, NOx, levels). Creatine (1-10 mM) or MK-801 (0.1-10 μM) reduced glutamate- and H2O2-induced toxicity. The protective effect of creatine against glutamate-induced toxicity involves its antioxidant effect, since creatine, similar to MK-801, prevented the increase on DCF fluorescence induced by glutamate or H2O2. Furthermore, creatine or MK-801 blocked glutamate- and H2O2-induced increases in NOx levels. In another set of experiments, the repeated, but not acute, administration of creatine (300 mg/kg, po) in mice prevented the decreases on cellular viability and mitochondrial membrane potential (assessed by tetramethylrhodamine ethyl ester, TMRE, probe) of hippocampal slices incubated with glutamate (10 mM). Creatine concentration-dependent decreased the amount of nitrite formed in the reaction of oxygen with NO produced from sodium nitroprusside solution, suggesting that its protective effect against glutamate or H2O2-induced toxicity might be due to its scavenger activity. Overall, the results suggest that creatine may be useful as adjuvant therapy for neurodegenerative disease treatments.
Blackberry subjected to in vitro gastrointestinal digestion affords protection against Ethyl Carbamate-induced cytotoxicity.
Chen, Wei; Xu, Yang; Zhang, Lingxia; Su, Hongming; Zheng, Xiaodong
Ethyl Carbamate (EC) was detected in many fermented foods. Previous studies indicated that frequent exposure to ethyl carbamate may increase the risk to suffer from cancers. Blackberry is rich in polyphenols and possesses potent antioxidant activity. This study aims to investigate the protective effect of blackberry homogenates produced before (BH) and after in vitro simulated gastrointestinal digestion (BD) on EC-induced toxicity in Caco-2 cells. Our results showed that blackberry homogenates after digestion (BD) was more effective than that before digestion (BH) in ameliorating EC-induced toxicity in Caco-2 cells. Further investigation revealed that BD remarkably attenuated EC-induced toxicity through restoring mitochondrial function, inhibiting glutathione depletion and decreasing overproduction of intracellular reactive oxygen species. Additionally, LC-MS result implied that the better protective capacity of BD may be related to the increased content of two anthocyanins (cyanidin-3-glucoside and cyanidin-3-dioxalyglucoside). Overall, the present study may give implication to prevent EC-induced health problem.
UV protection afforded by gel-trapped TiO2 particles.
Sojka, Milan F; Cummins, Phillip G; Declercq, Lieve A G; Fthenakis, Christina G; Ionita-Manzatu, Mirela C; Lee, Wilson A; Maes, Daniel H; McKeever-Alfieri, Mary Ann; Najdek, Linda J; Pernodet, Nadine; Sente, Ilse M E; Teta, Lawrence P; Van Rillaer, Katrin; Yarosh, Daniel B; Giacomoni, Paolo U
We have developed a technology to incorporate micronized titanium dioxide (TiO(2)), together with antioxidants, in particles of a UV-visible transparent polymer gel. These particles are coated with silica to avoid clustering and the size of the micronized TiO(2) reduces the back scattering of white light. gel-trapped TiO(2) minimizes the oxidative stress exerted by UV radiation, increases the photo-stability of some accompanying ingredients, such as avobenzone. The size of the particles is in the micrometre range. This favors their permanence on the top of the stratum corneum. Gel-trapped TiO(2)-based sunscreens provide a larger SPF and two-fold larger UVA protection than equal-composition sunscreens that contain larger amounts of untrapped TiO(2).
Hybrid cluster proteins and flavodiiron proteins afford protection to Desulfovibrio vulgaris upon macrophage infection.
Figueiredo, Mafalda C O; Lobo, Susana A L; Sousa, Sara H; Pereira, Fábio P; Wall, Judy D; Nobre, Lígia S; Saraiva, Lígia M
Desulfovibrio species are Gram-negative anaerobic sulfate-reducing bacteria that colonize the human gut. Recently, Desulfovibrio spp. have been implicated in gastrointestinal diseases and shown to stimulate the epithelial immune response, leading to increased production of inflammatory cytokines by macrophages. Activated macrophages are key cells of the immune system that impose nitrosative stress during phagocytosis. Hence, we have analyzed the in vitro and in vivo responses of Desulfovibrio vulgaris Hildenborough to nitric oxide (NO) and the role of the hybrid cluster proteins (HCP1 and HCP2) and rubredoxin oxygen oxidoreductases (ROO1 and ROO2) in NO protection. Among the four genes, hcp2 was the gene most highly induced by NO, and the hcp2 transposon mutant exhibited the lowest viability under conditions of NO stress. Studies in murine macrophages revealed that D. vulgaris survives incubation with these phagocytes and triggers NO production at levels similar to those stimulated by the cytokine gamma interferon (IFN-γ). Furthermore, D. vulgaris hcp and roo mutants exhibited reduced viability when incubated with macrophages, revealing that these gene products contribute to the survival of D. vulgaris during macrophage infection.
77 FR 67865 - Enhancing Protections Afforded Customers and Customer Funds Held by Futures Commission Merchants...
Federal Register 2010, 2011, 2012, 2013, 2014
... proceedings. On October 31, 2011, MF Global, Inc. (``MFGI''), which was dually-registered as an FCM with the... significant transfers of funds out of the customer accounts that were used by MFGI for various purposes other... re MF Global Inc., No. 11-2790 (MG) SIPA (Bankr. S.D.N.Y. Jun. 4, 2012). In addition, the...
Insurance Enrollment at a Student-Run Free Clinic After the Patient Protection and Affordable Care Act.
McGeehan, Megan; DeMaria, Rebecca; Charney, Pamela; Batavia, Ashita S
The Patient Protection and Affordable Care Act (ACA) aims to increase insurance coverage through government subsidies. Medical student-run free clinics (SRFC) are an important entry point into the healthcare system for the uninsured. SRFCs do not have a standardized approach for navigating the complexities of enrollment. The Weill Cornell Community Clinic (WCCC) developed a unique enrollment model that may inform other SRFCs. Our objective is to describe enrollment processes at SRFCs throughout New York City, and to evaluate enrollment outcomes and persistent barriers to coverage at WCCC. We surveyed SRFC leadership throughout NYC to understand enrollment processes. We evaluated enrollment outcomes at WCCC through chart review and structured phone interviews. Subjects included WCCC patients seen in clinic between October 1, 2013 and September 30, 2015 (N = 140). Demographic information, method of insurance enrollment, and qualitative description of enrollment barriers were collected. SRFCs in New York City have diverse enrollment processes. 48% (N = 42) of WCCC patients obtained health insurance. Immigration status was a barrier to coverage in 21% of patients. Failure to gain coverage was predicted by larger household size (p = 0.02). Gender and employment status were not associated with remaining uninsured. The main barriers to enrollment were inability to afford premiums and lack of interest. Insurance enrollment processes at SRFCs in New York City are mostly ad hoc and outcomes are rarely tracked. Following implementation of the ACA, WCCC stands out for its structured approach, with approximately half of eligible WCCC patients gaining coverage during the study period.
Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade.
Manchikanti, Laxmaiah; Caraway, David L; Parr, Allan T; Fellows, Bert; Hirsch, Joshua A
The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama's signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured - subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system - neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and
Evidence of Zinc in Affording Protection Against X-Ray-Induced Brain Injury in Rats.
Sharma, Priyanka; Singla, Neha; Dhawan, D K
In the present world, X-rays have been regarded as one of the most efficient tools in medicine, industry and research. On the contrary, extensive human exposure to these rays is responsible for causing detrimental effects on physiological system. The aim of the present study was to investigate the role of zinc (Zn), if any, in mitigating the adverse effects induced by fractionated X-irradiation on rat brain. Female Sprague-Dawley rats weighing 170-200 g were divided into four different groups viz.: (a) normal control, (b) X-irradiated (21Gy), (c) zinc treated (227 mg/L in drinking water) and (d) X-irradiated + zinc treated. The skulls of animals belonging to groups (b) and (d) were exposed to X-rays in 30 fractions. Each fraction delivered a radiation dose of 70 rads, and rats were exposed to two fractions every day for 15 days, consecutively. X-ray treatment resulted in significant alterations in the neurobehavior, neurotransmitter levels and neuro-histoarchitecture of rats, whereas zinc co-treatment with X-rays resulted in significant improvement in these parameters. X-ray exposure also caused a significant increase in the levels of lipid peroxidation as well as activities of catalase and superoxide dismutase, which however were decreased upon simultaneous Zn treatment. On the contrary, X-ray treatment down-regulated the glutathione system, which were found to be up-regulated by zinc co-treatment. Further, protein expressions of p53 and NF-ҚB were found to be significantly elevated after X-irradiation, which were reversed following Zn supplementation. Hence, Zn seems to be an effective agent in mitigating the detrimental effects caused by exposure to X-rays.
Residential building codes, affordability, and health protection: a risk-tradeoff approach.
Hammitt, J K; Belsky, E S; Levy, J I; Graham, J D
Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.
Group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act. Final rules.
These regulations finalize, without change, interim final regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act.
Health insurance coverage in the Houston-Galveston area under the patient protection and affordable care act.
Begley, Charles; Deshmukh, Ashish; Eschbach, Karl; Fouladi, Negin; Liu, Qian June; Reynolds, Thomas
This study projects the number of nonelderly people who could gain coverage under the Patient Protection and Affordable Care Act (PPACA) for the period from 2014 through 2020 in the 13-county Houston-Galveston area region. The major PPACA provisions aimed at expanding coverage as well as the populations targeted by those provisions are described. Projections of the impact of PPACA on coverage in the area are based on estimates of growth in the size of targeted populations in each county and the anticipated responses of those populations to the major provisions of PPACA. The projections indicate that, if fully implemented, PPACA could cut the uninsurance rate in the region by half, from 26% in 2010 to 13% in 2020. This change translates into health insurance coverage for approximately 2 million additional people, from the current 4.2 million to a projected 5.9 million. The number of Medicaid enrollees could increase by an estimated 600,000 (a 79% increase), although private insurance coverage, which could increase by as much as 1 million enrollees (a 30% increase), will remain the primary source of coverage for most people. Coverage gains from PPACA will vary considerably by county, depending on the age-income-citizenship characteristics of the population, current uninsurance rates, and the rate of population growth.
Perceptions of Occupational Therapists on the Patient Protection and Affordable Care Act: Five Years After Its Enactment.
Yuen, Hon K; Spicher, Hillary S; Semon, Madelyn R; Winwood, Leah M; Dudgeon, Brian J
This study explored the perceptions of occupational therapists regarding the impact and implications of the Patient Protection and Affordable Care Act (PPACA or ACA) on occupational therapy practice. Fifteen occupational therapists participated in an interview to answer open-ended questions related to their thoughts and perceptions regarding the impact and implications of the ACA on their practice. The participants were practicing in eight different states and worked in five different settings with clinical experience ranging from 3 to 38 years; their positions ranged from staff therapist to owner of a free-standing outpatient clinic. Qualitative content analysis was used to synthesize the interview transcripts. Results showed that therapists did not have sufficient knowledge on the various mandates and provisions of the ACA, or were uncertain about what implications the ACA would have on practice, with the ACA affecting some settings more than others. Data revealed the perceived impacts of the ACA on occupational therapy practice include greater attention on documenting outcome-focused care, external accountability pressures on productivity, conscientiousness about clients' insurance coverage, uncertainty about collaborative care delivery, and survival of small businesses. Findings suggest training regarding knowledge about and implications of different elements of the ACA is needed as well as practices needing to promote the services that occupational therapists can provide to improve cost-effectiveness and outcomes in collaborative care environments.
Keeping up with the Cadillacs: What Health Insurance Disparities, Moral Hazard, and the Cadillac Tax Mean to The Patient Protection and Affordable Care Act.
Fletcher, Rebecca Adkins
A major goal of The Patient Protection and Affordable Care Act is to broaden health care access through the extension of insurance coverage. However, little attention has been given to growing disparities in access to health care among the insured, as trends to reduce benefits and increase cost sharing (deductibles, co-pays) reduce affordability and access. Through a political economic perspective that critiques moral hazard, this article draws from ethnographic research with the United Steelworkers (USW) at a steel mill and the Retail, Wholesale and Department Store Union (RWDSU) at a food-processing plant in urban Central Appalachia. In so doing, this article describes difficulties of health care affordability on the eve of reform for differentially insured working families with employer-sponsored health insurance. Additionally, this article argues that the proposed Cadillac tax on high-cost health plans will increase problems with appropriate health care access and medical financial burden for many families.
[Clinical significance of gastrointestinal decontamination under protected environment].
Nagao, T; Yonekura, S; Komatsuda, M; Nozaki, H; Arimori, S; Sawamura, S; Ozawa, A; Sasaki, S
Many infections are caused by the patient's own oro-intestinal microbial flora under a protected environment. Thirty-eight patients with acute leukemia and two patients with blast crisis of chronic myelocytic leukemia were treated under a protected environment with or without prophylactic antibiotics. Antibiotics used for decontamination were vancomycin (V), polymyxin B (P) and nystatin (N). The number of patients in the VPN, PN and the no antibiotic group were 13, 13 and 14, respectively. While the intestinal microbial flora was almost completely eliminated in VPN group, the number of bacteria decreased slightly in PN group. The mean number of pharyngeal and anorectal bacterial species decreased most markedly in the VPN group, but there were no significant differences among the three groups. The number of febrile days was significantly lower in the VPN and PN group than the no antibiotics group with neutrophil counts of less than 100 microliters. The average number of episodes of infection per patient was lowest in VPN group and highest in the no antibiotic group. These data indicate that VPN administration is effective for eliminating intestinal bacterial flora and resultantly protecting endogenous infections.
NASA Astrophysics Data System (ADS)
Slegers, Karin; de Roeck, Dries; Arnall, Timo
The workshop "Touch Affordances" addresses a concept relevant to human computer interactions based on touch. The main topic is the challenge of applying the notion of affordances to domains related to touch interactions (e.g. (multi)touch screens, RFID & NFC, ubiquitous interfaces). The goals of this workshop are to launch a community of researchers, designers, etc. interested in this topic, to create a common understanding of the field of touch affordances and to generate ideas for new research areas for intuitive touch interactions. The workshop will be highly interactive and will have a creative, generative character.
Assessment of the protection afforded by triple baculovirus recombinant coexpressing H5, N3, M1 proteins against a homologous H5N3 low-pathogenicity avian influenza virus challenge in Muscovy ducks.
Prel, Anne; Le Gall-Reculé, Ghislaine; Cherbonnel, Martine; Grasland, Béatrice; Amelot, Michel; Jestin, Véronique
In Asia, domestic ducks have been shown to play a pivotal role in H5 high-pathogenicity avian influenza virus transmission. We have also observed that the same situation may exist for H5 low-pathogenicity avian influenza (LPAI) virus. No data are available regarding the protection afforded by commercial inactivated vaccines against H5 LPAI virus infection in ducks, and two preliminary experiments using commercial inactivated vaccines gave poor results. Virus-like particles (VLPs) have been shown to be immunogenic in different species. With regard to the influenza model, the matrix (M) protein has been shown to be necessary for the formation of VLPs. In order to attempt to develop a VLP influenza vaccine expressing hemagglutinin and neuraminidase (NA) of interest, we generated a triple recombinant baculovirus (rB) expressing three structural proteins: H5, N3, and M, derived from a recent French LPAI virus strain. Although the three proteins were successfully expressed in rB-infected cells and displayed the expected biological activity, no VLPs were observed. Despite this result, the protection afforded to ducks by rB-infected cell lysates was assessed and was compared with the protection afforded by an inactivated commercial H5N9 vaccine. For this purpose, specific-pathogen-free Muscovy ducks (15 per group) received rB-infected cell lysates (3 wk apart), while a second group received the H5N9 vaccine. Ten days after the boost, a homologous virus challenge was implemented. Both vaccines induced positive hemagglutination inhibition titers and M immune response, whereas lysates of rB-infected cells elicited NA immune response. Tracheal and cloacal sheddings were measured using M-based real-time-reverse transcription-polymerase chain reaction and were compared with the sheddings of vaccinated and unvaccinated infected controls. Lysates of rB-infected cells afforded a significant decrease of cloacal shedding and a delayed peak of tracheal shedding, whereas the
Lack of protection afforded by ribonucleic acid preparations from Mycobacterium tuberculosis against Mycobacterium leprae infections in mice.
Shepard, C C; Youmans, A Y; Youmans, G P
Mycobacterial ribonucleic acid preparations from H37Ra, an attenuated strain of Mycobacterium tuberculosis, provide their usual marked protection against M. tuberculosis challenge; however, they provided no protection against Mycobacterium leprae challenge. Suspensions of intact H37Ra were not effective against M. leprae. Suspensions of BCG gave their usual distinct protection against M. leprae challenge. PMID:404242
Interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Interim final rules with request for comments.
This document contains interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan.
Rak, Sofija; Coffin, Janis
The Patient Protection and Affordable Care Act of 2010 (PPACA), although a subject of much debate in the Unites States, was enacted on March 23, 2010, and upheld by the Supreme Court on June 28, 2012. This act advocates that "healthcare is a right, not a privilege." The main goals of PPACA are to minimize the number of uninsured Americans and make healthcare available to everyone at an affordable price. The Congressional Budget Office has determined that 94% of Americans will have healthcare coverage while staying under the $900 billion limit that President Barack Obama established by bending the healthcare cost curve and reducing the deficit over the next 10 years.
A role for lipid rafts in the protection afforded by docosahexaenoic acid against ethanol toxicity in primary rat hepatocytes.
Aliche-Djoudi, Fatiha; Podechard, Normand; Collin, Aurore; Chevanne, Martine; Provost, Emilie; Poul, Martine; Le Hégarat, Ludovic; Catheline, Daniel; Legrand, Philippe; Dimanche-Boitrel, Marie-Thérèse; Lagadic-Gossmann, Dominique; Sergent, Odile
Previously, we demonstrated that eicosapentaenoic acid enhanced ethanol-induced oxidative stress and cell death in primary rat hepatocytes via an increase in membrane fluidity and lipid raft clustering. In this context, another n-3 polyunsaturated fatty acid, docosahexaenoic acid (DHA), was tested with a special emphasis on physical and chemical alteration of lipid rafts. Pretreatment of hepatocytes with DHA reduced significantly ethanol-induced oxidative stress and cell death. DHA protection could be related to an alteration of lipid rafts. Indeed, rafts exhibited a marked increase in membrane fluidity and packing defects leading to the exclusion of a raft protein marker, flotillin. Furthermore, DHA strongly inhibited disulfide bridge formation, even in control cells, thus suggesting a disruption of protein-protein interactions inside lipid rafts. This particular spatial organization of lipid rafts due to DHA subsequently prevented the ethanol-induced lipid raft clustering. Such a prevention was then responsible for the inhibition of phospholipase C-γ translocation into rafts, and consequently of both lysosome accumulation and elevation in cellular low-molecular-weight iron content, a prooxidant factor. In total, the present study suggests that DHA supplementation could represent a new preventive approach for patients with alcoholic liver disease based upon modulation of the membrane structures.
Carvedilol-Afforded Protection against Daunorubicin-Induced Cardiomyopathic Rats In Vivo: Effects on Cardiac Fibrosis and Hypertrophy
Arozal, Wawaimuli; Sari, Flori R.; Watanabe, Kenichi; Arumugam, Somasundaram; Veeraveedu, Punniyakoti T.; Ma, Meilei; Thandavarayan, Rajarajan A.; Sukumaran, Vijayakumar; Lakshmanan, Arun Prasath; Kobayashi, Yoshiyasu; Mito, Sayaka; Soetikno, Vivian; Suzuki, Kenji
Anthracyclines, most powerful anticancer agents, suffer from their cardiotoxic effects, which may be due to the induction of oxidative stress. Carvedilol, a third-generation, nonselective β-adrenoreceptor antagonist, possesses both reactive oxygen species (ROS) scavenging and ROS suppressive effects. It showed protective effects against daunorubicin- (DNR-) induced cardiac toxicity by reducing oxidative stress and apoptosis. This study therefore was designed to examine the effects of carvedilol on DNR-induced cardiomyopathic rats, focused on the changes of left ventricular function, cardiac fibrosis, and hypertrophy. Carvedilol increased survival rate, prevented systolic and diastolic dysfunction, and attenuated myocardial fibrosis and hypertrophy. DNR alone treated rats showed upregulated myocardial expression of ANP, PKC-α, OPN, and TGF-β1 and downregulation of GATA-4 in comparison with control, and treatment with carvedilol significantly reversed these changes. The results of the present study add the available evidences on the cardioprotection by carvedilol when associated with anthracyclines and explain the mechanisms underlying the benefits of their coadministration. PMID:22084713
75 FR 60482 - Proposed Extension of Information Collection Request Submitted for Public Comment; Affordable...
Federal Register 2010, 2011, 2012, 2013, 2014
... Comment; Affordable Care Act Enrollment Opportunity Notice Relating to Dependent Coverage; Affordable Care Act Grandfathered Health Plan Disclosure and Recordkeeping Requirement; Affordable Care Act Rescission Notice; Affordable Care Act Patient Protections Notice; Affordable Care Act Enrollment Opportunity...
The Significance of Animal Cruelty in Child Protection Investigations
ERIC Educational Resources Information Center
Girardi, Alberta; Pozzulo, Joanna D.
The purpose of this study was to investigate the frequency with which child protection workers (CPWs) in Ontario, Canada, seek information about animal cruelty during investigations of child maltreatment and the extent to which they consider information about animal cruelty when making decisions about whether intervention is required. The CPWs (N…
Thermal protection afforded by two anti-exposure coveralls when worn in cold water. Final technical report, December 1987-July 1988
Pimental, N.A.; Avellini, B.A.
The Navy Clothing and Textile Research Facility (NCTRF) was contracted by U.S. Coast Guard Headquarters to evaluate the thermal protection afforded by two prototype aircrew anti exposure coveralls when worn in cold water. The coveralls were developed by two different manufacturers to meet U.S. Coast Guard specification G-OAV-3-1401/A of 15 July 1986. The coveralls were evaluated on seven male subjects immersed in 10/sup 0/C water for 2 hours (with air temperature 13/sup 0/C, minimal wind). When either of the two anti-exposure coveralls was worn, all subjects were able to complete the 2-hour water immersion. There were no differences in the thermal protection afforded by the two coveralls, as measured by rectal temperature, skin temperature, heart rate, and oxygen uptake responses (P>0.05). The decrease in rectal temperature after 2 hours of cold water immersion averaged 1.0 C; mean weighted skin temperature averaged 2.3/sup 0/C. Final heart rate averaged 77 b/min. Oxygen consumption, used as a measure of shivering, was the same when either coverall was worn. Both coveralls met the Coast Guard requirement of preventing rectal temperature from dropping more than 1 C per hour.
Protective efficacy afforded by live Pasteurella multocida vaccines in chickens is independent of lipopolysaccharide outer core structure.
Harper, Marina; John, Marietta; Edmunds, Mark; Wright, Amy; Ford, Mark; Turni, Conny; Blackall, P J; Cox, Andrew; Adler, Ben; Boyce, John D
Pasteurella multocida is a major animal pathogen that causes a range of diseases including fowl cholera. P. multocida infections result in considerable losses to layer and breeder flocks in poultry industries worldwide. Both killed whole-cell and live-attenuated vaccines are available; these vaccines vary in their protective efficacy, particularly against heterologous strains. Moreover, until recently there was no knowledge of P. multocida LPS genetics and structure to determine precisely how LPS structure affects the protective capacity of these vaccines. In this study we show that defined lipopolysaccharide (LPS) mutants presented as killed whole-cell vaccines elicited solid protective immunity only against P. multocida challenge strains expressing highly similar or identical LPS structures. This finding indicates that vaccination of commercial flocks with P. multocida killed cell formulations will not protect against strains producing an LPS structure different to that produced by strains included in the vaccine formulation. Conversely, protective immunity conferred by vaccination with live P. multocida strains was found to be largely independent of LPS structure. Birds vaccinated with a range of live mutants belonging to the L1 and L3 LPS genotypes, each expressing a specific truncated LPS structure, were protected against challenge with the parent strain. Moreover, birds vaccinated with any of the five LPS mutants belonging to the L1 LPS genotype were also protected against challenge with an unrelated strain and two of the five groups vaccinated with live LPS mutants belonging to the L3 genotype were protected against challenge with an unrelated strain. In summary, vaccination with live P. multocida aroA mutants producing full-length L1 or L3 LPS or vaccination with live strains producing shortened L1 LPS elicited strong protective immunity against both homologous and heterologous challenge.
Goldstein, Adam O
Once a year, Stuart, a long-haul truck driver, visited a physician to get a signature on the forms that allowed him to continue driving his 18-wheeler. Over 8 years, he had never seen the same physician twice, in large part because of a lack of health insurance. Upon seeing him for the first time, I assured him that we could make financial arrangements, and he subsequently became my continuity patient. Two years later, we both looked forward to his impending 65th birthday, allowing Medicare to ease his fiscal health care burdens. His unexpected death made me ponder how a lack of access to affordable health care profoundly affects patients and their clinicians.
Immunogenicity and Cross Protection in Mice Afforded by Pandemic H1N1 Live Attenuated Influenza Vaccine Containing Wild-Type Nucleoprotein
Isakova-Sivak, Irina; Petukhova, Galina; Korenkov, Daniil; Losev, Igor; Smolonogina, Tatiana; Tretiak, Tatiana; Donina, Svetlana; Shcherbik, Svetlana; Bousse, Tatiana; Rudenko, Larisa
Since conserved viral proteins of influenza virus, such as nucleoprotein (NP) and matrix 1 protein, are the main targets for virus-specific CD8+ cytotoxic T-lymphocytes (CTLs), we hypothesized that introduction of the NP gene of wild-type virus into the genome of vaccine reassortants could lead to better immunogenicity and afford better protection. This paper describes in vitro and in vivo preclinical studies of two new reassortants of pandemic H1N1 live attenuated influenza vaccine (LAIV) candidates. One had the hemagglutinin (HA) and neuraminidase (NA) genes from A/South Africa/3626/2013 H1N1 wild-type virus on the A/Leningrad/134/17/57 master donor virus backbone (6 : 2 formulation) while the second had the HA, NA, and NP genes of the wild-type virus on the same backbone (5 : 3 formulation). Although both LAIVs induced similar antibody immune responses, the 5 : 3 LAIV provoked greater production of virus-specific CTLs than the 6 : 2 variant. Furthermore, the 5 : 3 LAIV-induced CTLs had higher in vivo cytotoxic activity, compared to 6 : 2 LAIV. Finally, the 5 : 3 LAIV candidate afforded greater protection against infection and severe illness than the 6 : 2 LAIV. Inclusion in LAIV of the NP gene from wild-type influenza virus is a new approach to inducing cross-reactive cell-mediated immune responses and cross protection against pandemic influenza. PMID:28210631
How Much Protection Does a College Degree Afford? The Impact of the Recession on Recent College Graduates
ERIC Educational Resources Information Center
Economic Mobility Project, 2013
This report examines whether a college degree protected recent graduates from a range of poor employment outcomes during the recession, including unemployment, low-skill jobs, and lesser wages. The report draws upon data from the 2003-2011 Current Population Survey (CPS) to examine the early labor market outcomes of 21- through 24-year-olds. The…
Practical and affordable measures for the protection of health care workers from tuberculosis in low-income countries.
Harries, A. D.; Maher, D.; Nunn, P.
With the global upsurge in tuberculosis (TB), fueled by the human immunodeficiency virus (HIV) pandemic, and the increase in multidrug-resistant TB, the condition has become a serious occupational hazard for health care workers worldwide. Much of the current understanding about nosocomial TB transmission stems from the USA; however, little is known about the risk of such transmission in low-income countries. The focus of this review is on sub-Saharan Africa, since this is the region with the highest TB incidence, the highest HIV incidence, the worst epidemic of HIV-related TB, and where the risk to health care workers is probably greatest. Measures used in industralized countries to control nosocomial TB transmission (ventilation systems, isolation rooms, personal protective equipment) are beyond the resources of low-income countries. Protecting health care workers in these settings involves practical measures relating to diagnosis and treatment of infectious cases; appropriate environmental control; and relevant personal protection and surveillance of health care workers. Research needs to be carried out to examine the feasibility and cost-effectiveness of measures such as voluntary HIV-testing of health care workers (to enable known HIV-positive health care workers to avoid high-risk settings) and isoniazid preventive therapy for workers in high-risk settings. More resources are also needed to ensure full implementation of currently recommended measures to decrease the risk of nosocomial and laboratory-acquired TB. PMID:9447782
The Protective Effect against Extracellular Histones Afforded by Long-Pentraxin PTX3 as a Regulator of NETs
Daigo, Kenji; Takamatsu, Yuichiro; Hamakubo, Takao
Pentraxin 3 (PTX3) is a soluble pattern recognition molecule that plays critical roles in innate immunity. Its fundamental functions include recognition of microbes, activation of complement cascades, and opsonization. The findings that PTX3 is one of the component proteins in neutrophil extracellular traps (NETs) and binds with other NET proteins imply the importance of PTX3 in the NET-mediated trapping and killing of bacteria. As NETs play certain critically important host-protective roles, aberrant NET production results in tissue damage. Extracellular histones, the main source of which is considered to be NETs, are mediators of septic death due to their cytotoxicity toward endothelial cells. PTX3 protects against extracellular histones-mediated cytotoxicity through coaggregation. In addition to the anti-bacterial roles performed in coordination with other NET proteins, PTX3 appears to mitigate the detrimental effect of over-activated NETs. A better understanding of the role of the PTX3 complexes in NETs would be expected to lead to new strategies for maintaining a healthy balance between the helpful bactericidal and undesirable detrimental activities of NETs. PMID:27656184
Significant Decisions in Labor Cases.
ERIC Educational Resources Information Center
Monthly Labor Review, 1979
Several significant court decisions involving labor cases are discussed including a series of decisions concerning constitutional protections afforded aliens; the First Amendment and national labor relations laws; and the bifurcated backpay rule. (BM)
77 FR 47768 - Protection of Stratospheric Ozone: Determination 27 for Significant New Alternatives Policy Program
Federal Register 2010, 2011, 2012, 2013, 2014
... ozone-depleting substances (ODSs) in all industrial sectors, visit EPA's Ozone Layer Protection Web site... AGENCY 40 CFR Part 82 RIN 2060-AG12 Protection of Stratospheric Ozone: Determination 27 for Significant... substitutes for ozone-depleting substances under the U.S. Environmental Protection Agency's (EPA)...
Amendment to the interim final rules for group health plans and health insurance coverage relating to status as a grandfathered health plan under the Patient Protection and Affordable Care Act. Amendment to interim final rules with request for comments.
This document contains an amendment to interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Patient Protection and Affordable Care Act regarding status as a grandfathered health plan; the amendment permits certain changes in policies, certificates, or contracts of insurance without loss of grandfathered status.
Overview of the Affordable Care Act's impact on military and veteran mental health services: nine implications for significant improvements in care.
Russell, Mark C; Figley, Charles R
On March 23, 2010, President Barack Obama signed the Affordable Care Act (ACA) into law. Implications of the ACA on mental health care for 9.7 million military active-duty, reserve, and family members and 22.2 million veterans, as well as 1.3 uninsured veterans, is reviewed in light of a major crisis. The authors trace historical roots of the ACA to the World War II generation and efforts to transform the mental health care system by implementing hard-won war trauma lessons. The authors posit 9 principles reflected in the ACA that represent unfulfilled generational war trauma lessons and potential transformation of the military and national mental health care systems.
Meeting the Tobacco Cessation Coverage Requirement of the Patient Protection and Affordable Care Act: State Smoking Cessation Quitlines and Cost Sharing
Bailey, Linda; Leischow, Scott J.
Objectives. We explored whether various key stakeholders considered cost sharing with state telephone-based tobacco cessation quitlines, because including tobacco cessation services as part of the required essential health benefits is a new requirement of the Patient Protection and Affordable Care Act (ACA). Methods. We analyzed qualitative data collected from interviews conducted in April and May of 2014 with representatives of state health departments, quitline service providers, health plans, and insurance brokers in 4 US states. Results. State health departments varied in the strategies they considered the role their state quitline would play in meeting the ACA requirements. Health plans and insurance brokers referred to state quitlines because they were perceived as effective and free, but in 3 of the 4 states, the private stakeholder groups did not consider cost sharing. Conclusions. If state health departments are going to initiate cost-sharing agreements with private insurance providers, then they will need to engage a broad array of stakeholders and will need to overcome the perception that state quitline services are free. PMID:26447918
Enhanced protective efficacy against Mycobacterium tuberculosis afforded by BCG prime-DNA boost regimen in an early challenge mouse model is associated with increased splenic interleukin-2-producing CD4 T-cell frequency post-vaccination.
Kang, Han; Yuan, Qin; Ma, Hui; Hu, Zhi-Dong; Han, De-Ping; Wu, Kang; Lowrie, Douglas B; Fan, Xiao-Yong
The development of improved vaccines and vaccination strategies against Mycobacterium tuberculosis has been hindered by a limited understanding of the immune correlates of anti-tuberculosis protective immunity. Simple measurement of interferon-γ frequency or production per se does not provide adequate prediction of immune protection. In this study, we examined the relationship between T-cell immune responses and protective efficacy conferred by the heterologous vaccination strategy, bacillus Calmette-Guérin (BCG) prime-Ag85A DNA boost (B/D), in an early challenge mouse model of pulmonary tuberculosis. The results demonstrated that mice vaccinated with the B/D regimen had a significantly reduced bacillary load compared with BCG-vaccinated mice, and the reduction in colony-forming units was associated with decreased pathology and lower levels of inflammatory cytokines in the infected lungs. Further analysis of immunogenicity showed that the superior protection afforded by the B/D regimen was associated with significantly increased frequency of splenic interleukin-2 (IL-2) -producing CD4 T cells and increased IL-2 production when measured as integrated mean fluorescence intensity post-vaccination as well. These data suggest that measurement of elevated frequency of IL-2-producing CD4 T cells or IL-2 production in the spleens of vaccinated mice can predict vaccine efficacy, at least in the B/D strategy, and add to the accumulating body of evidence suggesting that BCG prime-boost strategies may be a useful approach to the control of M. tuberculosis infection.
Patient turnover and nursing employment in Massachusetts hospitals before and after health insurance reform: implications for the Patient Protection and Affordable Care Act.
Shindul-Rothschild, Judith; Gregas, Matt
The Affordable Care Act is modeled after Massachusetts insurance reforms enacted in 2006. A linear mixed effect model examined trends in patient turnover and nurse employment in Massachusetts, New York, and California nonfederal hospitals from 2000 to 2011. The linear mixed effect analysis found that the rate of increase in hospital admissions was significantly higher in Massachusetts hospitals (p<.001) than that in California and New York (p=.007). The rate of change in registered nurses full-time equivalent hours per patient day was significantly less (p=.02) in Massachusetts than that in California and was not different from zero. The rate of change in admissions to registered nurses full-time equivalent hours per patient day was significantly greater in Massachusetts than California (p=.001) and New York (p<.01). Nurse staffing remained flat in Massachusetts, despite a significant increase in hospital admissions. The implications of the findings for nurse employment and hospital utilization following the implementation of national health insurance reform are discussed.
76 FR 61269 - Protection of Stratospheric Ozone: acceptability Determination 26 for Significant New...
Federal Register 2010, 2011, 2012, 2013, 2014
...'s Ozone Layer Protection Web site at http://www.epa.gov/ozone/snap/lists/index.html . The sections... 1115 formulations are not expected to pose any significant adverse impacts on the ozone layer or... formulations are not expected to pose any significant adverse impacts on the ozone layer or climate....
Protection afforded by quercetin against H2O2-induced apoptosis on PC12 cells via activating PI3K/Akt signal pathway.
Chen, Liang; Sun, Lejin; Liu, Zhene; Wang, Hongxia; Xu, Cunli
Cell damage and apoptosis induced by oxidative stress have been involved in various neurodegenerative diseases. This study aims to explore the neuro-protective effects of quercetin on PC12 cells apoptosis induced by hydrogen peroxide (H(2)O(2)) and the underlying mechanisms. The cell viability was detected, as well as the production of reactive oxygen species (ROS), lactate dehydrogenase (LDH) leakage, and the activities of glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and malondialdehyde (MDA) of the cells in control, H(2)O(2) and quercetin groups. It finally turned out that quercetin might protect PC12 cells against the negative effect of H(2)O(2) by decreasing of LDH release, ROS concentration and MDA level and regaining the GSH-Px and SOD activities. To investigate the mechanism, LY294002 was introduced, the phosphatidylinositol-3-kinase (PI3K) inhibitor. Bax/Bcl-2 ratio and Akt phosphorylation (p-Akt) were examined by Western blot analysis. The data showed that LY294002 almost had the same effects with H(2)O(2), which was also significantly reversed by quercetin could enhance Bax/Bcl-2 ratio and adjust the p-Akt expression, which indicated quercetin might protect PC12 cells against the negative effect of H(2)O(2) via activating the PI3K/Akt signal pathway.
78 FR 13575 - Coverage of Certain Preventive Services Under the Affordable Care Act; Correction
Federal Register 2010, 2011, 2012, 2013, 2014
... Affordable Care Act; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Correction to... Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended,...
Prime-boost vaccination with recombinant H5-fowlpox and Newcastle disease virus vectors affords lasting protection in SPF Muscovy ducks against highly pathogenic H5N1 influenza virus.
Niqueux, Eric; Guionie, Olivier; Amelot, Michel; Jestin, Véronique
Vaccination protocols were evaluated in one-day old Muscovy ducklings, using an experimental Newcastle disease recombinant vaccine (vNDV-H5) encoding an optimized synthetic haemagglutinin gene from a clade 2.2.1 H5N1 highly pathogenic (HP) avian influenza virus (AIV), either as a single administration or as a boost following a prime inoculation with a fowlpox vectored vaccine (vFP89) encoding a different H5 HP haemagglutinin from an Irish H5N8 strain. These vaccination schemes did not induce detectable levels of serum antibodies in HI test using a clade 2.2.1 H5N1 antigen, and only induced H5 ELISA positive response in less than 10% of vaccinated ducks. However, following challenge against a clade 2.2.1 HPAIV, both protocols afforded full clinical protection at six weeks of age, and full protection against mortality at nine weeks. Only the prime-boost vaccination (vFP89+vNDV-H5) was still fully protecting Muscovy ducks against disease and mortality at 12 weeks of age. Reduction of oropharyngeal shedding levels was also constantly observed from the onset of the follow-up at 2.5 or three days post-infection in vaccinated ducks compared to unvaccinated controls, and was significantly more important for vFP89+vNDV-H5 vaccination than for vNDV-H5 alone. Although the latter vaccine is shown immunogenic in one-day old Muscovy ducks, the present work is original in demonstrating the high efficacy of the successive administration of two different vector vaccines encoding two different H5 in inducing lasting protection (at least similar to the one induced by an inactivated reassortant vaccine, Re-5). In addition, such a prime-boost schedule allows implementation of a DIVA strategy (to differentiate vaccinated from infected ducks) contrary to Re-5, involves easy practice on the field (with injection at the hatchery and mass vaccination later on), and should avoid eventual interference with NDV maternally derived antibodies. Last, the HA insert could be updated according to
75 FR 34017 - Protection of Stratospheric Ozone: Notice 25 for Significant New Alternatives Policy Program
Federal Register 2010, 2011, 2012, 2013, 2014
... Montreal Protocol on Substances that Deplete the Ozone Layer (Montreal Protocol) and the CAA, HCFCs are... AGENCY 40 CFR Part 82 RIN 2060-AG12 Protection of Stratospheric Ozone: Notice 25 for Significant New... Acceptability. SUMMARY: This Determination of Acceptability expands the list of acceptable substitutes for...
Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA).
Eibner, Christine; Girosi, Federico; Miller, Amalia; Cordova, Amado; McGlynn, Elizabeth A; Pace, Nicholas M; Price, Carter C; Vardavas, Raffaele; Gresenz, Carole Roan
The Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA) changes the regulatory environment within which health insurance policies on the small-group market are bought and sold. New regulations include rate bands that limit premium price variation, risk-adjustment policies that will transfer funds from low-actuarial-risk to high-actuarial-risk plans, and requirements that plans include "essential health benefits." While the new regulations will be applied to all non-grandfathered fully insured policies purchased by businesses with 100 or fewer workers, self-insured plans are exempt from these regulations. As a result, some firms may have a stronger incentive to offer self-insured plans after the ACA takes full effect. In this article we identify factors that influence employers' decisions to self-insure and estimate how the ACA will influence self-insurance rates. We also consider the implications of higher self-insurance rates for adverse selection in the non-self-insured small-group market and whether enrollees in self-insured plans receive different benefits than enrollees in fully-insured plans. Results are based on data analysis, literature review, findings from discussions with stakeholders, and microsimulation analysis using the COMPARE model. Overall, we find little evidence that self-insured plans differ systematically from fully insured plans in terms of benefit generosity, price, or claims denial rates. Stakeholders expressed significant concern about adverse selection in the health insurance exchanges due to regulatory exemptions for self-insured plans. However, our microsimulation analysis predicts a sizable increase in self-insurance only if comprehensive stop-loss policies become widely available after the ACA takes full effect and the expected cost of self-insuring with stop-loss is comparable to the cost of being fully insured in a market without rating regulations.
Metagenomic analysis reveals significant changes of microbial compositions and protective functions during drinking water treatment.
Chao, Yuanqing; Ma, Liping; Yang, Ying; Ju, Feng; Zhang, Xu-Xiang; Wu, Wei-Min; Zhang, Tong
The metagenomic approach was applied to characterize variations of microbial structure and functions in raw (RW) and treated water (TW) in a drinking water treatment plant (DWTP) at Pearl River Delta, China. Microbial structure was significantly influenced by the treatment processes, shifting from Gammaproteobacteria and Betaproteobacteria in RW to Alphaproteobacteria in TW. Further functional analysis indicated the basic metabolic functions of microorganisms in TW did not vary considerably. However, protective functions, i.e. glutathione synthesis genes in 'oxidative stress' and 'detoxification' subsystems, significantly increased, revealing the surviving bacteria may have higher chlorine resistance. Similar results were also found in glutathione metabolism pathway, which identified the major reaction for glutathione synthesis and supported more genes for glutathione metabolism existed in TW. This metagenomic study largely enhanced our knowledge about the influences of treatment processes, especially chlorination, on bacterial community structure and protective functions (e.g. glutathione metabolism) in ecosystems of DWTPs.
Transient Loss of Protection Afforded by a Live Attenuated Non-typhoidal Salmonella Vaccine in Mice Co-infected with Malaria
Lokken, Kristen L.; Nanton, Minelva R.; Nuccio, Sean-Paul; McSorley, Stephen J.; Tsolis, Renée M.
In immunocompetent individuals, non-typhoidal Salmonella serovars (NTS) are associated with gastroenteritis, however, there is currently an epidemic of NTS bloodstream infections in sub-Saharan Africa. Plasmodium falciparum malaria is an important risk factor for invasive NTS bloodstream in African children. Here we investigated whether a live, attenuated Salmonella vaccine could be protective in mice, in the setting of concurrent malaria. Surprisingly, mice acutely infected with the nonlethal malaria parasite Plasmodium yoelii 17XNL exhibited a profound loss of protective immunity to NTS, but vaccine-mediated protection was restored after resolution of malaria. Absence of protective immunity during acute malaria correlated with maintenance of antibodies to NTS, but a marked reduction in effector capability of Salmonella-specific CD4 and CD8 T cells. Further, increased expression of the inhibitory molecule PD1 was identified on memory CD4 T cells induced by vaccination. Blockade of IL-10 restored protection against S. Typhimurium, without restoring CD4 T cell effector function. Simultaneous blockade of CTLA-4, LAG3, and PDL1 restored IFN-γ production by vaccine-induced memory CD4 T cells but was not sufficient to restore protection. Together, these data demonstrate that malaria parasite infection induces a temporary loss of an established adaptive immune response via multiple mechanisms, and suggest that in the setting of acute malaria, protection against NTS mediated by live vaccines may be interrupted. PMID:26366739
Transient Loss of Protection Afforded by a Live Attenuated Non-typhoidal Salmonella Vaccine in Mice Co-infected with Malaria.
Mooney, Jason P; Lee, Seung-Joo; Lokken, Kristen L; Nanton, Minelva R; Nuccio, Sean-Paul; McSorley, Stephen J; Tsolis, Renée M
In immunocompetent individuals, non-typhoidal Salmonella serovars (NTS) are associated with gastroenteritis, however, there is currently an epidemic of NTS bloodstream infections in sub-Saharan Africa. Plasmodium falciparum malaria is an important risk factor for invasive NTS bloodstream in African children. Here we investigated whether a live, attenuated Salmonella vaccine could be protective in mice, in the setting of concurrent malaria. Surprisingly, mice acutely infected with the nonlethal malaria parasite Plasmodium yoelii 17XNL exhibited a profound loss of protective immunity to NTS, but vaccine-mediated protection was restored after resolution of malaria. Absence of protective immunity during acute malaria correlated with maintenance of antibodies to NTS, but a marked reduction in effector capability of Salmonella-specific CD4 and CD8 T cells. Further, increased expression of the inhibitory molecule PD1 was identified on memory CD4 T cells induced by vaccination. Blockade of IL-10 restored protection against S. Typhimurium, without restoring CD4 T cell effector function. Simultaneous blockade of CTLA-4, LAG3, and PDL1 restored IFN-γ production by vaccine-induced memory CD4 T cells but was not sufficient to restore protection. Together, these data demonstrate that malaria parasite infection induces a temporary loss of an established adaptive immune response via multiple mechanisms, and suggest that in the setting of acute malaria, protection against NTS mediated by live vaccines may be interrupted.
A Block Compressive Sensing Based Scalable Encryption Framework for Protecting Significant Image Regions
NASA Astrophysics Data System (ADS)
Zhang, Yushu; Zhou, Jiantao; Chen, Fei; Zhang, Leo Yu; Xiao, Di; Chen, Bin; Liao, Xiaofeng
The existing Block Compressive Sensing (BCS) based image ciphers adopted the same sampling rate for all the blocks, which may lead to the desirable result that after subsampling, significant blocks lose some more-useful information while insignificant blocks still retain some less-useful information. Motivated by this observation, we propose a scalable encryption framework (SEF) based on BCS together with a Sobel Edge Detector and Cascade Chaotic Maps. Our work is firstly dedicated to the design of two new fusion techniques, chaos-based structurally random matrices and chaos-based random convolution and subsampling. The basic idea is to divide an image into some blocks with an equal size and then diagnose their respective significance with the help of the Sobel Edge Detector. For significant block encryption, chaos-based structurally random matrix is applied to significant blocks whereas chaos-based random convolution and subsampling are responsible for the remaining insignificant ones. In comparison with the BCS based image ciphers, the SEF takes lightweight subsampling and severe sensitivity encryption for the significant blocks and severe subsampling and lightweight robustness encryption for the insignificant ones in parallel, thus better protecting significant image regions.
Global affordability of fluoride toothpaste
Goldman, Ann S; Yee, Robert; Holmgren, Christopher J; Benzian, Habib
Objective Dental caries remains the most common disease worldwide and the use of fluoride toothpaste is a most effective preventive public health measure to prevent it. Changes in diets following globalization contribute to the development of dental caries in emerging economies. The aim of this paper is to compare the cost and relative affordability of fluoride toothpaste in high-, middle- and low-income countries. The hypothesis is that fluoride toothpaste is not equally affordable in high-, middle- and low-income countries. Methods Data on consumer prices of fluoride toothpastes were obtained from a self-completion questionnaire from 48 countries. The cost of fluoride toothpaste in high-, middle- and low-income countries was compared and related to annual household expenditure as well as to days of work needed to purchase the average annual usage of toothpaste per head. Results The general trend seems to be that the proportion of household expenditure required to purchase the annual dosage of toothpaste increases as the country's per capita household expenditure decreases. While in the UK for the poorest 30% of the population only 0.037 days of household expenditure is needed to purchase the annual average dosage (182.5 g) of the lowest cost toothpaste, 10.75 days are needed in Kenya. The proportion of annual household expenditure ranged from 0.02% in the UK to 4% in Zambia to buy the annual average amount of lowest cost toothpaste per head. Conclusion Significant inequalities in the affordability of this essential preventive care product indicate the necessity for action to make it more affordable. Various measures to improve affordability based on experiences from essential pharmaceuticals are proposed. PMID:18554382
Significance of skin flavonoids for UV-B-protection in apple fruits.
Solovchenko, Alexei; Schmitz-Eiberger, Michaela
An attempt has been made to assess the UV-B-protective capacity of phenolic compounds accumulated in superficial structures of plants using apple fruit as a model. Two apple (Malus domestica Borkh.) cultivars (Braeburn and Granny Smith) differing in response to high fluxes of solar radiation were selected and exposed to increasing doses of UV-B radiation. The extent of UV-B-induced damage to photosystem II of apple skin correlated with its quercetin glycoside (but not anthocyanin) content. Granny Smith apples did not demonstrate a pronounced response to high sunlight in terms of the accumulation of phenolic substances in the skin and exhibited similar patterns of Fo, Fm, and Fv/Fm changes in the course of UV-B irradiation both on sun-exposed and shaded surfaces of a fruit. Unlike Granny Smith, Braeburn fruits were characterized by a significant accumulation of quercetin glycosides in sun-exposed skin, however, shaded skin contained these compounds in similar amounts to those in Granny Smith. Accordingly, photosystem II in sun-exposed skin of Braeburn apples was resistant to high doses of UV-B radiation (up to 97 kJ m-2), whereas the susceptibility of the photosynthetic apparatus in shaded skin of Braeburn to UV-B-induced damage was much higher and similar to that of both sun-exposed and shaded skin of Granny Smith fruits. Anthocyanins, at least in the amounts found in Braeburn, did not show an additional effect in UV-B protection.
Affordable Vehicle Avionics Overview
NASA Technical Reports Server (NTRS)
Cockrell, James J.
Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters
Affordable Vehicle Avionics Overview
NASA Technical Reports Server (NTRS)
Cockrell, James J.
Public and private launch vehicle developers are reducing the cost of propulsion for small commercial launchers, but conventional high-performance, high-reliability avionics remain the disproportionately high cost driver for launch. AVA technology performs as well or better than conventional launch vehicle avionics, but with a fraction of the recurring costs. AVA enables small launch providers to offer affordable rides to LEO to nano-satellites as primary payloads meaning, small payloads can afford to specify their own launch and orbit parameters.
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Montana: An Analysis from RAND COMPARE.
Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Montana, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Montana will fall to 3 percent; without the law, it would remain at 18 percent. The model projects that total state government spending on health care will be 3 percent higher for the combined 2011-2020 period because of the ACA.
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Illinois: An Analysis from RAND COMPARE.
Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Illinois, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Illinois will fall to 3 percent; without the law, it would remain near 15 percent. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in California: An Analysis from RAND COMPARE.
Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For California, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in California will fall to 4 percent; without the law, it would remain at 20 percent. The model projects that total state government spending on health care will be 7 percent higher for the combined 2011-2020 period because of the ACA.
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Texas: An Analysis from RAND COMPARE.
Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Texas, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Texas will fall to 6 percent; without the law, it would remain at 28 percent, the highest in the nation. The model projects that total state government spending on health care will be 10 percent higher for the combined 2011-2020 period because of the ACA.
ERIC Educational Resources Information Center
Brown, Jill P.; Stillman, Gloria
Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…
Can Consumers Make Affordable Care Affordable? The Value of Choice Architecture
Johnson, Eric J.; Hassin, Ran; Baker, Tom; Bajger, Allison T.; Treuer, Galen
Tens of millions of people are currently choosing health coverage on a state or federal health insurance exchange as part of the Patient Protection and Affordable Care Act. We examine how well people make these choices, how well they think they do, and what can be done to improve these choices. We conducted 6 experiments asking people to choose the most cost-effective policy using websites modeled on current exchanges. Our results suggest there is significant room for improvement. Without interventions, respondents perform at near chance levels and show a significant bias, overweighting out-of-pocket expenses and deductibles. Financial incentives do not improve performance, and decision-makers do not realize that they are performing poorly. However, performance can be improved quite markedly by providing calculation aids, and by choosing a "smart" default. Implementing these psychologically based principles could save purchasers of policies and taxpayers approximately 10 billion dollars every year. PMID:24367484
Patents and the obligation to protect health: examining the significance of human rights considerations in the protection of pharmaceutical patents.
Owoeye, Olasupo Ayodeji
This article discusses the human right to health in the context of patent protection and access to medicines. It considers the limitations in international human rights law, especially in relation to socioeconomic rights, that make it difficult for the right to health to be a potent justification for derogation from trade or intellectual property agreements. It concludes by taking the view that while the right to health may be somewhat unenforceable in international law, its close association with enforceable rights such as the right to life can be a legitimate basis for making maximum use of the flexibilities in the international intellectual property regime to protect public health. The article takes the view that trade and intellectual property agreements must be interpreted in a way that endeavours as much as possible to resolve any seeming inconsistency with the right to health.
Possible prebiotic significance of polyamines in the condensation, protection, encapsulation, and biological properties of DNA
NASA Technical Reports Server (NTRS)
Baeza, I.; Ibanez, M.; Wong, C.; Chavez, P.; Gariglio, P.; Oro, J.
Some properties of DNA condensed with spermidine have been compared with the properties of DNA condensed with Co3+(NH3)6 to determine whether condensation of DNA with these trivalent cations protects DNA against the action of DNase I and increases transcription and encapsulation of DNA into liposomes. It was shown that DNA condensed with Co3+(NH3)6 was resistant to the action of the endonuclease DNase I such as DNA condensed with spermidine was. However, DNA condensed with Co3+(NH3)6 was significantly less active in transcription with the E. coli RNA polymerase than DNA-spermidine condensed forms. In addition, it was demonstrated that both compacted forms of DNA were more efficiently encapsulated into neutral liposomes; however, negatively, charged liposomes were scarcely formed in the presence of DNA condensed with Co3+(NH3)6. These experiments and the well documented properties of polyamines increasing the resistance to radiations and hydrolysis of nucleic acids, as well as their biological activities, such as replication, transcription, and translation, together with the low concentration of Co3+ in the environment, lead us to propose spermidine as a plausible prebiotic DNA condensing agent rather than Co3+ and the basic proteins proposed by other authors. Then, we consider the possible role and relevance of the polyamine-nucleic acids complexes in the evolution of life.
Protect and enhance: Lowi's juridical democracy and the prevention of significant deterioration of air quality
Meiburg, A.S.
The capture of Federal regulatory agencies by the groups they were supposed to be regulating has been a topic of concern in the traditional literature of public administration. In his influential book The End of Liberalism, Professor Theordore Lowi suggested that capture resulted in part from vauge delegations of authority of Congress to regulatory agencies. Lowi argued that democracy would be better served if Congress were more specific in drafting laws, if agencies made greater use of formal rulemaking in implementing them, and if the courts rejected statutes which contained excessively vague delegations of authority - a remedy which he labeled juridicial democracy. This dissertation examines Lowi's theory in light of the experience of Congress and the Environmental Protection Agency (EPA) with the requirements of the Clean Air Act to prevent the significant deterioration of air quality in areas where air was already relatively clean. The history of the program to develop and carry out these requirements, known as PSD, is described in detail from its inception in the late 1960's through EPA's final regulations in 1980. Special attention is given to the actions taken by EPA after environmental groups successfully used the courts to force EPA to develop a PSD program in 1974, how Congress responded by amending the Clean Air Act in 1977, and the difficulties these amendments and subsequent additional court reviews caused for EPA.
Experimental shielding evaluation of the radiation protection provided by the structurally significant components of residential structures.
Dickson, E D; Hamby, D M
The human health and environmental effects following a postulated accidental release of radioactive material to the environment have been a public and regulatory concern since the early development of nuclear technology. These postulated releases have been researched extensively to better understand the potential risks for accident mitigation and emergency planning purposes. The objective of this investigation is to provide an updated technical basis for contemporary building shielding factors for the US housing stock. Building shielding factors quantify the protection from ionising radiation provided by a certain building type. Much of the current data used to determine the quality of shielding around nuclear facilities and urban environments is based on simplistic point-kernel calculations for 1950s era suburbia and is no longer applicable to the densely populated urban environments realised today. To analyse a building's radiation shielding properties, the ideal approach would be to subject a variety of building types to various radioactive sources and measure the radiation levels in and around the building. While this is not entirely practicable, this research analyses the shielding effectiveness of ten structurally significant US housing-stock models (walls and roofs) important for shielding against ionising radiation. The experimental data are used to benchmark computational models to calculate the shielding effectiveness of various building configurations under investigation from two types of realistic environmental source terms. Various combinations of these ten shielding models can be used to develop full-scale computational housing-unit models for building shielding factor calculations representing 69.6 million housing units (61.3%) in the United States. Results produced in this investigation provide a comparison between theory and experiment behind building shielding factor methodology.
"Affordable" Private Schools in South Africa. Affordable for Whom?
ERIC Educational Resources Information Center
Languille, Sonia
The paper sets out to challenge the notions of "affordable" private schools in the context of South Africa. It is guided by one main question: "affordable private schools for whom?" It argues that, contrary to claims by its public and private proponents, affordable private schools in South Africa do not cater for poor children.…
Notification: Assessment of the Qualifications of Environmental Protection Agency Personnel With Significant Security Responsibilities
Project #OMS-FY12-0006, February 15, 2012. The U.S. Environmental Protection Agency (EPA) Office of Inspector General plans to begin preliminary research for the subject project, which will be performed by a contractor.
Combined TIM-3 blockade and CD137 activation affords the long-term protection in a murine model of ovarian cancer
Background T-cell immunoglobulin and mucin domain 3 (TIM-3) is known as a negative immune regulator and emerging data have implicated TIM-3 a pivotal role in suppressing antitumor immunity. The co-stimulatory receptor CD137 is transiently upregulated on T-cells following activation and increases their proliferation and survival when engaged. Although antagonistic anti-TIM-3 or agonistic anti-CD137 antibodies can promote the rejection of several murine tumors, some poorly immunogenic tumors were refractory to this treatment. In this study, we sought to evaluate whether combined TIM-3 blockade and CD137 activation would significantly improve the immunotherapy in the murine ID8 ovarian cancer model. Methods Mice with established ID8 tumor were intraperitoneally injected with single or combined anti-TIM-3/CD137 monoclonal antibody (mAb); mice survival was recorded, the composition and gene expression of tumor-infiltrating immune cells in these mice was analyzed by flow cytometry and quantitative RT-PCR respectively, and the function of CD8+ cells was evaluated by ELISA and cytotoxicity assay. Results Either anti-TIM-3 or CD137 mAb alone, although effective in 3 days established tumor, was unable to prevent tumor progression in mice bearing 10 days established tumor, however, combined anti-TIM-3/CD137 mAb significantly inhibited the growth of these tumors with 60% of mice tumor free 90 days after tumor inoculation. Therapeutic efficacy was associated with a systemic immune response with memory and antigen specificity, required CD4+ cells and CD8+ cells. The 2 mAb combination increased CD4+ and CD8+ cells and decreased immunosuppressive CD4+FoxP3+ regulatory T (Treg) cells and CD11b+Gr-1+ myeloid suppressor cells (MDSC) at tumor sites, giving rise to significantly elevated ratios of CD4+ and CD8+ cells to Treg and MDSC; This is consistent with biasing local immune response towards an immunostimulatory Th1 type and is further supported by quantitative RT-PCR data
A small subset of protected areas are a highly significant source of carbon emissions
NASA Astrophysics Data System (ADS)
Collins, Murray B.; Mitchard, Edward T. A.
Protected areas (PAs) aim to protect multiple ecosystem services. However, not all are well protected. For the first time, using published carbon and forest loss maps, we estimate carbon emissions in large forest PAs in tropical countries (N = 2018). We found 36 ± 16 Pg C stored in PA trees, representing 14.5% of all tropical forest biomass carbon. However the PAs lost forest at a mean rate of 0.18% yr‑1 from 2000–2012. Lower protection status areas experienced higher forest losses (e.g. 0.39% yr‑1 in IUCN cat III), yet even highest status areas lost 0.13% yr‑1 (IUCN Cat I). Emissions were not evenly distributed: 80% of emissions derived from 8.3% of PAs (112 ± 49.5 Tg CO2 yr‑1 n = 171). Unsurprisingly the largest emissions derived from PAs that started with the greatest total forest area; accounting for starting forest area and relating that to carbon lost using a linear model (r2 = 0.41), we found 1.1% outlying PAs (residuals >2σ N = 23), representing 1.3% of the total PA forest area, yet causing 27.3% of all PA emissions. These results suggest PAs have been a successful means of protecting biomass carbon, yet a subset causing a disproportionately high share of emissions should be an urgent priority for management interventions.
A small subset of protected areas are a highly significant source of carbon emissions
Collins, Murray B.; Mitchard, Edward T. A.
Protected areas (PAs) aim to protect multiple ecosystem services. However, not all are well protected. For the first time, using published carbon and forest loss maps, we estimate carbon emissions in large forest PAs in tropical countries (N = 2018). We found 36 ± 16 Pg C stored in PA trees, representing 14.5% of all tropical forest biomass carbon. However the PAs lost forest at a mean rate of 0.18% yr−1 from 2000–2012. Lower protection status areas experienced higher forest losses (e.g. 0.39% yr−1 in IUCN cat III), yet even highest status areas lost 0.13% yr−1 (IUCN Cat I). Emissions were not evenly distributed: 80% of emissions derived from 8.3% of PAs (112 ± 49.5 Tg CO2 yr−1; n = 171). Unsurprisingly the largest emissions derived from PAs that started with the greatest total forest area; accounting for starting forest area and relating that to carbon lost using a linear model (r2 = 0.41), we found 1.1% outlying PAs (residuals >2σ; N = 23), representing 1.3% of the total PA forest area, yet causing 27.3% of all PA emissions. These results suggest PAs have been a successful means of protecting biomass carbon, yet a subset causing a disproportionately high share of emissions should be an urgent priority for management interventions. PMID:28186155
Protected Area Reconfiguration Project. Environmental Assessment and Finding of No Significant Impact
DOE has decided to consolidate, process, and store Category I and II Special Nuclear Material (SNM) in Building 371 at Rocky Flats, in order to improve safeguards and security and to reduce baseline facility and personnel costs. Once all SNM in consolidated into this building, maintaining the full 200-acre protected area would no longer be necessary, and the protected area (PA) could be reconfigured to include only the protection requirements necessary for Building 371. DOE Environmental Assessment 1132 has been written to evaluate options for reconfiguration of the PA; it addressed potential environmental impacts resulting from construction of fence alternatives. Possible routes for the new fence section were examined for environmental impact, feasibility, cost, and complexity. A number of the alternatives, including the proposed action, would impact wetlands.
African swine fever virus serotype-specific proteins are significant protective antigens for African swine fever
Technology Transfer Automated Retrieval System (TEKTRAN)
African swine fever (ASF) is an emerging disease threat for the swine industry worldwide. No ASF vaccine is available and progress is hindered by lack of knowledge concerning the extent of African swine fever virus (ASFV) strain diversity and the viral antigens conferring type specific protective im...
78 FR 29034 - Protection of Stratospheric Ozone: Determination 28 for Significant New Alternatives Policy Program
Federal Register 2010, 2011, 2012, 2013, 2014
..., visit EPA's Ozone Layer Protection Web site at http://www.epa.gov/ozone/snap/lists/index.html . The... Montreal Protocol on Substances that Deplete the Ozone Layer and the CAA and to other available or... deplete the ozone layer found that even with worst-case estimates of emissions which assume that...
The Impact of the Coverage-Related Provisions of the Patient Protection and Affordable Care Act on Insurance Coverage and State Health Care Expenditures in Connecticut: An Analysis from RAND COMPARE.
Auerbach, David I; Nowak, Sarah A; Ringel, Jeanne S; Girosi, Federico; Eibner, Christine; McGlynn, Elizabeth A; Wasserman, Jeffrey
The Patient Protection and Affordable Care Act (ACA) contains substantial new requirements aimed at increasing rates of health insurance coverage. Because many of these provisions impose additional costs on the states, officials need reliable estimates of the likely impact of the ACA in their state. To demonstrate the usefulness of modeling for state-level decisionmaking, RAND undertook a preliminary analysis of the impact of the ACA on five states-California, Connecticut, Illinois, Montana, and Texas-using the RAND COMPARE microsimulation model. For Connecticut, the model predicts that, in 2016 (the year that all of the provisions in the ACA related to coverage expansion will be fully implemented), the uninsured rate in Connecticut will fall to 5 percent; without the law, it would remain at 11 percent. The model projects that total state government spending on health care will be 10 percent lower for the combined 2011-2020 period than it would be without the ACA, mostly because of federal subsidies for residents who would have been covered by Connecticut's state-run health insurance program (State-Administered General Assistance).
Ergonomics: Injury Protection You Can Afford.
ERIC Educational Resources Information Center
Sturgeon, Julie
Examines the physical health risks attributed to poor furniture and equipment ergonomics and looks at ways to help assure that furniture and equipment purchases and practices are ergonomically sound. Cautions to be wary wary of marketing hype that a company's furniture is ergonomically set, and acquire adjustable furniture and encourage students…
Friendly protection of houses by affordable isolation
Mazzolani, Federico M.; Mandara, Alberto; Froncillo, Salvatore
The paper deals with a case of seismic isolation carried out in Campania (Italy), referring to the construction of a house building. The concerned case is a three-storey reinforced concrete frame building, in which the isolation system has been applied between the basement top and the first floor deck. The paper reports the main steps of this work, starting from the design, carried out according to the latest Italian seismic code, going throughout the construction stage, up to the extensive on-site testing program performed to evaluate the dynamic response of the building. Relevant technological solutions are illustrated and discussed. Both theoretical calculation and experimental measurements demonstrate the effectiveness of the solution adopted, not only from the technical point of view, but also in an economic perspective.
Pharmaceutical pricing: a review of proposals to improve access and affordability of prescription drugs.
Tironi, Paula
This article discusses how pharmaceutical innovation achieves remarkable improvements in human health but a significant portion of the U.S. population cannot afford prescription drugs. The author examines ways that patent protection, generics, supply chain complexity, and the cost of innovation and promotion affect access and affordability. The author then looks at the influences of marketing strategies and industry trends such as the patent cliff and pipeline for new drugs, innovations in biotechnology and genomics, comparative effectiveness analysis, and payor and employer strategies on drug prices. An analysis of reform proposals in the context of industry trends suggests that promoting generic drug use and availability through education, prohibiting authorized generics, and restricting the practice of developing follow-on drugs and discontinuing the original formulations upon patent expiration could improve access and affordability most quickly and significantly.
Affordability of Defense Acquisition Programs
the Office of Director, Cost Assessment and Program Evaluation (CAPE). The DPP is a particularly useful tool for assessing the affordability of DOD...within the Service programming communities. • The Defense Program Projection is a valuable tool for DOD's use in assessing affordability; however, in... tool for assessing the affordability of future acquisition in the spirit of the Better Buying Power initiative. A. Ground Rules, Assumptions, and
Selective and potent furin inhibitors protect cells from anthrax without significant toxicity.
Remacle, Albert G; Gawlik, Katarzyna; Golubkov, Vladislav S; Cadwell, Gregory W; Liddington, Robert C; Cieplak, Piotr; Millis, Sherri Z; Desjardins, Roxane; Routhier, Sophie; Yuan, Xue Wen; Neugebauer, Witold A; Day, Robert; Strongin, Alex Y
Furin and related proprotein convertases cleave the multibasic motifs R-X-R/K/X-R in the precursor proteins and, as a result, transform the latent proproteins into biologically active proteins and peptides. Furin is present both in the intracellular secretory pathway and at the cell surface. Intracellular furin processes its multiple normal cellular targets in the Golgi and secretory vesicle compartments while cell-surface furin appears to be essential only for the processing of certain pathogenic proteins and, importantly, anthrax. To design potent, safe and selective inhibitors of furin, we evaluated the potency and selectivity of the derivatized peptidic inhibitors modeled from the extended furin cleavage sequence of avian influenza A H5N1. We determined that the N- and C-terminal modifications of the original RARRRKKRT inhibitory scaffold produced selective and potent, nanomolar range, inhibitors of furin. These inhibitors did not interfere with the normal cellular function of furin because of the likely functional redundancy existing between furin and other proprotein convertases. These furin inhibitors, however, were highly potent in blocking the furin-dependent cell-surface processing of anthrax protective antigen-83 both in vitro and cell-based assays and in vivo. We conclude that the inhibitors we have designed have a promising potential as selective anthrax inhibitors, without affecting major cell functions.
75 FR 81662 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...
Federal Register 2010, 2011, 2012, 2013, 2014
...; Affordable Care Act Patient Protection Notice ACTION: Notice. SUMMARY: The Department of Labor (DOL) hereby... collection request (ICR) titled, ``Affordable Care Act Patient Protection Notice,'' to the Office of...email@example.com . SUPPLEMENTARY INFORMATION: The Patient Protection Notice is used by health...
Possible prebiotic significance of polyamines in the condensation, protection, encapsulation, and biological properties of DNA
NASA Technical Reports Server (NTRS)
Baeza, Isabel; Ibanez, Miguel; Wong, Carlos; Chavez, Pedro; Gariglio, Patricio; Oro, J.
While DNA which has undergone ionic condensation with Co(3+)(NH3)6 is resistant to the action of the endonuclase DNAse I, in much the same way as DNA condensed with spermidine, it was significantly less active in transcription with the E. coli RNA polymerase than DNA-spermidine condensed forms. Although both compacted forms of DNA were more efficiently encapsulated into neutral liposomes, negatively charged liposomes were seldom formed in the presence of the present, positive ion-condensed DNA; spermidine is accordingly proposed as a plausible prebiotic DNA-condensing agent. Attention is given to the relevance of the polyimide-nucleic acids complexes in the evolution of life.
77 FR 16501 - Certain Preventive Services Under the Affordable Care Act
Federal Register 2010, 2011, 2012, 2013, 2014
...-AR42 Certain Preventive Services Under the Affordable Care Act AGENCIES: Internal Revenue Service... regarding certain preventive health services under provisions of the Patient Protection and Affordable Care Act (Affordable Care Act). The proposed amendments would establish alternative ways to fulfill...
77 FR 17143 - Medicaid Program; Eligiblity Changes Under the Affordable Care Act of 2010
Federal Register 2010, 2011, 2012, 2013, 2014
...This final rule implements several provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act). The Affordable Care Act expands access to health insurance coverage through improvements to the Medicaid and Children's Health Insurance (CHIP) programs, the establishment of......
Exogenous NAD+ administration significantly protects against myocardial ischemia/reperfusion injury in rat model
Zhang, Youjun; Wang, Ban; Fu, Xingli; Guan, Shaofeng; Han, Wenzheng; Zhang, Jie; Gan, Qian; Fang, Weiyi; Ying, Weihai; Qu, Xinkai
Acute myocardial infarction is one of the leading causes for death around the world. Although essential for successful interventional therapy, it is inevitably complicated by reperfusion injury. Thus effective approaches to reduce ischemia/reperfusion (I/R) injury are still critically needed. To test our hypothesis that intravenous administration of NAD+ can attenuate I/R injury by reducing apoptotic damage and enhancing antioxidant capacity, we used a rat mode of myocardial I/R. Our study found that administration of 10-20 mg/kg NAD+ can dose dependently reduce myocardial infarct induced by I/R, with an approximately 85% reduction of the infarct at the dosage of 20 mg/kg NAD+. We further found that the injection of NAD+ can significantly decrease I/R-induced apoptotic damage in the heart: NAD+ administration can both decrease the TUNEL signals, Bax, cleaved caspase-3 levels and increase the Bcl-XL levels in the rats that are subjected to myocardial I/R injury. NAD+ administration can also significantly attenuate I/R-induced decreases in SOD activity and SOD-2 protein levels in the hearts. NAD+ can profoundly decrease myocardial I/R injury at least partially by attenuating apoptotic damage and enhancing the antioxidant capacity, thus suggesting that NAD+ may become a promising therapeutic agent for myocardial I/R injury. PMID:27648125
Phytate in foods and significance for humans: food sources, intake, processing, bioavailability, protective role and analysis.
Schlemmer, Ulrich; Frølich, Wenche; Prieto, Rafel M; Grases, Felix
The article gives an overview of phytic acid in food and of its significance for human nutrition. It summarises phytate sources in foods and discusses problems of phytic acid/phytate contents of food tables. Data on phytic acid intake are evaluated and daily phytic acid intake depending on food habits is assessed. Degradation of phytate during gastro-intestinal passage is summarised, the mechanism of phytate interacting with minerals and trace elements in the gastro-intestinal chyme described and the pathway of inositol phosphate hydrolysis in the gut presented. The present knowledge of phytate absorption is summarised and discussed. Effects of phytate on mineral and trace element bioavailability are reported and phytate degradation during processing and storage is described. Beneficial activities of dietary phytate such as its effects on calcification and kidney stone formation and on lowering blood glucose and lipids are reported. The antioxidative property of phytic acid and its potentional anticancerogenic activities are briefly surveyed. Development of the analysis of phytic acid and other inositol phosphates is described, problems of inositol phosphate determination and detection discussed and the need for standardisation of phytic acid analysis in foods argued.
Antibody treatment against pulmonary exposure to abrin confers significantly higher levels of protection than treatment against ricin intoxication.
Sabo, Tamar; Gal, Yoav; Elhanany, Eitan; Sapoznikov, Anita; Falach, Reut; Mazor, Ohad; Kronman, Chanoch
Abrin, a potent plant-derived toxin bearing strong resemblance to ricin, irreversibly inactivates ribosomes by site-specific depurination, thereby precipitating cessation of protein synthesis in cells. Due to its high availability and ease of preparation, abrin is considered a biological threat, especially in context of bioterror warfare. To date, there is no established therapeutic countermeasure against abrin intoxication. In the present study, we examined the progress of pulmonary abrin intoxication in mice, evaluated the protective effect of antibody-based post-exposure therapy, and compared these findings to those observed for ricin intoxication and therapy. Salient features of abrin intoxication were found to be similar to those of ricin and include massive recruitment of neutrophils to the lungs, high levels of pro-inflammatory markers in the bronchoalveolar lavage fluid and damage of the alveolar-capillary barrier. In contrast, the protective effect of anti-abrin antibody treatment was found to differ significantly from that of anti-ricin treatment. While anti-ricin treatment efficiency was quite limited even at 24h post-exposure (34% protection), administration of polyclonal anti-abrin antibodies even as late as 72h post-exposure, conferred exceedingly high-level protection (>70%). While both anti-toxin antibody treatments caused neutrophil and macrophage levels in the lungs to revert to normal, only anti-abrin treatment brought about a significant decline in the pulmonary levels of the pro-inflammatory cytokine IL-6. The differential ability of the anti-toxin treatments to dampen inflammation caused by the two similar toxins, abrin and ricin, could explain the radically different levels of protection achieved following antibody treatment.
Proposed regulations could limit access to affordable health coverage for workers' children and family members.
Jacobs, Ken; Graham-Squire, Dave; Roby, Dylan H; Kominski, Gerald F; Kinane, Christina M; Needleman, Jack; Watson, Greg; Gans, Daphna
Key Findings. The Patient Protection and Affordable Care Act (ACA) is designed to offer premium subsidies to help eligible individuals and their families purchase insurance coverage when affordable job-based coverage is not available. However, the law is unclear on how this affordability protection is applied in those instances where self-only coverage offered by an employer is affordable but family coverage is not. Regulations recently proposed by the Department of the Treasury would make family members ineligible for subsidized coverage in the exchange if an employee is offered affordable self-only coverage by an employer, even if family coverage is unaffordable. This could have significant financial consequences for low- and moderate-income families that fall in this gap. Using an alternative interpretation of the law could allow the entire family to enter the exchange when family coverage is unaffordable, which would broaden access to coverage. However, this option has been cited as cost prohibitive. In this brief we consider a middle ground alternative that would base eligibility for the individual worker on the cost of self-only coverage, but would use the additional cost to the employee for family coverage as the basis for determining affordability and eligibility for subsidies for the remaining family members. We find that: Under the middle ground alternative scenario an additional 144,000 Californians would qualify for and use premium subsidies in the California Health Benefit Exchange, half of whom are children. Less than 1 percent of those with employer-based coverage would move to subsidized coverage in the California Health Benefit Exchange as a result of having unaffordable coverage on the job.
Why the affordable care act needs a better name: 'Americare'.
Sage, William M
The culmination of a century's effort to enact universal coverage in the United States is a law with an uninspiring title, the Patient Protection and Affordable Care Act, and an even more awkward acronym, PPACA. The Obama administration has decided to call the legislation the Affordable Care Act, but the expansion of health coverage that the law sets in motion has no name, and therefore no identity. It badly needs one.
Housing Affordability And Children's Cognitive Achievement.
Newman, Sandra; Holupka, C Scott
Housing cost burden-the fraction of income spent on housing-is the most prevalent housing problem affecting the healthy development of millions of low- and moderate-income children. By affecting disposable income, a high burden affects parents' expenditures on both necessities for and enrichment of their children, as well as investments in their children. Reducing those expenditures and investments, in turn, can affect children's development, including their cognitive skills and physical, social, and emotional health. This article summarizes the first empirical evidence of the effects of housing affordability on children's cognitive achievement and on one factor that appears to contribute to these effects: the larger expenditures on child enrichment by families in affordable housing. We found that housing cost burden has the same relationship to both children's cognitive achievement and enrichment spending on children, exhibiting an inverted U shape in both cases. The maximum benefit occurs when housing cost burden is near 30 percent of income-the long-standing rule-of-thumb definition of affordable housing. The effect of the burden is stronger on children's math ability than on their reading comprehension and is more pronounced with burdens above the 30 percent standard. For enrichment spending, the curve is "shallower" (meaning the effect of optimal affordability is less pronounced) but still significant.
A simple and effective decision rule for choosing a significance test to protect against non-normality.
Zimmerman, Donald W
There is no formal and generally accepted procedure for choosing an appropriate significance test for sample data when the assumption of normality is doubtful. Various tests of normality that have been proposed over the years have been found to have limited usefulness, and sometimes a preliminary test makes the situation worse. The present paper investigates a specific and easily applied rule for choosing between a parametric and non-parametric test, the Student t test and the Wilcoxon-Mann-Whitney test, that does not require a preliminary significance test of normality. Simulations reveal that the rule, which can be applied to sample data automatically by computer software, protects the Type I error rate and increases power for various sample sizes, significance levels, and non-normal distribution shapes. Limitations of the procedure in the case of heterogeneity of variance are discussed.
Implementing a comprehensive approach for evaluating significance and disturbance in protected karst areas to guide management strategies.
Angulo, Bárbara; Morales, Tomás; Uriarte, Jesús A; Antigüedad, Iñaki
Many environmental studies have acquired an almost exclusively biotic perspective over the years, neglecting important key land characteristics like those of a geological and hydrological nature. This situation leads to incomplete, and even inappropriate, management strategies, particularly unjustified in the case of karst environments which form the basis of important protected areas around the world and are inherently very fragile environments compared to other natural systems. This study presents a holistic methodological approach to analyse the level of significance and disturbance in the Natural Park of Aralar (Basque Country, northern Spain) using two standardized indices: zonal Karst Significance Index (KSIZ) and zonal Karst Disturbance Index (KDIZ). The distribution of both indices in the park is based on the Geographic Information System (GIS). Thus, thematic maps regarding geological, geomorphological, biological, hydrological and cultural aspects provide the essential data for this work. The obtained results enable us to recognize the most significant and disturbed sectors of the park. These indices are subsequently combined to generate the Priority Management Index (PMI), which determine the different management needs of the territory. This comprehensive information not only serves efforts to better manage protected karst areas, but also to provide a snapshot view of the researched area to compare achieved results over time.
Combination of the two schistosomal antigens Sm14 and Sm29 elicits significant protection against experimental Schistosoma mansoni infection.
Ewaisha, Radwa E; Bahey-El-Din, Mohammed; Mossallam, Shereen F; Amer, Eglal I; Aboushleib, Hamida M; Khalil, Amal M
Schistosomiasis continues to be a serious helminthic disease that is widespread in many regions in the world. Disease management relies mainly on early treatment with praziquantel, nevertheless, re-infection rates can still be high. An effective vaccine against Schistosoma mansoni is still lacking; a situation which hinders the efforts to eradicate the disease worldwide. Most investigators test S. mansoni antigens individually, rather than in combination, in their vaccine trials. A single-antigen vaccine is likely to elicit less protection against schistosomiasis than a multi-antigen vaccine. In the current study, we have selected two promising S. mansoni antigens, Sm14 and Sm29, and investigated their combination as a potential vaccine. Recombinant Sm14 and a truncated form of Sm29, designated TrSm29, were successfully expressed in Escherichiacoli. The two antigens were purified using affinity chromatography and administered to Swiss albino mice individually and in combination. Significant protection against S. mansoni infection was observed in mice immunized with the Sm14/TrSm29 combination in the presence/absence of the immunoadjuvant poly (I:C). The poly (I:C)-adjuvanted combination resulted in 40.3%, 68.2%, and 57.9% reduction in adult worm burden, liver egg burden and intestinal eggs, respectively. Granuloma size and count were also reduced besides improvement of the histopathological picture of livers of immunized mice. This study demonstrates the importance of using multi-antigen vaccines as an effective and simple approach to fulfill enhanced protection against schistosomiasis.
Breastfeeding and the Affordable Care Act.
Hawkins, Summer Sherburne; Dow-Fleisner, Sarah; Noble, Alice
Mothers who receive or qualify for the Women, Infants, and Children (WIC) program or have lower income are less likely to start and continue breastfeeding than their more advantaged counterparts. The Patient Protection and Affordable Care Act (ACA) requires employers to provide break time and space to express breast milk and requires insurance companies to cover breastfeeding support, supplies, and counseling at no cost to mothers. This ACA benefit does not extend to all Medicaid recipients or women in the WIC program. Legislative and regulatory efforts are needed to provide comprehensive coverage for all women and reduce disparities in breastfeeding.
The impact of comparative effectiveness research on interventional pain management: evolution from Medicare Modernization Act to Patient Protection and Affordable Care Act and the Patient-Centered Outcomes Research Institute.
Manchikanti, Laxmaiah; Falco, Frank J E; Benyamin, Ramsin M; Helm, Standiford; Parr, Allan T; Hirsch, Joshua A
The Patient-Centered Outcomes Research Institute (PCORI) was established by the Affordable Care Act of 2010 to promote comparative effectiveness research (CER) to assist patients, clinicians, purchasers, and policy-makers in making informed health decisions by advancing the quality and relevance of evidence concerning the manner in which diseases, disorders, and other health conditions can effectively and appropriately be prevented, diagnosed, treated, monitored, and managed through research and evidence synthesis. The development of PCORI is vested in the Medicare Modernization Act (MMA) and the American Recovery and Reinvestment Act (ARRA). The framework of CER and PCORI describes multiple elements which are vested in all 3 regulations including stakeholder involvement, public participation, and open transparent decision-making process. Overall, PCORI is much more elaborate with significant involvement of stakeholders, transparency, public participation, and open decision-making. However, there are multiple issues concerning the operation of such agencies in the United States including the predecessor of Agency for Healthcare Research and Quality (AHRQ), the Agency for Healthcare Policy and Research (AHCPR), AHRQ Effectiveness Health Care programs, and others. The CER in the United States may be described at cross-roads or at the beginnings of a scientific era of CER and evidence-based medicine (EBM). However the United States suffers as other countries, including the United Kingdom with its National Health Services (NHS) and National Institute for Health and Clinical Excellence (NICE), with major misunderstandings of methodology, an inordinate focus on methodological assessment, lack of understanding of the study design (placebo versus active control), lack of involvement of clinicians, and misinterpretation of the evidence which continues to be disseminated. Consequently, PCORI and CER have been described as government-driven solutions without following the
76 FR 52663 - Notice of Intent To Award Affordable Care Act Funding, DP-09-001
Federal Register 2010, 2011, 2012, 2013, 2014
... Care Act Funding, DP-09-001 AGENCY: Centers for Disease Control and Prevention (CDC), Department of... Centers (U48).'' It is the intent of CDC to fund the applications with Patient Protection Affordable Care... 4002 of the Patient Protection and Affordable Care Act (Pub. L. 111-148.). DATES: The effective...
What does the Affordable Care Act mean for nursing?
Luther, Brenda; Hart, Sara
Nurses are ethically bound to engage in efforts of improving health and healthcare delivery and, even more important, nurses recently have been called out as key leaders in the reform of healthcare delivery, including many components of the Patient Protection and Affordable Care Act. The Patient Protection and Affordable Care Act, its history, and what healthcare will look like during and after implementation are addressed in this article. A discussion of the role and value of nurses in healthcare reform accompanies knowledge-building and action-oriented resources available to nurses and clients.
Visual object affordances: object orientation.
Symes, Ed; Ellis, Rob; Tucker, Mike
Five experiments systematically investigated whether orientation is a visual object property that affords action. The primary aim was to establish the existence of a pure physical affordance (PPA) of object orientation, independent of any semantic object-action associations or visually salient areas towards which visual attention might be biased. Taken together, the data from these experiments suggest that firstly PPAs of object orientation do exist, and secondly, the behavioural effects that reveal them are larger and more robust when the object appears to be graspable, and is oriented in depth (rather than just frontally) such that its leading edge appears to point outwards in space towards a particular hand of the viewer.
Emerging Affordances in Telecollaborative Multimodal Interactions
ERIC Educational Resources Information Center
Dey-Plissonneau, Aparajita; Blin, Françoise
Drawing on Gibson's (1977) theory of affordances, Computer-Assisted Language Learning (CALL) affordances are a combination of technological, social, educational, and linguistic affordances (Blin, 2016). This paper reports on a preliminary study that sought to identify the emergence of affordances during an online video conferencing session between…
Developing Strategies for Affordable Bandwidth.
ERIC Educational Resources Information Center
Educause Quarterly, 2000
Written by Educause's Net@EDU Broadband Pricing Working Group, this article discusses what institutions of higher education can do to develop good partnerships with broadband vendors in order to negotiate affordable pricing for increased bandwidth. Describes problems with the marketplace, examples from a few universities, and points to remember…
Post-exposure Treatment with Anti-rabies VHH and Vaccine Significantly Improves Protection of Mice from Lethal Rabies Infection
Terryn, Sanne; Francart, Aurélie; Rommelaere, Heidi; Stortelers, Catelijne; Van Gucht, Steven
Post-exposure prophylaxis (PEP) against rabies infection consists of a combination of passive immunisation with plasma-derived human or equine immune globulins and active immunisation with vaccine delivered shortly after exposure. Since anti-rabies immune globulins are expensive and scarce, there is a need for cheaper alternatives that can be produced more consistently. Previously, we generated potent virus-neutralising VHH, also called Nanobodies, against the rabies glycoprotein that are effectively preventing lethal disease in an in vivo mouse model. The VHH domain is the smallest antigen-binding functional fragment of camelid heavy chain-only antibodies that can be manufactured in microbial expression systems. In the current study we evaluated the efficacy of half-life extended anti-rabies VHH in combination with vaccine for PEP in an intranasal rabies infection model in mice. The PEP combination therapy of systemic anti-rabies VHH and intramuscular vaccine significantly delayed the onset of disease compared to treatment with anti-rabies VHH alone, prolonged median survival time (35 versus 14 days) and decreased mortality (60% versus 19% survival rate), when treated 24 hours after rabies virus challenge. Vaccine alone was unable to rescue mice from lethal disease. As reported also for immune globulins, some interference of anti-rabies VHH with the antigenicity of the vaccine was observed, but this did not impede the synergistic effect. Post exposure treatment with vaccine and human anti-rabies immune globulins was unable to protect mice from lethal challenge. Anti-rabies VHH and vaccine act synergistically to protect mice after rabies virus exposure, which further validates the possible use of anti-rabies VHH for rabies PEP. PMID:27483431
Affordability of medicines in the European Union
Zaprutko, Tomasz; Kopciuch, Dorota; Kus, Krzysztof; Merks, Piotr; Nowicka, Monika; Augustyniak, Izabela; Nowakowska, Elżbieta
Background Medications and their prices are key issues for healthcare. Although access to medicines at affordable prices had been specified as a key objective of the European Health Policy, it seems that these goals have not been achieved. Therefore, we attempted an evaluation of affordability of selected medicines at full prices. Methods The analysis concerned 2012 and was conducted between 2013 and 2015 in all the European Union (EU) countries divided into 3 groups depending on the date of their accession to the EU. Finally, we considered 9 originators used in the treatment of schizophrenia and multiple sclerosis. Information on drug prices were collected from pharmacies. Participation in the study was voluntary and anonymous in order to avoid accusations of advertising. To evaluate affordability, several factors were used (e.g. minimum earnings and Gini coefficient). Due to unavailability in some countries, the exact number of analyzed medicines varies. Results Drug prices vary significantly between EU Member States. Almost eleven fold difference was observed between Germany (EUR 1451.17) and Croatia (EUR 132.77) in relation to Interferone beta-1a 22 μg. Generally, prices were the highest in Germany. The cheapest drugs were found in various countries but never in the poorest ones like Bulgaria or Romania. Discrepancies in wages were observed too (the smallest minimum wage was EUR 138.00 in Bulgaria and the highest EUR 1801.00 in Luxembourg). Full price of olanzapine 5mg, however, was higher in Bulgaria (EUR 64.53) than, for instance, in Belgium (EUR 37.26). Conclusions Analyzed medications are still unaffordable for many citizens of the EU. Besides, access to medicines is also impaired e.g. due to parallel trade. Unaffordability of medications may lead to the patients' non-compliance and therefore to increased direct and indirect costs of treatment. Common European solutions are needed to achieve a real affordability and accessibility of medications. PMID
Quercetin phospholipid complex significantly protects against oxidative injury in ARPE-19 cells associated with activation of Nrf2 pathway.
Xu, Xin-Rong; Yu, Hai-Tao; Yang, Yan; Hang, Li; Yang, Xue-Wen; Ding, Shu-Hua
Age-related macular degeneration (AMD) is a major cause of blindness worldwide. Oxidative stress plays a crucial role in the pathogenesis of dry AMD. Quercetin has potent anti-oxidative activities, but poor bioavailability limits its therapeutic application. Herein, we prepared the phospholipid complex of quercetin (quercetin-PC), characterized its structure by differential scanning calorimetry, infrared spectrum and x-ray diffraction. Quercetin-PC had equilibrium solubility of 38.36 and 1351.27μg/ml in water and chloroform, respectively, which was remarkably higher than those of quercetin alone. Then we established hydrogen peroxide (H2O2)-induced oxidative injury model in human ARPE-19 cells to examine the effects of quercetin-PC. Quercetin-PC, stronger than quercetin, promoted cell proliferation, and the proliferation rate was increased to be 78.89% when treated with Quercetin-PC at 400μM. Moreover, quercetin-PC effectively prevented ARPE-19 cells from apoptosis, and the apoptotic rate was reduced to be 3.1% when treated with Quercetin-PC at 200μM. In addition, quercetin-PC at 200μM significantly increased the activities of SOD, CAT and GSH-PX, and reduced the levels of reactive oxygen species and MDA in H2O2-treated ARPE-19 cells, but quercetin at 200μM failed to do so. Molecular examinations revealed that quercetin-PC at 200μM significantly activated Nrf2 nuclear translocation and significantly enhanced the expression of target genes HO-1, NQO-1 and GCL by different folds at both mRNA and protein levels. Our current data collectively indicated that quercetin-PC had stronger protective effects against oxidative-induced damages in ARPE-19 cells, which was associated with activation of Nrf2 pathway and its target genes implicated in antioxidant defense.
Optics learning through affordable kit
P, Anusha N E-mail: firstname.lastname@example.com Shaji, Chitra E-mail: email@example.com Sharan, Alok E-mail: email@example.com
An affordable kit which helps to understand some of the optical phenomena qualitatively and quantitatively is presented in this paper. It supplements optics taught in classes. The kit consists of equipments which are available in the market at nominal cost such as laser pointer, lenses, glass plates, razor blades, coins, ball bearing etc. Experiments which come under wave optics (interference and diffraction) and ray optics (reflection and refraction) are explained using this kit.
CD38 Knockout Mice Show Significant Protection Against Ischemic Brain Damage Despite High Level Poly-ADP-Ribosylation.
Long, Aaron; Park, Ji H; Klimova, Nina; Fowler, Carol; Loane, David J; Kristian, Tibor
Several enzymes in cellular bioenergetics metabolism require NAD(+) as an essential cofactor for their activity. NAD(+) depletion following ischemic insult can result in cell death and has been associated with over-activation of poly-ADP-ribose polymerase PARP1 as well as an increase in NAD(+) consuming enzyme CD38. CD38 is an NAD(+) glycohydrolase that plays an important role in inflammatory responses. To determine the contribution of CD38 activity to the mechanisms of post-ischemic brain damage we subjected CD38 knockout (CD38KO) mice and wild-type (WT) mice to transient forebrain ischemia. The CD38KO mice showed a significant amelioration in both histological and neurologic outcome following ischemic insult. Decrease of hippocampal NAD(+) levels detected during reperfusion in WT mice was only transient in CD38KO animals, suggesting that CD38 contributes to post-ischemic NAD(+) catabolism. Surprisingly, pre-ischemic poly-ADP-ribose (PAR) levels were dramatically higher in CD38KO animals compared to WT animals and exhibited reduction post-ischemia in contrast to the increased levels in WT animals. The high PAR levels in CD38 mice were due to reduced expression levels of poly-ADP-ribose glycohydrolase (PARG). Thus, the absence of CD38 activity can not only directly affect inflammatory response, but also result in unpredicted alterations in the expression levels of enzymes participating in NAD(+) metabolism. Although the CD38KO mice showed significant protection against ischemic brain injury, the changes in enzyme activity related to NAD(+) metabolism makes the determination of the role of CD38 in mechanisms of ischemic brain damage more complex.
29 CFR 1977.12 - Exercise of any right afforded by the Act.
Code of Federal Regulations, 2014 CFR
... 29 Labor 9 2014-07-01 2014-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise "of any right afforded by this Act." Certain rights are explicitly provided in...
29 CFR 1977.12 - Exercise of any right afforded by the Act.
Code of Federal Regulations, 2011 CFR
... 29 Labor 9 2011-07-01 2011-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise "of any right afforded by this Act." Certain rights are explicitly provided in...
29 CFR 1977.12 - Exercise of any right afforded by the Act.
Code of Federal Regulations, 2010 CFR
... 29 Labor 9 2010-07-01 2010-07-01 false Exercise of any right afforded by the Act. 1977.12 Section... OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970 Specific Protections § 1977.12 Exercise of any right afforded by the... because of the exercise "of any right afforded by this Act." Certain rights are explicitly provided in...
Consequences of BBPs Affordability Initiative
extending programming from five years in the future to the full life of each acquisition program—typically in excess of 25 years—and discussing the full ...concepts that are fundamental to the affordability vision. The memo text begins with the example of a program that the Army decided to cancel (thus...reducing spending. This is a laudable goal, but it cannot be the DoD's only one. BBP 3.0's full title includes the words Achieving Dominant
78 FR 19917 - Medicaid Program; Increased Federal Medical Assistance Percentage Changes Under the Affordable...
Federal Register 2010, 2011, 2012, 2013, 2014
...This final rule implements the provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010 (collectively referred to as the Affordable Care Act) relating to the availability of increased Federal Medical Assistance Percentage (FMAP) rates for certain adult populations under states' Medicaid programs. This final rule......
Perceiving Affordances for Fitting through Apertures
ERIC Educational Resources Information Center
Ishak, Shaziela; Adolph, Karen E.; Lin, Grace C.
Affordances--possibilities for action--are constrained by the match between actors and their environments. For motor decisions to be adaptive, affordances must be detected accurately. Three experiments examined the correspondence between motor decisions and affordances as participants reached through apertures of varying size. A psychophysical…
Perceiving affordances in rugby union.
Passos, Pedro; Cordovil, Rita; Fernandes, Orlando; Barreiros, João
To succeed in competitive environments, players need to continuously adjust their decisions and actions to the behaviour of relevant others. Players' interactions demand ongoing decisions that are constrained by what is previously defined (e.g., coaches' prescriptions that establish 'what' to do) and by information that is available in the context and specifies not only 'what' the player should do, but also 'how', 'when' and 'where'. We describe what affordances emerge to the ball carrier as a consequence of changes in kinematic variables, such as interpersonal distances or distances to the nearest sideline. Changes in these variables determine whether and when different actions are possible. The ball carrier tended to perform a pass when the tackler was farthest from the sideline and the velocity of approach to the tackler did not seem to effect the ball carrier's decision. In the few episodes where the ball carrier moved forward instead of passing the ball, he was mainly influenced by contextual information, such as the variability of the players' distance to the nearest sideline. In sum, actors must be aware of the affordances of others that are specified by particular variables that become available just before decision-making.
The Affordable Care Act: a primer for plastic surgeons.
Chen, Jenny T; Israel, Jacqueline S; Poore, Samuel O; Rao, Venkat K
The Patient Protection and Affordable Care Act, sometimes referred to as Obamacare, was signed into law on March 23, 2010. It represents the most extensive overhaul of the country's health care system since the passage of Medicare and Medicaid in 1965. The Affordable Care Act has two goals. The first goal is to reduce the uninsured population in the United States. Key elements to covering the uninsured include the following: (1) expanding Medicaid coverage for low-income individuals and (2) establishing health insurance marketplaces for moderate-income individuals with subsidies and tax cuts in an effort to make health insurance more affordable. The second goal of the Affordable Care Act is to address concerns about quality and the overall cost of U.S. health care. It is imperative that plastic surgeons thoroughly understand the impact that the Affordable Care Act will undoubtedly have on the country, on our patients, and on our clinical practices. Plastic surgery will see many changes in the future. This will include an overall increase in the number of insured patients, a push toward joining accountable care organizations, and a shift in payment systems to bundled reimbursement for episodes of care. In this article, the authors describe how these changes are likely to occur and what plastic surgeons must do to be part of the change.
Energy efficient affordable housing. Final report
In 1994, the Southface Energy Institute, working with support from US DOE, initiated a program to provide technical assistance to nonprofit organizations developing affordable housing in the Olympic target communities of Atlanta. The specific project goals were: Identify the barriers that nonprofit affordable housing providers face in increasing the energy and resource efficiency of affordable housing; Assist them in developing the resources to overcome these barriers; Develop specific technical materials and program models that will enable these affordable housing groups to continue to improve the energy efficiency of their programs; and, To transfer the program materials to other affordable housing providers. This report summarizes the progress made in each of these areas.
Affordable In-Space Transportation
NASA Technical Reports Server (NTRS)
Curtis, L. A.; VanDyke, M. K.; Lajoie, R. M.; Woodcock, G. R.
Current and proposed launch systems will provide access to low-Earth orbit (LEO), and destinations beyond LEO, but the cost of delivering payloads will preclude the use of these services by many users. To develop and encourage revolutionary commercial utilization of geosynchronous orbit (GEO) and to provide an affordable means to continue NASA space science and exploration missions, the transportation costs to in-space destinations must be reduced. The principal objective of this study was to conceptually define three to four promising approaches to in-space transportation for delivery of satellites and other payloads, 3,000- to 10,000-lb class, to GEO destinations. This study established a methodology for evaluating in-space transportation systems based on life-cycle cost. The reusable concepts seemed to fare better in the evaluation than expendable, since a major driver in the life-cycle cost was the stage production cost.
Immunization of Mastomys coucha with Brugia malayi recombinant trehalose-6-phosphate phosphatase results in significant protection against homologous challenge infection.
Kushwaha, Susheela; Singh, Prashant Kumar; Rana, Ajay Kumar; Misra-Bhattacharya, Shailja
Development of a vaccine to prevent or reduce parasite development in lymphatic filariasis would be a complementary approach to existing chemotherapeutic tools. Trehalose-6-phosphate phosphatase of Brugia malayi (Bm-TPP) represents an attractive vaccine target due to its absence in mammals, prevalence in the major life stages of the parasite and immunoreactivity with human bancroftian antibodies, especially from endemic normal subjects. We have recently reported on the cloning, expression, purification and biochemical characterization of this vital enzyme of B. malayi. In the present study, immunoprophylactic evaluation of Bm-TPP was carried out against B. malayi larval challenge in a susceptible host Mastomys coucha and the protective ability of the recombinant protein was evaluated by observing the adverse effects on microfilarial density and adult worm establishment. Immunization caused 78.4% decrease in microfilaremia and 71.04% reduction in the adult worm establishment along with sterilization of 70.06% of the recovered live females. The recombinant protein elicited a mixed Th1/Th2 type of protective immune response as evidenced by the generation of both pro- and anti-inflammatory cytokines IL-2, IFN-γ, TNF-α, IL-4 and an increased production of antibody isotypes IgG1, IgG2a, IgG2b and IgA. Thus immunization with Bm-TPP conferred considerable protection against B. malayi establishment by engendering a long-lasting effective immune response and therefore emerges as a potential vaccine candidate against lymphatic filariasis (LF).
Small businesses and the Affordable Care Act of 2010.
Collins, Sara R; Davis, Karen; Nicholson, Jennifer L; Stremikis, Kristof
The Patient Protection and Affordable Care Act (ACA) includes several short- and long-term provisions designed to help small businesses pay for and maintain health insurance for their workers, and to allow workers without employer coverage to gain access to affordable, comprehensive health insurance. Provisions include a small business tax credit to offset premium costs for firms that offer coverage starting this taxable year, establishment of state-based insurance exchanges that promise to lower administrative costs and pool risk more broadly, and creation of new market rules and an essential benefit standard to protect small firms and their workers. Analysis shows that up to 16.6 million workers are in firms that would be eligible for the tax credit in 2010 to 2013. Over the next 10 years, small businesses and organizations could receive an estimated $40 billion in federal support through the premium credit program.
Immunization of Mastomys coucha with Brugia malayi Recombinant Trehalose-6-Phosphate Phosphatase Results in Significant Protection against Homologous Challenge Infection
Kushwaha, Susheela; Singh, Prashant Kumar; Rana, Ajay Kumar; Misra-Bhattacharya, Shailja
Development of a vaccine to prevent or reduce parasite development in lymphatic filariasis would be a complementary approach to existing chemotherapeutic tools. Trehalose-6-phosphate phosphatase of Brugia malayi (Bm-TPP) represents an attractive vaccine target due to its absence in mammals, prevalence in the major life stages of the parasite and immunoreactivity with human bancroftian antibodies, especially from endemic normal subjects. We have recently reported on the cloning, expression, purification and biochemical characterization of this vital enzyme of B. malayi. In the present study, immunoprophylactic evaluation of Bm-TPP was carried out against B. malayi larval challenge in a susceptible host Mastomys coucha and the protective ability of the recombinant protein was evaluated by observing the adverse effects on microfilarial density and adult worm establishment. Immunization caused 78.4% decrease in microfilaremia and 71.04% reduction in the adult worm establishment along with sterilization of 70.06% of the recovered live females. The recombinant protein elicited a mixed Th1/Th2 type of protective immune response as evidenced by the generation of both pro- and anti-inflammatory cytokines IL-2, IFN-γ, TNF-α, IL-4 and an increased production of antibody isotypes IgG1, IgG2a, IgG2b and IgA. Thus immunization with Bm-TPP conferred considerable protection against B. malayi establishment by engendering a long-lasting effective immune response and therefore emerges as a potential vaccine candidate against lymphatic filariasis (LF). PMID:24015262
Availability, accessibility, and affordability of neurodiagnostic tests in 37 countries
McLane, Hannah C.; Berkowitz, Aaron L.; Patenaude, Bryan N.; McKenzie, Erica D.; Wolper, Emma; Wahlster, Sarah; Fink, Günther
Objective: To determine the availability, accessibility, and affordability of EEG, EMG, CSF analysis, head CT, and brain MRI for neurologic disorders across countries. Methods: An online, 60-question survey was distributed to neurology practitioners in 2014 to assess the presence, wait time, and cost of each test in private and public health sectors. Data were stratified by World Bank country income group. Affordability was calculated with reference to the World Health Organization's definition of catastrophic health expenditure as health-related out-of-pocket expenditure of >40% of disposable household income, and assessment of providers' perceptions of affordability to the patient. Results: Availability of EEG and EMG is correlated with higher World Bank income group (correlation coefficient 0.38, test for trend p = 0.046; 0.376, p = 0.043); CSF, CT, and MRI did not show statistically significant associations with income groups. Patients in public systems wait longer for neurodiagnostic tests, especially MRI, EEG, and urgent CT (p < 0.0001). The mean cost per test, across all tests, was lower in the public vs private sector (US $55.25 vs $214.62, p < 0.001). Each drop in World Bank income group is associated with a 29% decrease in the estimated share of the population who can afford a given test (95% confidence interval −33.4, 25.2; p < 0.001). In most low-income countries surveyed, only the top 10% or 20% of the population was able to afford tests below catastrophic levels. In surveyed lower-middle-income countries, >40% of the population, on average, could not afford neurodiagnostic tests. Conclusions: Neurodiagnostic tests are least affordable in the lowest income settings. Closing this "diagnostic gap" for countries with the lowest incomes is essential. PMID:26446063
Dopamine, Affordance and Active Inference
Friston, Karl J.; Shiner, Tamara; FitzGerald, Thomas; Galea, Joseph M.; Adams, Rick; Brown, Harriet; Dolan, Raymond J.; Moran, Rosalyn; Stephan, Klaas Enno; Bestmann, Sven
The role of dopamine in behaviour and decision-making is often cast in terms of reinforcement learning and optimal decision theory. Here, we present an alternative view that frames the physiology of dopamine in terms of Bayes-optimal behaviour. In this account, dopamine controls the precision or salience of (external or internal) cues that engender action. In other words, dopamine balances bottom-up sensory information and top-down prior beliefs when making hierarchical inferences (predictions) about cues that have affordance. In this paper, we focus on the consequences of changing tonic levels of dopamine firing using simulations of cued sequential movements. Crucially, the predictions driving movements are based upon a hierarchical generative model that infers the context in which movements are made. This means that we can confuse agents by changing the context (order) in which cues are presented. These simulations provide a (Bayes-optimal) model of contextual uncertainty and set switching that can be quantified in terms of behavioural and electrophysiological responses. Furthermore, one can simulate dopaminergic lesions (by changing the precision of prediction errors) to produce pathological behaviours that are reminiscent of those seen in neurological disorders such as Parkinson's disease. We use these simulations to demonstrate how a single functional role for dopamine at the synaptic level can manifest in different ways at the behavioural level. PMID:22241972
A single immunization with modified vaccinia virus Ankara-based influenza virus H7 vaccine affords protection in the influenza A(H7N9) pneumonia ferret model.
Kreijtz, Joost H C M; Wiersma, Lidewij C M; De Gruyter, Heidi L M; Vogelzang-van Trierum, Stella E; van Amerongen, Geert; Stittelaar, Koert J; Fouchier, Ron A M; Osterhaus, Albert D M E; Sutter, Gerd; Rimmelzwaan, Guus F
Since the first reports in early 2013, >440 human cases of infection with avian influenza A(H7N9) have been reported including 122 fatalities. After the isolation of the first A(H7N9) viruses, the nucleotide sequences became publically available. Based on the coding sequence of the influenza virus A/Shanghai/2/2013 hemagglutinin gene, a codon-optimized gene was synthesized and cloned into a recombinant modified vaccinia virus Ankara (MVA). This MVA-H7-Sh2 viral vector was used to immunize ferrets and proved to be immunogenic, even after a single immunization. Subsequently, ferrets were challenged with influenza virus A/Anhui/1/2013 via the intratracheal route. Unprotected animals that were mock vaccinated or received empty vector developed interstitial pneumonia characterized by a marked alveolitis, accompanied by loss of appetite, weight loss, and heavy breathing. In contrast, animals vaccinated with MVA-H7-Sh2 were protected from severe disease.
Evaluation of reproductive protection against bovine viral diarrhea virus and bovine herpesvirus-1 afforded by annual revaccination with modified-live viral or combination modified-live/killed viral vaccines after primary vaccination with modified-live viral vaccine.
Walz, Paul H; Givens, M Daniel; Rodning, Soren P; Riddell, Kay P; Brodersen, Bruce W; Scruggs, Daniel; Short, Thomas; Grotelueschen, Dale
The objective of this study was to compare reproductive protection in cattle against bovine viral diarrhea virus (BVDV) and bovine herpesvirus 1 (BoHV-1) provided by annual revaccination with multivalent modified-live viral (MLV) vaccine or multivalent combination viral (CV) vaccine containing temperature-sensitive modified-live BoHV-1 and killed BVDV when MLV vaccines were given pre-breeding to nulliparous heifers. Seventy-five beef heifers were allocated into treatment groups A (n=30; two MLV doses pre-breeding, annual revaccination with MLV vaccine), B (n=30; two MLV doses pre-breeding, annual revaccination with CV vaccine) and C (n=15; saline in lieu of vaccine). Heifers were administered treatments on days 0 (weaning), 183 (pre-breeding), 366 (first gestation), and 738 (second gestation). After first calving, primiparous cows were bred, with pregnancy assessment on day 715. At that time, 24 group A heifers (23 pregnancies), 23 group B heifers (22 pregnancies), and 15 group C heifers (15 pregnancies) were commingled with six persistently infected (PI) cattle for 16days. Ninety-nine days after PI removal, cows were intravenously inoculated with BoHV-1. All fetuses and live offspring were assessed for BVDV and BoHV-1. Abortions occurred in 3/23 group A cows, 1/22 group B cows, and 11/15 group C cows. Fetal infection with BVDV or BoHV-1 occurred in 4/23 group A offspring, 0/22 group B offspring, and 15/15 group C offspring. This research demonstrates efficacy of administering two pre-breeding doses of MLV vaccine with annual revaccination using CV vaccine to prevent fetal loss due to exposure to BVDV and BoHV-1.
Managing Requirements for Acquisition Program Affordability
to buy weapon systems at a lower cost and higher quality by leveraging commercial technology. He also directed program managers (PMs) and... Managing Requirements for Acquisition Program Affordability by Colonel James O. Winbush, Jr. United States Army...2011 to 11-04-2012 4. TITLE AND SUBTITLE Managing Requirements for Acquisition Program Affordability 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c
College Affordability: Implications for College Opportunity
ERIC Educational Resources Information Center
Perna, Laura W.; Li, Chunyan
By examining trends in college affordability, this article explores the extent to which the public perception that college is not affordable is justified. First, the article describes trends in national indicators that contribute to ability to pay, including income growth, health care costs, debt burden, and personal savings rates. Trends in…
Section 8: Affordable Housing for Exceptional Families
ERIC Educational Resources Information Center
Wright, Wesley E.
Shelter is a basic human need. Unfortunately, affordable housing is a need that low income families who are caring for children and adults with disabilities can rarely afford without assistance. Because participating families generally pay rent of no more than 30 percent of their adjusted monthly income, the Section 8 program can provide…
Affordability Approaches for Human Space Exploration
NASA Technical Reports Server (NTRS)
Holladay, Jon; Smith, David Alan
The design and development of historical NASA Programs (Apollo, Shuttle and International Space Station), have been based on pre-agreed missions which included specific pre-defined destinations (e.g., the Moon and low Earth orbit). Due to more constrained budget profiles, and the desire to have a more flexible architecture for Mission capture as it is affordable, NASA is working toward a set of Programs that are capability based, rather than mission and/or destination specific. This means designing for a performance capability that can be applied to a specific human exploration mission/destination later (sometime years later). This approach does support developing systems to flatter budgets over time, however, it also poses the challenge of how to accomplish this effectively while maintaining a trained workforce, extensive manufacturing, test and launch facilities, and ensuring mission success ranging from Low Earth Orbit to asteroid destinations. NASA Marshall Space Flight Center (MSFC) in support of Exploration Systems Directorate (ESD) in Washington, DC has been developing approaches to track affordability across multiple Programs. The first step is to ensure a common definition of affordability: the discipline to bear cost in meeting a budget with margin over the life of the program. The second step is to infuse responsibility and accountability for affordability into all levels of the implementing organization since affordability is no single person s job; it is everyone s job. The third step is to use existing data to identify common affordability elements organized by configuration (vehicle/facility), cost, schedule, and risk. The fourth step is to analyze and trend this affordability data using an affordability dashboard to provide status, measures, and trends for ESD and Program level of affordability tracking. This paper will provide examples of how regular application of this approach supports affordable and therefore sustainable human space exploration
The Affordable Care Act's Impacts on Access to Insurance and Health Care for Low-Income Populations.
Kominski, Gerald F; Nonzee, Narissa J; Sorensen, Andrea
The Patient Protection and Affordable Care Act (ACA) expands access to health insurance in the United States, and, to date, an estimated 20 million previously uninsured individuals have gained coverage. Understanding the law's impact on coverage, access, utilization, and health outcomes, especially among low-income populations, is critical to informing ongoing debates about its effectiveness and implementation. Early findings indicate that there have been significant reductions in the rate of uninsurance among the poor and among those who live in Medicaid expansion states. In addition, the law has been associated with increased health care access, affordability, and use of preventive and outpatient services among low-income populations, though impacts on inpatient utilization and health outcomes have been less conclusive. Although these early findings are generally consistent with past coverage expansions, continued monitoring of these domains is essential to understand the long-term impact of the law for underserved populations.
Determination of ecological significance based on geostatistical assessment: a case study from the Slovak Natura 2000 protected area
NASA Astrophysics Data System (ADS)
Klaučo, Michal; Gregorová, Bohuslava; Stankov, Uglješa; Marković, Vladimir; Lemenkova, Polina
The Sitno Natura 2000 Site covers an area of 935,56 hectares. The Sitno region is significant due to the number of rare and endangered species of plants, and as a result is considered a location of great importance to the maintenance of floral gene pools. The study area suffers human impacts in the form of tourism. The main purpose of this study is to the measure landscape elements, determine the ecological significance of habitats within the Sitno area, and from this data, organize the study area into conservation zones. The results of this landscape quantification are numerical values that can be used to interpret the quality of ongoing ecological processes within individual landscape types. Interpretation of this quantified data can be used to determine the ecological significance of landscapes in other study areas. This research examines the habitats of Natura 2000 Sites by a set of landscape metrics for habitat area, size, density, and shape, such as Number of patches (NP), Patch density (PD), Mean patch size (MPS), Patch size standard deviation (PSSD) and Mean shape index (MSI). The classification of land cover patches is based on the Annex Code system.
The significance of renewable energy use for economic output and environmental protection: evidence from the Next 11 developing economies.
Paramati, Sudharshan Reddy; Sinha, Avik; Dogan, Eyup
Increasing economic activities in developing economies raise demand for energy mainly sourced from conventional sources. The consumption of more conventional energy will have a significant negative impact on the environment. Therefore, attention of policy makers has recently shifted towards the promotion of renewable energy generation and uses across economic activities to ensure low carbon economy. Given the recent scenario, in this paper, we aim to examine the role of renewable energy consumption on the economic output and CO2 emissions of the next fastest developing economies of the world. The study employs several robust panel econometric models by using annual data from 1990 to 2012. Empirical findings confirm the significant long-run association among the variables. Similarly, results show that renewable energy consumption positively contributes to economic output and has an adverse effect on CO2 emissions. Given our findings, we suggest policy makers of those economies to initiate further effective policies to promote more renewable energy generation and uses across economic activities to ensure sustainable economic development.
[Advantages and prospects of the use of genetic vaccines for the protection from dangerous and socially significant infections].
Tutykhina, I L; Shcherbinin, D N; Shmarov, M M; Logunov, D Iu; Naroditskiĭ, B S
High frequency of epidemiological threats (H5N1 influenza, SARS, etc.) in modern world calls for the development of new flexible technologies for manufacturing efficacious vaccines and rapid reorientation of their production as appropriate. Genetic vaccination is one of such technologies aimed at prophylaxis of dangerous and socially significant infections. The technology is based on administration of one or several functionally active genes encoding for antigens of pathogens which induces formation of both cellular and humoral immunity against the respective microorganism. This property of genetic vaccines is used for the development of prophylactic schemes. New vaccines are currently being designed to prevent a variety of infections. The aim of the present review is to outline major trends in genetic vaccination leading to the improvement of its efficacy.
MISSE-X: Affordable Space Environment Testing
MISSEâX is a robotically serviceable ISS external facility providing government, industry and academia experimenters with affordable access to space for materials durability testing of potential ...
Clinton Foundation - Home Energy Affordability Loan (HEAL)
Home Energy Affordability Loan (HEAL) provides the infrastructure that allows employers to offer Energy Upgrades in a turnkey manner. This document will breakdown the different models of HEAL, financing, etc.
Modulation of visual attention by object affordance
Garrido-Vásquez, Patricia; Schubö, Anna
Some objects in our environment are strongly tied to motor actions, a phenomenon called object affordance. A cup, for example, affords us to reach out to it and grasp it by its handle. Studies indicate that merely viewing an affording object triggers motor activations in the brain. The present study investigated whether object affordance would also result in an attention bias, that is, whether observers would rather attend to graspable objects within reach compared to non-graspable but reachable objects or to graspable objects out of reach. To this end, we conducted a combined reaction time and motion tracking study with a table in a virtual three-dimensional space. Two objects were positioned on the table, one near, the other one far from the observer. In each trial, two graspable objects, two non-graspable objects, or a combination of both was presented. Participants were instructed to detect a probe appearing on one of the objects as quickly as possible. Detection times served as indirect measure of attention allocation. The motor association with the graspable object was additionally enhanced by having participants grasp a real object in some of the trials. We hypothesized that visual attention would be preferentially allocated to the near graspable object, which should be reflected in reduced reaction times in this condition. Our results confirm this assumption: probe detection was fastest at the graspable object at the near position compared to the far position or to a non-graspable object. A follow-up experiment revealed that in addition to object affordance per se, immediate graspability of an affording object may also influence this near-space advantage. Our results suggest that visuospatial attention is preferentially allocated to affording objects which are immediately graspable, and thus establish a strong link between an object' s motor affordance and visual attention. PMID:24567725
The Affordable Care Act and Implications for Health Care Services for American Indian and Alaska Native Individuals
Ross, Raven E.; Garfield, Lauren D.; Brown, Derek S.; Raghavan, Ramesh
American Indian and Alaska Native (AI/AN) populations report poor physical and mental health outcomes while tribal health providers and the Indian Health Service (IHS) operate in a climate of significant under funding. Understanding how the Patient Protection and Affordable Care Act (ACA) affects Native American tribes and the IHS is critical to addressing the improvement of the overall access, quality, and cost of health care within AI/AN communities. This paper summarizes the ACA provisions that directly and/or indirectly affect the service delivery of health care provided by tribes and the IHS. PMID:26548665
To repeal the Patient Protection and Affordable Care Act.
Rep. King, Steve [R-IA-5
06/16/2010 Motion to Discharge Committee filed by Mr. King (IA). Petition No: 111-11. (Discharge petition text with signatures.) (All Actions) Notes: On 6/16/2010, a motion was filed to discharge the Committees on Energy and Commerce, Ways and Means, Education and Labor, the Judiciary, Natural Resources, Rules, House Administration, and Appropriations from consideration of H.R.4972. A discharge petition requires 218 signatures for... Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Modification of a Braided Support Catheter into a Rapid Exchange System for Navigation of a Distal Protection Device through Significant Vascular Tortuosity
Ding, Dale; Starke, Robert M.; Durst, Christopher R.; Evans, Avery J
Summary Cerebral embolic protection devices (EPD) reduce the rate of periprocedural thromboembolic complications and are currently used in all carotid artery stenting (CAS) procedures. However, tortuous vascular anatomy of the internal carotid artery (ICA) may prevent navigation of distal EPDs, thereby leading to inadequate cerebral protection. We present a case in which significant tortuosity of the ICA distal to the stenotic lesion precluded navigation of currently available distal EPDs. During a CAS procedure, significant vascular tortuosity of the distal cervical ICA was noted which prevented navigation of currently available distal EPDs due to catheter kinking. In order to overcome this anatomic barrier, a novel rapid exchange catheter system (RECS) was created using a modified DAC 038 braided catheter through which a distal EPD and microguidewire were placed. This newly devised RECS allowed navigation of the distal EPD past the tortuous ICA bend and successful completion of the CAS procedure without periprocedural complications. We demonstrate that modification of currently available devices can, in select cases, effectively address cases of significant vascular tortuosity which limit the use of conventional distal EPDs. PMID:25496675
Vaccination with the ospA- and ospB-Negative Borrelia burgdorferi Strain 50772 Provides Significant Protection against Canine Lyme Disease
LaFleur, Rhonda L.; Dant, Jennifer C.; Wasmoen, Terri L.; Jobe, Dean A.; Lovrich, Steven D.
Beagles received placebo or ospA- and ospB-negative Borrelia burgdorferi before a tick challenge. A total of 28 (41%) ticks and skin biopsy specimens from each control dog (n = 10) contained B. burgdorferi. In contrast, 12 (19%) ticks recovered from the vaccine recipients (n = 10) were infected (P = 0.0077), and 5 dogs yielded spirochetes from the skin biopsy specimens (P = 0.0325). In addition, 9 (90%) placebo recipients and 4 (40%) vaccine recipients developed joint abnormalities (P = 0.0573). Therefore, vaccination with the ospA- and ospB-negative spirochete provided significant protection against Lyme disease. PMID:25972405
The Politics of Native American Health Care and the Affordable Care Act.
Skinner, Daniel
This article examines an important but largely overlooked dimension of the Patient Protection and Affordable Care Act (ACA), namely, its significance for Native American health care. The author maintains that reading the ACA against the politics of Native American health care policy shows that, depending on their regional needs and particular contexts, many Native Americans are well-placed to benefit from recent Obama-era reforms. At the same time, the kinds of options made available by the ACA constitute a departure from the service-based (as opposed to insurance-based) Indian Health Service (IHS). Accordingly, the author argues that ACA reforms--private marketplaces, Medicaid expansion, and accommodations for Native Americans--are best read as potential "supplements" to an underfunded IHS. Whether or not Native Americans opt to explore options under the ACA will depend in the long run on the quality of the IHS in the post-ACA era. Beyond understanding the ACA in relation to IHS funding, the author explores how Native American politics interacts with the key tenets of Obama-era health care reform--especially "affordability"--which is critical for understanding what is required from and appropriate to future Native American health care policy making.
Achieving Sustainable Construction in Affordable Housing
Barcik, M.K.; Creech, D.B.; Ternes, M.P.
An energy-efficient design and construction checklist and information sheets on energy-efficient design and construction are two products being developed. These products will help affordable housing providers take the first steps toward a whole-house approach to the design and implementation of energy-efficient construction practices. The checklist presents simple and clear guidance on energy improvements that can be readily addressed now by most affordable housing providers. The information sheets complement the checklist by providing installation instructions and material specifications that are accompanied by detailed graphics. The information sheets also identify benefits of recommended energy-efficiency measures and procedures including cost savings and impacts on health and comfort. This paper presents details on the checklist and information sheets and discusses their use in two affordable housing projects.
The Transformation of Ergonomic Affordances into Cultural Affordances: The Case of the Alnuset System
ERIC Educational Resources Information Center
Chiappini, Giampaolo
Is it possible to study the ergonomic affordances offered by a system designed for educational aims and their transformation into cultural affordances? To this purpose, what references can we adopt? This work describes the theoretical framework used to realise this study referring to AlNuSet, a system realised within the EC ReMath project to…
Affordance Templates for Shared Robot Control
NASA Technical Reports Server (NTRS)
Hart, Stephen; Dinh, Paul; Hambuchen, Kim
This paper introduces the Affordance Template framework used to supervise task behaviors on the NASA-JSC Valkyrie robot at the 2013 DARPA Robotics Challenge (DRC) Trials. This framework provides graphical interfaces to human supervisors that are adjustable based on the run-time environmental context (e.g., size, location, and shape of objects that the robot must interact with, etc.). Additional improvements, described below, inject degrees of autonomy into instantiations of affordance templates at run-time in order to enable efficient human supervision of the robot for accomplishing tasks.
Access To Care And Affordability Have Improved Following Affordable Care Act Implementation; Problems Remain.
Shartzer, Adele; Long, Sharon K; Anderson, Nathaniel
There is growing evidence that millions of adults have gained insurance coverage under the Affordable Care Act, but less is known about how access to and affordability of care may be changing. This study used data from the Health Reform Monitoring Survey to describe changes in access and affordability for nonelderly adults from September 2013, just prior to the first open enrollment period in the Marketplace, to March 2015, after the end of the second open enrollment period. Overall, we found strong improvements in access to care for all nonelderly adults and across income and state Medicaid expansion groups. We also found improvements in the affordability of care for all adults and for low- and moderate-income adults. Despite this progress, there were still large gaps in access and affordability in March 2015, particularly for low-income adults.
The Affordable Care Act, remedy, and litigation reform.
Maher, Brendan S
The Patient Protection and Affordable Care Act of 2010 (ACA) rewrote the law of private health insurance. How the ACA rewrote the law of civil remedies, however, is a question largely unexamined by scholars. Courts everywhere, including the U.S. Supreme Court, will soon confront this important issue. This Article offers a foundational treatment of the ACA on remedy. It predicts a series of flashpoints over which litigation reform battles will be fought. It identifies several themes that will animate those conflicts and trigger others. It explains how judicial construction of the statute's functional predecessor, the Employee Retirement Income Security Act of 1974 (ERISA), converted a protective statute into a uniquely effective piece of federal litigation reform. Ultimately, it considers whether the ACA--which incorporates, modifies, and rejects ERISA in several notable ways--will experience a similar fate.
Gedunin and photogedunin of Xylocarpus granatum show significant anti-secretory effects and protect the gastric mucosa of peptic ulcer in rats.
Lakshmi, V; Singh, N; Shrivastva, S; Mishra, S K; Dharmani, P; Mishra, V; Palit, G
In the present study, the gastroprotective mechanism of Xylocarpus granatum fruit and its active constituents gedunin and photogedunin was investigated. Chloroform fraction (Fr-CHCl(3)) of X. granatum fruit was evaluated against cold restraint (CRU), aspirin (AS), alcohol (AL) and pyloric ligation (PL) induced gastric ulcer models in rats and histamine (HA) induced duodenal ulcer model in guinea pigs. Potential anti-ulcer activity of Fr-CHCl(3) was observed against CRU (58.28%), AS (67.81%), AL (84.38%), PL (65.66%) and HA (61.93%) induced ulcer models. The standard drug omeprazole (10mg/kg, p.o.) showed 68.25% protection against CRU, 57.08% against AS and 69.42% against PL model and 70.79% against HA induced duodenal ulcer. Sucralfate, another standard drug (500 mg/kg, p.o.) showed 62.72% protection in AL induced ulcer model. Fr-CHCl(3) significantly reduced free acidity (51.42%), total acidity (30.76%) and upregulated mucin secretion by 58.37% respectively. Phytochemical investigations of Fr-CHCl(3) yielded gedunin (36%), photogedunin (2%). Further, Fr-CHCl(3) and its compounds gedunin and photogedunin significantly inhibited H(+) K(+)-ATPase activity in vitro with IC(50) of 89.37, 56.86 and 66.54 microg/ml respectively as compared to the IC(50) value of omeprazole (30.24 microg/ml) confirming their anti-secretory activity. Conclusively, Fr-CHCl(3) of Xylocarpus granatum was found to possess anti-ulcerogenic activity which might be due to its anti-secretory activity and subsequent strengthening of the defensive mechanism. This study is the first of its kind to show significant anti-secretory effect of gedunin and photogedunin. Therefore it could act as a potent therapeutic agent against peptic ulcer disease.
An oral DNA vaccine against infectious haematopoietic necrosis virus (IHNV) encapsulated in alginate microspheres induces dose-dependent immune responses and significant protection in rainbow trout (Oncorrhynchus mykiss).
Ballesteros, Natalia A; Alonso, Marta; Saint-Jean, Sylvia Rodríguez; Perez-Prieto, Sara I
Administered by intramuscular injection, a DNA vaccine (pIRF1A-G) containing the promoter regions upstream of the rainbow trout interferon regulatory factor 1A gene (IRF1A) driven the expression of the infectious hematopoietic necrosis virus (IHNV) glycoprotein (G) elicited protective immune responses in rainbow trout (Oncorhynchus mykiss). However, less laborious and cost-effective routes of DNA vaccine delivery are required to vaccinate large numbers of susceptible farmed fish. In this study, the pIRF1A-G vaccine was encapsulated into alginate microspheres and orally administered to rainbow trout. At 1, 3, 5, and 7 d post-vaccination, IHNV G transcripts were detected by quantitative real-time PCR in gills, spleen, kidney and intestinal tissues of vaccinated fish. This result suggested that the encapsulation of pIRF1A-G in alginate microparticles protected the DNA vaccine from degradation in the fish stomach and ensured vaccine early delivery to the hindgut, vaccine passage through the intestinal mucosa and its distribution thought internal and external organs of vaccinated fish. We also observed that the oral route required approximately 20-fold more plasmid DNA than the injection route to induce the expression of significant levels of IHNV G transcripts in kidney and spleen of vaccinated fish. Despite this limitation, increased IFN-1, TLR-7 and IgM gene expression was detected by qRT-PCR in kidney of vaccinated fish when a 10 μg dose of the oral pIRF1A-G vaccine was administered. In contrast, significant Mx-1, Vig-1, Vig-2, TLR-3 and TLR-8 gene expression was only detected when higher doses of pIRF1A-G (50 and 100 μg) were orally administered. The pIRF1A-G vaccine also induced the expression of several markers of the adaptive immune response (CD4, CD8, IgM and IgT) in kidney and spleen of immunized fish in a dose-dependent manner. When vaccinated fish were challenged by immersion with live IHNV, evidence of a dose-response effect of the oral vaccine could also
12 CFR 1807.400 - Affordable housing-general.
Code of Federal Regulations, 2013 CFR
... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-general. 1807.400 Section... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...
12 CFR 1807.401 - Affordable housing-rental housing.
Code of Federal Regulations, 2012 CFR
... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...
12 CFR 1807.401 - Affordable housing-rental housing.
Code of Federal Regulations, 2011 CFR
... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...
12 CFR 1807.400 - Affordable housing-general.
Code of Federal Regulations, 2012 CFR
... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-general. 1807.400 Section... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...
12 CFR 1807.400 - Affordable housing-general.
Code of Federal Regulations, 2014 CFR
... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-general. 1807.400 Section... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable housing—general. Each Awardee that uses CMF funding to support Affordable Housing Activities shall ensure that...
12 CFR 1807.401 - Affordable housing-rental housing.
Code of Federal Regulations, 2013 CFR
... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...
12 CFR 1807.401 - Affordable housing-rental housing.
Code of Federal Regulations, 2014 CFR
... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-rental housing. 1807.401... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.401 Affordable housing—rental housing. To qualify as Affordable Housing, a rental Multi-family housing project financed with a CMF...
No Role for Motor Affordances in Visual Working Memory
ERIC Educational Resources Information Center
Pecher, Diane
Motor affordances have been shown to play a role in visual object identification and categorization. The present study explored whether working memory is likewise supported by motor affordances. Use of motor affordances should be disrupted by motor interference, and this effect should be larger for objects that have motor affordances than for…
Options for Affordable Fission Surface Power Systems
NASA Technical Reports Server (NTRS)
Houts, Mike; Gaddis, Steve; Porter, Ron; VanDyke, Melissa; Martin Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise
Fission surface power systems could provide abundant power anywhere on free surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized; however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems.
9 Tips for Affordable Student Trips
ERIC Educational Resources Information Center
Adams, Jonathan
The trick to having a successful and affordable trip is planning ahead and planning thoroughly. Keep the spirits high and the costs low by following a well-traveled ensemble director's suggestions as presented in this article. These tips include finding local attractions that are unique to the city that the group will be visiting, looking at…
Actions and Affordances in Syntactic Ambiguity Resolution
ERIC Educational Resources Information Center
Chambers, Craig G.; Tanenhaus, Michael K.; Magnuson, James S.
In 2 experiments, eye movements were monitored as participants followed instructions containing temporary syntactic ambiguities (e.g., "Pour the egg in the bowl over the flour"). The authors varied the affordances of task-relevant objects with respect to the action required by the instruction (e.g., whether 1 or both eggs in the visual workspace…
Diabetes and the Affordable Care Act
Schade, David S.
Abstract The Affordable Care Act—"Obamacare"—is the most important federal medical legislation to be enacted since Medicare. Although the goal of the Affordable Care Act is to improve healthcare coverage, access, and quality for all Americans, people with diabetes are especially poised to benefit from the comprehensive reforms included in the act. Signed into law in 2010, this massive legislation will slowly be enacted over the next 10 years. In the making for at least a decade, it will affect every person in the United States, either directly or indirectly. In this review, we discuss the major changes in healthcare that will take place in the next several years, including (1) who needs to purchase insurance on the Web-based exchange, (2) the cost to individuals and the rebates that they may expect, (3) the rules and regulations for purchasing insurance, (4) the characteristics of the different "metallic" insurance plans that are available, and (5) the states that have agreed to participate. With both tables and figures, we have tried to make the Affordable Care Act both understandable and appreciated. The goal of this comprehensive review is to highlight aspects of the Affordable Care Act that are of importance to practitioners who care for people with diabetes by discussing both the positive and the potentially negative aspects of the program as they relate to diabetes care. PMID:24927108
Can the US afford a lunar base
Keaton, P.W.
Establishing a lunar base will require steady funding for a decade or two. The question addressed here is whether such a large space project is affordable at this time. The relevant facts and methodology are presented so that the reader may formulate independent answers. It is shown that a permanent lunar base can be financed without increasing NASA's historical budgetary trends.
Are Selective Private and Public Colleges Affordable?
ERIC Educational Resources Information Center
Karikari, John A.; Dezhbakhsh, Hashem
We examine college affordability under the existing pricing and financial aid system that awards both non need-based and need-based aid. Using data of freshmen attending a large number of selective private and public colleges in the USA, we find that the prices students actually pay for college have increased over time. Need-based grant aid has…
Significance of Selective Predation and Development of Prey Protection Measures for Juvenile Salmonids in the Columbia and Snake River Reservoirs: Annual Progress Report, February 1991-February 1992.
Poe, Thomas P.
This document is the 1991 annual report of progress for the Bonneville Power Administration (BPA) research Project conducted by the US Fish and Wildlife Service (FWS). Our approach was to present the progress achieved during 1991 in a series of separate reports for each major project task. Each report is prepared in the format of a scientific paper and is able to stand alone, whatever the state of progress or completion. This project has two major goals. One is to understand the significance of selective predation and prey vulnerability by determining if substandard juvenile salmonids (dead, injured, stressed, diseased, or naive) are more vulnerable to predation by northern squawfish, than standard or normal juvenile salmonids. The second goal is to develop and test prey protection measures to control predation on juvenile salmonids by reducing predator-smolt encounters or predator capture efficiency.
Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator Implantation to Prevent Tachyarrhythmias following Acute Myocardial Infarction (PROTECT-ICD): Trial Protocol, Background and Significance.
Zaman, Sarah; Taylor, Andrew J; Stiles, Martin; Chow, Clara; Kovoor, Pramesh
The 'Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator Implantation to Prevent Tachyarrhythmias following Acute Myocardial Infarction' (PROTECT-ICD) trial is an Australian-led multicentre randomised controlled trial targeting prevention of sudden cardiac death in patients who have at least moderately reduced cardiac function following a myocardial infarct (MI). The primary objective of the trial is to assess whether electrophysiological study to guide prophylactic implantation of an implantable cardioverter-defibrillator (ICD) early following MI (first 40 days) will lead to a significant reduction in sudden cardiac death and non-fatal arrhythmia. The secondary objective is to assess the utility of cardiac MRI (CMR) in assessing early myocardial characteristics, and its predictive value for both inducible ventricular tachycardia (VT) at EPS and SCD/ non-fatal arrhythmia at follow-up.
How the affordable care act and mental health parity and addiction equity act greatly expand coverage of behavioral health care.
Beronio, Kirsten; Glied, Sherry; Frank, Richard
The Patient Protection and Affordable Care Act (ACA) will expand coverage of mental health and substance use disorder benefits and federal parity protections to over 60 million Americans. The key to this expansion is the essential health benefit provision in the ACA that requires coverage of mental health and substance use disorder services at parity with general medical benefits. Other ACA provisions that should improve access to treatment include requirements on network adequacy, dependent coverage up to age 26, preventive services, and prohibitions on annual and lifetime limits and preexisting exclusions. The ACA offers states flexibility in expanding Medicaid (primarily to childless adults, not generally eligible previously) to cover supportive services needed by those with significant behavioral health conditions in addition to basic benefits at parity. Through these various new requirements, the ACA in conjunction with Mental Health Parity and Addiction Equity Act (MHPAEA) will expand coverage of behavioral health care by historic proportions.
Correspondence effects with torches: grasping affordance or visual feature asymmetry?
Song, Xiaolei; Chen, Jing; Proctor, Robert W
Three experiments were conducted to determine whether an object-based correspondence effect for torch (flashlight) stimuli reported by Pellicano et al. [( 2010 ). Simon-like and functional affordance effects with tools: The effects of object perceptual discrimination and object action state. Quarterly Journal of Experimental Psychology, 63, 2190-2201] is due to a grasping affordance provided by the handle or asymmetry of feature markings on the torch. In Experiment 1 the stimuli were the same as those from Pellicano et al.'s Experiment 2, whereas in Experiments 2 and 3 the stimuli were modified versions with the graspable handle removed. Participants in all experiments performed upright/inverted orientation judgements on the torch stimuli. The results of Experiment 1 replicated those of Pellicano et al.: A small but significant object-based correspondence effect was evident, mainly when the torch was in an active state. With the handle of the torch removed in Experiment 2, making the barrel markings more asymmetric in the display, the correspondence effect was larger. Experiment 3 directly demonstrated an effect of barrel-marking asymmetry on the correspondence effect: When only the half of the markings nearest the light end of the torch was included, the correspondence effect reversed to favour the light end. The results are in agreement with a visual feature-asymmetry account and are difficult to reconcile with a grasping-affordance account.
Alternatives to the ACA's Affordability Firewall
Nowak, Sarah A.; Saltzman, Evan; Cordova, Amado
Abstract The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the "entire family" scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the "dependents only" scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally
Alternatives to the ACA's Affordability Firewall.
Nowak, Sarah A; Saltzman, Evan; Cordova, Amado
The Affordable Care Act (ACA) was designed to increase health insurance coverage while limiting the disruption to individuals with existing sources of insurance coverage, particularly those with employer-sponsored insurance (ESI). To limit disruption to those with coverage, the ACA implements the employer mandate, which requires firms with more than 50 employees to offer health insurance or face penalties, and the individual "affordability firewall," which limits subsidies to individuals lacking access to alternative sources of coverage that are "affordable." This article examines the policy impacts of the affordability firewall and investigates two potential modifications. Option 1, which is the "entire family" scenario, involves allowing an exception to the firewall for anyone in a family where the family ESI premium contribution exceeds 9.5 percent of the worker's household income. In Option 2, the "dependents only" scenario, only dependents (and not the worker) become eligible for Marketplace subsidies when the ESI premium contribution exceeds 9.5 percent of the worker's household income. Relative to the ACA, RAND researchers estimate that nongroup enrollment will increase by 4.1 million for Option 1 and by 1.4 million for Option 2. However, the number without insurance only declines by 1.5 million in Option 1 and 0.7 million in Option 2. The difference between the increase in nongroup enrollment and the decrease in uninsurance is primarily due to ESI crowd-out, which is more pronounced for Option 1. Researchers also estimated that about 1.3 million families who have ESI and unsubsidized nongroup coverage under current ACA policy would receive Marketplace subsidies under the alternative affordability firewall scenarios. For these families, health insurance coverage would become substantially more affordable; these families' risk of spending at least 20 percent of income on health care would drop by more than two thirds. We additionally estimated that federal
Protected Graft Copolymer Excipient Leads to a Higher Acute Maximum Tolerated Dose and Extends Residence Time of Vasoactive Intestinal Peptide Significantly Better than Sterically Stabilized Micelles
Reichstetter, Sandra; Castillo, Gerardo M.; Rubinstein, Israel; Nishimoto-Ashfield, Akiko; Lai, ManShun; Jones, Cynthia C.; Banjeree, Aryamitra; Lyubimov, Alex; Bloedow, Duane C.; Bogdanov, Alexei; Bolotin, Elijah M.
Purpose To determine and compare pharmacokinetics and toxicity of two nanoformulations of Vasoactive Intestinal Peptide (VIP). Methods VIP was formulated using a micellar (Sterically Stabilized Micelles, SSM) and a polymer-based (Protected Graft Copolymer, PGC) nanocarrier at various loading percentages. VIP binding to the nanocarriers, pharmacokinetics, blood pressure, blood chemistry, and acute maximum tolerated dose (MTD) of the formulations after injection into BALB/c mice were determined. Results Both formulations significantly extend in vivo residence time compared to unformulated VIP. Formulation toxicity is dependent on loading percentage, showing major differences between the two carrier types. Both formulations increase in vivo potency of unformulated VIP and show acute MTDs at least 140 times lower than unformulated VIP, but still at least 100 times higher than the anticipated highest human dose, 1–5 μg/kg. These nanocarriers prevented a significant drop in arterial blood pressure compared to unformulated VIP. Conclusions While both carriers enhance in vivo residence time compared to unformulated VIP and reduce the drop in blood pressure immediately after injection, PGC is the excipient of choice to extend residence time and improve the safety of potent therapeutic peptides such as VIP. PMID:23224976
78 FR 8456 - Coverage of Certain Preventive Services Under the Affordable Care Act
Federal Register 2010, 2011, 2012, 2013, 2014
...This document proposes amendments to rules regarding coverage for certain preventive services under section 2713 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the Public Health Service Act requires coverage without......
78 FR 71667 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Affordable...
Federal Register 2010, 2011, 2012, 2013, 2014
... Protection and Affordable Care Act (ACA), Public Law 111-148, section 1251 provides that certain plans and... ACA grandfathered plan provision, requires a grandfathered health plan to include a statement in any... ] grandfathered health plan within the meaning of ACA section1251. To maintain its status as a...
The Affording Mars Workshop: Background and Recommendations
NASA Technical Reports Server (NTRS)
Thronson, Harley A.; Carberry, Christopher
A human mission to Mars is the stated "ultimate" goal for NASA and is widely believed by the public to be the most compelling destination for America's space program. However, widely cited enormous costs - perhaps as much as a trillion dollars for a many-decade campaign - seem to be an impossible hurdle, although political and budget instability over many years may be equally challenging. More recently, a handful of increasingly detailed architectures for initial Mars missions have been developed by commercial companies that have estimated costs much less than widely believed and roughly comparable with previous major human space flight programs: the Apollo Program, the International Space Station, and the space shuttle. Several of these studies are listed in the bibliography to the workshop report. As a consequence of these new scenarios, beginning in spring, 2013 a multiinstitutional planning team began developing the content and invitee list for a winter workshop that would critically assess concepts, initiatives, technology priorities, and programmatic options to reduce significantly the costs of human exploration of Mars. The output of the workshop - findings and recommendations - would be presented in a number of forums and discussed with national leaders in human space flight. It would also be made available to potential international partners. This workshop was planned from the start to be the first in a series. Subsequent meetings, conferences, and symposia will concentrate on topics not able to be covered in December. In addition, to make progress in short meeting, a handful of ground rules were adopted by the planning team and agreed to by the participants. Perhaps the two most notable such ground rules were (1) the Space Launch System (SLS) and Orion would be available during the time frame considered by the participants and (2) the International Space Station (ISS) would remain the early linchpin in preparing for Mars exploration over the coming decade
Affordances and the musically extended mind
Krueger, Joel
I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea. PMID:24432008
An Affordable Open-Source Turbidimeter
Kelley, Christopher D.; Krolick, Alexander; Brunner, Logan; Burklund, Alison; Kahn, Daniel; Ball, William P.; Weber-Shirk, Monroe
Turbidity is an internationally recognized criterion for assessing drinking water quality, because the colloidal particles in turbid water may harbor pathogens, chemically reduce oxidizing disinfectants, and hinder attempts to disinfect water with ultraviolet radiation. A turbidimeter is an electronic/optical instrument that assesses turbidity by measuring the scattering of light passing through a water sample containing such colloidal particles. Commercial turbidimeters cost hundreds or thousands of dollars, putting them beyond the reach of low-resource communities around the world. An affordable open-source turbidimeter based on a single light-to-frequency sensor was designed and constructed, and evaluated against a portable commercial turbidimeter. The final product, which builds on extensive published research, is intended to catalyze further developments in affordable water and sanitation monitoring. PMID:24759114
System Concepts for Affordable Fission Surface Power
NASA Technical Reports Server (NTRS)
Mason, Lee; Poston, David; Qualls, Louis
This paper presents an overview of an affordable Fission Surface Power (FSP) system that could be used for NASA applications on the Moon and Mars. The proposed FSP system uses a low temperature, uranium dioxide-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The concept was determined by a 12 month NASA/DOE study that examined design options and development strategies based on affordability and risk. The system is considered a low development risk based on the use of terrestrial-derived reactor technology, high efficiency power conversion, and conventional materials. The low-risk approach was selected over other options that could offer higher performance and/or lower mass.
Affordable Heavy Lift Capability: 2000-2004
NASA Technical Reports Server (NTRS)
This custom bibliography from the NASA Scientific and Technical Information Program lists a sampling of records found in the NASA Aeronautics and Space Database. The scope of this topic includes technologies to allow robust, affordable access of cargo, particularly to low-Earth orbit. This area of focus is one of the enabling technologies as defined by NASA s Report of the President s Commission on Implementation of United States Space Exploration Policy, published in June 2004.
Information Dominance: Can We Afford It
dominate all campaign areas such as air and fire superiority. This paper focuses on information warfare (IW) and its subset, information dominance (ID...the U.S. need information dominance , especially offensively, against second and third world countries, or should it put resources into active defense...Does the U.S. need defensive and offensive modes of information dominance ; can we afford both? Are we headed for information 'overkill' to gain
America's Affordable Health Choices Act of 2009
Rep. Dingell, John D. [D-MI-15
10/14/2009 Placed on the Union Calendar, Calendar No. 168. (All Actions) Notes: For further action, see H.R.3590, which became Public Law 111-148 on 3/23/2010. H.R.3590, often referred to as the Affordable Care Act, is the bill that became the health care reform law. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Significance of Selective Predation and Development of Prey Protection Measures for Juvenile Salmonids in the Columbia and Snake River Reservoirs: Annual Report, February 1992-February 1993.
Poe, Thomas P.; Gadomski, Dena M.
This document is the 1992 annual report of progress for the Bonneville Power Administration (BPA) research Project No. 82-003 conducted by the U.S. Fish and Wildlife Service (FWS), the Oregon Cooperative Fishery Research Unit (OCFRU), and the Idaho Cooperative Fish and Wildlife Research Unit (ICFWRU). The approach was to present the progress achieved during 1992 in a series of separate reports for each major project task. Each report is prepared in the format of a scientific paper and is able to stand alone, whatever the state of progress or completion. Reports 1, 2, and 4 consist of the Abstract only (journal papers were submitted in lieu of reports). This project has two major goals. One is to understand the significance of selective predation and prey vulnerability by determining if substandard juvenile salmonids (dead, injured, stressed, diseased, or naive) are more vulnerable to predation by northern squawfish, Ptychocheilus oregonensis, than standard or normal juvenile salmonids. The second goal is to develop and test prey protection measures to control predation on juvenile salmonids by reducing predator-smolt encounters or predator capture efficiency. Separate abstracts have been submitted to the database for the seven articles in this report.
Capsules from Pathogenic and Non-Pathogenic Cryptococcus spp. Manifest Significant Differences in Structure and Ability to Protect against Phagocytic Cells
Araujo, Glauber de S.; Fonseca, Fernanda L.; Pontes, Bruno; Torres, Andre; Cordero, Radames J. B.; Zancopé-Oliveira, Rosely M.; Casadevall, Arturo; Viana, Nathan B.; Nimrichter, Leonardo; Rodrigues, Marcio L.; Garcia, Eloi S.; de Souza, Wanderley; Frases, Susana
Capsule production is common among bacterial species, but relatively rare in eukaryotic microorganisms. Members of the fungal Cryptococcus genus are known to produce capsules, which are major determinants of virulence in the highly pathogenic species Cryptococcus neoformans and Cryptococcus gattii. Although the lack of virulence of many species of the Cryptococcus genus can be explained solely by the lack of mammalian thermotolerance, it is uncertain whether the capsules from these organisms are comparable to those of the pathogenic cryptococci. In this study, we compared the characteristic of the capsule from the non-pathogenic environmental yeast Cryptococcus liquefaciens with that of C. neoformans. Microscopic observations revealed that C. liquefaciens has a capsule visible in India ink preparations that was also efficiently labeled by three antibodies generated to specific C. neoformans capsular antigens. Capsular polysaccharides of C. liquefaciens were incorporated onto the cell surface of acapsular C. neoformans mutant cells. Polysaccharide composition determinations in combination with confocal microscopy revealed that C. liquefaciens capsule consisted of mannose, xylose, glucose, glucuronic acid, galactose and N-acetylglucosamine. Physical chemical analysis of the C. liquefaciens polysaccharides in comparison with C. neoformans samples revealed significant differences in viscosity, elastic properties and macromolecular structure parameters of polysaccharide solutions such as rigidity, effective diameter, zeta potential and molecular mass, which nevertheless appeared to be characteristics of linear polysaccharides that also comprise capsular polysaccharide of C. neoformans. The environmental yeast, however, showed enhanced susceptibility to the antimicrobial activity of the environmental phagocytes, suggesting that the C. liquefaciens capsular components are insufficient in protecting yeast cells against killing by amoeba. These results suggest that capsular
Dissociating between object affordances and spatial compatibility effects using early response components
Wilf, Meytal; Holmes, Nicholas P.; Schwartz, Isabella; Makin, Tamar R.
Perception and action are tightly linked: objects may be perceived not only in terms of visual features, but also in terms of possibilities for action. Previous studies showed that when a centrally located object has a salient graspable feature (e.g., a handle), it facilitates motor responses corresponding with the feature's position. However, such so-called affordance effects have been criticized as resulting from spatial compatibility effects, due to the visual asymmetry created by the graspable feature, irrespective of any affordances. In order to dissociate between affordance and spatial compatibility effects, we asked participants to perform a simple reaction-time task to typically graspable and non-graspable objects with similar visual features (e.g., lollipop and stop sign). Responses were measured using either electromyography (EMG) on proximal arm muscles during reaching-like movements, or with finger key-presses. In both EMG and button press measurements, participants responded faster when the object was either presented in the same location as the responding hand, or was affordable, resulting in significant and independent spatial compatibility and affordance effects, but no interaction. Furthermore, while the spatial compatibility effect was present from the earliest stages of movement preparation and throughout the different stages of movement execution, the affordance effect was restricted to the early stages of movement execution. Finally, we tested a small group of unilateral arm amputees using EMG, and found residual spatial compatibility but no affordance, suggesting that spatial compatibility effects do not necessarily rely on individuals' available affordances. Our results show dissociation between affordance and spatial compatibility effects, and suggest that rather than evoking the specific motor action most suitable for interaction with the viewed object, graspable objects prompt the motor system in a general, body-part independent fashion
DOE-HUD Initiative: Making Housing Affordable Through Energy Efficiency
Not Available
A new collaborative program of the U.S. Department of Energy (DOE) and the U.S. Department of Housing and Urban Development (HUD) is a significant step toward making HUD-aided housing more comfortable and affordable through greater energy efficiency. The initiative on Energy Efficiency in Housing combines DOE's technical capabilities and HUD's experience in housing assistance. Over the next decade, the energy savings potential of this initiative is estimated to be 150 trillion Btu (0.15 quad) per year, or nearly $1.5 billion in annual energy costs.
A study of social information control affordances and gender difference in Facebook self-presentation.
Kuo, Feng-Yang; Tseng, Chih-Yi; Tseng, Fan-Chuan; Lin, Cathy S
Affordances refer to how interface features of an IT artifact, perceived by its users in terms of their potentials for action, may predict the intensity of usage. This study investigates three social information affordances for expressive information control, privacy information control, and image information control in Facebook. The results show that the three affordances can significantly explain how Facebook's interface designs facilitate users' self-presentation activities. In addition, the findings reveal that males are more engaged in expressing information than females, while females are more involved in privacy control than males. A practical application of our study is to compare and contrast the level of affordances offered by various social network sites (SNS) like Facebook and Twitter, as well as differences in online self-presentations across cultures. Our approach can therefore be useful to investigate how SNS design features can be tailored to specific gender and culture needs.
Perceiving Affordances for Different Motor Skills
Cole, Whitney G.; Chan, Gladys L. Y.; Vereijken, Beatrix; Adolph, Karen E.
We examined several factors that affect people's ability to perceive possibilities for action. In Experiment 1, 24 participants crossed expanses of various sizes in three conditions: leaping, a familiar, launching action system; arm-swinging on monkey bars, an unpracticed skill that uses the arms rather than the legs; and crawling on hands and knees, a disused skill that involves all four limbs. Before and after performing each action, participants gave verbal judgments about the largest gap they could cross. Participants scaled initial judgments to their actual abilities in all three conditions. But they considerably underestimated their abilities for leaping, a launching action, and for arm-swinging when it was performed as a launching action; judgments about crawling, a non-launching action, and arm-swinging when it was performed as a non-launching action were more accurate. Thus, launching actions appear to produce a deficit in perceiving affordances that is not ameliorated by familiarity with the action. However, after performing the actions, participants partially corrected for the deficiency and more accurately judged their abilities for launching actions—suggesting that even brief action experience facilitates the perception of affordances. In Experiment 2, we confirmed that the deficit was due to the launching nature of the leaping and arm-swinging actions in Experiment 1. We asked an additional 12 participants to cross expanses using two non-launching actions using the legs (stepping across an expanse) and the arms (reaching across an expanse). Participants were highly accurate when judging affordances for these actions, supporting launching as the cause of the underestimation reported in Experiment 1. PMID:23411672
Technologies for affordable access to space
NASA Technical Reports Server (NTRS)
Colladay, R. S.; Sadin, S. R.
NASA plans for advanced research and technology programs aimed at reducing operating costs and extending the capability of future space systems are described. The evolution of an almost entirely space-based mode is discussed, including the role of earth launch, servicing, fabrication and assembly and communications. The development of technology for affordable access to space is examined, taking into account progress in the areas of telerobotics, machine autonomy, human autonomy, space-based manufacturing and construction, electric power, and space-based propulsion.
12 CFR 1807.402 - Affordable housing-homeownership.
Code of Federal Regulations, 2014 CFR
... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable housing-homeownership. 1807.402... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...
12 CFR 1291.12 - Affordable Housing Reserve Fund.
Code of Federal Regulations, 2014 CFR
... 12 Banks and Banking 10 2014-01-01 2014-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...
12 CFR 1291.12 - Affordable Housing Reserve Fund.
Code of Federal Regulations, 2013 CFR
... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...
12 CFR 1807.402 - Affordable housing-homeownership.
Code of Federal Regulations, 2013 CFR
... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Affordable housing-homeownership. 1807.402... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...
12 CFR 1291.12 - Affordable Housing Reserve Fund.
Code of Federal Regulations, 2012 CFR
... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...
12 CFR 1807.402 - Affordable housing-homeownership.
Code of Federal Regulations, 2012 CFR
... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Affordable housing-homeownership. 1807.402... TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable housing—homeownership. (a) Acquisition with or without rehabilitation. Housing that is for Homeownership purchase...
12 CFR 1291.12 - Affordable Housing Reserve Fund.
Code of Federal Regulations, 2010 CFR
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordable Housing Reserve Fund. 1291.12 Section 1291.12 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION FEDERAL HOME LOAN BANKS' AFFORDABLE HOUSING PROGRAM § 1291.12 Affordable Housing Reserve Fund. (a) Deposits. If...
12 CFR 1807.400 - Affordable housing-general.
Code of Federal Regulations, 2011 CFR
... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-general. 1807.400 Section 1807.400 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.400 Affordable...
12 CFR 1807.402 - Affordable housing-homeownership.
Code of Federal Regulations, 2011 CFR
... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Affordable housing-homeownership. 1807.402 Section 1807.402 Banks and Banking COMMUNITY DEVELOPMENT FINANCIAL INSTITUTIONS FUND, DEPARTMENT OF THE TREASURY CAPITAL MAGNET FUND Qualification as Affordable Housing § 1807.402 Affordable...
Affordable access to care for the undocumented.
Rosen, Dennis
How do you tell a sick kid that nobody cares if he gets better? That's an exaggeration, of course, but it is the fundamental message our society sends when we tell him that, because he and his family are undocumented immigrants, we are unwilling to extend them access to affordable and reliable health insurance. One major shortcoming of the Affordable Care Act is its specific exclusion of the almost twelve million undocumented immigrants-including millions of children-in this country from access to the state and federal insurance exchanges where coverage can be purchased. It is true that providing undocumented immigrants access to the exchanges and subsidies mandated by the ACA would require additional funding. However, a recent analysis in California has found that the costs of expanding state-supported care to include undocumented immigrants would largely be offset by the increased state sales tax revenue paid by managed care organizations and by reduced spending at the county level on emergency-room and hospital care of the uninsured.
Social affordances and the possibility of ecological linguistics.
Kono, Tetsuya
This paper includes an effort to extend the notion of affordance from a philosophical point of view the importance of ecological approach for social psychology, ethics, and linguistics. Affordances are not always merely physical but also interpersonal and social. I will conceptualize affordance in general and social affordance in particular, and will elucidate the relation between intentional action and affordances, and that between affordances and free will. I will also focus on the relation between social institution and affordance. An extended theory of affordances can provide a way to analyze in concrete ways how social institution works as an implicit background of interpersonal interactions. Ecological approach considers social institution as the producer and maintainer of affordances. Social institutions construct the niches for human beings. Finally, I will argue the possibility of the ecological linguistics. Language is a social institution. The system of signs is the way to articulate and differentiate interpersonal affordances. Language acquires its meaning, i.e. communicative power in the interpersonal interactions, and interpersonal interactions, in turn, develop and are elaborated through the usage of signs. Communication is seen as never aimed to transmit inner ideas to others, but to guide and adjust the behaviors of others thorough articulating the affordance of responsible-ness.
Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA.
Gresenz, Carole Roan; Laugesen, Miriam J; Yesus, Ambeshie; Escarce, José J
Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.
Piecing Together the College Affordability Puzzle: Student Characteristics and Patterns of (Un)Affordability
ERIC Educational Resources Information Center
Welbeck, Rashida; Diamond, John; Mayer, Alexander; Richburg-Hayes, Lashawn
The cost of attending college has risen sharply over the last 40 years. Although more credit and grant aid have been made available to students, there are still major gaps between aid and the cost of attendance for many students in the United States, all of whom are left to figure out whether they can afford the remaining costs associated with…
NASA's Space Launch System: Affordability for Sustainability
NASA Technical Reports Server (NTRS)
May, Todd A.; Creech, Stephen D.
The National Aeronautics and Space Administration's (NASA) Space Launch System (SLS) Program, managed at the Marshall Space Flight Center, is charged with delivering a new capability for human exploration beyond Earth orbit in an austere economic climate. But the SLS value is clear and codified in United States (U.S.) budget law. The SLS Program knows that affordability is the key to sustainability and will provide an overview of initiatives designed to fit within the funding guidelines by using existing engine assets and hardware now in testing to meet a first launch by 2017 within the projected budget. It also has a long-range plan to keep the budget flat, yet evolve the 70-tonne (t) initial lift capability to 130-t lift capability after the first two flights. To achieve the evolved configuration, advanced technologies must offer appropriate return on investment to be selected through the competitive process. For context, the SLS will be larger than the Saturn V that took 12 men on 6 trips for a total of 11 days on the lunar surface some 40 years ago. Astronauts train for long-duration voyages on platforms such as the International Space Station, but have not had transportation to go beyond Earth orbit in modern times, until now. To arrive at the launch vehicle concept, the SLS Program conducted internal engineering and business studies that have been externally validated by industry and reviewed by independent assessment panels. In parallel with SLS concept studies, NASA is now refining its mission manifest, guided by U.S. space policy and the Global Exploration Roadmap, which reflects the mutual goals of a dozen member nations. This mission planning will converge with a flexible heavy-lift rocket that can carry international crews and the air, water, food, and equipment they need for extended trips to asteroids and Mars. In addition, the SLS capability will accommodate very large science instruments and other payloads, using a series of modular fairings and
Critical Care Implications of the Affordable Care Act
Dogra, Anjali P.; Dorman, Todd
Objectives To provide an overview of key elements of the Affordable Care Act (ACA). To evaluate ways in which the ACA will likely impact the practice of critical care medicine. To describe strategies that may help health systems and providers effectively adapt to changes brought about by the ACA. Data Sources and Synthesis Data sources for this concise review include search results from the PubMed and Embase databases, as well as sources relevant to public policy such as the text of the Patient Protection and Affordable Care Act and reports of the Congressional Budget Office (CBO). As all of the ACA's provisions will not be fully implemented until 2019, we also drew upon cost, population and utilization projections as well as the experience of existing state-based healthcare reforms. Conclusion The ACA represents the furthest reaching regulatory changes in the US healthcare system since the 1965 Medicare and Medicaid provisions of the Social Security Act. The ACA aims to expand health insurance coverage to millions of Americans and place an emphasis on quality and cost-effectiveness of care. From models which link pay and performance to those which center on episodic care, the ACA outlines sweeping changes to health systems, reimbursement structures, and the delivery of critical care. Staffing models that include daily rounding by an intensivist, palliative care integration, and expansion of the role of telemedicine in areas where intensivists are inaccessible are potential strategies that may improve quality and profitability of ICU care in the post-ACA era. PMID:26565630
Significance of Selective Predation and Development of Prey Protection Measures for Juvenile Salmonids in the Columbia and Snake River Reservoirs: Annual Progress Report, February 1993-February 1994.
Poe, Thomas P.
This report addresses the problem of predator-prey interactions of juvenile salmonids in the Columbia and Snake River. Six papers are included on selective predation and prey protection. Attention is focused on monitoring the movements, the distribution, and the behavior of juvenile chinook salmon and northern squawfish.
Affordable Laser Communication in the Classroom
NASA Astrophysics Data System (ADS)
Walker, Constance E.; Sparks, R.; Pompea, S.
Several companies sell systems that illustrate laser communication such as Arbor Scientific1. These systems can be too expensive for classroom use. We will demonstrate a technique to modulate a standard diode laser using a microphone or other sound source that is capable of transmitting voice and music. This affordable system can transmit over 350 feet using simple, inexpensive parts readily available at your local electronics store. We will provide a list of parts necessary for assembly, detailed assembly instructions, as well as some suggested investigations using the laser communication system. This system can be used in the classroom either as a demonstration or hands-on activity to explore the physics and technology involved, citing more sophisticated laser communication systems on board spacecraft such as the Mercury Messenger Mission and the Mars Telecommunications Orbiter. 1http://www.arborsci.com
Affordable Care Act and Diabetes Mellitus.
Shi, Qian; Nellans, Frank P; Shi, Lizheng
The Affordable Care Act (ACA) has the potential for great impact on U.S. health care, especially for chronic disease patients requiring long-term care and management. The act was designed to improve insurance coverage, health care access, and quality of care for all Americans, which will assist patients with diabetes mellitus in acquiring routine monitoring and diabetes-related complication screening for better health management and outcomes. There is great potential for patients with diabetes to benefit from the new policy mandating health insurance coverage and plan improvement, Medicaid expansion, minimum coverage guarantees, and free preventative care. However, policy variability among states and ACA implementation present challenges to people with diabetes in understanding and optimizing ACA impact. This paper aims to select the most influential components of the ACA as relates to people with diabetes and discuss how the ACA may improve health care for this vulnerable population.
Why epidemiologists cannot afford to ignore poverty.
Krieger, Nancy
Epidemiologists cannot afford to ignore poverty. To do so would, first, wrongly obscure the devastating impact of poverty on population health, and, second, undercut our commitment to scientific rigor. At issue is doing correct science, not "politically correct" science. Blot poverty and inequity from view, and not only will we contribute to making suffering invisible but our understanding of disease etiology and distribution will be marred. To make this case, I address current debates about the causal relationships between poverty and health, and provide examples of how failing to consider the impact of socioeconomic position has biased epidemiologic knowledge and harmed the public's health. By definition, the people we study are simultaneously social beings and biologic organisms-and we cannot study the latter without taking into account the former. It is the responsibility of all epidemiologists, and not only social epidemiologists, to keep in mind the connections between poverty and health.
Affordable Hybrid Heat Pump Clothes Dryer
TeGrotenhuis, Ward E.; Butterfield, Andrew; Caldwell, Dustin D.; Crook, Alexander
This project was successful in demonstrating the feasibility of a step change in residential clothes dryer energy efficiency by demonstrating heat pump technology capable of 50% energy savings over conventional standard-size electric dryers with comparable drying times. A prototype system was designed from off-the-shelf components that can meet the project's efficiency goals and are affordable. An experimental prototype system was built based on the design that reached 50% energy savings. Improvements have been identified that will reduce drying times of over 60 minutes to reach the goal of 40 minutes. Nevertheless, the prototype represents a step change in efficiency over heat pump dryers recently introduced to the U.S. market, with 30% improvement in energy efficiency at comparable drying times.
Both Creatine and Its Product Phosphocreatine Reduce Oxidative Stress and Afford Neuroprotection in an In Vitro Parkinson's Model
Martín-de-Saavedra, Maria D.; Romero, Alejandro; Egea, Javier; Ludka, Fabiana K.; Tasca, Carla I.; Farina, Marcelo; Rodrigues, Ana Lúcia S.; López, Manuela G.
Creatine is the substrate for creatine kinase in the synthesis of phosphocreatine (PCr). This energetic system is endowed of antioxidant and neuroprotective properties and plays a pivotal role in brain energy homeostasis. The purpose of this study was to investigate the neuroprotective effect of creatine and PCr against 6-hydroxydopamine (6-OHDA)-induced mitochondrial dysfunction and cell death in rat striatal slices, used as an in vitro Parkinson's model. The possible involvement of the signaling pathway mediated by phosphatidylinositol-3 kinase (PI3K), protein kinase B (Akt), and glycogen synthase kinase-3β (GSK3β) was also evaluated. Exposure of striatal slices to 6-OHDA caused a significant disruption of the cellular homeostasis measured as 3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide reduction, lactate dehydrogenase release, and tyrosine hydroxylase levels. 6-OHDA exposure increased the levels of reactive oxygen species and thiobarbituric acid reactive substances production and decreased mitochondrial membrane potential in rat striatal slices. Furthermore, 6-OHDA decreased the phosphorylation of Akt (Serine473) and GSK3β (Serine9). Coincubation with 6-OHDA and creatine or PCr reduced the effects of 6-OHDA toxicity. The protective effect afforded by creatine or PCr against 6-OHDA-induced toxicity was reversed by the PI3K inhibitor LY294002. In conclusion, creatine and PCr minimize oxidative stress in striatum to afford neuroprotection of dopaminergic neurons. PMID:25424428
Both creatine and its product phosphocreatine reduce oxidative stress and afford neuroprotection in an in vitro Parkinson's model.
Cunha, Mauricio Peña; Martín-de-Saavedra, Maria D; Romero, Alejandro; Egea, Javier; Ludka, Fabiana K; Tasca, Carla I; Farina, Marcelo; Rodrigues, Ana Lúcia S; López, Manuela G
Creatine is the substrate for creatine kinase in the synthesis of phosphocreatine (PCr). This energetic system is endowed of antioxidant and neuroprotective properties and plays a pivotal role in brain energy homeostasis. The purpose of this study was to investigate the neuroprotective effect of creatine and PCr against 6-hydroxydopamine (6-OHDA)-induced mitochondrial dysfunction and cell death in rat striatal slices, used as an in vitro Parkinson's model. The possible involvement of the signaling pathway mediated by phosphatidylinositol-3 kinase (PI3K), protein kinase B (Akt), and glycogen synthase kinase-3β (GSK3β) was also evaluated. Exposure of striatal slices to 6-OHDA caused a significant disruption of the cellular homeostasis measured as 3-(4,5 dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide reduction, lactate dehydrogenase release, and tyrosine hydroxylase levels. 6-OHDA exposure increased the levels of reactive oxygen species and thiobarbituric acid reactive substances production and decreased mitochondrial membrane potential in rat striatal slices. Furthermore, 6-OHDA decreased the phosphorylation of Akt (Serine(473)) and GSK3β (Serine(9)). Coincubation with 6-OHDA and creatine or PCr reduced the effects of 6-OHDA toxicity. The protective effect afforded by creatine or PCr against 6-OHDA-induced toxicity was reversed by the PI3K inhibitor LY294002. In conclusion, creatine and PCr minimize oxidative stress in striatum to afford neuroprotection of dopaminergic neurons.
The Affordable Care Act, Accountable Care Organizations, and Mental Health Care for Older Adults: Implications and Opportunities.
Bartels, Stephen J; Gill, Lydia; Naslund, John A
The Patient Protection and Affordable Care Act (ACA) represents the most significant legislative change in the United States health care system in nearly half a century. Key elements of the ACA include reforms aimed at addressing high-cost, complex, vulnerable patient populations. Older adults with mental health disorders are a rapidly growing segment of the population and are among the most challenging subgroups within health care, and they account for a disproportionate amount of costs. What does the ACA mean for geriatric mental health? We address this question by highlighting opportunities for reaching older adults with mental health disorders by leveraging the diverse elements of the ACA. We describe nine relevant initiatives: (1) accountable care organizations, (2) patient-centered medical homes, (3) Medicaid-financed specialty health homes, (4) hospital readmission and health care transitions initiatives, (5) Medicare annual wellness visit, (6) quality standards and associated incentives, (7) support for health information technology and telehealth, (8) Independence at Home and 1915(i) State Plan Home and Community-Based Services program, and (9) Medicare-Medicaid Coordination Office, Center for Medicare and Medicaid Innovation, and the Patient-Centered Outcomes Research Institute. We also consider potential challenges to full implementation of the ACA and discuss novel solutions for advancing geriatric mental health in the context of projected workforce shortages and the opportunities afforded by the ACA.
A general protocol to afford enantioenriched linear homoprenylic amines.
Bosque, Irene; Foubelo, Francisco; Gonzalez-Gomez, Jose C
The reaction of a readily obtained chiral branched homoprenylamonium salt with a range of aldehydes, including aliphatic substrates, affords the corresponding linear isomers in good yields and enantioselectivities.
Community-specific evaluation of tool affordances in wild chimpanzees.
Gruber, Thibaud; Muller, Martin N; Reynolds, Vernon; Wrangham, Richard; Zuberbühler, Klaus
The notion of animal culture, defined as socially transmitted community-specific behaviour patterns, remains controversial, notably because the definition relies on surface behaviours without addressing underlying cognitive processes. In contrast, human cultures are the product of socially acquired ideas that shape how individuals interact with their environment. We conducted field experiments with two culturally distinct chimpanzee communities in Uganda, which revealed significant differences in how individuals considered the affording parts of an experimentally provided tool to extract honey from a standardised cavity. Firstly, individuals of the two communities found different functional parts of the tool salient, suggesting that they experienced a cultural bias in their cognition. Secondly, when the alternative function was made more salient, chimpanzees were unable to learn it, suggesting that prior cultural background can interfere with new learning. Culture appears to shape how chimpanzees see the world, suggesting that a cognitive component underlies the observed behavioural patterns.
Affordable, Robust Ceramic Joining Technology (ARCJoint) Developed
NASA Technical Reports Server (NTRS)
Steele, Gynelle C.
Affordable, Robust Ceramic Joining Technology (ARCJoint) is a method for joining high temperature- resistant ceramic pieces together, establishing joints that are strong, and allowing joining to be done in the field. This new way of joining allows complex shapes to be formed by joining together geometrically simple shapes. The joining technology at NASA is one of the enabling technologies for the application of silicon-carbide-based ceramic and composite components in demanding and high-temperature applications. The technology is being developed and tested for high-temperature propulsion parts for aerospace use. Commercially, it can be used for joining ceramic pieces used for high temperature applications in the power-generating and chemical industries, as well as in the microelectronics industry. This innovation could yield big payoffs for not only the power-generating industry but also the Silicon Valley chipmakers. This technology, which was developed at the NASA Glenn Research Center by Dr. Mrityunjay Singh, is a two-step process involving first using a paste to join together ceramic pieces and bonding them by heating the joint to 110 to 120 C for between 10 and 20 min. This makes the joint strong enough to be handled for the final joining. Then, a silicon-based substance is applied to the joint and heated to 1400 C for 10 to 15 min. The resulting joint is as strong as the original ceramic material and can withstand the same high temperatures.
Partnerships for affordable and equitable disaster insurance
NASA Astrophysics Data System (ADS)
Mysiak, J.; Pérez-Blanco, C. D.
Extreme events are becoming more frequent and intense, inflating the economic damages and social hardship set-off by natural catastrophes. Amidst budgetary cuts, there is a growing concern on societies' ability to design solvent disaster recovery strategies, while addressing equity and affordability concerns. The participation of private sector along with public one through Public-Private Partnerships (PPPs) has gained on importance as a means to address these seemingly conflicting objectives through the provision of (catastrophic) natural hazard insurance. This is the case of many OECD countries, notably some EU Member States such as the United Kingdom and Spain. The EU legislator has adapted to this new scenario and recently produced major reforms in the legislation and regulation that govern the framework in which PPPs for (catastrophic) natural hazard insurance develop. This paper has a dual objective: (1) review the complex legal background that rules the provision of insurance against natural catastrophes in the EU after these major reforms, (2) assess the implications of the reforms and offer concise Policy Guiding Principles.
Affordable underwater wireless optical communication using LEDs
NASA Astrophysics Data System (ADS)
Pilipenko, Vladimir; Arnon, Shlomi
In recent years the need for high data rate underwater wireless communication (WC) has increased. Nowadays, the conventional technology for underwater communication is acoustic. However, the maximum data rate that acoustic technology can provide is a few kilobits per second. On the other hand, emerging applications such as underwater imaging, networks of sensors and swarms of underwater vehicles require much faster data rates. As a result, underwater optical WC, which can provide much higher data rates, has been proposed as an alternative means of communication. In addition to high data rates, affordable communication systems become an important feature in the development requirements. The outcome of these requirements is a new system design based on off-the-shelf components such as blue and green light emitting diodes (LEDs). This is due to the fact that LEDs offer solutions characterized by low cost, high efficiency, reliability and compactness. However, there are some challenges to be met when incorporating LEDs as part of the optical transmitter, such as low modulation rates and non linearity. In this paper, we review the main challenges facing the incorporation of LEDs as an integral part of underwater WC systems and propose some techniques to mitigate the LED limitations in order to achieve high data rate communication
Robust, affordable, semi-direct Mars mission
NASA Astrophysics Data System (ADS)
Salotti, Jean-Marc
A new architecture is proposed for the first manned Mars mission, based on current NASA developments (SLS and Orion), chemical propulsion for interplanetary transit, aerocapture for all vehicles, a split strategy, and a long stay on the surface. Two important choices make this architecture affordable and appropriate for the first mission. The first is splitting the Earth return vehicle into two parts that are launched separately and dock in Mars orbit. This is necessary to make aerocapture feasible and efficient, which considerably reduces mass. The second is reducing the crew to 3 astronauts. This simplifies the mission and reduces the SLS payload mass under the 45-metric ton limit for a direct TMI (trans-Mars injection) burn without LEO assembly. Only 4 SLS launches are required. The first takes the Mars ascent vehicle and in situ resource utilization systems to the planet's surface. The second takes the first part of the Earth return vehicle, the habitat, into Mars orbit. Two years later, two further SLS launches take a dual-use habitat (outbound trip and surface), Orion, and an enhanced service module to LEO, and then into Mars orbit, followed by the landing of the habitat on the surface. Transit time is demonstrated to be easily reduced to less than 6 months, with relatively low impact on propellant mass and none at all on the architecture.
A New Measure of Medication Affordability
This study developed a new measure of medication affordability that examines out-of-pocket drug expenses relative to available household resources. The authors assessed the spending patterns of ~2.1 million poor households (≤100% federal poverty level) of adults aged 51 and older by Medicaid status. The data were drawn from the 2000–2001 Health and Retirement Study. Household spending was categorized into three broad types: basic living, health care, and discretionary. Older (aged 51 or older) poor households without Medicaid allocated about 72% of their total resources ($17,421, SE $783) to basic living needs. In comparison, those with Medicaid had scarcer total resources ($12,498, SE $423) and allocated 85% to basic living needs. Medication costs consumed the largest proportion of health care expenses for both types of poor households (Medicaid: $463, SE $67; non-Medicaid: $970, SE $102). After paying for basic living needs and health care costs, these families had, on average, only $16 left each week. Poor families have very few resources available for anything beyond basic living needs, even when they have Medicaid coverage. There is no great reservoir of discretionary funds to pay for increases in cost-sharing under Medicaid and Medicare Part D. PMID:19821195
To Copy-Protect or Not to Copy-Protect?
ERIC Educational Resources Information Center
Sacks, Jonathan
Discusses the issues of software piracy, why people illegally copy software, protection afforded software developers by copyright laws, and current and future methods of disk-based protection built into software by developers and the problems these methods have created. (MBR)
Ground Processing Affordability for Space Vehicles
NASA Technical Reports Server (NTRS)
Ingalls, John; Scott, Russell
Launch vehicles and most of their payloads spend the majority of their time on the ground. The cost of ground operations is very high. So, why so often is so little attention given to ground processing during development? The current global space industry and economic environment are driving more need for efficiencies to save time and money. Affordability and sustainability are more important now than ever. We can not continue to treat space vehicles as mere science projects. More RLV's (Reusable Launch Vehicles) are being developed for the gains of reusability which are not available for ELV's (Expendable Launch Vehicles). More human-rated vehicles are being developed, with the retirement of the Space Shuttles, and for a new global space race, yet these cost more than the many unmanned vehicles of today. We can learn many lessons on affordability from RLV's. DFO (Design for Operations) considers ground operations during design, development, and manufacturing-before the first flight. This is often minimized for space vehicles, but is very important. Vehicles are designed for launch and mission operations. You will not be able to do it again if it is too slow or costly to get there. Many times, technology changes faster than space products such that what is launched includes outdated features, thus reducing competitiveness. Ground operations must be considered for the full product Lifecycle, from concept to retirement. Once manufactured, launch vehicles along with their payloads and launch systems require a long path of processing before launch. Initial assembly and testing always discover problems to address. A solid integration program is essential to minimize these impacts, as was seen in the Constellation Ares I-X test rocket. For RLV's, landing/recovery and post-flight turnaround activities are performed. Multi-use vehicles require reconfiguration. MRO (Maintenance, Repair, and Overhaul) must be well-planned--- even for the unplanned problems. Defect limits and
Affordable Space Tourism: SpaceStationSim
NASA Technical Reports Server (NTRS)
For over 5 years, people have been living and working in space on the International Space Station (ISS), a state-of-the-art laboratory complex orbiting high above the Earth. Offering a large, sustained microgravity environment that cannot be duplicated on Earth, the ISS furthers humankind s knowledge of science and how the body functions for extended periods of time in space all of which will prove vital on long-duration missions to Mars. On-orbit construction of the station began in November 1998, with the launch of the Russian Zarya Control Module, which provided battery power and fuel storage. This module was followed by additional components and supplies over the course of several months. In November 2000, the first ISS Expedition crew moved in. Since then, the ISS has continued to change and evolve. The space station is currently 240 feet wide, measured across the solar arrays, and 171 feet long, from the NASA Destiny Laboratory to the Russian Zvezda Habitation Module. It is 90 feet tall, and it weighs approximately 404,000 pounds. Crews inhabit a living space of about 15,000 cubic feet. To date, 90 scientific investigations have been conducted on the space station. New results from space station research, from basic science to exploration research, are being published each month, and more breakthroughs are likely to come. It is not all work on the space station, though. The orbiting home affords many of the comforts one finds on Earth. There is a weightless "weight room" and even a musical keyboard alongside research facilities. Holidays are observed, and with them, traditional foods such as turkey and cobbler are eaten, with lemonade to wash them down
Affordable WDM components: the polymer solution
NASA Astrophysics Data System (ADS)
Eldada, Louay A.; Yin, Shing; Norwood, Robert A.; Yardley, James T.
An advanced polymeric waveguide technology was developed for affordable WDM components that address the needs of both the Telecom and the Datacom industries. We engineered high- performance organic polymers that can be readily made into both multimode and single-mode optical waveguide structures of controlled numerical aperture and geometry. These materials are formed from highly-crosslinked acrylate monomers with specific linkages that determine properties such as flexibility, toughness, loss, and environmental stability. These monomers are intermiscible, providing for precise adjustment of the refractive index from 1.3 to 1.6. In polymer form, they exhibit state-of-the-art loss values, high thermal stability, high humidity resistance, low dispersion and low birefringence. Waveguides are formed photolithographically, with the liquid monomer mixture polymerizing upon illumination in the UV via either mask exposure or laser direct writing. A wide range of rigid and flexible substrates can be used, including glass, quartz, oxidized silicon, glass-filled epoxy printed circuit board substrate, and flexible polyimide film. Waveguiding structures measuring tens of inches in length can be produced on computer boards, and guides that are meters long can be printed on rolls of plastic. We describe the fabrication of both Bragg gratings and waveguide grating routes in our polymers for filtering and demultiplexing applications in Telecom WDM systems. In Datacom, we describe polymeric components that we produced for aerospace WDM sensor systems. The importance of CAD tools in designing WDM devices is emphasized in this work. We further discuss the low-cost manufacturing of WDM components in an industrial environment.
Commercial Platforms Allow Affordable Space Research
NASA Technical Reports Server (NTRS)
At an altitude of about 240 miles, its orbital path carries it over 90 percent of the Earth s population. It circles the Earth in continuous free fall; its crew of six and one Robonaut pass the days, experiencing 16 sunrises and 16 sunsets every 24 hours, in microgravity, an environment in which everything from bodily functions to the physical behavior of materials changes drastically from what is common on the ground. Outside its shielded confines, temperatures cycle from one extreme to the other, radiation is rampant, and atomic oxygen corrodes everything it touches. A unique feat of engineering, the International Space Station (ISS) also represents the most remarkable platform for scientific research ever devised. In 2005, anticipating the space station s potential for NASA and non-NASA scientists alike, the NASA Authorization Act designated the US segment of the ISS as a national laboratory, instructing the Agency to "increase the utilization of the ISS by other Federal entities and the private sector." With the ISS set to maintain operations through at least 2020, the station offers an unprecedented long-term access to space conditions, enabling research not previously possible. "There will be new drug discoveries, new pharmaceuticals, a better understanding of how we affect the planet and how we can maintain it," says Marybeth Edeen, the ISS National Laboratory manager, based at Johnson Space Center. The ISS, she says, represents a major example of the government s role in making such advancements possible. "The government is key in that researchers cannot afford to build the kind of infrastructure that the government can provide. But we then have to make that infrastructure available at a reasonable cost." Enter Jeff Manber, who saw in the ISS National Lab an extraordinary opportunity to advance science, education, and business in ways never before seen.
Utilizing Fission Technology to Enable Rapid and Affordable Access to any Point in the Solar System
NASA Technical Reports Server (NTRS)
Houts, Mike; Bonometti, Joe; Morton, Jeff; Hrbud, Ivana; Bitteker, Leo; VanDyke, Melissa; Godfroy, T.; Pedersen, K.; Dobson, C.; Patton, B.; Martin, J.; Chakrabarti, S.
Fission technology can enable rapid, affordable access to any point in the solar system. Potential fission-based transportation options include bimodal nuclear thermal rockets, high specific energy propulsion systems, and pulsed fission propulsion systems. In-space propellant re-supply enhances the effective performance of all systems, but requires significant infrastructure development. Safe, timely, affordable utilization of first-generation space fission propulsion systems will enable the development of more advanced systems. First generation systems can build on over 45 years of US and international space fission system technology development to minimize cost.
Report: ECHO Data Quality Audit – Phase I Results: The Integrated Compliance Information System Needs Security Controls to Protect Significant Non-Compliance Data
Report #09-P-0226, August 31, 2009. End users of the Permit Compliance System and Integrated Compliance Information System National Pollutant Discharge Elimination System can override the Significant Non-Compliance data field without more access controls.
One Hand, Two Objects: Emergence of Affordance in Contexts
ERIC Educational Resources Information Center
Borghi, Anna M.; Flumini, Andrea; Natraj, Nikhilesh; Wheaton, Lewis A.
Studies on affordances typically focus on single objects. We investigated whether affordances are modulated by the context, defined by the relation between two objects and a hand. Participants were presented with pictures displaying two manipulable objects linked by a functional (knife-butter), a spatial (knife-coffee mug), or by no relation. They…
Affordance Analysis--Matching Learning Tasks with Learning Technologies
ERIC Educational Resources Information Center
Bower, Matt
This article presents a design methodology for matching learning tasks with learning technologies. First a working definition of "affordances" is provided based on the need to describe the action potentials of the technologies (utility). Categories of affordances are then proposed to provide a framework for analysis. Following this, a…
12 CFR 1282.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2010 CFR
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Special Affordable Housing Goal. 1282.14 Section 1282.14 Banks and Banking FEDERAL HOUSING FINANCE AGENCY HOUSING GOALS AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.14 Special Affordable Housing Goal. (a) Purpose of the...
The Influence of Affordability in Strategic Enrollment Management
ERIC Educational Resources Information Center
Pugh, Susan L.; Thompson, Roger J.
In state houses around the country, one of the common higher education themes is affordability. As tuition costs have increased at rates exceeding that of inflation, students and families have pressed their legislative representatives to examine these increases. Affordability is a term used by various constituent groups, and its definition varies…
Affordability Tradeoffs Under Uncertainty Using Epoch-Era Analysis
exploration and change-related "ilities." Dr. Ross holds a dual A.B. in Physics and Astronomy and Astrophysics from Harvard University, S.M. in Aeronautics...1 Introduction of Affordability in Defense Acquisition................................................. 2 Recent Definitions of Affordability...20 Introduction and Background ............................................................................... 20 Application
What Are the Affordances of Information and Communication Technologies?
ERIC Educational Resources Information Center
Conole, Grainne; Dyke, Martin
The paper examines the notion that Information and Communication Technologies (ICT) have affordances that epitomize the features of our late modern age (Giddens, 1991) and explores whether these affordances (Salomon, 1993, p. 51) can be used to facilitate particular approaches to educational practice. It argues that a clear articulation of these…
Nurturing Opportunities for Educational Leadership: How Affordance and Leadership Interconnect
ERIC Educational Resources Information Center
Margolin, Ilana
This qualitative ethnographic study focused on the affordances that facilitated the emergence of leadership, capturing a range of perspectives on leadership and leadership development of four groups: district superintendents; teacher-educators; mentor-teachers and graduates. The term "affordances" implies a reciprocal relationship…
Embodied Perception: A Proposal to Reconcile Affordance and Spatial Perception
Proffitt's embodied approach to perception is deeply indebted to Gibson's ecological approach to visual perception, in particular the idea that the primary objects of perception are affordances or what the environment offers for action. Yet, rather than directly addressing affordance perception, most of the empirical work evaluating Proffitt's approach focuses on the perception of spatial properties of the environment. We propose that theoretical and empirical efforts should be directed toward an understanding of the relationship between affordance perception and spatial perception, keeping in mind that this relationship is nontrivial because affordance perception is dichotomous, whereas the perception of spatial properties is gradual. We argue that the perception of spatial properties of the environment is enslaved by affordance perception, most notably at the critical boundaries for action. To empirically scrutinize this proposition, and to solve issues raised regarding the validity of several empirical findings, we call for joint research efforts to further understanding of embodied perception.
An Affordability Comparison Tool (ACT) for Space Transportation
NASA Technical Reports Server (NTRS)
McCleskey, C. M.; Bollo, T. R.; Garcia, J. L.
NASA bas recently emphasized the importance of affordability for Commercial Crew Development Program (CCDP), Space Launch Systems (SLS) and Multi-Purpose Crew Vehicle (MPCV). System architects and designers are challenged to come up with architectures and designs that do not bust the budget. This paper describes the Affordability Comparison Tool (ACT) analyzes different systems or architecture configurations for affordability that allows for a comparison of: total life cycle cost; annual recurring costs, affordability figures-of-merit, such as cost per pound, cost per seat, and cost per flight, as well as productivity measures, such as payload throughput. Although ACT is not a deterministic model, the paper develops algorithms and parametric factors that use characteristics of the architectures or systems being compared to produce important system outcomes (figures-of-merit). Example applications of outcome figures-of-merit are also documented to provide the designer with information on the relative affordability and productivity of different space transportation applications.
Evaporation-Cooled Protective Suits for Firefighters
NASA Technical Reports Server (NTRS)
Weinstein, Leonard Murray
Suits cooled by evaporation of water have been proposed as improved means of temporary protection against high temperatures near fires. When air temperature exceeds 600 F (316 C) or in the presence of radiative heating from nearby sources at temperatures of 1,200 F (649 C) or more, outer suits now used by firefighters afford protection for only a few seconds. The proposed suits would exploit the high latent heat of vaporization of water to satisfy a need to protect against higher air temperatures and against radiant heating for significantly longer times. These suits would be fabricated and operated in conjunction with breathing and cooling systems like those with which firefighting suits are now equipped
Fact Sheet: Protection of the Stratospheric Ozone: New Substitute in the Motor Vehicle Air Conditioning Sector under the Significant New Alternatives Policy (SNAP) Program
Under the Significant New Alternatives Policy (SNAP) program, EPA is listing HFO-1234yf as an acceptable substitute for ozone depleting substances (ODS) in motor vehicle air conditioning (MVAC) systems in new cars and other light duty-vehicles and is speci
Affordable Earth Observatories for Developing Countries
NASA Astrophysics Data System (ADS)
Meurer, R. H.
Traditionally high cost has been the principal impediment to developing nations desiring to pursue space programs. More particularly, the benefits derivable from a space system have been less than adequate to justify the investment required. Chief among the causes has been the inability of the system to produce results with sufficient direct economic value to the peoples of their countries. Over the past 15 years, however, "the Microspace Revolution" has resulted in dramatic reductions in the cost of space systems, while at the same time technology has improved to provide greater capabilities in the smallest micro- and nano-class1 satellites. Because of these advances, it behooves developing nations to reevaluate space as an option for their national development. This paper summarizes two new micro-satellite concepts - NanoObservatoryTM and MicroObservatoryTM that offer the prom- ise of a dedicated Earth remote sensing capability at costs comparable to or less than simply buying data from the best known large systems, Landsat and SPOT. Each system is defined both by its observation capabilities and technical parameters of the system's design. Moreover, the systems are characterized in terms of the other potential benefits to developing economies, i.e., education of a technical workforce or applications of Earth imagery in solving national needs. Comparisons are provided with more traditional Earth observing satellites. NanoObservatoryTM is principally intended to serve as a developmental system to build general technical expertise space technology and Earth observation. MicroObservatoryTM takes the next step by focusing on a more sophisticated optical imag- ing camera while keeping the spacecraft systems simple and affordable. For both programs, AeroAstro is working with non- profit institutions to develop a corresponding program of technical participation with the nations that elect to pursue such programs. Dependent upon current capabilities, this might include
Balancing adequacy and affordability?: Essential Health Benefits under the Affordable Care Act.
Haeder, Simon F
The Essential Health Benefits provisions under the Affordable Care Act require that eligible plans provide coverage for certain broadly defined service categories, limit consumer cost-sharing, and meet certain actuarial value requirements. Although the Department of Health and Human Services (HHS) was tasked with the regulatory development of these EHB under the ACA, the department quickly devolved this task to the states. Not surprisingly, states fully exploited the leeway provided by HHS, and state decision processes and outcomes differed widely. However, none of the states took advantage of the opportunity to restructure fundamentally their health insurance markets, and only a very limited number of states actually included sophisticated policy expertise in their decisionmaking processes. As a result, and despite a major expansion of coverage, the status quo ex ante in state insurance markets was largely perpetuated. Decisionmaking for the 2016 revisions should be transparent, included a wide variety of stakeholders and policy experts, and focus on balancing adequacy and affordability. However, the 2016 revisions provide an opportunity to address these previous shortcomings.
The Affordable Care Act: the ethical call to transform the organizational culture.
Piper, Llewellyn E
The Patient Protection and Affordable Care Act will require health care leaders and managers to develop strategies and implement organizational tactics for their organization to survive and thrive under the federal mandates of this new health care law. Successful health care organizations and health care systems will be defined by their adaptability in the new value-based marketplace created by the Affordable Care Act. The most critical underlining challenge for this success will be the effective transformation of the organizational culture. Transformational value-based leadership is now needed to answer the ethical call for transforming the organizational culture. This article provides a model and recommendations to influence change in the most difficult leadership duty-transforming the organizational culture.
What Health Care Reform Means for Immigrants: Comparing the Affordable Care Act and Massachusetts Health Reforms.
Joseph, Tiffany D
The 2010 Patient Protection and Affordable Care Act (ACA) was passed to provide more affordable health coverage to Americans beginning in 2014. Modeled after the 2006 Massachusetts health care reform, the ACA includes an individual mandate, Medicaid expansion, and health exchanges through which middle-income individuals can purchase coverage from private insurance companies. However, while the ACA provisions exclude all undocumented and some documented immigrants, Massachusetts uses state and hospital funds to extend coverage to these groups. This article examines the ACA reform using the Massachusetts reform as a comparative case study to outline how citizenship status influences individuals' coverage options under both policies. The article then briefly discusses other states that provide coverage to ACA-ineligible immigrants and the implications of uneven ACA implementation for immigrants and citizens nationwide.
The Affordable Care Act: the ethical call for value-based leadership to transform quality.
Piper, Llewellyn E
Hospitals in America face a daunting and historical challenge starting in 2013 as leadership navigates their organizations toward a new port of call-the Patient Protection and Affordable Care Act. Known as the Affordable Care Act (ACA) was signed into law in March 2010 and held in abeyance waiting on 2 pivotal points-the Supreme Court's June 2012 ruling upholding the constitutionality of the ACA and the 2012 presidential election of Barack Obama bringing to reality to health care organizations that leadership now must implement the mandates of health care delivery under the ACA. This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.
Response to Letter Regarding the Louisiana Department of Environmental Protection's Position on the PSD Significant Emission Level for ODS at Existing Major Sources
This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.
Ninety-day waiting period limitation and technical amendments to certain health coverage requirements under the Affordable Care Act. Final rule.
These final regulations implement the 90-day waiting period limitation under section 2708 of the Public Health Service Act, as added by the Patient Protection and Affordable Care Act (Affordable Care Act), as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. These regulations also finalize amendments to existing regulations to conform to Affordable Care Act provisions. Specifically, these rules amend regulations implementing existing provisions such as some of the portability provisions added by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) because those provisions of the HIPAA regulations have become superseded or require amendment as a result of the market reform protections added by the Affordable Care Act.
Conditional deletion of the glutamate transporter GLT-1 reveals that astrocytic GLT-1 protects against fatal epilepsy while neuronal GLT-1 contributes significantly to glutamate uptake into synaptosomes.
Petr, Geraldine T; Sun, Yan; Frederick, Natalie M; Zhou, Yun; Dhamne, Sameer C; Hameed, Mustafa Q; Miranda, Clive; Bedoya, Edward A; Fischer, Kathryn D; Armsen, Wencke; Wang, Jianlin; Danbolt, Niels C; Rotenberg, Alexander; Aoki, Chiye J; Rosenberg, Paul A
GLT-1 (EAAT2; slc1a2) is the major glutamate transporter in the brain, and is predominantly expressed in astrocytes, but at lower levels also in excitatory terminals. We generated a conditional GLT-1 knock-out mouse to uncover cell-type-specific functional roles of GLT-1. Inactivation of the GLT-1 gene was achieved in either neurons or astrocytes by expression of synapsin-Cre or inducible human GFAP-CreERT2. Elimination of GLT-1 from astrocytes resulted in loss of ∼80% of GLT-1 protein and of glutamate uptake activity that could be solubilized and reconstituted in liposomes. This loss was accompanied by excess mortality, lower body weight, and seizures suggesting that astrocytic GLT-1 is of major importance. However, there was only a small (15%) reduction that did not reach significance of glutamate uptake into crude forebrain synaptosomes. In contrast, when GLT-1 was deleted in neurons, both the GLT-1 protein and glutamate uptake activity that could be solubilized and reconstituted in liposomes were virtually unaffected. These mice showed normal survival, weight gain, and no seizures. However, the synaptosomal glutamate uptake capacity (Vmax) was reduced significantly (40%). In conclusion, astrocytic GLT-1 performs critical functions required for normal weight gain, resistance to epilepsy, and survival. However, the contribution of astrocytic GLT-1 to glutamate uptake into synaptosomes is less than expected, and the contribution of neuronal GLT-1 to synaptosomal glutamate uptake is greater than expected based on their relative protein expression. These results have important implications for the interpretation of the many previous studies assessing glutamate uptake capacity by measuring synaptosomal uptake.
The Value of Full Correction: Achieving Excellent and Affordable Results.
Kaplan, Julie Bass
Patients often come to medical aesthetic offices with hopes to fully correct lost facial volume and achieve a natural appearance. Unfortunately, the cost per syringe of dermal filler can be a barrier to desired outcomes. Many aesthetic practitioners do the best they can with the amount of product the patient can afford, often falling short of the "wow" effect for the patient. This article describes what one office implemented to solve the conundrum of affordability while still allowing offices to cover its own financial realities. This tool can help patients achieve beautiful, natural, and affordable outcomes while helping offices advance in manufacturer's tiers, improve word-of-mouth advertising, and increase job satisfaction.
Procedures for the Handling of Retaliation Complaints Under Section 1558 of the Affordable Care Act. Final rule.
This document provides the final text of regulations governing employee protection (retaliation or whistleblower) claims under section 1558 of the Affordable Care Act, which added section 18C to the Fair Labor Standards Act to provide protections to employees who may have been subject to retaliation for seeking assistance under certain affordability assistance provisions (for example, health insurance premium tax credits) or for reporting potential violations of the Affordable Care Act's consumer protections (for example, the prohibition on rescissions). An interim final rule (IFR) governing these provisions and request for comments was published in the Federal Register on February 27, 2013. Thirteen comments were received; eleven were responsive to the IFR. This rule responds to those comments and establishes the final procedures and time frames for the handling of retaliation complaints under section 18C, including procedures and time frames for employee complaints to the Occupational Safety and Health Administration (OSHA), investigations by OSHA, appeals of OSHA determinations to an administrative law judge (ALJ) for a hearing de novo, hearings by ALJs, review of ALJ decisions by the Administrative Review Board (ARB) (acting on behalf of the Secretary of Labor), and judicial review of the Secretary of Labor's (Secretary's) final decision. It also sets forth the Secretary's interpretations of the Affordable Care Act whistleblower provision on certain matters.
Sirpal, Sanjeev
The Patient Protection and Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The proposed rules are promulgated by the Department of Health and Human Services (HHS), the Department of Labor, and the Treasury Department, and seek to encourage appropriately designed, consumer-protective wellness programs in group health coverage. This legislative landscape raises significant federalism concerns insofar as it largely shifts the responsibility for administration of health incentive programs to the states. Little attention has been paid to the shifting "administrative burden" that would thereby ensue. This paper will address the distribution of power in the American federal system vis-à-vis subnational counterparts in the wake of rampant, recent health care reform efforts. This paper will therefore explore the willingness of the national government to delegate policymaking responsibility to state governments in the context of an important aspect of healthcare reform. This, in turn, can be used to assess the distribution of powers between governmental levels--a subject that has received little systematic inquiry to date. Finally, this paper will explore the degree of administrative burden shifting that may likely occur as a result of these changes in health reform and what potential impacts it may have on individual health.
Object Affordances Potentiate Responses but Do Not Guide Attentional Prioritization
Yamani, Yusuke; Ariga, Atsunori; Yamada, Yuki
Handled objects automatically activate afforded responses. The current experiment examined whether objects that afford a response are also prioritized for attentional processing in visual search. Targets were pictures of coffee cups with handles oriented either to the right or the left. Subjects searched for a target, a right-handled vs. left-handled coffee cup, among a varying number of distractor cups oriented in the opposite direction. Responses were faster when the direction of target handle and the key press were spatially matched than mismatched (stimulus-response compatibility (SRC) effect), but object affordance did not moderate slopes of the search functions, indicating the absence of attentional prioritization effect. These findings imply that handled objects prime afforded responses without influencing attentional prioritization. PMID:26793077
Reducing costs in aircraft: The metals affordability initiative consortium
NASA Astrophysics Data System (ADS)
Martin, Rick; Evans, Daniel
Emerging metallic materials, processing, and manufacturing technologies offer an important opportunity to meet current aircraft-airframe and jet-engine affordability goals, due to their inherent low material costs and excellent producibility characteristics. But to successfully meet systems goals within this new affordability-driven scenario, a consolidation ofindustry and military-agency development resources and technology-implementation activities is necessary to positively impact the military-aircraft production and sustainment infrastructure. To address this need, a consortium of aircraft and engine manufacturers and key material-and engine manufacturers and key material-and component-supplier companies has been formed to identify critical affordable metal technologies, develop a strategic roadmap for accelerated development and insertion of these technologies, and oversee execution of development activities by integrated industry teams. the goal of the Metals Affordability Initiative is to reduce the cost of metallic components by 50 percent while accelerating the implementation time.
47 CFR 73.9008 - Interim approval of authorized digital output protection technologies and authorized recording...
Code of Federal Regulations, 2010 CFR
... information: (1) A general description of how the digital output protection technology or recording method... digital output protection technology or recording method affords content; (3) Information regarding... information to evaluate the appropriateness of the underlying digital output protection technology...
Affordable Exploration of Mars: Recommendations from a Community Workshop
NASA Technical Reports Server (NTRS)
Thronson, Harley A.; Carberry, Chris; Cassady, R. Joseph; Cooke, Doug; Kirkpatrick, Jim; Perino, Maria Antonietta; Raftery, Michael; Westenberg, Artemis; Zucker, Richard
There is a growing opinion that within two decades initial human missions to Mars are affordable under plausible budget scenarios, with sustained international participation, and --- especially --- without requiring those first missions to achieve a burdensome number of goals. In response to this view, a group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December 2013. Participants reviewed scenarios for proposed affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station as the essential early step toward humans to Mars, possible "bridge" or "transition" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and usable definitions of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop. In the context of affordable early missions to Mars, we also discuss the recent report of the National Research Council on human space flight and a pair of recent scenarios that appear to promise reduced costs.
New metrics of affordable nutrition: which vegetables provide most nutrients for least cost?
Drewnowski, Adam
Measuring food prices per gram, rather than per calorie, is one way to make healthful vegetables appear less expensive. However, a better measure of affordability would take the nutrient content of vegetables into account. This study, based on analyses of US Department of Agriculture datasets, aimed to identify which vegetables, including juices and soups, provided the most nutrients per unit cost. Nutrient density was measured using the Nutrient Rich Foods (NRF) index, based on nine nutrients to encourage: protein; fiber; vitamins A, C, and E; calcium; iron; magnesium; and potassium; and on three nutrients to limit: saturated fat, added sugar, and sodium. Food cost in dollars was calculated per 100 g, per 100 kcal, per serving, and per nutrient content. One-way analyses of variance with post hoc tests were used to determine statistical significance. Results showed that tomato juices and tomato soups, dark green leafy and nonleafy vegetables, and deep yellow vegetables, including sweet potatoes, had the highest NRF scores overall. Highest NRF scores per dollar were obtained for sweet potatoes, white potatoes, tomato juices and tomato soups, carrots, and broccoli. Tomato sauces, raw tomatoes, and potato chips were eaten more frequently than were many other vegetables that were both more affordable and more nutrient-rich. These new measures of affordable nutrition can help foodservice and health professionals identify those vegetables that provide the highest nutrient density per unit cost. Processed vegetables, including soups and juices, can contribute to the quality and the affordability of the diet.
Experimental Enhanced Upper Stage (XEUS): An affordable large lander system
NASA Astrophysics Data System (ADS)
Scotkin, J.; Masten, D.; Powers, J.; O'Konek, N.; Kutter, B.; Stopnitzky, B.
The Experimental Enhanced Upper Stage (XEUS) offers a path to reduce costs and development time to sustainable activity beyond LEO by equipping existing large cryogenic propulsion stages with MSS VTVL propulsion and GNC to create a large, multi-thrust axis lander. Conventional lander designs have been driven by the assumption that a single, highly reliable, and efficient propulsion system should conduct the entire descent, approach, and landing. Compromises in structural, propulsion, and operational efficiency result from this assumption. System reliability and safety also suffer. The result is often an iterative series of optimizations, making every subsystem mission-unique and expensive. The XEUS multi-thrust axis lander concept uniquely addresses the programmatic and technical challenges of large-mass planetary landing by taking advantage of proven technologies and decoupling the deorbit and descent propulsion system from the landing propulsion system. Precise control of distributed, multi-thrust axis landing propulsion units mounted on the horizontal axis of a Centaur stage will ultimately enable the affordable deployment of large planetary rovers, uncrewed base infrastructure and manned planetary expeditions. The XEUS lander has been designed to offer a significantly improved mass fraction and mass to surface capability over conventional lander designs, while reducing airlock/payload to surface distances and distributing plume effects by using multiple gimbaled landing thrusters. In utilizing a proven cryogenic propulsion stage, XEUS reduces development costs required for development of new cryogenic propulsion stages and fairings and builds upon the strong heritage of successful Centaur and MSS RLV flights.
Twitter Sentiment Predicts Affordable Care Act Marketplace Enrollment
Sap, Maarten; Schwartz, Andrew; Town, Robert; Baker, Tom; Ungar, Lyle; Merchant, Raina M
Background Traditional metrics of the impact of the Affordable Care Act (ACA) and health insurance marketplaces in the United States include public opinion polls and marketplace enrollment, which are published with a lag of weeks to months. In this rapidly changing environment, a real-time barometer of public opinion with a mechanism to identify emerging issues would be valuable. Objective We sought to evaluate Twitter's role as a real-time barometer of public sentiment on the ACA and to determine if Twitter sentiment (the positivity or negativity of tweets) could be predictive of state-level marketplace enrollment. Methods We retrospectively collected 977,303 ACA-related tweets in March 2014 and then tested a correlation of Twitter sentiment with marketplace enrollment by state. Results A 0.10 increase in the sentiment score was associated with an 8.7% increase in enrollment at the state level (95% CI 1.32-16.13; P=.02), a correlation that remained significant when adjusting for state Medicaid expansion (P=.02) or use of a state-based marketplace (P=.03). Conclusions This correlation indicates Twitter's potential as a real-time monitoring strategy for future marketplace enrollment periods; marketplaces could systematically track Twitter sentiment to more rapidly identify enrollment changes and potentially emerging issues. As a repository of free and accessible consumer-generated opinions, this study reveals a novel role for Twitter in the health policy landscape. PMID:25707038
Nondestructive Evaluation (NDE) Results on Sikorsky Aircraft Survivable Affordable Reparable Airframe Program (SARAP) Samples
NASA Technical Reports Server (NTRS)
Zalameda, Joseph N.; Anastasi, Robert F.; Madaras, Eric I.
The Survivable, Affordable, Reparable Airframe Program (SARAP) will develop/produce new structural design concepts with lower structural weight, reduced manufacturing complexity and development time, increased readiness, and improved threat protection. These new structural concepts will require advanced field capable inspection technologies to help meet the SARAP structural objectives. In the area of repair, damage assessment using nondestructive inspection (NDI) is critical to identify repair location and size. The purpose of this work is to conduct an assessment of new and emerging NDI methods that can potentially satisfy the SARAP program goals.
Relationship of Affordable Care Act Implementation to Emergency Department Utilization Among Young Adults
Hernandez-Boussard, Tina; Morrison, Doug; Goldstein, Ben A.; Hsia, Renee Y.
Study objective The 2010 provision of the Patient Protection and Affordable Care Act (ACA) extended eligibility for health insurance for young adults aged 19 to 25 years. It is unclear, however, how expanded coverage changes health care behavior and promotes efficient use of emergency department (ED) services. Our objective was to use population-level emergency department data to characterize any changes in diagnoses seen in ED among young adults since the implementation of the ACA dependent coverage expansion. Methods We performed a difference-in-differences analysis of 2009 to 2011 ED visits from California, Florida, and New York, using all-capture administrative data to determine how the use of ED services changed for clinical categories after the ACA provision among young adults aged 19 to 25 years compared with slightly older adults unaffected by the provision, aged 26 to 31 years. Results We analyzed a total of 10,158,254 ED visits made by 4,734,409 patients. After the implementation of the 2010 ACA provision, young adults had a relative decrease of 0.5% ED visits per 1,000 people compared with the older group. For the majority of diagnostic categories, young adults' rates and risk of visit did not change relative to that of slightly older adults after the implementation of the ACA. However, although young adults' ED visits significantly increased for mental illnesses (2.6%) and diseases of the circulatory system (eg, nonspecific chest pain) (4.8%), visits decreased for pregnancy-related diagnoses and diseases of the skin (eg, cellulitis, abscess) compared with that of the older group (3.7% and 3.1%, respectively). Conclusion Our results indicate that increased coverage has kept young adults out of the ED for specific conditions that can be cared for through access to other channels. As EDs face capacity challenges, these results are encouraging and offer insight into what could be expected under further insurance expansions from health care reform. PMID
Object affordance and spatial-compatibility effects in Parkinson's disease.
Galpin, Adam; Tipper, Steven P; Dick, Jeremy P R; Poliakoff, Ellen
Movement in Parkinson's disease (PD) is strongly influenced by sensory stimuli. Here, we investigated two features of visual stimuli known to affect response times in healthy individuals; the spatial location of an object (the spatial effect) and its action-relevance (the 'affordance' effect). Poliakoff et al. (2007) found that while PD patients show normal spatial effects, they do not show an additional affordance effect. Here we investigated whether these effects are driven by facilitation or inhibition, and whether the affordance effect emerges over a longer time-course in PD. Participants (24 PD and 24 controls) viewed either a lateralised door handle (affordance condition), a lateralised abstract stimulus (spatial condition), or a centrally presented baseline stimulus (baseline condition), and responded to a colour change in the stimulus occurring after 0 msec, 500 msec or 1000 msec. The colour change indicated whether to respond with the left or right hand, which were either spatially compatible or incompatible with the lateralised stimulus orientation in the affordance and spatial conditions. The baseline condition allowed us to assess whether compatibility effects were driven by facilitation of the compatible response or inhibition of the incompatible response. The results indicate that stimulus orientation elicited faster responses from the nearest hand. For controls, the affordance effect was stronger and driven by facilitation, whilst the spatial condition was driven by inhibition. In contrast, the affordance and spatial-compatibility effects did not differ between conditions in the PD group and both were driven by facilitation. This suggests that the PD group responded as if all stimuli were action-relevant, and may have implications for understanding the cueing of movement in PD.
The Affordable Care Act, health care reform, prescription drug formularies and utilization management tools.
Ung, Brian L; Mullins, C Daniel
The U.S. Patient Protection and Affordable Care Act (hence, Affordable Care Act, or ACA) was signed into law on March 23, 2010. Goals of the ACA include decreasing the number of uninsured people, controlling cost and spending on health care, increasing the quality of care provided, and increasing insurance coverage benefits. This manuscript focuses on how the ACA affects pharmacy benefit managers and consumers when they have prescriptions dispensed. PBMs use formularies and utilization control tools to steer drug usage toward cost-effective and efficacious agents. A logic model was developed to explain the effects of the new legislation. The model draws from peer-reviewed and gray literature commentary about current and future U.S. healthcare reform. Outcomes were identified as desired and undesired effects, and expected unintended consequences. The ACA extends health insurance benefits to almost 32 million people and provides financial assistance to those up to 400% of the poverty level. Increased access to care leads to a similar increase in overall health care demand and usage. This short-term increase is projected to decrease downstream spending on disease treatment and stunt the continued growth of health care costs, but may unintentionally exacerbate the current primary care physician shortage. The ACA eliminates limitations on insurance and increases the scope of benefits. Online health care insurance exchanges give patients a central location with multiple insurance options. Problems with prescription drug affordability and control utilization tools used by PBMs were not addressed by the ACA. Improving communication within the U.S. healthcare system either by innovative health care delivery models or increased usage of health information technology will help alleviate problems of health care spending and affordability.
Treatment of osteoarthritis with tiaprofenic acid: biochemical and histological protection against cartilage breakdown in the Pond-Nuki canine model.
Howell, D S; Pita, J C; Muller, F J; Manicourt, D H; Altman, R D
Experimental and cage matched control animals were sacrificed 12 weeks after production of ligamentous instability in the right knee, and biochemical studies were performed on eroded OA and normal articular cartilage. Significant protection was afforded by tiaprofenic acid administered orally at 15 mg/kg body weight. Chondroprotection was manifested by reduction of fast sedimenting proteoglycan aggregates, as well as retention of hyaluronate content, and favorable proteoglycan aggregate S value levels. This agent showed significant chondroprotective action under the conditions of these studies.
Affordability Engineering: Bridging the Gap Between Design and Cost
NASA Technical Reports Server (NTRS)
Reeves, J. D.; DePasquale, Dominic; Lim, Evan
Affordability is a commonly used term that takes on numerous meanings depending on the context used. Within conceptual design of complex systems, the term generally implies comparisons between expected costs and expected resources. This characterization is largely correct, but does not convey the many nuances and considerations that are frequently misunderstood and underappreciated. In the most fundamental sense, affordability and cost directly relate to engineering and programmatic decisions made throughout development programs. Systems engineering texts point out that there is a temporal aspect to this relationship, for decisions made earlier in a program dictate design implications much more so than those made during latter phases. This paper explores affordability engineering and its many sub-disciplines by discussing how it can be considered an additional engineering discipline to be balanced throughout the systems engineering and systems analysis processes. Example methods of multidisciplinary design analysis with affordability as a key driver will be discussed, as will example methods of data visualization, probabilistic analysis, and other ways of relating design decisions to affordability results.
The Affordance Template ROS Package for Robot Task Programming
NASA Technical Reports Server (NTRS)
Hart, Stephen; Dinh, Paul; Hambuchen, Kimberly
This paper introduces the Affordance Template ROS package for quickly programming, adjusting, and executing robot applications in the ROS RViz environment. This package extends the capabilities of RViz interactive markers by allowing an operator to specify multiple end-effector waypoint locations and grasp poses in object-centric coordinate frames and to adjust these waypoints in order to meet the run-time demands of the task (specifically, object scale and location). The Affordance Template package stores task specifications in a robot-agnostic XML description format such that it is trivial to apply a template to a new robot. As such, the Affordance Template package provides a robot-generic ROS tool appropriate for building semi-autonomous, manipulation-based applications. Affordance Templates were developed by the NASA-JSC DARPA Robotics Challenge (DRC) team and have since successfully been deployed on multiple platforms including the NASA Valkyrie and Robonaut 2 humanoids, the University of Texas Dreamer robot and the Willow Garage PR2. In this paper, the specification and implementation of the affordance template package is introduced and demonstrated through examples for wheel (valve) turning, pick-and-place, and drill grasping, evincing its utility and flexibility for a wide variety of robot applications.
Nuclear Cryogenic Propulsion Stage Affordable Development Strategy
NASA Technical Reports Server (NTRS)
Doughty, Glen E.; Gerrish, H. P.; Kenny, R. J.
The development of nuclear power for space use in nuclear thermal propulsion (NTP) systems will involve significant expenditures of funds and require major technology development efforts. The development effort must be economically viable yet sufficient to validate the systems designed. Efforts are underway within the National Aeronautics and Space Administration's (NASA) Nuclear Cryogenic Propulsion Stage Project (NCPS) to study what a viable program would entail. The study will produce an integrated schedule, cost estimate and technology development plan. This will include the evaluation of various options for test facilities, types of testing and use of the engine, components, and technology developed. A "Human Rating" approach will also be developed and factored into the schedule, budget and technology development approach.
SPACEWAY: Providing affordable and versatile communication solutions
NASA Astrophysics Data System (ADS)
Fitzpatrick, E. J.
By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.
SPACEWAY: Providing affordable and versatile communication solutions
NASA Technical Reports Server (NTRS)
Fitzpatrick, E. J.
By the end of this decade, Hughes' SPACEWAY network will provide the first interactive 'bandwidth on demand' communication services for a variety of applications. High quality digital voice, interactive video, global access to multimedia databases, and transborder workgroup computing will make SPACEWAY an essential component of the computer-based workplace of the 21st century. With relatively few satellites to construct, insure, and launch -- plus extensive use of cost-effective, tightly focused spot beams on the world's most populated areas -- the high capacity SPACEWAY system can pass its significant cost savings onto its customers. The SPACEWAY network is different from other proposed global networks in that its geostationary orbit location makes it a truly market driven system: each satellite will make available extensive telecom services to hundreds of millions of people within the continuous view of that satellite, providing immediate capacity within a specific region of the world.
Polyimide Based Nanocomposites for Affordable Space Transport
NASA Technical Reports Server (NTRS)
Dean, Derrick; Islam, Mohsina; Small, Sharee; Aldridge, Brandon; Campbell, Sandra G. (Technical Monitor)
In setting forth its strategic plan, NASA has indicated that low-cost access to space is the key to unleashing the commercial potential of space and greatly expanding space research and exploration. The development of advanced materials will be an enabling technology for this quest for low-cost space access. In this research program, we are attempting to address the need for new advanced materials by developing high-performance nanodispersed inorganic/organic and organic/organic polyimide composites utilizing specific interactions. Our goal is to systematically manipulate these interactions and investigate the resulting processing morphology-property relationships. Specifically, we will investigate three main parameters on these relationships. These include (1) the type of polyimide; (2) the structure of the inorganic nanoparticle being used; and (3) manipulation of the interfacial energy. During the first year of this effort, we have demonstrated the successful synthesis of PMR-15/layered silicate nanocomposites. Morphological studies indicate that exfoliated structures were obtained in most instances, with a mixture of exfoliated and intercalated structures being observed also. Significant enhancements of the onset of decomposition were obtained by varying the strength of the interaction between the nanoparticle and the polymer. Varying the amount of a specific nanoparticle also affected the decomposition temperatures. A slight catalytic effect of the nanoparticles on both the imidization and crosslinking reaction has been observed and will be presented. In addition, incorporation of the nanoparticles was found to increase the glass transition temperature and slightly broaden the breadth of this relaxation.
Control your mind, make affordance available
Jin, Zheng; Lee, Yang; Zhu, Jin
Evaluating the affordance–control interpretation of the relationship between performance and object estimation has been proposed by psychophysical and psychonomic studies. This study examined the weight estimation–performance relationship. Individuals with visual impairment or blindness put shots that varied in weight among five scales. In Experiment 1, only the perceived weight was a significant performance constraint. In Experiment 2, the weight was perceived as heavier when the participants' actions were manipulated through cognitive interpretation. The increase in perceived weight appeared to be related to performance and intrinsically scaled to the action, even when the action was only mental rather than physical. The study's findings suggest that bodily experience and action are the basis for physical judgments and likely underlie other basic cognitive interpretations of sensory stimuli. This suggestion goes hand in hand with the biofunctional approaches which assume direct experience of the integrated wholeness of one's body is fundamental for developing other kinds of awareness. Different perspectives from oriental philosophy and psychology are also discussed. PMID:25741298
Assessment of the DARPA Affordable Polymer Matrix Composites Programs.
and CATM Aft-aft center fuselage structure IATA PR500/IM7 plus CATB RTM bulkhead PR500/IM7 plus CATC 5ftx5ftx5ft wing section VARTM keelson Upper...Institute of Standards and Technology National Science Foundation OHC OPvNL OUSD(A&T) PMC R&D RaPat RAPTECH RTM S&T SAMPE SPF/DB TRP VARTM ...Affordability (IATA) ü-4 C. Cure-Form Processing ü-4 D. Rapid RTM Tooling Project (RaPat) II-6 E. Induction Hearing II-7 F. Affordable
Approach to an Affordable and Sustainable Space Transportation System
NASA Technical Reports Server (NTRS)
McCleskey, Caey M.; Rhodes, R. E.; Robinson, J. W.; Henderson, E. M.
This paper describes an approach and a general procedure for creating space transportation architectural concepts that are at once affordable and sustainable. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on a functional system breakdown structure for an architecture and definition of high-payoff design techniques with a technology integration strategy. This paper follows up by using a structured process that derives architectural solutions focused on achieving life cycle affordability and sustainability. Further, the paper includes an example concept that integrates key design techniques discussed in previous papers. !
Rhythm as an affordance for the entrainment of movement.
Cummins, Fred
A general account of rhythm in human behaviour is provided, according to which rhythm inheres in the affordance that a signal provides for the entrainment of movement on the part of a perceiver. This generic account is supported by an explication of the central concepts of affordance and entrainment. When viewed in this light, rhythm appears as the correct explanandum to account for coordinated behaviour in a wide variety of situations, including such core senses as dance and the production of music. Speech may appear to be only marginally rhythmical under such an account, but several experimental studies reveal that speech, too, has the potential to entrain movement.
Planetary Protection Technologies: Technical Challenges for Mars Exploration
NASA Technical Reports Server (NTRS)
Buxbaum, Karen L.
The search for life in the solar system, using either in situ analysis or sample return, brings with it special technical challenges in the area of planetary protection. Planetary protection (PP) requires planetary explorers to preserve biological and organic conditions for future exploration and to protect the Earth from potential extraterrestrial contamination that could occur as a result of sample return to the Earth-Moon system. In view of the exploration plans before us, the NASA Solar System Exploration Program Roadmap published in May 2003 identified planetary protection as one of 13 technologies for "high priority technology investments." Recent discoveries at Mars and Jupiter, coupled with new policies, have made this planning for planetary protection technology particularly challenging and relevant.New missions to Mars have been formulated, which present significantly greater forward contamination potential. New policies, including the introduction by COSPAR of a Category IVc for planetary protection, have been adopted by COSPAR in response. Some missions may not be feasible without the introduction of new planetary protection technologies. Other missions may be technically possible but planetary protection requirements may be so costly to implement with current technology that they are not affordable. A strategic investment strategy will be needed to focus on technology investments designed to enable future missions and reduce the costs of future missions. This presentation will describe some of the potential technological pathways that may be most protective.
Reliability and Maintainability Engineering - A Major Driver for Safety and Affordability
NASA Technical Reports Server (NTRS)
Safie, Fayssal M.
The United States National Aeronautics and Space Administration (NASA) is in the midst of an effort to design and build a safe and affordable heavy lift vehicle to go to the moon and beyond. To achieve that, NASA is seeking more innovative and efficient approaches to reduce cost while maintaining an acceptable level of safety and mission success. One area that has the potential to contribute significantly to achieving NASA safety and affordability goals is Reliability and Maintainability (R&M) engineering. Inadequate reliability or failure of critical safety items may directly jeopardize the safety of the user(s) and result in a loss of life. Inadequate reliability of equipment may directly jeopardize mission success. Systems designed to be more reliable (fewer failures) and maintainable (fewer resources needed) can lower the total life cycle cost. The Department of Defense (DOD) and industry experience has shown that optimized and adequate levels of R&M are critical for achieving a high level of safety and mission success, and low sustainment cost. Also, lessons learned from the Space Shuttle program clearly demonstrated the importance of R&M engineering in designing and operating safe and affordable launch systems. The Challenger and Columbia accidents are examples of the severe impact of design unreliability and process induced failures on system safety and mission success. These accidents demonstrated the criticality of reliability engineering in understanding component failure mechanisms and integrated system failures across the system elements interfaces. Experience from the shuttle program also shows that insufficient Reliability, Maintainability, and Supportability (RMS) engineering analyses upfront in the design phase can significantly increase the sustainment cost and, thereby, the total life cycle cost. Emphasis on RMS during the design phase is critical for identifying the design features and characteristics needed for time efficient processing
Motivation for aggressive religious radicalization: goal regulation theory and a personality × threat × affordance hypothesis
McGregor, Ian; Hayes, Joseph; Prentice, Mike
A new set of hypotheses is presented regarding the cause of aggressive religious radicalization (ARR). It is grounded in classic and contemporary theory of human motivation and goal regulation, together with recent empirical advances in personality, social, and neurophysiological psychology. We specify personality traits, threats, and group affordances that combine to divert normal motivational processes toward ARR. Conducive personality traits are oppositional, anxiety-prone, and identity-weak (i.e., morally bewildered). Conducive threats are those that arise from seemingly insurmountable external forces and frustrate effective goal regulation. Conducive affordances include opportunity for immediate and concrete engagement in active groups that are powered by conspiracy narratives, infused with cosmic significance, encouraging of moral violence, and sealed with religious unfalsifiability. We propose that ARR is rewarding because it can spur approach motivated states that mask vulnerability for people whose dispositions and circumstances would otherwise leave them mired in anxious distress. PMID:26441709
Motivation for aggressive religious radicalization: goal regulation theory and a personality × threat × affordance hypothesis.
McGregor, Ian; Hayes, Joseph; Prentice, Mike
A new set of hypotheses is presented regarding the cause of aggressive religious radicalization (ARR). It is grounded in classic and contemporary theory of human motivation and goal regulation, together with recent empirical advances in personality, social, and neurophysiological psychology. We specify personality traits, threats, and group affordances that combine to divert normal motivational processes toward ARR. Conducive personality traits are oppositional, anxiety-prone, and identity-weak (i.e., morally bewildered). Conducive threats are those that arise from seemingly insurmountable external forces and frustrate effective goal regulation. Conducive affordances include opportunity for immediate and concrete engagement in active groups that are powered by conspiracy narratives, infused with cosmic significance, encouraging of moral violence, and sealed with religious unfalsifiability. We propose that ARR is rewarding because it can spur approach motivated states that mask vulnerability for people whose dispositions and circumstances would otherwise leave them mired in anxious distress.
76 FR 20354 - Notice of Intent To Award Supplemental Affordable Care Act Funding
Federal Register 2010, 2011, 2012, 2013, 2014
... Affordable Care Act Funding Notice of Intent to award supplemental Affordable Care Act funding to support...: Notice. SUMMARY: This notice provides public announcement of CDC's intent to use Affordable Care Act (ACA....'' Funding is appropriated under the Affordable Care Act (Pub. L. 111-148), Title IV, Section...
Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion
NASA Technical Reports Server (NTRS)
Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.
Nuclear Thermal Propulsion (NTP) is a concept which uses a nuclear reactor to heat a propellant to high temperatures without combustion and can achieve significantly greater specific impulse than chemical engines. NTP has been considered many times for human and cargo missions beyond low earth orbit. A lot of development and technical maturation of NTP components took place during the Rover/NERVA program of the 60's and early 70's. Other NTP programs and studies followed attempting to further mature the NTP concept and identify a champion customer willing to devote the funds and support the development schedule to a demonstration mission. Budgetary constraints require the use of an affordable development and qualification strategy that takes into account all the previous work performed on NTP to construct an existing database, and include lessons learned and past guidelines followed. Current guidelines and standards NASA uses for human rating chemical rocket engines is referenced. The long lead items for NTP development involve the fuel elements of the reactor and ground testing the engine system, subsystem, and components. Other considerations which greatly impact the development plans includes the National Space Policy, National Environmental Policy Act, Presidential Directive/National Security Council Memorandum #25 (Scientific or Technological Experiments with Possible Large-Scale Adverse Environmental Effects and Launch of Nuclear Systems into Space), and Safeguards and Security. Ground testing will utilize non-nuclear test capabilities to help down select components and subsystems before testing in a nuclear environment to save time and cost. Existing test facilities with minor modifications will be considered to the maximum extent practical. New facilities will be designed to meet minimum requirements. Engine and test facility requirements are based on the driving mission requirements with added factors of safety for better assurance and reliability
Issaquah Highlands Zero Energy Affordable Housing (WA) - YWCA
Tom, Vincent; DeRobbio, Wendy; Hall, Linda
The YWCA Family Village at Issaquah, Net Zero Energy Approach Project provides a compelling model for how the nation can seriously respond to the critical need for affordable housing while advancing environmental standards and reducing economic inequities. Affordable housing developments for vulnerable members of the community and in today's workforce cannot overlook issues, such as climate impact, energy security and water conservation. This project's advanced building design was based on the goal of creating a 100 year building that could achieve net zero energy usage if funding had been available to support the final pieces of energy generation. The team worked closely with community stakeholders to ensure the baseline components of high quality and efficient building envelopes along with efficient systems were in place to set the stage for future incorporation of energy generating systems such as solar panels. As built, these 146 homes, large child care center and community services areas are proving the value of investing upfront for the benefit of future generations by reducing ongoing utility and maintenance costs with an eye toward environmental stewardship and community/resident education. The DOE award helped fund two critical energy conservation features for the YWCA Family Village at Issaquah campus: 1) super-insulated roof assembly with a continuous air barrier and 2) domestic hot water preheat system. The roof system at the YWCA Family Village at Issaquah project was built to include 6" of Polyiso rigid insulation (R-38) on top of the roof sheathing to provide a super-insulated roof in line with the other green features of the project. Placing the rigid insulation on top of the roof sheathing allows the building to have a continuous layer of insulation and provides a continuous air barrier. The domestic hot water preheat system includes flat panel arrays on roofs of the buildings that heat the water using solar power, which reduces the amount of
7 CFR 3565.352 - Preservation of affordable housing.
Code of Federal Regulations, 2013 CFR
... 7 Agriculture 15 2013-01-01 2013-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...
7 CFR 3565.352 - Preservation of affordable housing.
Code of Federal Regulations, 2012 CFR
... 7 Agriculture 15 2012-01-01 2012-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...
7 CFR 3565.352 - Preservation of affordable housing.
Code of Federal Regulations, 2014 CFR
... 7 Agriculture 15 2014-01-01 2014-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...
7 CFR 3565.352 - Preservation of affordable housing.
Code of Federal Regulations, 2010 CFR
... 7 Agriculture 15 2010-01-01 2010-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...
7 CFR 3565.352 - Preservation of affordable housing.
Code of Federal Regulations, 2011 CFR
... 7 Agriculture 15 2011-01-01 2011-01-01 false Preservation of affordable housing. 3565.352 Section 3565.352 Agriculture Regulations of the Department of Agriculture (Continued) RURAL HOUSING SERVICE, DEPARTMENT OF AGRICULTURE GUARANTEED RURAL RENTAL HOUSING PROGRAM Project Management § 3565.352...
Lean, Mean and Green: An Affordable Net Zero School
ERIC Educational Resources Information Center
Stanfield, Kenneth
From its conception, Richardsville Elementary was designed to be an affordable net zero facility. The design team explored numerous energy saving strategies to dramatically reduce energy consumption. By reducing energy use to 19.31 kBtus annually, the net zero goal could be realized through the implementation of a solar array capable of producing…
Affordances for Second Language Learning in "World of Warcraft"
ERIC Educational Resources Information Center
Rama, Paul S.; Black, Rebecca W.; van Es, Elizabeth; Warschauer, Mark
What are the affordances of online gaming environments for second language learning and socialization? To answer this question, this qualitative study examines two college-age Spanish learners' experiences participating in the Spanish language version of the massively multi-player online game "World of Warcraft." Using data culled from participant…
Learning Affordances of Language and Communication National Curricula
ERIC Educational Resources Information Center
Scott, David
This article focuses on the learning affordances of different language and communication curricula in the world. For reasons of space, only two national education systems (Finland and Singapore) and their language and communication curricula are referred to. The accounts of national education systems consist of the identification of mechanisms…
24 CFR 81.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2011 CFR
... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14 Special..., as a Special Affordable Housing Home Purchase Subgoal, 17 percent of the total number of home purchase mortgages in metropolitan areas financed by each GSE's mortgage purchases shall be home...
24 CFR 1000.101 - What is affordable housing?
Code of Federal Regulations, 2012 CFR
... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false What is affordable housing? 1000.101 Section 1000.101 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...
24 CFR 81.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2014 CFR
... 24 Housing and Urban Development 1 2014-04-01 2014-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14...
24 CFR 81.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2013 CFR
... 24 Housing and Urban Development 1 2013-04-01 2013-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and... MAE) AND THE FEDERAL HOME LOAN MORTGAGE CORPORATION (FREDDIE MAC) Housing Goals § 81.14...
24 CFR 1006.201 - Eligible affordable housing activities.
Code of Federal Regulations, 2012 CFR
... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Eligible affordable housing activities. 1006.201 Section 1006.201 Housing and Urban Development REGULATIONS RELATING TO HOUSING AND URBAN DEVELOPMENT (CONTINUED) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING...
Pedagogical Affordances of Multiple External Representations in Scientific Processes
NASA Astrophysics Data System (ADS)
Wu, Hsin-Kai; Puntambekar, Sadhana
Multiple external representations (MERs) have been widely used in science teaching and learning. Theories such as dual coding theory and cognitive flexibility theory have been developed to explain why the use of MERs is beneficial to learning, but they do not provide much information on pedagogical issues such as how and in what conditions MERs could be introduced and used to support students' engagement in scientific processes and develop competent scientific practices (e.g., asking questions, planning investigations, and analyzing data). Additionally, little is understood about complex interactions among scientific processes and affordances of MERs. Therefore, this article focuses on pedagogical affordances of MERs in learning environments that engage students in various scientific processes. By reviewing literature in science education and cognitive psychology and integrating multiple perspectives, this article aims at exploring (1) how MERs can be integrated with science processes due to their different affordances, and (2) how student learning with MERs can be scaffolded, especially in a classroom situation. We argue that pairing representations and scientific processes in a principled way based on the affordances of the representations and the goals of the activities is a powerful way to use MERs in science education. Finally, we outline types of scaffolding that could help effective use of MERs including dynamic linking, model progression, support in instructional materials, teacher support, and active engagement.
Disengaged Students and Dialogic Learning: The Role of CSCL Affordances
ERIC Educational Resources Information Center
Slakmon, Benzi; Schwarz, Baruch B.
Only a few studies have dealt with the challenge of bridging the linguistic gap between the dialogic realm and the talk of disengaged students. Bridging this gap is particularly relevant to the CSCL community since one of its utmost aims is to promote the dialogic. This study aims to articulate how to harness the CSCL design and affordances to…
Teaching Text Structure: Examining the Affordances of Children's Informational Texts
ERIC Educational Resources Information Center
Jones, Cindy D.; Clark, Sarah K.; Reutzel, D. Ray
This study investigated the affordances of informational texts to serve as model texts for teaching text structure to elementary school children. Content analysis of a random sampling of children's informational texts from top publishers was conducted on text structure organization and on the inclusion of text features as signals of text…
The Weight of Time: Affordances for an Integrated Magnitude System
ERIC Educational Resources Information Center
Lu, Aitao; Mo, Lei; Hodges, Bert H.
In five experiments we explored the effects of weight on time in different action contexts to test the hypothesis that an integrated magnitude system is tuned to affordances. Larger magnitudes generally seem longer; however, Lu and colleagues (2009) found that if numbers were presented as weights in a range heavy enough to affect lifting, the…
24 CFR 81.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2012 CFR
... 24 Housing and Urban Development 1 2012-04-01 2012-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...
Affordances of Learning Technologies in Higher Education Multicultural Environments
ERIC Educational Resources Information Center
Arenas, Edilson
A cluster of research has been conducted in higher education to investigate the affordances (action possibilities) and the influence information and communication technologies (ICT) may have on students' learning experiences and outcomes. Such studies have given rise to the implementation of a wide range of educational frameworks with a great deal…
Can Canadian Seniors on Public Pensions Afford a Nutritious Diet?
ERIC Educational Resources Information Center
Green, Rebecca J.; Williams, Patricia L.; Johnson, C. Shanthi; Blum, Ilya
This study examined whether Canada's public pensions (Old Age Security and Canada Pension Plan) provided adequate income for seniors living in Nova Scotia in 2005 to afford a basic nutritious diet. Monthly incomes were compared to essential monthly expenses for four household scenarios: (a) married couple, 80 years and 78 years, in urban Nova…
Ubiquitous Knowledge and Experiences to Foster EFL Learning Affordances
ERIC Educational Resources Information Center
García-Sánchez, Soraya; Luján-García, Carmen
This article explores the implementation of experiential learning affordances to improve skills in English as a Foreign Language (EFL) in higher education. The administration of an online anonymous survey to 100 students of different undergraduate degrees presents current learning reflections from EFL students at the Universidad de Las Palmas de…
Monitoring the price and affordability of foods and diets globally.
Lee, A; Mhurchu, C N; Sacks, G; Swinburn, B; Snowdon, W; Vandevijvere, S; Hawkes, C; L'abbé, M; Rayner, M; Sanders, D; Barquera, S; Friel, S; Kelly, B; Kumanyika, S; Lobstein, T; Ma, J; Macmullan, J; Mohan, S; Monteiro, C; Neal, B; Walker, C
Food prices and food affordability are important determinants of food choices, obesity and non-communicable diseases. As governments around the world consider policies to promote the consumption of healthier foods, data on the relative price and affordability of foods, with a particular focus on the difference between 'less healthy' and 'healthy' foods and diets, are urgently needed. This paper briefly reviews past and current approaches to monitoring food prices, and identifies key issues affecting the development of practical tools and methods for food price data collection, analysis and reporting. A step-wise monitoring framework, including measurement indicators, is proposed. 'Minimal' data collection will assess the differential price of 'healthy' and 'less healthy' foods; 'expanded' monitoring will assess the differential price of 'healthy' and 'less healthy' diets; and the 'optimal' approach will also monitor food affordability, by taking into account household income. The monitoring of the price and affordability of 'healthy' and 'less healthy' foods and diets globally will provide robust data and benchmarks to inform economic and fiscal policy responses. Given the range of methodological, cultural and logistical challenges in this area, it is imperative that all aspects of the proposed monitoring framework are tested rigorously before implementation.
The ICCE Framework: Framing Learning Experiences Afforded by Games
ERIC Educational Resources Information Center
Foster, Aroutis; Shah, Mamta
There is a need for game-based learning frameworks that provide a lens for understanding learning experiences afforded in digital games. These frameworks should aim to facilitate game analyses, identification of learning opportunities, and support for learner experiences. This article uses the inquiry, communication, construction, and expression…
Affordable comfort 95 - investing in our energy future
This report describes the topics from the conference on Affordable Comfort, held March 26-31, 1995. Topics are concerned with energy efficiency in homes, retrofitting, weatherization, and monitoring of appliances, heating, and air conditioning systems for performance, as well as topics on electric utilities.
Material Affordances: The Potential of Scrapbooks in the Composition Classroom
ERIC Educational Resources Information Center
Alexander, Kara Poe
A multiliteracies pedagogy has renewed our interest in materiality, or how the physical text interacts with the author's choices and the context to contribute to the message, yet little attention has been paid to materiality in analog texts, such as the scrapbook, even though this medium contains affordances (capabilities and limitations) that…
A Few Reflections on Accountability, Affordability, and Access Worldwide
ERIC Educational Resources Information Center
Toma, J. Douglas
Considering accountability, affordability, and access through the experiences in Chile, East Asia, Australia, Croatia, and the United States offers a clear reminder that trends and issues in higher education are often more similar across national contexts than they are distinct. Across higher education, institutions and systems are responding to…
Can the United States afford a lunar base
NASA Technical Reports Server (NTRS)
Keaton, Paul W.
Establishing a lunar base will require steady funding for a decade or two. The question addressed is whether such a large space project is affordable at this time. The relevant facts and methodology are presented so that the reader may formulate independent answers. It is shown that a permanent lunar base can be financed without increasing NASA's historical budgetary trend.
24 CFR 81.14 - Special Affordable Housing Goal.
Code of Federal Regulations, 2010 CFR
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Special Affordable Housing Goal. 81.14 Section 81.14 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development THE SECRETARY OF HUD'S REGULATION OF THE FEDERAL NATIONAL MORTGAGE ASSOCIATION...
Toward Affordability: Policy Recommendations for Virginia Higher Education
ERIC Educational Resources Information Center
State Council of Higher Education for Virginia, 2009
In its 2007-13 strategic plan, Advancing Virginia: Access, Alignment, Investment, the State Council highlighted 12 strategic higher education initiatives that it believed were necessary to ensure Virginia's future. Key among these goals was improvement of the affordability of a college education in the Commonwealth. Recent events have reinforced…
Learning at Work: Organisational Affordances and Individual Engagement
ERIC Educational Resources Information Center
Bryson, Jane; Pajo, Karl; Ward, Robyn; Mallon, Mary
Purpose: The purpose of this research is to explore the interaction between organisational affordances for the development of individuals' capability, and the engagement of workers at various levels with those opportunities. Design/methodology/approach: A case study of a large New Zealand wine company, using in-depth interviews. Interviews were…
Reinventing Financial Aid: Charting a New Course to College Affordability
ERIC Educational Resources Information Center
Kelly, Andrew P., Ed.; Goldrick-Rab, Sara, Ed.
In this provocative volume, two experts with very different points of view address the growing concern that student loan programs are not a sustainable solution to the problem of mounting college costs. They argue that the time has come to reform the financial aid system so that it is more effective in promoting college affordability, access, and…
Affordance, Learning Opportunities, and the Lesson Plan Pro Forma
ERIC Educational Resources Information Center
Anderson, Jason
This article argues that the most commonly used lesson plan pro formas in language teacher education are inappropriately premised on an outcomes-based approach to teaching, one that is in conflict with what we know about how languages are learnt and how experienced teachers teach. It proposes an alternative, affordance-based approach to lesson…
Early Visual Perception Potentiated by Object Affordances: Evidence From a Temporal Order Judgment Task
Yamada, Yuki; Yamani, Yusuke
Perceived objects automatically potentiate afforded action. Object affordances also facilitate perception of such objects, and this occurrence is known as the affordance effect. This study examined whether object affordances facilitate the initial visual processing stage, or perceptual entry processes, using the temporal order judgment task. The onset of the graspable (right-handled) coffee cup was perceived earlier than that of the less graspable (left-handled) cup for right-handed participants. The affordance effect was eliminated when the coffee cups were inverted, which presumably conveyed less affordance information. These results suggest that objects preattentively potentiate the perceptual entry processes in response to their affordances. PMID:27698991
24 CFR 5.2005 - VAWA protections.
Code of Federal Regulations, 2014 CFR
... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...
24 CFR 5.2005 - VAWA protections.
Code of Federal Regulations, 2011 CFR
... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...
24 CFR 5.2005 - VAWA protections.
Code of Federal Regulations, 2013 CFR
... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...
24 CFR 5.2005 - VAWA protections.
Code of Federal Regulations, 2012 CFR
... GENERAL HUD PROGRAM REQUIREMENTS; WAIVERS Protection for Victims of Domestic Violence, Dating Violence, or... applicable, must include a description of specific protections afforded to the victims of domestic violence, dating violence, or stalking, as provided in this subpart. (b) Applicants. Admission to the program...
DIVA defense: Broad protection for salmonella suppression
Technology Transfer Automated Retrieval System (TEKTRAN)
A live, attenuated Salmonella enterica serovar Typhimurium vaccine was developed to confer broad protection against multiple Salmonella serovars to prevent disease and reduce pathogen colonization and shedding. Two vaccine trials were performed in swine to determine the protection afforded by the va...
Skin protection creams in medical settings: successful or evil?
Xhauflaire-Uhoda, Emmanuelle; Macarenko, Elena; Denooz, Raphaël; Charlier, Corinne; Piérard, Gérald E
Background Chronic exposure to mild irritants including cleansing and antiseptic products used for hand hygiene generates insults to the skin. To avoid unpleasant reactions, skin protection creams are commonly employed, but some fail to afford protection against a variety of xenobiotics. In this study, two skin protection creams were assayed comparatively looking for a protective effect if any against a liquid soap and an alcohol-based gel designed for hand hygiene in medical settings. Methods Corneosurfametry and corneoxenometry are two in vitro bioessays which were selected for their good reproducibility, sensitivity and ease of use. A Kruskal-Wallis ANOVA test followed by the Dunn test was realized to compare series of data obtained. Results Significant differences in efficacy were obtained between the two assayed skin protection creams. One of the two tested creams showed a real protective effect against mild irritants, but the other tested cream presented an irritant potential in its application with mild irritants. Conclusion The differences observed for the two tested skin protection creams were probably due to their galenic composition and their possible interactions with the offending products. As a result, the present in vitro bioassays showed contrasted effects of the creams corresponding to either a protective or an irritant effect on human stratum corneum. PMID:18655702
Repeal and Replace of Affordable Care: A Complex, but Not an Impossible Task.
Manchikanti, Laxmaiah; Hirsch, Joshua A
The Affordable Care Act (ACA), signature legislation of President Obama, was arguably the most consequential and comprehensive health care reform since Medicare was introduced as part of President Lyndon B. Johnson's great society. It has been claimed that many of the law's reforms are now so integrated in the health system that full repeal would be impractical, while others including President Elect Trump have rejected that idea and called for full repeal and replacement claiming ACA law cannot be fixed. A tsunami of increasing regulatory burden over the past 8 years, the current health care milieu has moved independent practitioners towards hospital employment in great numbers. In addition, public opinion has been slowly climbing against ObamaCare with 54% of Americans now opposing the law.President Obama has indicated that the law has accomplished many of its goals, including increasing accessibility, affordability, and quality of health care. However, others have contradicted these assertions and described the ACA as "insurance for many with coverage for few." Some believe that the ACA might be more appropriately labeled the "Medicaid Expansion Act."There are multiple plans developed over the years by republican members of the congress; however, of significant consequence and importance are President-elect Trump's proposals and the plan developed by Speaker Paul Ryan to repeal and replace the ACA. The President-elect has described the problems he perceives with the ACA; rapidly rising premiums and deductibles, narrow networks, and limits of coverage imposed by health insurance companies. The President-elect has indicated that his goal will be to create a patient-centered health care system that promotes choice, quality, and affordability with health insurance and health care, and take any needed action to alleviate the burdens imposed on American families and businesses by law.Key words: Affordable Care Act, ObamaCare, Medicaid, exchanges, Trump plan, repeal
Parenteral Vaccination Can Be an Effective Means of Inducing Protective Mucosal Responses
Freytag, Lucy C.
The current paradigm in vaccine development is that nonreplicating vaccines delivered parenterally fail to induce immune responses in mucosal tissues. However, both clinical and experimental data have challenged this concept, and numerous studies have shown that induction of mucosal immune responses after parenteral vaccination is not a rare occurrence and might, in fact, significantly contribute to the protection against mucosal infections afforded by parenteral vaccines. While the mechanisms underlying this phenomenon are not well understood, the realization that parenteral vaccination can be an effective means of inducing protective mucosal responses is paradigm-shifting and has potential to transform the way vaccines are designed and delivered. PMID:27122485
Protective effects of green tea polyphenols administered by oral intubation against chemical carcinogen-induced forestomach and pulmonary neoplasia in A/J mice.
Katiyar, S K; Agarwal, R; Mukhtar, H
Our studies and others have shown the cancer chemopreventive effects of chronic administration of green tea in several animal tumor models. In this study, the administration of a polyphenolic fraction isolated from green tea (GTP) by oral intubation at a dose of 5 mg in 0.2 ml water 30 min prior to challenge with carcinogen, afforded significant protection against both diethylnitrosamine (DEN)- and benzo(a)pyrene (BP)-induced forestomach and lung tumorigenesis in A/J mice. The protective effects were evident by a decrease in numbers of tumors/mouse in GTP-fed groups compared to non GTP-fed controls. In the forestomach tumorigenesis protocol, GTP afforded 71 and 66% protection against, respectively DEN- and BP-induced tumor multiplicity. In the case of lung tumorigenesis protocol, however, the protective effects of GTP were 41 and 39%, respectively. Histological examination of forestomach tumors showed significantly lesser number of squamous cell carcinoma formation in GTP-fed groups of mice compared to carcinogen alone-treated controls. When pulmonary tumors were examined histologically, no adenocarcinomas were observed in GTP-fed groups compared to 15% mice with adenocarcinomas in DEN and BP alone-treated controls. The results of this study suggest that limited doses of GTP administration by gavage 30 min prior to carcinogen challenge may afford protection against carcinogen-induced tumorigenesis in internal body organs.
Affordable ART in Kenya: The only hope for involuntary childlessness
Ndegwa, SW
Abstract The reported overall subfertility rate in Kenia is 26.1% with 50% attributed to tubal factors and 15% due to male factors. This is probably an underestimation taking into consideration that due to the stigma and myths of the disease, many couples are seeking alternative care from religious sects, witchdoctors, herbalists. Because the costs associated with IVF in private centres are only affordable for the happy few, the only true hope for most Kenyans struggling with unintended childlessness lies in the introduction of affordable ART services. The major challenge is to reduce the costs of ovarian stimulation medication and the equipment set-up cost of the ART laboratory. An important foreseeable barrier to low-cost ART is adequately trained personnel. PMID:27909571
Motivational Affordance and Risk-Taking Across Decision Domains.
Zou, Xi; Scholer, Abigail A
We propose a motivational affordance account to explain both stability and variability in risk-taking propensity in major decision domains. We draw on regulatory focus theory to differentiate two types of motivation (prevention, promotion) that play a key role in predicting risk-taking. Study 1 demonstrated that prevention motivation is negatively associated with risk-taking across six key decision domains, including health/safety, ethics, recreation, gambling, investment, and social. In contrast, promotion motivation is positively associated with risk-taking in the social and investment domains. Study 2 replicated the same pattern and provided direct evidence that promotion motivation is a strong predictor of risk-taking only in domains where there is true potential for gains. Study 3 manipulated promotion (vs. prevention) motivation experimentally to demonstrate that motivational affordance is a critical mechanism for understanding risk-taking behaviors.
The Affordable Care Act: A Prescription for Homeland Security Preparedness?
purchase health insurance Correct the inequity of Medicaid preventive coverage for new beneficiaries vs. existing beneficiaries Design and...might incentivize choosing health insurance over penalties. D. ADDRESS MEDICAID PREVENTIVE COVERAGE INEQUITY As noted in Chapter V, § 1001 of the...Affordable Care Act (ACA), tens of millions of U.S. citizens were without health insurance coverage. Without health insurance, health care can be
Options for Affordable Planetary Fission Surface Power Systems
NASA Technical Reports Server (NTRS)
Houts, Mike; Gaddis, Steve; Porter, Ron; VanDyke, Melissa; Martin, Jim; Godfroy, Tom; Bragg-Sitton, Shannon; Garber, Anne; Pearson, Boise
Nuclear fission systems could serve as "workhorse" power plants for the Vision for Space Exploration. In this context, the "workhorse" power plant is defined as a system that could provide power anywhere on the surface of the moon or Mars, land on the moon using a Robotic Lunar Exploration Program (RLEP)-developed lander, and would be a viable, affordable option once power requirements exceed that which can be provided by existing energy systems.
Setting the price of essential drugs: necessity and affordability.
Litvack, J I; Shepard, D S; Quick, J D
A method has been developed for fine tuning the selection of drugs to improve cost recovery, to promote appropriate drug use, and to make more drugs more affordable. This scheme is based on a classification of drug necessity (vital, essential, non-essential) and on the relative cost of complete courses of treatment so that expensive drugs can be subsidised by marking up inexpensive ones.
Promoting Prevention Through the Affordable Care Act: Workplace Wellness
Roffenbender, Jason S.; Goetzel, Ron Z.; Millard, Francois; Wildenhaus, Kevin; DeSantis, Charles; Novelli, William
Public health in the United States can be improved by building workplace "cultures of health" that support healthy lifestyles. The Affordable Care Act (ACA), which includes the Prevention and Public Health Fund, will support a new focus on prevention and wellness, offering opportunities to strengthen the public's health through workplace wellness initiatives. This article describes the opportunity the ACA provides to improve worker wellness. PMID:23237245
Affordability of emergency obstetric and neonatal care at public hospitals in Madagascar.
Honda, Ayako; Randaoharison, Pierana Gabriel; Matsui, Mitsuaki
Timely access to emergency obstetric care is necessary to save the lives of women experiencing complications at delivery, and for newborn babies. Out-of-pocket costs are one of the critical factors hindering access to such services in low- and middle-income countries. This study measured out-of-pocket costs for caesarean section and neonatal care at an urban tertiary public hospital in Madagascar, assessed affordability in relation to household expenditure and investigated where families found the money to cover these costs. Data were collected for 103 women and 73 newborns at the Centre Hospitalier Universitaire de Mahajanga in the Boeny region of Madagascar between September 2007 and January 2008. Out-of-pocket costs for caesarean section were catastrophic for middle and lower socio-economic households, and treatment for neonatal complications also created a big financial burden, with geographical and other financial barriers further limiting access to hospital care. This study identified 12 possible cases where the mother required an emergency caesarean section and her newborn required emergency care, placing a double burden on the household. In an effort to make emergency obstetric and neonatal care affordable and available to all, including those living in rural areas and those of medium and lower socio-economic status, well-designed financial risk protection mechanisms and a strong commitment by the government to mobilise resources to finance the country's health system are necessary.
Coverage of certain preventive services under the Affordable Care Act. Final rules.
This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. Among these services are women's preventive health services, as specified in guidelines supported by the Health Resources and Services Administration (HRSA). As authorized by the current regulations, and consistent with the HRSA guidelines, group health plans established or maintained by certain religious employers (and group health insurance coverage provided in connection with such plans) are exempt from the otherwise applicable requirement to cover certain contraceptive services. These final regulations simplify and clarify the religious employer exemption. These final regulations also establish accommodations with respect to the contraceptive coverage requirement for group health plans established or maintained by eligible organizations (and group health insurance coverage provided in connection with such plans), as well as student health insurance coverage arranged by eligible organizations that are institutions of higher education. These regulations also finalize related amendments to regulations concerning Affordable Insurance Exchanges.
Approach to an Affordable and Productive Space Transportation System
NASA Technical Reports Server (NTRS)
McCleskey, Carey M.; Rhodes, Russel E.; Lepsch, Roger A.; Henderson, Edward M.; Robinson, John W.
This paper describes an approach for creating space transportation architectures that are affordable, productive, and sustainable. The architectural scope includes both flight and ground system elements, and focuses on their compatibility to achieve a technical solution that is operationally productive, and also affordable throughout its life cycle. Previous papers by the authors and other members of the Space Propulsion Synergy Team (SPST) focused on space flight system engineering methods, along with operationally efficient propulsion system concepts and technologies. This paper follows up previous work by using a structured process to derive examples of conceptual architectures that integrate a number of advanced concepts and technologies. The examples are not intended to provide a near-term alternative architecture to displace current near-term design and development activity. Rather, the examples demonstrate an approach that promotes early investments in advanced system concept studies and trades (flight and ground), as well as in advanced technologies with the goal of enabling highly affordable, productive flight and ground space transportation systems.
Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act
Collins, Lydia N.
This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn't know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA. PMID:25798077
Healthy Libraries Develop Healthy Communities: Public Libraries and their Tremendous Efforts to Support the Affordable Care Act.
Collins, Lydia N
This article is about the dedication of public library staff and my role as the Consumer Health Coordinator for the National Network of Libraries of Medicine, Middle Atlantic Region (NN/LM MAR) to support outreach efforts for health insurance enrollment under the Patient Protection and Affordable Care Act (ACA). ACA was created in order to ensure that all Americans have access to affordable health care. What we didn't know is that public libraries across the nation would play such an integral role in the health insurance enrollment process. The National Network of Libraries of Medicine (NN/LM) worked closely with public libraries in order to assist with this new role. As we approach the second enrollment and re-enrollment periods, public libraries are gearing up once again to assist with ACA.
The visual encoding of tool-object affordances.
Natraj, N; Pella, Y M; Borghi, A M; Wheaton, L A
The perception of tool-object pairs involves understanding their action-relationships (affordances). Here, we sought to evaluate how an observer visually encodes tool-object affordances. Eye-movements were recorded as right-handed participants freely viewed static, right-handed, egocentric tool-object images across three contexts: correct (e.g. hammer-nail), incorrect (e.g. hammer-paper), spatial/ambiguous (e.g. hammer-wood), and three grasp-types: no hand, functional grasp-posture (grasp hammer-handle), non-functional/manipulative grasp-posture (grasp hammer-head). There were three areas of interests (AOI): the object (nail), the operant tool-end (hammer-head), the graspable tool-end (hammer-handle). Participants passively evaluated whether tool-object pairs were functionally correct/incorrect. Clustering of gaze scanpaths and AOI weightings grouped conditions into three distinct grasp-specific clusters, especially across correct and spatial tool-object contexts and to a lesser extent within the incorrect tool-object context. The grasp-specific gaze scanpath clusters were reasonably robust to the temporal order of gaze scanpaths. Gaze was therefore automatically primed to grasp-affordances though the task required evaluating tool-object context. Participants also primarily focused on the object and the operant tool-end and sparsely attended to the graspable tool-end, even in images with functional grasp-postures. In fact, in the absence of a grasp, the object was foveally weighted the most, indicative of a possible object-oriented action priming effect wherein the observer may be evaluating how the tool engages on the object. Unlike the functional grasp-posture, the manipulative grasp-posture caused the greatest disruption in the object-oriented priming effect, ostensibly as it does not afford tool-object action due to its non-functional interaction with the operant tool-end that actually engages with the object (e.g., hammer-head to nail). The enhanced attention
Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.
Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie
Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults.
NASA Technical Reports Server (NTRS)
Denning, Peter J.
Accidental overwriting of files or of memory regions belonging to other programs, browsing of personal files by superusers, Trojan horses, and viruses are examples of breakdowns in workstations and personal computers that would be significantly reduced by memory protection. Memory protection is the capability of an operating system and supporting hardware to delimit segments of memory, to control whether segments can be read from or written into, and to confine accesses of a program to its segments alone. The absence of memory protection in many operating systems today is the result of a bias toward a narrow definition of performance as maximum instruction-execution rate. A broader definition, including the time to get the job done, makes clear that cost of recovery from memory interference errors reduces expected performance. The mechanisms of memory protection are well understood, powerful, efficient, and elegant. They add to performance in the broad sense without reducing instruction execution rate.
Coverage of Certain Preventive Services Under the Affordable Care Act. Final rules.
This document contains final regulations regarding coverage of certain preventive services under section 2713 of the Public Health Service Act (PHS Act), added by the Patient Protection and Affordable Care Act, as amended, and incorporated into the Employee Retirement Income Security Act of 1974 and the Internal Revenue Code. Section 2713 of the PHS Act requires coverage without cost sharing of certain preventive health services by non-grandfathered group health plans and health insurance coverage. These regulations finalize provisions from three rulemaking actions: Interim final regulations issued in July 2010 related to coverage of preventive services, interim final regulations issued in August 2014 related to the process an eligible organization uses to provide notice of its religious objection to the coverage of contraceptive services, and proposed regulations issued in August 2014 related to the definition of "eligible organization,'' which would expand the set of entities that may avail themselves of an accommodation with respect to the coverage of contraceptive services.
Achieving a deeper understanding of the implemented provisions of the Affordable Care Act.
Zhang, Shuang Qin; Polite, Blase N
The Patient Protection and Affordable Care Act (ACA) was signed into law by President Barack Obama on March 23, 2010. Since that time, numerous regulations have been promulgated, legal battles continue to be fought and the major provisions of the law are being implemented. In the following article, we outline components of the ACA that are relevant to cancer health care, review current implementation of the new health care reform law, and identify challenges that may lie ahead in the post-ACA era. Specifically, among the things we explore are Medicaid expansion, health insurance exchanges, essential health benefits and preventive services, subsidies, access to clinical trials, the Medicare Part D donut hole, and physician quality payment reform.
The Relevance of the Affordable Care Act for Improving Mental Health Care.
Mechanic, David; Olfson, Mark
Provisions of the Affordable Care Act provide unprecedented opportunities for expanded access to behavioral health care and for redesigning the provision of services. Key to these reforms is establishing mental and substance abuse care as essential coverage, extending Medicaid eligibility and insurance parity, and protecting insurance coverage for persons with preexisting conditions and disabilities. Many provisions, including Accountable Care Organizations, health homes, and other structures, provide incentives for integrating primary care and behavioral health services and coordinating the range of services often required by persons with severe and persistent mental health conditions. Careful research and experience are required to establish the services most appropriate for primary care and effective linkage to specialty mental health services. Research providing guidance on present evidence and uncertainties is reviewed. Success in redesign will follow progress building on collaborative care and other evidence-based practices, reshaping professional incentives and practices, and reinvigorating the behavioral health workforce.
Quality Health Care for Children and the Affordable Care Act: A Voltage Drop Checklist
Wise, Paul H.; Halfon, Neal
The Affordable Care Act (ACA) introduces enormous policy changes to the health care system with several anticipated benefits and a growing number of unanticipated challenges for child and adolescent health. Because the ACA gives each state and their payers substantial autonomy and discretion on implementation, understanding potential effects will require state-by-state monitoring of policies and their impact on children. The "voltage drop" framework is a useful interpretive guide for assessing the impact of insurance market change on the quality of care received. Using this framework we suggest a state-level checklist to examine ACA statewide implementation, assess its impact on health care delivery, and frame policy correctives to improve child health system performance. Although children's health care is a small part of US health care spending, child health provides the foundation for adult health and must be protected in ACA implementation. PMID:25225140
Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform.
Oberlander, Jonathan
The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation-the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion-and analyze how these issues have shaped its evolution. The article concludes by exploring the political and policy challenges that lie ahead for the ACA.
49 CFR 179.300-12 - Protection of fittings.
Code of Federal Regulations, 2010 CFR
... 49 Transportation 2 2010-10-01 2010-10-01 false Protection of fittings. 179.300-12 Section 179.300-12 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS... Protection of fittings. (a) Tanks shall be of such design as will afford maximum protection to any...
77 FR 17219 - Patient Protection and Affordable Care Act; Standards Related to Reinsurance, Risk Corridors and...
Federal Register 2010, 2011, 2012, 2013, 2014
... financially liable for contributions to be made by group health plans for which they administer benefits... behalf of group health plans make contributions. We are including text in Sec. 153.400 that clarifies... of self-insured group health plans, must make contributions to support reinsurance payments to...
78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...
Federal Register 2010, 2011, 2012, 2013, 2014
... Immunization Status 0038 X X Chlamydia Screening in Women (Ages 16-20). 0033 X Cholesterol Management for... Prescribed ADHD Medication: Initiation Phase. Cardiovascular Care... Cholesterol Management for Patients With Cardiovascular Conditions: LDL-C screening. Cholesterol Management for Patients With Cardiovascular...
76 FR 43237 - Patient Protection and Affordable Care Act; Establishment of Consumer Operated and Oriented Plan...
Federal Register 2010, 2011, 2012, 2013, 2014
... health insurance issuer. To ensure consumer control, the governance of the organization must be subject... generally advised the Department to develop flexible criteria that recognize the diversity of market...) Consumer operation, control, and focus must be the salient features of the CO-OP and must be sustained...
78 FR 33233 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...
Federal Register 2010, 2011, 2012, 2013, 2014
... used total Accident and Health earned premiums as a proxy for annual receipts. We estimated that there are 28 small entities with less than $7 million in accident and health earned premiums offering... premium assistance under Medicaid or the Children's Health Insurance Program (CHIP) or loses...
76 FR 76573 - Medical Loss Ratio Requirements Under the Patient Protection and Affordable Care Act
Federal Register 2010, 2011, 2012, 2013, 2014
... incurred in 2012 and 2013 up to 0.3 percent of an issuer's earned premium in the relevant State market in... earned premium, account for less than 0.02 percent of issuer spending in each market (individual, small... cap set at up to 0.3 percent of an issuer's earned premium is an appropriate amount based on past...
76 FR 60788 - Patient Protection and Affordable Care Act; Establishment of Exchanges and Qualified Health Plans...
Federal Register 2010, 2011, 2012, 2013, 2014
... Medicare & Medicaid Services, Department of Health and Human Services, Room 445-G, Hubert H. Humphrey... building. A stamp- in clock is available for persons wishing to retain a proof of filing by stamping in...
75 FR 37187 - Patient Protection and Affordable Care Act: Preexisting Condition Exclusions, Lifetime and Annual...
Federal Register 2010, 2011, 2012, 2013, 2014
...), generally apply to individual health insurance issuers for policy years beginning on or after September 23... individual health insurance issuers for policy years beginning on or after January 1, 2014, except that in... section 2704 apply for policy years beginning on or after September 23, 2010. ADDRESSES: Written...
77 FR 42658 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...
Federal Register 2010, 2011, 2012, 2013, 2014
... drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and... of data on treatment limitations, prescription drug coverage, and other descriptive information for... discriminatory, that prescription drug coverage is comparable to a typical employer plan and that benefit...
A bill to repeal the Patient Protection and Affordable Care Act.
Sen. DeMint, Jim [R-SC
03/23/2010 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 332. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
77 FR 70583 - Patient Protection and Affordable Care Act; Health Insurance Market Rules; Rate Review
Federal Register 2010, 2011, 2012, 2013, 2014
... states allow age rating (often unlimited). While 37 states explicitly allow gender rating, three states that prohibit gender rating do not require maternity coverage in all individual market policies... allow some form of gender rating in practice. In the small group market, 38 states allow health...
78 FR 54069 - Patient Protection and Affordable Care Act; Program Integrity: Exchange, SHOP, and Eligibility...
Federal Register 2010, 2011, 2012, 2013, 2014
... CHIP Children's Health Insurance Program CMP Civil Money Penalty CMS Centers for Medicare & Medicaid... enforce the Exchange standards using civil money penalties (CMPs) on the same basis as detailed in...
77 FR 33133 - Patient Protection and Affordable Care Act; Data Collection To Support Standards Related to...
Federal Register 2010, 2011, 2012, 2013, 2014
... To Support Standards Related to Essential Health Benefits; Recognition of Entities for the... Health and Human Services to define essential health benefits. This proposed rule outlines the data on applicable plans to be collected from certain issuers to support the definition of essential health...
78 FR 12833 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...
Federal Register 2010, 2011, 2012, 2013, 2014
... Qualified Health Plan SHOP Small Business Health Options Program SSA Social Security Administration The Act Social Security Act The Code Internal Revenue Code of 1986 USP United States Pharmacopeia...
78 FR 42823 - Patient Protection and Affordable Care Act; Exchange Functions: Standards for Navigators and Non...
Federal Register 2010, 2011, 2012, 2013, 2014
... enrollees be provided information in plain language and in a manner that is accessible and timely for... be certified, to register and receive HHS-approved training, the content required for training,...
Evaluation of the Fallout Protection Afforded by Brookhaven National Laboratory Medical Research Center
EFFECTS TEST OPERATIONS U.S. ATOMIC ENERGY COMMISSION NOTICE This report is published in the interest of providing information which may prove of...value to the reader in his study of effects data derived principally from nuclear weapons tests and from experiments designed to duplicate various...Z. Burson, and J. Jacovitch Approved by: R. L. CORSBIE Director Civil Effects Test Operations Edgerton, Germeshausen & Grier, Inc. Santa Barbara
78 FR 7348 - Patient Protection and Affordable Care Act; Exchange Functions: Eligibility for Exemptions...
Federal Register 2010, 2011, 2012, 2013, 2014
... shared responsibility payment for not maintaining minimum essential coverage as described in section 5000A of the Internal Revenue Code. Additionally, this proposed rule implements the responsibility of... responsibility payment. Amanda Ledford, (410) 786-1565, for provisions related to minimum essential...
S-nitrosoglutathione reductase affords protection against pathogens in Arabidopsis, both locally and systemically.
Rustérucci, Christine; Espunya, M Carme; Díaz, Maykelis; Chabannes, Matthieu; Martínez, M Carmen
Nitric oxide and S-nitrosothiols (SNOs) are widespread signaling molecules that regulate immunity in animals and plants. Levels of SNOs in vivo are controlled by nitric oxide synthesis (which in plants is achieved by different routes) and by S-nitrosoglutathione turnover, which is mainly performed by the S-nitrosoglutathione reductase (GSNOR). GSNOR is encoded by a single-copy gene in Arabidopsis (Arabidopsis thaliana; Martínez et al., 1996; Sakamoto et al., 2002). We report here that transgenic plants with decreased amounts of GSNOR (using antisense strategy) show enhanced basal resistance against Peronospora parasitica Noco2 (oomycete), which correlates with higher levels of intracellular SNOs and constitutive activation of the pathogenesis-related gene, PR-1. Moreover, systemic acquired resistance is impaired in plants overexpressing GSNOR and enhanced in the antisense plants, and this correlates with changes in the SNO content both in local and systemic leaves. We also show that GSNOR is localized in the phloem and, thus, could regulate systemic acquired resistance signal transport through the vascular system. Our data corroborate the data from other authors that GSNOR controls SNO in vivo levels, and shows that SNO content positively influences plant basal resistance and resistance-gene-mediated resistance as well. These data highlight GSNOR as an important and widely utilized component of resistance protein signaling networks conserved in animals and plants.
77 FR 70643 - Patient Protection and Affordable Care Act; Standards Related to Essential Health Benefits...
Federal Register 2010, 2011, 2012, 2013, 2014
... From the Federal Register Online via the Government Publishing Office ] Vol. 77 Monday, No. 227 November 26, 2012 Part V Department of Health and Human Services 45 CFR Parts 147, 155, and 156 Patient... Federal Register online database through Federal Digital System (FDsys), a service of the U.S....
78 FR 76212 - Patient Protection and Affordable Care Act; Maximizing January 1, 2014 Coverage Opportunities
Federal Register 2010, 2011, 2012, 2013, 2014
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND... prescription drug coverage. When shopping for coverage on an Exchange, prospective enrollees may base QHP selection decisions on whether their provider is considered in-network using the issuer's online...
What Protects Certain Nerves from Stretch Injury?
Schraut, Nicholas B; Walton, Sharon; Bou Monsef, Jad; Shott, Susan; Serici, Anthony; Soulii, Lioubov; Amirouche, Farid; Gonzalez, Mark H; Kerns, James M
The human tibial nerves is less prone to injury following joint arthroplasty compared with the peroneal nerves. Besides the anatomical distribution, other features may confer protection from stretch injury. We therefore examined the size, shape and connective tissue distribution for the two nerves. The tibial and peroneal nerves from each side of nine fresh human cadavers we reharvested mid-thigh. Proximal segments manually stretched 20%-25% were fixed in aldehyde, while the adjacent distal segments were fixed in their natural length. Paraffin sections stained by Masson's trichrome method for connective tissue were examined by light microscopy. Tibial nerves had 2X more fascicles compared with the peroneal, but the axonal content appeared similar. Analysis showed that neither nerve had a significant reduction in cross sectional area of the fascicles following stretch. However, fascicles from stretched tibial nerves become significantly more oval compared with those from unstretched controls and peroneal nerves. Tibial nerves had a greater proportion that was extrafascicular tissue (50-55%) compared with peroneal nerves (38%-42%). This epineurium was typically adipose tissue. Perineurial thickness in both nerves was directly related to fascicular size. Tibial nerves have several unique histological features associated with size, shape and tissue composition compared with the peroneal nerve. We suggest that more fascicles with their tightly bound perineurium and more robust epineurium afford protection against stretch injury. Mechanical studies should clarify how size and shape contribute to nerve protection and/or neurapraxia.
A Bootstrap Approach to an Affordable Exploration Program
NASA Technical Reports Server (NTRS)
Oeftering, Richard C.
This paper examines the potential to build an affordable sustainable exploration program by adopting an approach that requires investing in technologies that can be used to build a space infrastructure from very modest initial capabilities. Human exploration has had a history of flight programs that have high development and operational costs. Since Apollo, human exploration has had very constrained budgets and they are expected be constrained in the future. Due to their high operations costs it becomes necessary to consider retiring established space facilities in order to move on to the next exploration challenge. This practice may save cost in the near term but it does so by sacrificing part of the program s future architecture. Human exploration also has a history of sacrificing fully functional flight hardware to achieve mission objectives. An affordable exploration program cannot be built when it involves billions of dollars of discarded space flight hardware, instead, the program must emphasize preserving its high value space assets and building a suitable permanent infrastructure. Further this infrastructure must reduce operational and logistics cost. The paper examines the importance of achieving a high level of logistics independence by minimizing resource consumption, minimizing the dependency on external logistics, and maximizing the utility of resources available. The approach involves the development and deployment of a core suite of technologies that have minimum initial needs yet are able expand upon initial capability in an incremental bootstrap fashion. The bootstrap approach incrementally creates an infrastructure that grows and becomes self sustaining and eventually begins producing the energy, products and consumable propellants that support human exploration. The bootstrap technologies involve new methods of delivering and manipulating energy and materials. These technologies will exploit the space environment, minimize dependencies, and
Plastic modes of listening: affordance in constructed sound environments
NASA Astrophysics Data System (ADS)
Sjolin, Anders
This thesis is concerned with how the ecological approach to perception with the inclusion of listening modes, informs the creation of sound art installation, or more specifically as referred to in this thesis as constructed sound environments. The basis for the thesis has been a practiced based research where the aim and purpose of the written part of this PhD project has been to critically investigate the area of sound art, in order to map various approaches towards participating in and listening to a constructed sound environment. The main areas has been the notion of affordance as coined by James J. Gibson (1986), listening modes as coined by Pierre Schaeffer (1966) and further developed by Michel Chion (1994), aural architects as coined by Blesser and Salter (2007) and the holistic approach towards understanding sound art developed by Brandon LaBelle (2006). The findings within the written part of the thesis, based on a qualitative analysis, have informed the practice that has resulted in artefacts in the form of seven constructed sound environments that also functions as case studies for further analysis. The aim of the practice has been to exemplify the methodology, strategy and progress behind the organisation and construction of sound environments The research concerns point towards the acknowledgment of affordance as the crucial factor in understanding a constructed sound environment. The affordance approach govern the idea that perceiving a sound environment is a top-down process where the autonomic quality of a constructed sound environment is based upon the perception of structures of the sound material and its relationship with speaker placement and surrounding space. This enables a researcher to side step the conflicting poles of musical/abstract and non-musical/realistic classification of sound elements and regard these poles as included, not separated elements in the analysis of a constructed sound environment.
Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation
NASA Technical Reports Server (NTRS)
Jones, Jonathan E.; Kibbey, Timothy P.; Cobb, C. Brent; Harris, Lawanna L.
A launch vehicle at the scale and price point which allows developers to take reasonable risks with high payoff propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial technology "valley of death" that lies between demonstration in laboratory and flight environments. NASA's NanoLaunch effort will provide the framework to mature both earth-to-orbit and on-orbit propulsion and avionics technologies while also providing affordable, dedicated access to low earth orbit for cubesat class payloads.
Teacher Perceptions of Learning Affordances of Multi-User Virtual Environments
ERIC Educational Resources Information Center
Gamage, Vimani; Tretiakov, Alexei; Crump, Barbara
While the affordances of multi-user virtual environments (MUVEs) for teaching and learning are a subject of numerous experience reports, there is little research on educators' perceptions of various MUVE affordances claimed in the literature. We investigate the educators' perceptions of claimed MUVE affordances for learning by conducting in-depth…
24 CFR 954.306 - Rental housing: qualification as affordable housing and income targeting.
Code of Federal Regulations, 2010 CFR
... affordable housing and income targeting. 954.306 Section 954.306 Housing and Urban Development Regulations... Affordability § 954.306 Rental housing: qualification as affordable housing and income targeting. (a) Rent...: (1) Bears rents not greater than the lesser of— (i) The section 8 fair market rent for...
Learning Outcomes Afforded by Self-Assessed, Segmented Video-Print Combinations
ERIC Educational Resources Information Center
Koumi, Jack
Learning affordances of video and print are examined in order to assess the learning outcomes afforded by hybrid video-print learning packages. The affordances discussed for print are: navigability, surveyability and legibility. Those discussed for video are: design for constructive reflection, provision of realistic experiences, presentational…
76 FR 59702 - Notice of Intent To Award Affordable Care Act (ACA) Funding
Federal Register 2010, 2011, 2012, 2013, 2014
... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act... Services (HHS). ACTION: Notice. Overview Information Notice of Intent to Award Affordable Care Act (ACA...: This notice provides public announcement of CDC's intent to award Affordable Care Act...
Interaction between affordance and handedness recognition: a chronometric study.
Lameira, A P; Pereira, A; Conde, E; Gawryszewski, L G
The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT) task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation.
Reference Reactor Module for the Affordable Fission Surface Power System
NASA Astrophysics Data System (ADS)
Poston, David I.; Kapernick, Richard J.; Dixon, David D.; Amiri, Benjamin W.; Marcille, Thomas F.
Surface fission power systems on the Moon and Mars may provide the first US application of fission reactor technology in space since 1965. The requirements of many surface power applications allow the consideration of systems with much less development risk than most other space reactor applications, because of modest power (10s of kWe) and no driving need for minimal mass (allowing temperatures <1000 K). The Affordable Fission Surface Power System (AFSPS) study was completed by NASA/DOE to determine the cost of a modest performance, low-technical risk surface power system. This paper describes the reference AFSPS reactor module concept, which is designed to provide a net power of 40 kWe for 8 years on the lunar surface; note, the system has been designed with technologies that are fully compatible with a Martian surface application. The reactor concept uses stainless-steel based, UO2-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The reactor shielding approach utilizes both in-situ and launched shielding to keep the dose to astronauts much lower than the natural background radiation on the lunar surface. One of the important ``affordability'' attributes is that the concept has been designed to minimize both the technical and programmatic safety risk.
Spatial compatibility and affordance compatibility in patients with chronic schizophrenia.
Kume, Yu; Sato, Fumiyasu; Hiraoka, Yuya; Suzuki, Shingo; Niyama, Yoshitsugu
A deterioration in information-processing performance is commonly recognized in patients with chronic schizophrenia. Although the enhancement of cognitive skills in patients with schizophrenia is important, the types of external stimuli that influence performance have not received much attention. The aim of present study was to clarify the effects of spatial and affordance compatibility in patients with schizophrenia, compared with those in healthy people. The subjects (25 patients with schizophrenia and 25 healthy controls) participated in two experiment examining the effects of the spatial location of stimuli and the action-relevance of objects. The results showed that the effect of spatial compatibility was similar in both the patients and the controls, whereas the influence of action-relevant objects was not highlighted in either patients with chronic schizophrenia or healthy controls. These findings provide important evidence of a normal spatial compatibility effect in patients with chronic schizophrenia. However, further research examining the affordance compatibility effect is needed, taking into consideration the symptomatology and the severity of the social functioning level in patients with schizophrenia.
Interaction between affordance and handedness recognition: a chronometric study
Lameira, A.P.; Pereira, A.; Conde, E.; Gawryszewski, L.G.
The visualization of tools and manipulable objects activates motor-related areas in the cortex, facilitating possible actions toward them. This pattern of activity may underlie the phenomenon of object affordance. Some cortical motor neurons are also covertly activated during the recognition of body parts such as hands. One hypothesis is that different subpopulations of motor neurons in the frontal cortex are activated in each motor program; for example, canonical neurons in the premotor cortex are responsible for the affordance of visual objects, while mirror neurons support motor imagery triggered during handedness recognition. However, the question remains whether these subpopulations work independently. This hypothesis can be tested with a manual reaction time (MRT) task with a priming paradigm to evaluate whether the view of a manipulable object interferes with the motor imagery of the subject's hand. The MRT provides a measure of the course of information processing in the brain and allows indirect evaluation of cognitive processes. Our results suggest that canonical and mirror neurons work together to create a motor plan involving hand movements to facilitate successful object manipulation. PMID:25714894
Demonstrating the Viability and Affordability of Nuclear Surface Power Systems
NASA Technical Reports Server (NTRS)
Vandyke, Melissa K.
A set of tasks have been identified to help demonstrate the viability, performance, and affordability of surface fission systems. Completion of these tasks will move surface fission systems closer to reality by demonstrating affordability and performance potential. Tasks include fabrication and test of a 19-pin section of a Surface Power Unit Demonstrator (SPUD); design, fabrication, and utilization of thermal simulators optimized for surface fission' applications; design, fabrication, and utilization of GPHS module thermal simulators; design, fabrication, and test of a fission surface power system shield; and work related to potential fission surface power fuel/clad systems. Work on the SPUD will feed directly into joint NASA MSFC/NASA GRC fabrication and test of a surface power plant Engineering Development Unit (EDU). The goal of the EDU will be to perform highly realistic thermal, structural, and electrical testing on an integrated fission surface power system. Fission thermal simulator work will help enable high fidelity non-nuclear testing of pumped NaK surface fission power systems. Radioisotope thermal simulator work will help enable design and development of higher power radioisotope systems (power ultimately limited by Pu-238 availability). Shield work is designed to assess the potential of using a water neutron shield on the surface of the moon. Fuels work is geared toward assessing the current potential of using fuels that have already flown in space.
Reference Reactor Module for the Affordable Fission Surface Power System
Poston, David I.; Kapernick, Richard J.; Dixon, David D.; Amiri, Benjamin W.; Marcille, Thomas F.
Surface fission power systems on the Moon and Mars may provide the first US application of fission reactor technology in space since 1965. The requirements of many surface power applications allow the consideration of systems with much less development risk than most other space reactor applications, because of modest power (10s of kWe) and no driving need for minimal mass (allowing temperatures <1000 K). The Affordable Fission Surface Power System (AFSPS) study was completed by NASA/DOE to determine the cost of a modest performance, low-technical risk surface power system. This paper describes the reference AFSPS reactor module concept, which is designed to provide a net power of 40 kWe for 8 years on the lunar surface; note, the system has been designed with technologies that are fully compatible with a Martian surface application. The reactor concept uses stainless-steel based, UO{sub 2}-fueled, liquid metal-cooled fission reactor coupled to free-piston Stirling converters. The reactor shielding approach utilizes both in-situ and launched shielding to keep the dose to astronauts much lower than the natural background radiation on the lunar surface. One of the important 'affordability' attributes is that the concept has been designed to minimize both the technical and programmatic safety risk.
Lack of cross-protection against invasive pneumonia caused by heterologous strains following murine Streptococcus pneumoniae nasopharyngeal colonisation despite whole cell ELISAs showing significant cross-reactive IgG.
Cohen, Jonathan M; Wilson, Robert; Shah, Pranali; Baxendale, Helen E; Brown, Jeremy S
Prior exposure to intact Streptococcus pneumoniae can induce a protective antibody response to proteins antigens, which prevents subsequent invasive disease. This may be achieved either by colonisation with live bacteria or by immunisation with killed cells. Such approaches could provide novel vaccine strategies that overcome the serotype restriction of conjugate vaccines, and would aim to prevent disease caused by all strains of S. pneumoniae. Serum antibody is required to prevent invasive disease, but which in vitro measure of antibody response correlates best with protective immunity has not been established for protein antigens. Using a model of homologous protection induced through D39 colonisation of CD1 mice, we investigate the potential for heterologous protection against two distinct serotype strains and its serological correlates. Serum IgG from colonised mice bound to heterologous strains in whole cell ELISA at titres similar to the homologous D39. However, no cross-protection was observed, correlating with lack of surface binding of IgG to whole bacteria as measured by flow cytometry. Serum antibody binding to pre-lysed and untreated bacteria in the whole cell ELISA was similar suggesting that ELISA does not discriminate between surface and subcapsular antigens, unlike the flow cytometric approach. Thus, flow cytometric binding to whole bacteria maybe a more reliable correlate of cross-protection for novel species-wide vaccines than whole cell ELISA.
Advax-adjuvanted recombinant protective antigen provides protection against inhalational anthrax that is further enhanced by addition of murabutide adjuvant.
Feinen, Brandon; Petrovsky, Nikolai; Verma, Anita; Merkel, Tod J
Subunit vaccines against anthrax based on recombinant protective antigen (PA) potentially offer more consistent and less reactogenic anthrax vaccines but require adjuvants to achieve optimal immunogenicity. This study sought to determine in a murine model of pulmonary anthrax infection whether the polysaccharide adjuvant Advax or the innate immune adjuvant murabutide alone or together could enhance PA immunogenicity by comparison to an alum adjuvant. A single immunization with PA plus Advax adjuvant afforded significantly greater protection against aerosolized Bacillus anthracis Sterne strain 7702 than three immunizations with PA alone. Murabutide had a weaker adjuvant effect than Advax when used alone, but when murabutide was formulated together with Advax, an additive effect on immunogenicity and protection was observed, with complete protection after just two doses. The combined adjuvant formulation stimulated a robust, long-lasting B-cell memory response that protected mice against an aerosol challenge 18 months postimmunization with acceleration of the kinetics of the anamnestic IgG response to B. anthracis as reflected by ∼4-fold-higher anti-PA IgG titers by day 2 postchallenge versus mice that received PA with Alhydrogel. In addition, the combination of Advax plus murabutide induced approximately 3-fold-less inflammation than Alhydrogel as measured by in vivo imaging of cathepsin cleavage resulting from injection of ProSense 750. Thus, the combination of Advax and murabutide provided enhanced protection against inhalational anthrax with reduced localized inflammation, making this a promising next-generation anthrax vaccine adjuvanting strategy.
Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ
Albright, Len; Derickson, Elizabeth S.; Massey, Douglas S.
This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ – the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities. PMID:27390552
Do Affordable Housing Projects Harm Suburban Communities? Crime, Property Values, and Taxes in Mount Laurel, NJ.
Albright, Len; Derickson, Elizabeth S; Massey, Douglas S
This paper offers a mixed-method analysis of the municipal-level consequences of an affordable housing development built in suburban New Jersey. Opponents of affordable housing development often suggest that creating affordable housing will harm surrounding communities. Feared consequences include increases in crime, declining property values, and rising taxes. To evaluate these claims, the paper uses the case of Mt. Laurel, NJ - the site of a landmark affordable housing legal case and subsequent affordable housing development. Employing a multiple time series group control design, we compare crime rates, property values, and property taxes in Mt. Laurel to outcomes in similar nearby municipalities that do not contain comparable affordable housing developments. We find that the opening of the affordable housing development was not associated with trends in crime, property values, or taxes, and discuss management practices and design features that may have mitigated potential negative externalities.
Affordable Development and Demonstration of a Small NTR Engine and Stage: How Small is Big Enough?
NASA Technical Reports Server (NTRS)
Borowski, Stanley K.; Sefcik, Robert J.; Fittje, James E.; McCurdy, David R.; Qualls, Arthur L.; Schnitzler, Bruce G.; Werner, James E.; Weitzberg (Abraham); Joyner, Claude R.
The Nuclear Thermal Rocket (NTR) derives its energy from fission of uranium-235 atoms contained within fuel elements that comprise the engine's reactor core. It generates high thrust and has a specific impulse potential of approximately 900 seconds - a 100% increase over today's best chemical rockets. The Nuclear Thermal Propulsion (NTP) project, funded by NASA's AES program, includes five key task activities: (1) Recapture, demonstration, and validation of heritage graphite composite (GC) fuel (selected as the "Lead Fuel" option); (2) Engine Conceptual Design; (3) Operating Requirements Definition; (4) Identification of Affordable Options for Ground Testing; and (5) Formulation of an Affordable Development Strategy. During FY'14, a preliminary DDT&E plan and schedule for NTP development was outlined by GRC, DOE and industry that involved significant system-level demonstration projects that included GTD tests at the NNSS, followed by a FTD mission. To reduce cost for the GTD tests and FTD mission, small NTR engines, in either the 7.5 or 16.5 klbf thrust class, were considered. Both engine options used GC fuel and a "common" fuel element (FE) design. The small approximately 7.5 klbf "criticality-limited" engine produces approximately 157 megawatts of thermal power (MWt) and its core is configured with parallel rows of hexagonal-shaped FEs and tie tubes (TTs) with a FE to TT ratio of approximately 1:1. The larger approximately 16.5 klbf Small Nuclear Rocket Engine (SNRE), developed by LANL at the end of the Rover program, produces approximately 367 MWt and has a FE to TT ratio of approximately 2:1. Although both engines use a common 35 inch (approximately 89 cm) long FE, the SNRE's larger diameter core contains approximately 300 more FEs needed to produce an additional 210 MWt of power. To reduce the cost of the FTD mission, a simple "1-burn" lunar flyby mission was considered to reduce the LH2 propellant loading, the stage size and complexity. Use of existing and
NASA Affordable Vehicle Avionics (AVA): Common Modular Avionics System for Nano-Launchers Offering Affordable Access to Space
NASA Technical Reports Server (NTRS)
Cockrell, James
Small satellites are becoming ever more capable of performing valuable missions for both government and commercial customers. However, currently these satellites can only be launched affordably as secondary payloads. This makes it difficult for the small satellite mission to launch when needed, to the desired orbit, and with acceptable risk. NASA Ames Research Center has developed and tested a prototype low-cost avionics package for space launch vehicles that provides complete GNC functionality in a package smaller than a tissue box with a mass less than 0.84 kg. AVA takes advantage of commercially available, low-cost, mass-produced, miniaturized sensors, filtering their more noisy inertial data with realtime GPS data. The goal of the Advanced Vehicle Avionics project is to produce and flight-verify a common suite of avionics and software that deliver affordable, capable GNC and telemetry avionics with application to multiple nano-launch vehicles at 1 the cost of current state-of-the-art avionics.
Fresh Waters and Fish Diversity: Distribution, Protection and Disturbance in Tropical Australia
Januchowski-Hartley, Stephanie R.; Pearson, Richard G.; Puschendorf, Robert; Rayner, Thomas
Background Given the globally poor protection of fresh waters for their intrinsic ecological values, assessments are needed to determine how well fresh waters and supported fish species are incidentally protected within existing terrestrial protected-area networks, and to identify their vulnerability to human-induced disturbances. To date, gaps in data have severely constrained any attempt to explore the representation of fresh waters in tropical regions. Methodology and Results We determined the distribution of fresh waters and fish diversity in the Wet Tropics of Queensland, Australia. We then used distribution data of fresh waters, fish species, human-induced disturbances, and the terrestrial protected-area network to assess the effectiveness of terrestrial protected areas for fresh waters and fish species. We also identified human-induced disturbances likely to influence the effectiveness of freshwater protection and evaluated the vulnerability of fresh waters to these disturbances within and outside protected areas. The representation of fresh waters and fish species in the protected areas of the Wet Tropics is poor: 83% of stream types defined by order, 75% of wetland types, and 89% of fish species have less than 20% of their total Wet Tropics length, area or distribution completely within IUCN category II protected areas. Numerous disturbances affect fresh waters both within and outside of protected areas despite the high level of protection afforded to terrestrial areas in the Wet Tropics (>60% of the region). High-order streams and associated wetlands are influenced by the greatest number of human-induced disturbances and are also the least protected. Thirty-two percent of stream length upstream of protected areas has at least one human-induced disturbance present. Conclusions/Significance We demonstrate the need for greater consideration of explicit protection and off-reserve management for fresh waters and supported biodiversity by showing that, even in
Developing Countries Vaccine Manufacturers Network: doing good by making high-quality vaccines affordable for all.
Pagliusi, Sonia; Leite, Luciana C C; Datla, Mahima; Makhoana, Morena; Gao, Yongzhong; Suhardono, Mahendra; Jadhav, Suresh; Harshavardhan, Gutla V J A; Homma, Akira
The Developing Countries Vaccine Manufacturers Network (DCVMN) is a unique model of a public and private international alliance. It assembles governmental and private organizations to work toward a common goal of manufacturing and supplying high-quality vaccines at affordable prices to protect people around the world from known and emerging infectious diseases. Together, this group of manufacturers has decades of experience in manufacturing vaccines, with technologies, know-how, and capacity to produce more than 40 vaccines types. These manufacturers have already contributed more than 30 vaccines in various presentations that have been prequalified by the World Health Organization for use by global immunization programmes. Furthermore, more than 45 vaccines are in the pipeline. Recent areas of focus include vaccines to protect against rotavirus, human papillomavirus (HPV), Japanese encephalitis, meningitis, hepatitis E, poliovirus, influenza, and pertussis, as well as combined pentavalent vaccines for children. The network has a growing number of manufacturers that produce a growing number of products to supply the growing demand for vaccines in developing countries.
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Phased array ultrasonic processing for enhanced and affordable diagnosis
NASA Astrophysics Data System (ADS)
Dominguez, N.; Rougeron, G.; Leberre, S.; Pautel, R.
Phased array ultrasonic reconstruction techniques are often presented as a prospect for better and enhanced diagnosis. However to date few applications of these techniques can be found in the industry, partly because of questions on sizing but also because they often require heavy acquisitions. A way forward is then to propose techniques requiring less intensive data acquisition to make them broadly affordable in practice. Several approaches ranging from full matrix capture to paintbrush acquisitions are presented in this paper in combination with associated reconstruction processing like the Total Focusing Method (TFM) and the Time Domain Topological Energy (TDTE) techniques. Emphasis is given to their relative relevancies and practical applicability on typical configurations of interest for industries. The paper also presents recent efforts made on the acceleration of processing computation times, in particular through the use of GPU architectures.
Affordable, Robust Ceramic Joining Technology (ARCJoinT)
NASA Technical Reports Server (NTRS)
Singh, M.
Joining is recognized as one of the enabling technologies for the application of silicon carbide-based ceramic and composite components in a number of demanding and high temperature applications in aerospace and ground-based systems. An affordable, robust ceramic joining technology (ARCJoinT) for joining of silicon carbide-based ceramics and fiber reinforced composites has been developed. This technique is capable of producing joints with tailorable thickness and composition. A wide variety of silicon carbide-based ceramics and composites, in different shapes and sizes, have been joined using this technique. These joints maintain their mechanical strength up to 1350 C in air. This technology is suitable for the joining of large and complex shaped ceramic and composite components and with certain modifications, can be applied to repair ceramic components damaged in service.
Women and the Affordable Care Act of 2010.
Collins, Sara R; Rustgi, Sheila D; Doty, Michelle M
This issue brief analyzes how, over the next decade, the Affordable Care Act (ACA) is likely to stabilize and reverse women's growing exposure to health care costs. Up to 15 million women who now are uninsured could gain subsidized coverage under the law. In addition, 14.5 million insured women will benefit from provisions that improve coverage or reduce premiums. Women who have coverage through the individual insurance market and are charged higher premiums than men, who have been unable to secure coverage for the cost of pregnancy, or who have a preexisting health condition excluded from their benefits will ultimately find themselves on a level playing field with men, enjoying a full range of comprehensive benefits.
The Future of the Affordable Care Act and Insurance Coverage.
Glied, Sherry; Jackson, Adlan
We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities.
Design, analysis and testing of small, affordable HAWT rotors
NASA Astrophysics Data System (ADS)
Pricop, Mihai V.; Niculescu, Mihai L.; Cojocaru, Marius G.; Barsan, Dorin
The paper presents affordable technologies dedicated to design, CAD modelling and manufacturing of the small-medium HAWT rotors. Three numerical tools are developed: blade/rotor design, blade modelling for industry CATIA(CATScript) and blade modelling for small scale developers. Numerical analysis of the rotors is accomplished for both performance and noise level estimation using XFLOW (LES) and an in-house code (URANS). Results are presented for a 5KW rotor at the design point only, since computations are expensive. Developement examples are included as two rotors are designed, manufactured and tested for 1.5 and 5KW. A third one, rated for 20KW is under developement. Basic testing results are also included.
Pico Reentry Probes: Affordable Options for Reentry Measurements and Testing
NASA Technical Reports Server (NTRS)
Ailor, William H.; Kapoor, Vinod B.; Allen, Gay A., Jr.; Venkatapathy, Ethiraj; Arnold, James O.; Rasky, Daniel J.
It is generally very costly to perform in-space and atmospheric entry experiments. This paper presents a new platform - the Pico Reentry Probe (PREP) - that we believe will make targeted flight-tests and planetary atmospheric probe science missions considerably more affordable. Small, lightweight, self-contained, it is designed as a "launch and forget" system, suitable for experiments that require no ongoing communication with the ground. It contains a data recorder, battery, transmitter, and user-customized instrumentation. Data recorded during reentry or space operations is returned at end-of-mission via transmission to Iridium satellites (in the case of earth-based operations) or a similar orbiting communication system for planetary missions. This paper discusses possible applications of this concept for Earth and Martian atmospheric entry science. Two well-known heritage aerodynamic shapes are considered as candidates for PREP: the shape developed for the Planetary Atmospheric Experiment Test (PAET) and that for the Deep Space II Mars Probe.
An Object Oriented Extensible Architecture for Affordable Aerospace Propulsion Systems
NASA Technical Reports Server (NTRS)
Follen, Gregory J.
Driven by a need to explore and develop propulsion systems that exceeded current computing capabilities, NASA Glenn embarked on a novel strategy leading to the development of an architecture that enables propulsion simulations never thought possible before. Full engine 3 Dimensional Computational Fluid Dynamic propulsion system simulations were deemed impossible due to the impracticality of the hardware and software computing systems required. However, with a software paradigm shift and an embracing of parallel and distributed processing, an architecture was designed to meet the needs of future propulsion system modeling. The author suggests that the architecture designed at the NASA Glenn Research Center for propulsion system modeling has potential for impacting the direction of development of affordable weapons systems currently under consideration by the Applied Vehicle Technology Panel (AVT).
International examples of undocumented immigration and the affordable care act.
Stutz, Matthew; Baig, Arshiya
As it stands there is no viable health care option for undocumented immigrants of low socioeconomic status. Even more worrisome is that Affordable Care Act simply does not address this issue with any direct plan. The US is in a very influential time period in terms of undocumented immigration and its relationship with health care. The purpose of this paper is to examine international examples of undocumented immigrant health care and their implications for the United States' undocumented immigrant health care. This study found that physicians in the US must work to prevent the initiation of policies which exclude undocumented immigrants from accessing health care. Exclusionary policies implemented in European nations have had disastrous effects on physicians and patients. This paper examines the implications which similar policies would have if implemented in the US.
Gender performativity in physics: affordances or only constraints?
NASA Astrophysics Data System (ADS)
Danielsson, Anna T.; Lundin, Mattias
In this forum we engage in a dialogue with Allison Gonsalves's paper `"Physics and the girly girl—there is a contradiction somewhere": Doctoral students' positioning around discourses of gender and competence in physics'. In her paper Gonsalves uses a sociocultural approach to examine women doctoral students' stories about becoming physicists. In doing so her paper focuses on how discourses of masculinity and femininity can create available and unavailable positions for the women students. In this dialogue we do a parallel reading of two of the student narratives presented by Gonsalves, using Judith Butler's (1990) concept of discursive agency as a means to more explicitly bring the affordances for women identity constitution offered by their localized physicist context to the fore, rather focusing on its, often more visible, constraints.
Suggested Interactivity: Seeking Perceived Affordances for Information Visualization.
Boy, Jeremy; Eveillard, Louis; Detienne, Françoise; Fekete, Jean-Daniel
In this article, we investigate methods for suggesting the interactivity of online visualizations embedded with text. We first assess the need for such methods by conducting three initial experiments on Amazon's Mechanical Turk. We then present a design space for Suggested Interactivity (i. e., visual cues used as perceived affordances-SI), based on a survey of 382 HTML5 and visualization websites. Finally, we assess the effectiveness of three SI cues we designed for suggesting the interactivity of bar charts embedded with text. Our results show that only one cue (SI3) was successful in inciting participants to interact with the visualizations, and we hypothesize this is because this particular cue provided feedforward.
Mobilizing slit lamp to the field: A new affordable solution.
Farooqui, Javed Hussain; Jorgenson, Richard; Gomaa, Ahmed
We are describing a simple and affordable design to pack and carry the slit lamp to the field. Orbis staff working on the Flying Eye Hospital (FEH) developed this design to facilitate mobilization of the slit lamp to the field during various FEH programs. The solution involves using a big toolbox, a central plywood apparatus, and foam. These supplies were cut to measure and used to support the slit lamp after being fitted snuggly in the box. This design allows easy and safe mobilization of the slit lamp to remote places. It was developed with the efficient use of space in mind and it can be easily reproduced in developing countries using same or similar supplies. Mobilizing slit lamp will be of great help for staff and institutes doing regular outreach clinical work.
Multifunction protective relay
NASA Astrophysics Data System (ADS)
Harlow, J.; Yalla, M.; Kantor, J.
Since the enactment of the National Energy Act of 1979, many private energy producers have been planning and building small generation and cogeneration facilities in order to sell power to the local utility. Many of the non-utility generators built after 1979 are connected directly to the closest utility distribution circuit. Aware of the problems associated with connecting generators in this manner, electric utilities across the country developed specifications and standards to allow safe and reliable interconnection. The report describes a malfunction protective relay which uses state-of-the-art digital signal processing procedures to accomplish the objective of providing most of the relay requirements of utility electrical interconnections. The relay has been demonstrated to be suitable for this critical application through extensive laboratory and in-service field testing. The relay, incorporating thirteen distinct protection functions affords the user the savings of the initial capital cost plus simplicity of installation and use.
LNG: Clean affordable energy for power and town gas in Asia
Williams, M.F.; Grant, C.W.; King, N.
Some Asian countries such as Myanmar, Vietnam, and Indonesia are still at very low electricity consumption rates per capita, while others, such as Malaysia and Taiwan, are at much higher rates. What all Asian countries have in common is rapid growth in the demand for electricity. If the rising demand for additional electricity is not met, economic growth will be curtailed. However, all Asian countries face a major challenge in funding and constructing the required additional generating capacity fast enough to meet demand. Finding this amount of new capital is not going to be easy, and there will be much competition for scarce funds. The environmental challenge may be even greater than the financing hurdle. To date, most generation capacity in Asia has been coal based, and a significant amount of that is low technology and without flue gas desulfurization. The effect on the environment is already apparent. One argument has been that developing countries cannot afford the same standards of environmental performance as developed countries. With the levels of pollution that exist today, the question should be, can they afford not to? It has been estimated that pollution in China costs US$100 billion/a and that US$20 billion has to be spent over the next decade just to prevent worsening of pollution.
Respective capabilities of affordable Coronagraphs and Interferometers searching for Biosignatures
NASA Astrophysics Data System (ADS)
Leger, Alain M.
We describe an analytic model to estimate the capabilities of space missions dedicated to the search for biosignatures in the atmosphere of rocky planets located in the Habitable Zone of nearby stars. Relations between performance and parameters such as mirror diameter, distance to target, stellar properties, are obtained.Two types of instruments are considered: Coronagraphs observing in the visible, and Nulling Interferometers observing in the thermal infrared. Missions considered as affordable are single-pupil coronagraphs with a 2.4 m primary mirror, and formation flying interferometers with 4 x 0.75 m collecting mirrors with baselines ranging from a few decameters to a few hectometers.The numbers of accessible planets are calculated as a function of ηearth, the mean number of Earth analogues and super-Earths in stellar Habitable Zones.Based on current estimates, ηearth=10% around FGK stars and 20% around M stars, the built-in coronagraph and starshade could study only ~2.0 relevant planets, and the interferometer ~14. These numbers are obtained under the major assumption that the exozodiacal light around the target stars is not an issue for any of these instruments.For the coronagraphs, our estimates are in agreement with the values recently published by Stark et al. (2014), but these authors did not consider the case of interferometers.For the long-term future, building both types of spectroscopic instruments, and using them on the same targets, will be the optimal solution because they provide complementary information. But as a first affordable space mission, the interferometer looks the more promising in term of biosignature harvest.
Global cancer surgery: delivering safe, affordable, and timely cancer surgery.
Sullivan, Richard; Alatise, Olusegun Isaac; Anderson, Benjamin O; Audisio, Riccardo; Autier, Philippe; Aggarwal, Ajay; Balch, Charles; Brennan, Murray F; Dare, Anna; D'Cruz, Anil; Eggermont, Alexander M M; Fleming, Kenneth; Gueye, Serigne Magueye; Hagander, Lars; Herrera, Cristian A; Holmer, Hampus; Ilbawi, André M; Jarnheimer, Anton; Ji, Jia-Fu; Kingham, T Peter; Liberman, Jonathan; Leather, Andrew J M; Meara, John G; Mukhopadhyay, Swagoto; Murthy, Shilpa S; Omar, Sherif; Parham, Groesbeck P; Pramesh, C S; Riviello, Robert; Rodin, Danielle; Santini, Luiz; Shrikhande, Shailesh V; Shrime, Mark; Thomas, Robert; Tsunoda, Audrey T; van de Velde, Cornelis; Veronesi, Umberto; Vijaykumar, Dehannathparambil Kottarathil; Watters, David; Wang, Shan; Wu, Yi-Long; Zeiton, Moez; Purushotham, Arnie
Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.
Affordable Development and Qualification Strategy for Nuclear Thermal Propulsion
NASA Technical Reports Server (NTRS)
Gerrish, Harold P., Jr.; Doughty, Glen E.; Bhattacharyya, Samit K.
A number of recent assessments have confirmed the results of several earlier studies that Nuclear Thermal Propulsion (NTP) is a leading technology for human exploration of Mars. It is generally acknowledged that NTP provides the best prospects for the transportation of humans to Mars in the 2030's. Its high Isp coupled with the high thrusts achievable, allow reasonable trip times, thereby alleviating concerns about space radiation and "claustrophobia" effects. NASA has embarked on the latest phase of the development of NTP systems, and is adopting an affordable approach in response to the pressure of the times. The affordable strategy is built on maximizing the use of the large NTP technology base developed in the 1950's and 60's. The fact that the NTP engines were actually demonstrated to work as planned, is a great risk reduction feature in its development. The strategy utilizes non-nuclear testing to the fullest extent possible, and uses focused nuclear tests for the essential qualification and certification tests. The perceived cost risk of conducting the ground tests is being addressed by considering novel testing approaches. This includes the use of boreholes to contain radioactive effluents, and use of fuel with very high retention capability for fission products. The use of prototype flight tests is being considered as final steps in the development prior to undertaking human flight missions. In addition to the technical issues, plans are being prepared to address the institutional and political issues that need to be considered in this major venture. While the development and deployment of NTP system is not expected to be cheap, the value of the system will be very high, and amortized over the many missions that it enables and enhances, the imputed costs will be very reasonable. Using the approach outlined, NASA and its partners, currently the DOE, and subsequently industry, have a good chance of creating a sustained development program leading to human
Enabling Dedicated, Affordable Space Access Through Aggressive Technology Maturation
NASA Technical Reports Server (NTRS)
Jones, Jonathan; Kibbey, Tim; Lampton, Pat; Brown, Thomas
A recent explosion in nano-sat, small-sat, and university class payloads has been driven by low cost electronics and sensors, wide component availability, as well as low cost, miniature computational capability and open source code. Increasing numbers of these very small spacecraft are being launched as secondary payloads, dramatically decreasing costs, and allowing greater access to operations and experimentation using actual space flight systems. While manifesting as a secondary payload provides inexpensive rides to orbit, these arrangements also have certain limitations. Small, secondary payloads are typically included with very limited payload accommodations, supported on a non interference basis (to the prime payload), and are delivered to orbital conditions driven by the primary launch customer. Integration of propulsion systems or other hazardous capabilities will further complicate secondary launch arrangements, and accommodation requirements. The National Aeronautics and Space Administration's Marshall Space Flight Center has begun work on the development of small, low cost launch system concepts that could provide dedicated, affordable launch alternatives to small, risk tolerant university type payloads and spacecraft. These efforts include development of small propulsion systems and highly optimized structural efficiency, utilizing modern advanced manufacturing techniques. This paper outlines the plans and accomplishments of these efforts and investigates opportunities for truly revolutionary reductions in launch and operations costs. Both evolution of existing sounding rocket systems to orbital delivery, and the development of clean sheet, optimized small launch systems are addressed. A launch vehicle at the scale and price point which allows developers to take reasonable risks with new propulsion and avionics hardware solutions does not exist today. Establishing this service provides a ride through the proverbial "valley of death" that lies between
Burnout Stress Syndrome in Child Protection.
ERIC Educational Resources Information Center
Verstraete, Patricia A.
Burnout stress syndrome is a complex concept reflecting a failure in both the individual's defense mechanism and in the work environment. Since child protection agencies cannot afford the costs of staff burnout, time and money spent by the organization to reduce employee stress is an investment in better service delivery. (TJQ)
Metal- and Protection-Free [4 + 2] Cycloadditions of Alkynes with Azadienes: Assembly of Functionalized Quinolines.
Saunthwal, Rakesh K; Patel, Monika; Verma, Akhilesh K
A base promoted, protection-free, and regioselective synthesis of highly functionalized quinolines via [4 + 2] cycloaddition of azadienes (generated in situ from o-aminobenzyl alcohol) with internal alkynes has been discovered. The reaction tolerates a wide variety of functional groups which has been successfully extended with diynes, (2-aminopyridin-3-yl)methanol, and 1,4-bis(phenylethynyl)benzene to afford (Z)-phenyl-2-styrylquinolines, phenylnaphthyridine, and alkyne-substituted quinolines, respectively. The proposed mechanism and significant role of the solvent were well supported by isolating the azadiene intermediate and deuterium-labeling studies.
Knowledge and perceptions of the Affordable Care Act by uninsured patients at a free clinic.
Petrany, Stephen M; Christiansen, Matthew
The Affordable Care Act (ACA) has as one of its main objectives to reduce the number of uninsured Americans. The understanding of the ACA reforms by uninsured patients will likely influence the degree of success in achieving this objective. This study assessed the basic knowledge and opinions regarding the ACA of patients at a free clinic and the impact of a brief educational intervention on respondents' knowledge and opinions. One hundred uninsured adult patients completed a brief survey about the ACA before and after viewing a video outlining the major features of the act. The study cohort initially performed worse than national polls on all knowledge questions. Significant improvement was observed after the educational video. Our study suggests a need for educational efforts directed at those individuals most likely to benefit from the ACA. We demonstrated that a brief intervention during a routine office visit may improve knowledge of the ACA.
Implementing the Affordable Care Act: Revisiting the ACA's Essential Health Benefits Requirements.
Giovannelli, Justin; Lucia, Kevin W; Corlette, Sabrina
The Affordable Care Act broadens and strengthens the health insurance benefits available to consumers by requiring insurers to provide coverage of a minimum set of medical services known as "essential health benefits." Federal officials implemented this reform using transitional policies that left many important decisions to the states, while pledging to reassess that approach in time for the 2016 coverage year. This issue brief examines how states have exercised their options under the initial federal essential health benefits framework. We find significant variation in how states have developed their essential health benefits packages, including their approaches to benefit substitution and coverage of habilitative services. Federal regulators should use insurance company data describing enrollees' experiences with their coverage--information called for under the law's delayed transparency requirements--to determine whether states' differing strategies are producing the coverage improvements promised by reform.
The Health Insurance Gap After Implementation of the Affordable Care Act in Texas.
Gong, Gordon; Huey, Cassandra C; Johnson, Coleman; Curti, Debra; Philips, Billy U
Households with incomes between 18% and 99% of the federal poverty level (FPL) are ineligible for Medicaid or enrollment in the health insurance exchange marketplace in Texas, resulting in the health insurance gap. We sought to determine the number of non-elderly adult Texans (NEATs) aged between 18 and 64 years in the insurance gap in rural vs urban areas in East Texas, West Texas, and South Texas. Data were obtained from the US Census Bureau website. In 2014, there were 1,101,000 NEATs in the insurance gap, accounting for 24.5% of all uninsured persons in Texas. The gap was significantly higher in rural vs urban areas in East and South Texas and in Texas as a whole. Large coverage gaps in states like Texas not expanding Medicaid under the Affordable Care Act pose major hurdles to reducing the number of uninsured individuals in these states.
Health insurers' financial performance and quality improvement expenditures in the Affordable Care Act's second year.
McCue, Michael J; Hall, Mark
The Affordable Care Act requires health insurers to rebate any amounts less than 80%-85% of their premiums that they fail to spend on medical claims or quality improvement. This study uses the new comprehensive reporting under this law to examine changes in insurers' financial performance and differences in their quality improvement expenditures. In the ACA's second year (2012), insurers' median medical loss ratios continued to increase and their median administrative cost ratios dropped, producing moderate operating margins in the group markets but a small operating loss in the individual market, at the median. For-profit insurers showed larger changes, in general, than did nonprofits. For quality improvement, insurers reported spending a significantly greater amount per member in their government plans than they did on their self-insured members, with spending on commercial insurance being in between these two extremes. The magnitude and source of these differences varied by corporate ownership.
Wireless sensors linked to climate financing for globally affordable clean cooking
NASA Astrophysics Data System (ADS)
Ramanathan, Tara; Ramanathan, Nithya; Mohanty, Jeevan; Rehman, Ibrahim H.; Graham, Eric; Ramanathan, Veerabhadran
Three billion of the world's poorest people mostly rely on solid biomass for cooking, with major consequences to health and environment. We demonstrate the untapped potential of wireless sensors connected to the `internet of things' to make clean energy solutions affordable for those at the bottom of the energy pyramid. This breakthrough approach is demonstrated by a 17-month field study with 4,038 households in India. Major findings include: self-reported data on cooking duration have little correlation with actual usage data from sensors; sensor data revealed that the distribution of high and low users varied over time, and the actual mitigation of climate pollution was only 25% of the projected mitigation; climate credits were shown to significantly incentivize the use of cleaner technologies.
Skill transfer, affordances and dexterity in different climbing environments.
Seifert, L; Wattebled, L; L'hermette, M; Bideault, G; Herault, R; Davids, K
This study explored how skills in one region of a perceptual-motor landscape of performance, created in part by previous experience in rock climbing, can shape those that emerge in another region (ice climbing). Ten novices in rock climbing and five intermediate rock climbers were observed climbing an icefall. Locations of right and left ice tools and crampons were videotaped from a frontal camera. Inter-individual variability of upper and lower limb couplings and types of action regarding icefall properties were assessed by cluster hierarchical analysis, distinguishing three clusters. Pelvis vertical displacement, duration and number of pelvis pauses were also analyzed. Experienced rock climbers were grouped in the same cluster and showed the highest range and variability of limb angular locations and coordination patterns, the highest vertical displacement and the shortest pelvis plateaux durations. Non-fluent climbers (clusters 2 and 3) showed low range and variability of limb angular locations and coordination patterns. In particular, climbers of cluster 3 exhibited the lowest vertical displacement, the longest plateaux durations and the greatest ratio between tool swinging and definitive anchorage. Our results exemplified the positive influence of skills in rock climbing on ice climbing performance, facilitated by the detection of affordances from environmental properties.
Strategic options towards an affordable high-performance infrared camera
NASA Astrophysics Data System (ADS)
Oduor, Patrick; Mizuno, Genki; Dutta, Achyut K.; Lewis, Jay; Dhar, Nibir K.
The promise of infrared (IR) imaging attaining low-cost akin to CMOS sensors success has been hampered by the inability to achieve cost advantages that are necessary for crossover from military and industrial applications into the consumer and mass-scale commercial realm despite well documented advantages. Banpil Photonics is developing affordable IR cameras by adopting new strategies to speed-up the decline of the IR camera cost curve. We present a new short-wave IR (SWIR) camera; 640x512 pixel InGaAs uncooled system that is high sensitivity low noise (<50e-), high dynamic range (100 dB), high-frame rates (> 500 frames per second (FPS)) at full resolution, and low power consumption (< 1 W) in a compact system. This camera paves the way towards mass market adoption by not only demonstrating high-performance IR imaging capability value add demanded by military and industrial application, but also illuminates a path towards justifiable price points essential for consumer facing application industries such as automotive, medical, and security imaging adoption. Among the strategic options presented include new sensor manufacturing technologies that scale favorably towards automation, multi-focal plane array compatible readout electronics, and dense or ultra-small pixel pitch devices.
Small firm self-insurance under the Affordable Care Act.
Buettgens, Matthew; Blumberg, Linda J
The Affordable Care Act changes the small-group insurance market substantially beginning in 2014, but most changes do not apply to self-insured plans. This exemption provides an opening for small employers with healthier workers to avoid broader sharing of health care risk, isolating higher-cost groups in the fully insured market. Private stop-loss or reinsurance plans can mediate the risk of self-insurance for small employers, facilitating the decision to self-insure. We simulate small-employer coverage decisions under the law and find that low-risk stop-loss policies lead to higher premiums in the fully insured small-group market. Average single premiums would be up to 25 percent higher, if stop-loss insurance with no additional risk to employers than fully insuring is allowed--an option available in most states absent further government action. Regulation of stop-loss at the federal or state level can, however, prevent such adverse selection and increase stability in small-group insurance coverage.
Affordable Window Insulation with R-10/inch Rating
Jenifer Marchesi Redouane Begag; Je Kyun Lee; Danny Ou; Jong Ho Sonn; George Gould; Wendell Rhine
During the performance of contract DE-FC26-00-NT40998, entitled ''Affordable Window Insulation with R-10/inch Value'', research was conducted at Aspen Aerogels, Inc. to develop new transparent aerogel materials suitable for window insulation applications. The project requirements were to develop a formulation or multiple formulations that have high transparency (85-90%) in the visible region, are hydrophobic (will not opacify with exposure to water vapor or liquid), and have at least 2% resiliency (interpreted as recoverable 2% strain and better than 5% strain to failure in compression). Results from an unrelated project showed that silica aerogels covalently bonded to organic polymers exhibit excellent mechanical properties. At the outset of this project, we believed that such a route is the best to improve mechanical properties. We have applied Design of Experiment (DOE) techniques to optimize formulations including both silica aerogels and organically modified silica aerogels (''Ormosils''). We used these DOE results to optimize formulations around the local/global optimization points. This report documents that we succeeded in developing a number of formulations that meet all of the stated criteria. We successfully developed formulations utilizing a two-step approach where the first step involves acid catalyzed hydrolysis and the second step involves base catalyzed condensation to make the gels. The gels were dried using supercritical CO{sub 2} and we were able to make 1 foot x 1 foot x 0.5 inch panels that met the criteria established.
Practical and affordable ways to cultivate leadership in your organization.
Gaufin, Joyce R; Kennedy, Kathy I; Struthers, Ellen D
Leadership can be cultivated through the intentional actions of managers and others in public health organizations. This article provides a rationale for taking innovative and proactive steps to build leadership, discusses four general strategies for doing so, and presents seven practical, creative, and affordable actions that can have a positive influence on efforts to cultivate leadership qualities in the public health workforce. Each action is illustrated with an actual contemporary example from a local public health agency. The actions include providing formal or informal coaching/mentoring opportunities; assigning staff to lead new projects or collaborations, projects outside their disciplines, projects that cause growth in their information technology capacity, or orphan or struggling projects; facilitating a book club; and institutionalizing reflection. The best way to ensure that effective leadership is available when the organization needs it is to intentionally develop it through an ongoing process. Leadership growth can be supported during the ordinary course of business in a public health organization through thoughtful challenges, sharing ideas and experiences, and especially through the example set by managers and those in positions of authority.
Mission and Implementation of an Affordable Lunar Return
NASA Technical Reports Server (NTRS)
Spudis, Paul; Lavoie, Anthony
We present an architecture that establishes the infrastructure for routine space travel by taking advantage of the Moon's resources, proximity and accessibility. We use robotic assets on the Moon that are teleoperated from Earth to prospect, test, demonstrate and produce water from lunar resources before human arrival. This plan is affordable, flexible and not tied to any specific launch vehicle solution. Individual surface pieces are small, permitting them to be deployed separately on small launchers or combined together on single large launchers. Schedule is our free variable; even under highly constrained budgets, the architecture permits this program to be continuously pursued using small, incremental, cumulative steps. The end stage is a fully functional, human-tended lunar outpost capable of producing 150 metric tonnes of water per year enough to export water from the Moon and create a transportation system that allows routine access to all of cislunar space. This cost-effective lunar architecture advances technology and builds a sustainable transportation infrastructure. By eliminating the need to launch everything from the surface of the Earth, we fundamentally change the paradigm of spaceflight.
Innovating affordable neonatal care equipment for use at scale
Sashi Kumar, V; Paul, V K; Sathasivam, K
The care of small and sick neonates requires biomedical technologies, such as devices that can keep babies warm (radiant warmers and incubators), resuscitate (self-inflating bags), track growth (weighing scales), treat jaundice (phototherapy units) and provide oxygen or respiratory support (hoods, continuous positive airway pressure (CPAP) devices and ventilators). Until the 1990s, most of these products were procured through import at a high cost and with little maintenance support. Emerging demand and an informal collaboration of neonatologists, engineers and entrepreneurs has led to the production of good quality equipment of several high-volume categories at affordable cost in India. Radiant warmers, resuscitation bags, phototherapy units, weighing scales and other devices manufactured by Indian small-scale companies have enabled an expansion of neonatal care in the country, particularly in district hospitals, medical college hospitals and subdistrict facilities in the public sector as a part of the National Rural Health Mission. Indian products have acquired international quality standards and are even exported to developed nations. This paper captures this story of innovation and entrepreneurship in neonatal care. PMID:27924105
An Object Oriented Extensible Architecture for Affordable Aerospace Propulsion Systems
NASA Technical Reports Server (NTRS)
Follen, Gregory J.; Lytle, John K. (Technical Monitor)
Driven by a need to explore and develop propulsion systems that exceeded current computing capabilities, NASA Glenn embarked on a novel strategy leading to the development of an architecture that enables propulsion simulations never thought possible before. Full engine 3 Dimensional Computational Fluid Dynamic propulsion system simulations were deemed impossible due to the impracticality of the hardware and software computing systems required. However, with a software paradigm shift and an embracing of parallel and distributed processing, an architecture was designed to meet the needs of future propulsion system modeling. The author suggests that the architecture designed at the NASA Glenn Research Center for propulsion system modeling has potential for impacting the direction of development of affordable weapons systems currently under consideration by the Applied Vehicle Technology Panel (AVT). This paper discusses the salient features of the NPSS Architecture including its interface layer, object layer, implementation for accessing legacy codes, numerical zooming infrastructure and its computing layer. The computing layer focuses on the use and deployment of these propulsion simulations on parallel and distributed computing platforms which has been the focus of NASA Ames. Additional features of the object oriented architecture that support MultiDisciplinary (MD) Coupling, computer aided design (CAD) access and MD coupling objects will be discussed. Included will be a discussion of the successes, challenges and benefits of implementing this architecture.
Cosmetic dentistry for patients who can't afford it.
Kurthy, R
As I noted earlier, all things being equal, patients prefer tooth-colored restorations. This technique has removed virtually all the barriers to treatment and makes things a lot more equal. There's the cost factor (Dramatically reduced!) There's the fear-of-needle factor (Gone!) There's the time factor (Minimized!). In fact, prepping and placing these occlusal veneers is so fast I can now do 8 to 10 amalgam rehabs in one appointment. Doing so many in a short time is extremely profitable, even at the reduced fee. This technique certainly does not qualify as "great dentistry," but it brings "desire-motivated" cosmetic dentistry to an entirely new universe and those patients are appreciative. They're even referring their friends! In my practice, veneering amalgam has brought cosmetic dentistry to many patients who would never agree to have their restorations replaced with traditional composite resin. And it has brought me several additional thousand dollars in collections each month. So this is a classic "win-win" situation. Patients are getting cosmetic restorations they didn't think they could afford, and I'm making a great profit doing it.
Data mining of space heating system performance in affordable housing
Ren, Xiaoxin; Yan, Da; Hong, Tianzhen
The space heating in residential buildings accounts for a considerable amount of the primary energy use. Therefore, understanding the operation and performance of space heating systems becomes crucial in improving occupant comfort while reducing energy use. This study investigated the behavior of occupants adjusting their thermostat settings and heating system operations in a 62-unit affordable housing complex in Revere, Massachusetts, USA. The data mining methods, including clustering approach and decision trees, were used to ascertain occupant behavior patterns. Data tabulating ON/OFF space heating states was assessed, to provide a better understanding of the intermittent operation of space heating systems in terms of system cycling frequency and the duration of each operation. The decision tree was used to verify the link between room temperature settings, house and heating system characteristics and the heating energy use. The results suggest that the majority of apartments show fairly constant room temperature profiles with limited variations during a day or between weekday and weekend. Data clustering results revealed six typical patterns of room temperature profiles during the heating season. Space heating systems cycled more frequently than anticipated due to a tight range of room thermostat settings and potentially oversized heating capacities. In conclusion, from this study affirm data mining techniques are an effective method to analyze large datasets and extract hidden patterns to inform design and improve operations.
Data mining of space heating system performance in affordable housing
Ren, Xiaoxin; Yan, Da; Hong, Tianzhen
The space heating in residential buildings accounts for a considerable amount of the primary energy use. Therefore, understanding the operation and performance of space heating systems becomes crucial in improving occupant comfort while reducing energy use. This study investigated the behavior of occupants adjusting their thermostat settings and heating system operations in a 62-unit affordable housing complex in Revere, Massachusetts, USA. The data mining methods, including clustering approach and decision trees, were used to ascertain occupant behavior patterns. Data tabulating ON/OFF space heating states was assessed, to provide a better understanding of the intermittent operation of space heating systems inmore » terms of system cycling frequency and the duration of each operation. The decision tree was used to verify the link between room temperature settings, house and heating system characteristics and the heating energy use. The results suggest that the majority of apartments show fairly constant room temperature profiles with limited variations during a day or between weekday and weekend. Data clustering results revealed six typical patterns of room temperature profiles during the heating season. Space heating systems cycled more frequently than anticipated due to a tight range of room thermostat settings and potentially oversized heating capacities. In conclusion, from this study affirm data mining techniques are an effective method to analyze large datasets and extract hidden patterns to inform design and improve operations.« less
Delivery of affordable and equitable cancer care in India.
Pramesh, C S; Badwe, Rajendra A; Borthakur, Bibhuti B; Chandra, Madhu; Raj, Elluswami Hemanth; Kannan, T; Kalwar, Ashok; Kapoor, Sanjay; Malhotra, Hemant; Nayak, Sukdev; Rath, Goura K; Sagar, T G; Sebastian, Paul; Sarin, Rajiv; Shanta, V; Sharma, Suresh C; Shukla, Shilin; Vijayakumar, Manavalan; Vijaykumar, D K; Aggarwal, Ajay; Purushotham, Arnie; Sullivan, Richard
The delivery of affordable and equitable cancer care is one of India's greatest public health challenges. Public expenditure on cancer in India remains below US$10 per person (compared with more than US$100 per person in high-income countries), and overall public expenditure on health care is still only slightly above 1% of gross domestic product. Out-of-pocket payments, which account for more than three-quarters of cancer expenditures in India, are one of the greatest threats to patients and families, and a cancer diagnosis is increasingly responsible for catastrophic expenditures that negatively affect not only the patient but also the welfare and education of several generations of their family. We explore the complex nature of cancer care systems across India, from state to government levels, and address the crucial issues of infrastructure, manpower shortages, and the pressing need to develop cross-state solutions to prevention and early detection of cancer, in addition to governance of the largely unregulated private sector and the cost of new technologies and drugs. We discuss the role of public insurance schemes, the need to develop new political mandates and authority to set priorities, the necessity to greatly improve the quality of care, and the drive to understand and deliver cost-effective cancer care programmes.
The Future of the Affordable Care Act and Insurance Coverage
Jackson, Adlan
We describe the patterns of coverage gains associated with the Affordable Care Act (ACA) expansions and use these patterns to assess the potential impact of alternative repeal or repeal and replace strategies because Congress and the president are weighing options to repeal or replace the ACA. We find that specific provisions of the ACA, including the Medicaid expansion and the structure of premium subsidies, have been associated with large and robust gains in insurance coverage. We evaluate the impact of retaining dependent coverage and high-risk pool provisions and show, on the basis of the ACA experience, that these provisions would have little effect on coverage. We find that many replacement proposal components, including flat tax credits and maintaining cost savings provisions, could jeopardize the ability of many of the ACA's primary beneficiaries, as well as other Americans, to access coverage and care. By leading to a deterioration of the safety net, these strategies could also imperil population health activities. PMID:28207344
Developing affordable multi-touch technologies for use in physics
NASA Astrophysics Data System (ADS)
Potter, Mark; Ilie, Carolina; Schofield, Damian; Vampola, David
Physics is one of many areas which has the ability to benefit from a number of different teaching styles and sophisticated instructional tools due to it having both theoretical and practical applications which can be explored. The purpose of this research is to develop affordable large scale multi-touch interfaces which can be used within and outside of the classroom as both an instruction technology and a computer supported collaborative learning tool. Not only can this technology be implemented at university levels, but also at the K-12 level of education. Pedagogical research indicates that kinesthetic learning is a fundamental, powerful, and ubiquitous learning style [1]. Through the use of these types of multi-touch tools and teaching methods which incorporate them, the classroom can be enriched to allow for better comprehension and retention of information. This is due in part to a wider range of learning styles, such as kinesthetic learning, which are being catered to within the classroom. [4pt] [1] Wieman, C.E, Perkins, K.K., Adams, W.K., ``Oersted Medal Lecture 2007: Interactive Simulations for teaching physics: What works, what doesn't and why,'' American Journal of Physics. 76 393-99.
Can you afford to do an environmental audit? Update 1997
McLeod, D.P.; Marty, K.F.
For the fourth straight year this paper provides an updated summary of recent state and federal legislative efforts to protect the confidentiality of voluntary environmental compliance audit results. This paper summarizes the state audit privilege statutes, EPA`s final audit policy statement, and the common-law privileges that may protect compliance audit results from discovery by regulatory agencies and private party plaintiffs. This paper also focuses on the following specific issues: is confidentiality consistent with ISO 14001; do the state audit privilege statutes provide protection from disclosure of the results of multi-facility audits involving facilities in different states; how have EPA and the courts viewed claims of privilege for the results of environmental audits?
40 CFR 1508.27 - Significantly.
Code of Federal Regulations, 2010 CFR
... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Significantly. 1508.27 Section 1508.27 Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY TERMINOLOGY AND INDEX § 1508.27 Significantly. Significantly as used in NEPA requires considerations of both context and intensity: (a) Context. This...
Radiation protectants: current status and future prospects.
Seed, Thomas M
In today's heightened nuclear/biological/chemical threat environment, there is an increased need to have safe and effective means to protect not only special high-risk service groups, but also the general population at large, from the health hazards of unintended ionizing radiation exposures. An unfulfilled dream has been to have a globally effective pharmacologic that could be easily taken orally without any undue side effects prior to a suspected or impending nuclear/radiological event; such an ideal radioprotective agent has yet to be identified, let alone fully developed and approved for human use. No one would argue against the fact that this is problematic and needs to be corrected, but where might the ultimate solution to this difficult problem be found? Without question, representative species of the aminothiol family [e.g., Amifostine (MedImmune, Gaithersburg, Maryland)] have proven to be potent cytoprotectants for normal tissues subjected to irradiation or to radiomimetic chemicals. Although Amifostine is currently used clinically, drug toxicity, limited times of protection, and unfavorable routes of administration, all serve to limit the drug's utility in nonclinical settings. A full range of research and development strategies is being employed currently in the hunt for new safe and effective radioprotectants. These include: (1) large scale screening of new chemical classes or natural products; (2) restructuring/reformulating older protectants with proven efficacies but unwanted toxicities; (3) using nutraceuticals that are only moderately protective but are essentially nontoxic; (4) using low dose combinations of potentially toxic but efficacious agents that protect through different routes to foster radioprotective synergy; and (5) accepting a lower level of drug efficacy in lieu of reduced toxicity, banking on the premise that the protection afforded can be leveraged by post-exposure therapies. Although it is difficult to predict which of these
A comparison of small, affordable seismic sources at the Ketzin CO2 storage site, Germany
NASA Astrophysics Data System (ADS)
Sopher, Daniel; Juhlin, Christopher; Huang, Fei; Ivandic, Monika; Lueth, Stefan
Seismic methods have proven to be effective for monitoring the movement and location of injected CO2 within deep saline aquifers. However, a disadvantage of seismic monitoring is the high costs associated with many repeat seismic surveys as part of a long term monitoring strategy of a CO2 storage site. As the cost for the use of the seismic source is often a significant part of the overall survey cost, affordable, smaller sources would increase the potential feasibility of a long term seismic monitoring strategy. A comparison of three land seismic sources is performed at the Ketzin CO2 storage site, Germany. Two of these sources (Vibsist 500 and Bobcat drop hammer) can be considered to be smaller and more affordable sources than those conventionally used in the seismic monitor surveys at Ketzin. In this study these smaller sources are compared to a larger more conventional Vibsist 3000 source. The subsurface target for the three sources in this comparison is the CO2 storage reservoir for the Ketzin site, located within the Triassic Stuttgart formation, which lies at a depth of approximately 600m/500ms. Two of the sources are Swept Impact (SIST) type courses (Vibsist 500 and 3000) which use hydraulic concrete breaking hammers. The third source uses a concrete breaking drop hammer tool mounted on a Bobcat loader. Data were collected along a 984m long profile with 24m receiver spacing and 12m shot spacing in 2011, 2012 and 2013 using the three different sources. A quantitative and qualitative comparison of the raw data from the three sources was performed in order to assess their relative performance. Frequency content, signal to noise ratio and penetration depth curves were calculated for the raw data. Data from the three sources was also processed using a conventional workflow to produce stacked sections which were compared. Based on the results from this study the Bobcat drop hammer source appears to perform better than the Vibsist 500 source. However both of the
Insurers' policies on coverage for behavior management services and the impact of the Affordable Care Act.
Edelstein, Burton L
The impact of the Affordable Care Act (ACA) on dental insurance coverage for behavior management services depends upon the child's source of insurance (Medicaid, CHIP, private commercial) and the policies that govern each such source. This contribution describes historical and projected sources of pediatric dental coverage, catalogues the seven behavior codes used by dentists, compares how often they are billed by pediatric and general dentists, assesses payment policies and practices for behavioral services across coverage sources, and describes how ACA coverage policies may impact each source. Differences between Congressional intent to ensure comprehensive oral health services with meaningful consumer protections for all legal-resident children and regulatory action by the Departments of Treasury and Health and Human Services are explored to explain how regulations fail to meet Congressional intent as of 2014. The ACA may additionally impact pediatric dentistry practice, including dentists' behavior management services, by expanding pediatric dental training and safety net delivery sites and by stimulating the evolution of novel payment and delivery systems designed to move provider incentives away from procedure-based payments and toward health outcome-based payments.
Implementing the Affordable Care Act in North Carolina: the rubber hits the road.
Silberman, Pam
The health insurance mandate, perhaps the best-known provision of the Patient Protection and Affordable Care Act of 2010 (ACA), is slated to go into effect on January 1, 2014. Yet most people do not know how the ACA will affect them. More than one-third of people in a recent national poll were unaware that new health insurance marketplaces will make it easier to purchase coverage or that some people will qualify for subsidies to help them purchase coverage. The ACA includes many other provisions that will have a profound impact on our health care delivery system. Some changes are already helping to break down silos in the delivery of care. Groups of health care professionals are working together to manage the health of populations. The ACA places a much greater emphasis on measuring quality and on paying health professionals and health care institutions based on the value of the services they provide. In addition, the ACA makes greater investments in prevention and in population health management. This issue brief highlights some of the health system changes that have taken place over the past 3 years, as well as some of the potential changes that are yet to come relating to insurance coverage, access to care, quality of care, rising health care costs, and overall population health.
Health outcomes and related effects of using social media in chronic disease management: a literature review and analysis of affordances.
Merolli, Mark; Gray, Kathleen; Martin-Sanchez, Fernando
Whilst the future for social media in chronic disease management appears to be optimistic, there is limited concrete evidence indicating whether and how social media use significantly improves patient outcomes. This review examines the health outcomes and related effects of using social media, while also exploring the unique affordances underpinning these effects. Few studies have investigated social media's potential in chronic disease, but those we found indicate impact on health status and other effects are positive, with none indicating adverse events. Benefits have been reported for psychosocial management via the ability to foster support and share information; however, there is less evidence of benefits for physical condition management. We found that studies covered a very limited range of social media platforms and that there is an ongoing propensity towards reporting investigations of earlier social platforms, such as online support groups (OSG), discussion forums and message boards. Finally, it is hypothesized that for social media to form a more meaningful part of effective chronic disease management, interventions need to be tailored to the individualized needs of sufferers. The particular affordances of social media that appear salient in this regard from analysis of the literature include: identity, flexibility, structure, narration and adaptation. This review suggests further research of high methodological quality is required to investigate the affordances of social media and how these can best serve chronic disease sufferers. Evidence-based practice (EBP) using social media may then be considered.
Some perspectives on affordable healthcare systems in China.
Zhang, Y T; Yan, Y S; Poon, C C Y
Consistent with the global population trend, China is becoming an aging society. Over one-fifth of the world's elderly population (aged 65 and over) lives in China. Statistics show that the elderly populace in China constitutes 8% of the total population in 2006 and the percentage will be tripled to become 24% in 2050. As a result, there is inevitably an increase in the prevalence of chronic disease that accounted for almost 80% of all deaths in China in 2005. On the other hand, from 1978 to 2003, the total expenditure on healthcare in China increased from 11.02 billion RMB up to 658.41 billion RMB, and in terms of GDP, it is an increase from 3.04% to 5.62%. The annual average increase (12.1%) in healthcare investment is therefore even higher than the annual rate of GDP increase (9.38%) during the last two decades. Meeting the long-term healthcare needs of this growing elderly population and escalating healthcare expenditure pose a grim challenge to the current Chinese healthcare system and the solvency of state budgets. In fact, the healthcare services in China have become less accessible since the early 1980s when its costs soared up. The rising costs have prevented many Chinese people from seeking early medical care. The phenomenon has created a wide disparity in seeking healthcare between urban and rural areas. These trends are of particular concern to the elderly, who have higher healthcare needs yet lesser means to afford the services. Furthermore, according to the 3rd National Health Service Survey, 79.1% of rural residents and 44.8% of urban citizens did not have any form of medical insurance. Such a low percentage of coverage of medical insurance indicates that many people may not be able to afford medical services when they suffer from severe diseases. Therefore, there is a great need of a more effective and low-cost healthcare system. A new system that can allow multi-level, multi-dimensional and standardized healthcare services for urban and rural
Scientific experimentation afforded by the International Asteroid Mission
NASA Astrophysics Data System (ADS)
The International Asteroid Mission (IAM) affords scientists the opportunity to perform interesting and important experimentations. This opportunity is not sufficient in its own right to mandate inclusion of science into the mission. Certain scientific experimentations are essential to the success of the mission, and are the driving force behind the inclusion of science. Instrument designs incorporate the need for direct contribution to the success of the mining mission. Examples of these applications include the search for additional candidate asteroids, especially at the Earth-Sun Trojan points, with an infrared telescope facility; a gamma ray burst detector provides the crew with real-time notification of potentially harmful solar-flare activity; and a materials processing laboratory provides information on the porosity, composition, and crystalline structure of samples to optimize the mining operations in addition to yielding great insight into the history and formation of the solar-system. Instrument designs have emphasized the use of off-the-shelf hardware, demonstrated technologies. Their scientific value is derived from the location on an interplanetary platform, not necessarily advancements in technology or detection methods. Instrumentation will be delivered to the IAM project after completion of a thorough certification program. The program will include qualification, acceptance, performance, thermal balance, thermal vacuum, vibration, electromagnetic susceptibility and compatibility, and calibration testing. After delivery to the assembly-site in low-Earth orbit, an additional series of functional and compatibility tests will be required prior to initiation of the mission. The scientific instrumentation proposed for the IAM consists of experiments using a Gamma Ray Burst Detector, a Infrared Observatory, a Materials Processing Facility, Long-Wavelength Radar, Seismic Measurement Devices, Cosmic Ray Detectors, Interplanetary Plasma Measurements, a Solar
Affordable and personalized lighting using inverse modeling and virtual sensors
NASA Astrophysics Data System (ADS)
Basu, Chandrayee; Chen, Benjamin; Richards, Jacob; Dhinakaran, Aparna; Agogino, Alice; Martin, Rodney
Wireless sensor networks (WSN) have great potential to enable personalized intelligent lighting systems while reducing building energy use by 50%-70%. As a result WSN systems are being increasingly integrated in state-ofart intelligent lighting systems. In the future these systems will enable participation of lighting loads as ancillary services. However, such systems can be expensive to install and lack the plug-and-play quality necessary for user-friendly commissioning. In this paper we present an integrated system of wireless sensor platforms and modeling software to enable affordable and user-friendly intelligent lighting. It requires ⇠ 60% fewer sensor deployments compared to current commercial systems. Reduction in sensor deployments has been achieved by optimally replacing the actual photo-sensors with real-time discrete predictive inverse models. Spatially sparse and clustered sub-hourly photo-sensor data captured by the WSN platforms are used to develop and validate a piece-wise linear regression of indoor light distribution. This deterministic data-driven model accounts for sky conditions and solar position. The optimal placement of photo-sensors is performed iteratively to achieve the best predictability of the light field desired for indoor lighting control. Using two weeks of daylight and artificial light training data acquired at the Sustainability Base at NASA Ames, the model was able to predict the light level at seven monitored workstations with 80%-95% accuracy. We estimate that 10% adoption of this intelligent wireless sensor system in commercial buildings could save 0.2-0.25 quads BTU of energy nationwide.
Affordable Care Act risk adjustment: overview, context, and challenges.
Kautter, John; Pope, Gregory C; Keenan, Patricia
Beginning in 2014, individuals and small businesses will be able to purchase private health insurance through competitive marketplaces. The Affordable Care Act (ACA) provides for a program of risk adjustment in the individual and small group markets in 2014 as Marketplaces are implemented and new market reforms take effect. The purpose of risk adjustment is to lessen or eliminate the influence of risk selection on the premiums that plans charge and the incentive for plans to avoid sicker enrollees. This article--the first of three in the Medicare & Medicaid Research Review--describes the key program goal and issues in the Department of Health and Human Services (HHS) developed risk adjustment methodology, and identifies key choices in how the methodology responds to these issues. The goal of the HHS risk adjustment methodology is to compensate health insurance plans for differences in enrollee health mix so that plan premiums reflect differences in scope of coverage and other plan factors, but not differences in health status. The methodology includes a risk adjustment model and a risk transfer formula that together address this program goal as well as three issues specific to ACA risk adjustment: 1) new population; 2) cost and rating factors; and 3) balanced transfers within state/market. The risk adjustment model, described in the second article, estimates differences in health risks taking into account the new population and scope of coverage (actuarial value level). The transfer formula, described in the third article, calculates balanced transfers that are intended to account for health risk differences while preserving permissible premium differences.
On Medicaid and the Affordable Care Act in Connecticut
Manthous, Constantine A.; Sofair, Andre N.
Background: Medicaid is the federal program, administered by states, for health care for the poor. The Affordable Care Act (ACA) has added a large number of new recipients to this program. Hypothesis: Medicaid programs in some, if not many, states do not provide patients uniform access to subspecialty care guaranteed by the federal statutes. Insofar as the ACA does not address this pre-existing "sub-specialty gap" and more patients are now covered by Medicaid under the ACA, the gap is likely to increase and may contribute to disparities of health care access and outcomes. Methods: A brief description of previous studies demonstrating or suggesting a subspecialty gap in Medicaid services is accompanied by perspectives of the authors, using published literature — most notably the Denver, Colorado health care system — to propose various solutions that may be deployed to address gaps in subspecialty coverage. Results: All published studies describing the Medicaid subspecialty gap are qualitative, survey designs. There are no authoritative objective data regarding the exact prevalence of gaps for each subspecialty in each state. However, surveys of caregivers suggest that gaps were prevalent in the United States prior to initiation of the ACA. Even fewer papers have addressed solutions (in light of the paucity of data describing the magnitude of the problem), and proposed solutions remain speculative and not grounded in objective data. Conclusions: There is reason to believe that a substantial proportion of U.S. citizens — those who are guaranteed a full complement of health services through Medicaid — have difficult or no access to some subspecialty services, many of which other citizens take for granted. This problem deserves greater attention to verify its existence, quantify its magnitude, and develop solutions. PMID:25506291
Group 3 late embryogenesis abundant proteins from embryos of Artemia franciscana: structural properties and protective abilities during desiccation.
Boswell, Leaf C; Menze, Michael A; Hand, Steven C
Group 3 late embryogenesis abundant (LEA) proteins are highly hydrophilic, and their expression is associated with desiccation tolerance in both plants and animals. Here we show that two LEA proteins from embryos of Artemia franciscana, AfrLEA2 and AfrLEA3m, are intrinsically disordered in solution but upon desiccation gain secondary structure, as measured by circular dichroism. Trifluoroethanol and sodium dodecyl sulfate are both shown to induce α-helical structure in AfrLEA2 and AfrLEA3m. Bioinformatic predictions of secondary-structure content for both proteins correspond most closely to conformations measured in the dry state. Because some LEA proteins afford protection to desiccation-sensitive proteins during drying and subsequent rehydration, we tested for this capacity in AfrLEA2 and AfrLEA3m. The protective capacities vary, depending on the target enzyme. For the cytoplasmic enzyme lactate dehydrogenase, neither AfrLEA2 nor AfrLEA3m, with or without trehalose present, was able to afford protection better than that provided by bovine serum albumin (BSA) under the same conditions. However, for another cytoplasmic enzyme, phosphofructokinase, both AfrLEA2 and AfrLEA3m in the presence of trehalose were able to afford protection far greater than that provided by BSA with trehalose. Finally, for the mitochondrial enzyme citrate synthase, 400-μg/mL AfrLEA3m without trehalose provided significantly more protection than the same concentration of either AfrLEA2 or BSA.
Identifying perceived barriers and benefits to reducing energy consumption in an affordable housing complex using the Community-Based Social Marketing model
NASA Astrophysics Data System (ADS)
Reaves, Daniel
Energy production and consumption has a negative impact on both environmental and human health. Energy consumption can be directly impacted by human behavior, especially in the residential sector. As a result, this sector has been studied significantly; however, energy reducing behavior change research focusing on the affordable housing sector has not been studied thoroughly to date. This study seeks to implement the first two phases of the Community Based Social Marketing (CBSM) framework in an affordable housing setting. The goals were to identify the optimal behaviors for energy reduction based on phase one survey results and to identify the perceived benefits and barriers associated with those behaviors. Additionally, this study identified nuances in the CBSM process that researchers should take into consideration when implementing CBSM in an affordable housing environment.
77 FR 36272 - SunShot Prize: America's Most Affordable Rooftop
Federal Register 2010, 2011, 2012, 2013, 2014
... Affordable Rooftop rules at eere.energy.gov/solar/sunshot/prize.html . DATES: DOE will accept comments... ``America's Most Affordable Rooftop'' in the Subject line Mail: U.S. Department of Energy, Office of Solar....S. Department of Energy, Solar Program, 1000 Independence Avenue SW., Washington, DC 20585....
Affordability of Private Schools: Exploration of a Conundrum and towards a Definition of "Low-Cost"
ERIC Educational Resources Information Center
Tooley, James; Longfield, David
The affordability of private education is a contentious issue. While the extent of "low-cost" private schooling is widely accepted, there is no agreement on what "low-cost" means in this context and how this relates to affordability for poor families. This paper addresses the lacuna in the literature by defining…
Quality or Affordability: Trade-Offs for Early Childhood Programs? ERIC Digest.
ERIC Educational Resources Information Center
Willer, Barbara
The demand for child care services in the United States continues to grow, stretching the levels of program quality to the limit. In fact, the country is facing a crisis in child care. Affordable child care continues to be a major issue for many families. Solutions to the current crisis in child care must, in addition to insuring affordability,…
Using task dynamics to quantify the affordances of throwing for long distance and accuracy.
Wilson, Andrew D; Weightman, Andrew; Bingham, Geoffrey P; Zhu, Qin
In 2 experiments, the current study explored how affordances structure throwing for long distance and accuracy. In Experiment 1, 10 expert throwers (from baseball, softball, and cricket) threw regulation tennis balls to hit a vertically oriented 4 ft × 4 ft target placed at each of 9 locations (3 distances × 3 heights). We measured their release parameters (angle, speed, and height) and showed that they scaled their throws in response to changes in the target's location. We then simulated the projectile motion of the ball and identified a continuous subspace of release parameters that produce hits to each target location. Each subspace describes the affordance of our target to be hit by a tennis ball moving in a projectile motion to the relevant location. The simulated affordance spaces showed how the release parameter combinations required for hits changed with changes in the target location. The experts tracked these changes in their performance and were successful in hitting the targets. We next tested unusual (horizontal) targets that generated correspondingly different affordance subspaces to determine whether the experts would track the affordance to generate successful hits. Do the experts perceive the affordance? They do. In Experiment 2, 5 cricketers threw to hit either vertically or horizontally oriented targets and successfully hit both, exhibiting release parameters located within the requisite affordance subspaces. We advocate a task dynamical approach to the study of affordances as properties of objects and events in the context of tasks as the future of research in this area. (PsycINFO Database Record
An Exploratory Study of Emotional Affordance of a Massive Open Online Course
ERIC Educational Resources Information Center
Cheng, Jeremy C. Y.
This exploratory study examines emotional affordance of a massive open online course (MOOC). Postings in a discussion forum of a MOOC in computer science are analysed following a research design informed by virtual ethnography. Emotional affordance is investigated, focusing on non-achievement emotions which are not directly linked to achievement…
78 FR 41074 - 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing Design Student...
Federal Register 2010, 2011, 2012, 2013, 2014
... URBAN DEVELOPMENT 60-Day Notice of Proposed Information Collection: Innovation in Affordable Housing...: Innovation in Affordable Housing Design Student Competition. OMB Approval Number: N/A. Type of Request: New. Form Number: N/A. Description of the need for the information and proposed use: The Innovation...
The Affordability of University Education: A Perspective from Both Sides of the 49th Parallel
ERIC Educational Resources Information Center
Swail, Watson Scott
This study was conducted to better understand the relative affordability of public university education in Canada and the United States. The report was written to answer two key questions: (1) How does access to university education in Canada compare to access in the US? and (2) How affordable is the Canadian university system compared to the…
Educational Affordances of a Ubiquitous Learning Environment in a Natural Science Course
ERIC Educational Resources Information Center
Tan, Tan-Hsu; Lin, Min-Sheng; Chu, Yu-Ling; Liu, Tsung-Yu
Educational affordances are worthy of being explored because the affordances of Information and Communication Technologies (ICT) provide the pedagogical effects for promoting cognitive acceleration, increasing the self-management of students, facilitating data collection, and presentation in science learning. This study aims to explore educational…
Ecological Affordance and Anxiety in an Oral Asynchronous Computer-Mediated Environment
ERIC Educational Resources Information Center
McNeil, Levi
Previous research suggests that the affordances (van Lier, 2000) of asynchronous computer-mediated communication (ACMC) environments help reduce foreign language anxiety (FLA). However, FLA is rarely the focus of these studies and research has not adequately addressed the relationship between FLA and the affordances that students use. This study…
76 FR 20352 - Notice of Intent To Award Affordable Care Act (ACA) Funding
Federal Register 2010, 2011, 2012, 2013, 2014
... HUMAN SERVICES Centers for Disease Control and Prevention Notice of Intent To Award Affordable Care Act (ACA) Funding Notice of Intent to award Affordable Care Act (ACA) funding to two Emerging Infections... Care Act (ACA) appropriations to the Connecticut Department of Public Health and the Georgia...
Educational Affordances of PDAs: A Study of a Teacher's Exploration of This Technology
ERIC Educational Resources Information Center
Churchill, Daniel; Churchill, Natalia
This paper reports on a case study of a teacher from a technical education institution who explored the educational affordances of PDA technology over a period of six months. Based on this teacher's perspectives, the study was designed to inform our own understanding of educational affordances of this new and emerging technology. Understanding of…
Confined Metastable 2-Line Ferrihydrite for Affordable Point-of-Use Arsenic-Free Drinking Water.
Kumar, Avula Anil; Som, Anirban; Longo, Paolo; Sudhakar, Chennu; Bhuin, Radha Gobinda; Gupta, Soujit Sen; Anshup; Sankar, Mohan Udhaya; Chaudhary, Amrita; Kumar, Ramesh; Pradeep, Thalappil
Arsenic-free drinking water, independent of electrical power and piped water supply, is possible only through advanced and affordable materials with large uptake capacities. Confined metastable 2-line ferrihydrite, stable at ambient temperature, shows continuous arsenic uptake in the presence of other complex species in natural drinking water and an affordable water-purification device is made using the same.
Obstacles and Affordances for Integer Reasoning: An Analysis of Children's Thinking and the History of Mathematics
ERIC Educational Resources Information Center
Bishop, Jessica Pierson; Lamb, Lisa L.; Philipp, Randolph A.; Whitacre, Ian; Schappelle, Bonnie P.; Lewis, Melinda L.
We identify and document 3 cognitive obstacles, 3 cognitive affordances, and 1 type of integer understanding that can function as either an obstacle or affordance for learners while they extend their numeric domains from whole numbers to include negative integers. In particular, we highlight 2 key subsets of integer reasoning: understanding or…
24 CFR 81.19 - Affordability-Rent level definitions-tenant income is not known.
Code of Federal Regulations, 2010 CFR
... determining whether a rental unit is affordable to very-low-, low-, or moderate-income families where the income of the family in the dwelling unit is not known to the GSE, the affordability of the unit is... housing for moderate-income families shall not exceed the following percentages of area median income...
12 CFR 1282.19 - Affordability-Rent level definitions-tenant income is not known.
Code of Federal Regulations, 2010 CFR
... very low-, low-, or moderate-income families where the income of the family in the dwelling unit is not...) For moderate-income, maximum affordable rents to count as housing for moderate-income families shall... affordable rents to count as housing for low-income families shall not exceed the following percentages...
The Object-Based Simon Effect: Grasping Affordance or Relative Location of the Graspable Part?
ERIC Educational Resources Information Center
Cho, Dongbin; Proctor, Robert W.
Reaction time is often shorter when the irrelevant graspable handle of an object corresponds with the location of a keypress response to the relevant attribute than when it does not. This object-based Simon effect has been attributed to an affordance for grasping the handle with the hand to the same side. Because a grasping affordance should…
Navigating the Affordance Landscape: Feedback Control as a Process Model of Behavior and Cognition.
Pezzulo, Giovanni; Cisek, Paul
We discuss how cybernetic principles of feedback control, used to explain sensorimotor behavior, can be extended to provide a foundation for understanding cognition. In particular, we describe behavior as parallel processes of competition and selection among potential action opportunities ('affordances') expressed at multiple levels of abstraction. Adaptive selection among currently available affordances is biased not only by predictions of their immediate outcomes and payoffs but also by predictions of what new affordances they will make available. This allows animals to purposively create new affordances that they can later exploit to achieve high-level goals, resulting in intentional action that links across multiple levels of control. Finally, we discuss how such a 'hierarchical affordance competition' process can be mapped to brain structure.
Affordable Exploration of Mars: Recommendations from a Community Workshop on Sustainable Initial Human Missions
NASA Technical Reports Server (NTRS)
Thronson, Harley; Carberry, Chris; Cassady, R. J.; Cooke, Doug; Hopkins, Joshua; Perino, Maria A.; Kirkpatrick, Jim; Raftery, Michael; Westenberg, Artemis; Zucker, Richard
There is a growing consensus that within two decades initial human missions to Mars are affordable under plausible budget assumptions and with sustained international participation. In response to this idea, a distinguished group of experts from the Mars exploration stakeholder communities attended the "Affording Mars" workshop at George Washington University in December, 2013. Participants reviewed and discussed scenarios for affordable and sustainable human and robotic exploration of Mars, the role of the International Space Station over the coming decade as the essential early step toward humans to Mars, possible "bridge" missions in the 2020s, key capabilities required for affordable initial missions, international partnerships, and a usable definition of affordability and sustainability. We report here the findings, observations, and recommendations that were agreed to at that workshop.
Understanding the adoption dynamics of medical innovations: affordances of the da Vinci robot in the Netherlands.
Abrishami, Payam; Boer, Albert; Horstman, Klasien
This study explored the rather rapid adoption of a new surgical device - the da Vinci robot - in the Netherlands despite the high costs and its controversial clinical benefits. We used the concept 'affordances' as a conceptual-analytic tool to refer to the perceived promises, symbolic meanings, and utility values of an innovation constructed in the wider social context of use. This concept helps us empirically understand robot adoption. Data from 28 in-depth interviews with diverse purposively-sampled stakeholders, and from medical literature, policy documents, Health Technology Assessment reports, congress websites and patients' weblogs/forums between April 2009 and February 2014 were systematically analysed from the perspective of affordances. We distinguished five interrelated affordances of the robot that accounted for shaping and fulfilling its rapid adoption: 'characteristics-related' affordances such as smart nomenclature and novelty, symbolising high-tech clinical excellence; 'research-related' affordances offering medical-technical scientific excellence; 'entrepreneurship-related' affordances for performing better-than-the-competition; 'policy-related' affordances indicating the robot's liberalised provision and its reduced financial risks; and 'communication-related' affordances of the robot in shaping patients' choices and the public's expectations by resonating promising discourses while pushing uncertainties into the background. These affordances make the take-up and use of the da Vinci robot sound perfectly rational and inevitable. This Dutch case study demonstrates the fruitfulness of the affordances approach to empirically capturing the contextual dynamics of technology adoption in health care: exploring in-depth actors' interaction with the technology while considering the interpretative spaces created in situations of use. This approach can best elicit real-life value of innovations, values as defined through the eyes of (potential) users.
Cathodic protection of steel by electrodeposited zinc-nickel alloy coatings
Baldwin, K.R.; Smith, C.J.E.; Robinson, M.J.
The ability of electrodeposited zinc-nickel alloy coatings to cathodically protect steel was studied in dilute chloride solutions. The potential distribution along steel strips partly electroplated with zinc-nickel alloys was determined, and the length of exposed steel that was held below the minimum protection potential (E{sub prot}) was taken as a measure of the level of cathodic protection (CP) provided by the alloy coatings. The level of CP afforded by zinc alloy coatings was found to decrease with increasing nickel content. When nickel content was increased to {approx} {ge} 21 wt%, no CP was obtained. Surface analysis of uncoupled zinc-nickel alloys that were immersed in sodium chloride (NaCl) solutions showed the concentration of zinc decreased in the surface layers while the concentration of nickel increased, indicating that the alloys were susceptible to dezincification. The analysis of zinc-nickel alloy coatings on partly electroplated steel strips that were immersed in chloride solution showed a significantly higher level of dezincification than that found for uncoupled alloy coatings. This effect accounted for the rapid loss of CP afforded to steel by some zinc alloy coatings, particularly those with high initial nickel levels.
Sovereignty & Collaboration: Affordable Strategies in Times of Austerity?
shortfalls. This perspective has been mirrored by the United Kingdom defense policy shifting from a protective, mercantile approach to a more...sovereignty in equipment procurement is a complex issue. Modern weapon systems employing a " system of systems " approach to engineering means that...RUSI Defence Systems , June 2009, 102, http://www.rusi.org/downloads/assets/Acquisition_Issues_Lessons_from_the_MoD_RDS _Summer_09.pdf. 6

subset: commoncrawl