COSTS AND EFFECTS OF ARKANSAS' LONG-TERM CARE DEMONSTRATION PROJECT (MEDICAID, CHANELLING, COMMUNITY ASSESSMENT)

The purpose of this study was to assess the impact of the Arkansas Long-Term Care Demonstration Project upon Arkansas' Medicaid expenditures and upon the clients it serves. A Retrospective Medicaid expenditure study component used analyses of variance techniques to test for the Project's effects upon aggregated expenditures for 28 demonstration and control counties representing 25 percent of the State's population over four years, 1979-1982.^ A second approach to the study question utilized a 1982 prospective sample of 458 demonstration and control clients from the same 28 counties. The disability level or need for care of each patient was established a priori. The extent to which an individual's variation in Medicaid utilization and costs was explained by patient need, presence or absence of the channeling project's placement decision or some other patient characteristic was examined by multiple regression analysis. Long-term and acute care Medicaid, Medicare, third party, self-pay and the grand total of all Medicaid claims were analyzed for project effects and explanatory relationships.^ The main project effect was to increase personal care costs without reducing nursing home or acute care costs (Prospective Study). Expansion of clients appeared to occur in personal care (Prospective Study) and minimum care nursing home (Retrospective Study) for the project areas. Cost-shifting between Medicaid and Medicare in the project areas and two different patterns of utilization in the North and South projects tended to offset each other such that no differences in total costs between the project areas and demonstration areas occurred. The project was significant ((beta) = .22, p < .001) only for personal care costs. The explanatory power of this personal care regression model (R('2) = .36) was comparable to other reported health services utilization models. Other variables (Medicare buy-in, level of disability, Social Security Supplemental Income (SSI), net monthly income, North/South areas and age) explained more variation in the other twelve cost regression models. ^

Client Home or Agency Office? How Do We Decide Where to See Our Clients?

Decisions about location of services sometimes appear to be made more on the basis of agency preference than assessment of need. Today the profession has enough experience with service locations that it is possible to develop more clear guidelines for the decision about where work with clients should take place, in the client’s home or nearby community or in the practitioner’s office. This study was conducted with two purposes; 1) to identify at a higher level of evidence the various reasons for seeing clients in their own homes and nearby community setting; and 2) to demonstrate how readily available information can be used to gradually increase the level of evidence by which practice decisions are made.

Investment promotion agencies: do they work?

In this paper, we examine the role of investment promotion agencies (IPAs) in promoting outward FDI from Japan and Korea. Looking at two home countries enables us to control for both country-pair time-invariant characteristics and host country time-varying characteristics. Our empirical results suggest that home-country IPAs tend to be more effective in promoting outward FDI in politically risky host countries. However, this finding depends on whether the home-country firm is listed or unlisted. More specifically, we find that the positive effect of home country IPAs on outward FDI in politically risky countries is limited to unlisted home- country firms, which are widely assumed to be less competitive and productive.

Enhancement of a body area network to support smart health monitoring at the digital home

The deployment of home-based smart health services requires effective and reliable systems for personal and environmental data management. ooperation between Home Area Networks (HAN) and Body Area Networks (BAN) can provide smart systems with ad hoc reasoning information to support health care. This paper details the implementation of an architecture that integrates BAN, HAN and intelligent agents to manage physiological and environmental data to proactively detect risk situations at the digital home. The system monitors dynamic situations and timely adjusts its behavior to detect user risks concerning to health. Thus, this work provides a reasoning framework to infer appropriate solutions in cases of health risk episodes. Proposed smart health monitoring approach integrates complex reasoning according to home environment, user profile and physiological parameters defined by a scalable ontology. As a result, health care demands can be detected to activate adequate internal mechanisms and report public health services for requested actions.

LED bulbs technical specification and testing procedure for solar home systems

The definition of technical specifications and the corresponding laboratory procedures are necessary steps in order to assure the quality of the devices prior to be installed in Solar Home Systems (SHS). To clarify and unify criteria a European project supported the development of the Universal Technical Standard for Solar Home Systems (UTSfSHS). Its principles were to generate simple and affordable technical requirements to be optimized in order to facilitate the implementation of tests with basic and simple laboratory tools even on the same SHS electrification program countries. These requirements cover the main aspects of this type of installations and its lighting chapter was developed based on the most used technology at that time: fluorescent tubes and CFLs. However, with the consolidation of the new LED solid state lighting devices, particular attention is being given to this matter and new procedures are required. In this work we develop a complete set of technical specifications and test procedures that have been designed within the frame of the UTSfSHS, based on an intense review of the scientific and technical publications related to LED lighting and their practical application. They apply to lamp reliability, performance and safety under normal, extreme and abnormal operating conditions as a simple but complete quality meter tool for any LED bulb.

Demonstration of the operation principles of intermediate band solar cells at room temperature

In this work we report, for the first time at room temperature, experimental results that prove, simultaneously in the same device, the two main physical principles involved in the operation of intermediate band solar cells: (1) the production of sub-bandgap photocurrent by two optical transitions through the intermediate band; (2) the generation of an output voltage which is not limited by the photon energy absorption threshold. These principles, which had always required cryogenic temperatures to be evidenced all together, are now demonstrated at room temperature on an intermediate band solar cell based on InAs quantum dots with Al0.3Ga0.7As barriers.

A relaxation technique enhances psychological well-being and immune parameters in elderly people from a nursing home: A randomized controlled study

Background: The aging process involves a decline in immune functioning that renders elderly people more vulnerable to disease. In residential programs for the aged, it is vital to diminish their risk of disease, promote their independence, and augment their psychological well-being and quality of life. Methods: We performed a randomized controlled study, evaluating the ability of a relaxation technique based on Benson’s relaxation response to enhance psychological well-being and modulate the immune parameters of elderly people living in a geriatric residence when compared to a waitlist control group. The study included a 2-week intervention period and a 3-month follow-up period. The main outcome variables were psychological well-being and quality of life, biomedical variables, immune changes from the pre-treatment to post-treatment and follow-up periods. Results: Our findings reveal significant differences between the experimental and control groups in CD19, CD71, CD97, CD134, and CD137 lymphocyte subpopulations at the end of treatment. Furthermore, there was a decrease in negative affect, psychological discomfort, and symptom perception in the treatment group, which increased participants’ quality of life scores at the three-month follow-up. Conclusions: This study represents a first approach to the application of a passive relaxation technique in residential programs for the elderly. The method appears to be effective in enhancing psychological well-being and modulating immune activity in a group of elderly people. This relaxation technique could be considered an option for achieving health benefits with a low cost for residential programs, but further studies using this technique in larger samples of older people are needed to confirm the trends observed in the present study. Trial registration: International Standard Randomised Controlled Trial Number Register ISRCTN85410212.

First steps toward harmonized human biomonitoring in Europe : demonstration project to perform human biomonitoring on a European scale

'Reproduced with permission from Environmental Health Perspectives'

The Juncker Commission: A New Start for EU Justice and Home Affairs Policy? CEPS Essay No. 15, 18 September 2014

The team comprising Jean-Claude Juncker’s Commission was revealed on 10 September 2014: does it herald a new start for Justice and Home Affairs (JHA) cooperation in the EU? This essay outlines the main structural and thematic changes introduced by the new Commission, in particular those with direct or indirect relevance to EU JHA or the Area of Freedom, Security and Justice (AFSJ) policies. It also reflects on the new institutional configuration and what it means for the substantive work of the new Commission services and for their intra- and inter-institutional relations. The essay concludes with a set of proposed policy priorities for the new Commission.

Chris Sabo, UM Baseball, home run swing

[homerun vs Aquinas]

Chris Sabo, UM Baseball, vs Indiana, 1981, home run swing

[vs Indiana]