Does Mental Illness Affect Consumer Direction of Community-Based Care? Lessons From the Arkansas Cash and Counseling Program

Purpose: Previous research from the Cash and Counseling Demonstration and Evaluation (CCDE) in Arkansas, New Jersey, and Florida suggests that giving consumers control over their personal care greatly increases their satisfaction and improves their outlook on life. Still, some argue that consumerdirected care may not be appropriate for consumers with intellectual disabilities or mental health diagnoses. This study examined how Cash and Counseling— a new option allowing consumers to manage an individualized budget equivalent to what agencies would have spent on their care—changes the way consumers with mental health diagnoses meet their personal care needs and how that affects their wellbeing. Design and Methods: Using the Arkansas CCDE baseline and the 9-month follow-up data for individuals in the treatment and control groups, we compared and contrasted the experience of elderly consumers with and without mental health diagnoses utilizing logit regression. Results: After examining several outcome measures, including satisfaction with care arrangements and the paid caregiver’s reliability and schedule, unmet needs, and satisfaction with the relationship with paid caregivers, this study found evidence that, from the perspective of consumers, the Cash and Counseling program works well for participants with mental health diagnoses. Implications: Considering the growing need for long-term-care services and the limited resources available, a consumer-directed option makes sense, and it can be a valuable alternative for persons with mental health needs.

Anisotropic Mechanical Properties of ABS Parts Fabricated by Fused Deposition Modelling

In recent years, layered manufacturing (LM) processes have begun to progress from rapid prototyping techniques towards rapid manufacturing methods, where the objective is now to produce finished components for potential end use in a product (Caulfield et al., 2007). LM is especially promising for the fabrication of specific need, low volume products such as replacement parts for larger systems. This trend accentuates the need for a thorough understanding of the associated mechanical properties and the resulting behavior of parts produced by layered methods. Not only must the base material be durable, but the mechanical properties of the layered components must be sufficient to meet in-service loading and operational requirements, and be reasonably comparable to parts produced by more traditional manufacturing techniques. This chapter presents the details of a study completed to quantitatively analyze the potential of fused deposition modelling to fully evolve into a rapid manufacturing tool. The project objective is to develop an understanding of the dependence of the mechanical properties of FDM parts on raster orientation and to assess whether these parts are capable of maintaining their integrity while under service loading. The study examines the effect of fiber orientation, i.e. the direction of the polymer beads relative to the loading direction of the part, on a variety of important mechanical properties of ABS components fabricated by fused deposition modeling. Tensile, compressive, flexural, impact, and fatigue strength properties of FDM specimens are examined, evaluated, and placed in context in comparison with the properties of injection molded ABS parts.

Monitoring and Modeling of the Hydraulic and Sediment Processes at In-Stream Restoration Structures in the Vicinity of a Bridge Crossing

The long-term performance of infrastructure depends on reliable and sustainable designs. Many of Pennsylvania’s streams experience sediment transport problems that increase maintenance costs and lower structural integrity of bridge crossings. A stream restoration project is one common mitigation measure used to correct such problems at bridge crossings. Specifically, in an attempt to alleviate aggradation problems with the Old Route 15 Bridge crossing on White Deer Creek, in White Deer, PA, two in-stream structures (rock cross vanes) and several bank stabilization features were installed along with a complete channel redevelopment. The objectives of this research were to characterize the hydraulic and sediment transport processes occurring at the White Deer Creek site, and to investigate, through physical and mathematical modeling, the use of instream restoration structures. The goal is to be able to use the results of this study to prevent aggradation or other sediment related problems in the vicinity of bridges through improved design considerations. Monitoring and modeling indicate that the study site on White Deer Creek is currently unstable, experiencing general channel down-cutting, bank erosion, and several local areas of increased aggradation and degradation of the channel bed. An in-stream structure installed upstream of the Old Route 15 Bridge failed by sediment burial caused by the high sediment load that White Deer Creek is transporting as well as the backwater effects caused by the bridge crossing. The in-stream structure installed downstream of the Old Route 15 Bridge is beginning to fail because of the alignment of the structure with the approach direction of flow from upstream of the restoration structure.