Hybrid risk adjustment for pharmaceutical benefits

This paper analyses the application of hybrid risk adjustment versus either prospective orconcurrent risk adjustment formulae in the context of funding pharmaceutical benefits for thepopulation of an integrated healthcare delivery organization in Catalonia during years 2002 and2003. We apply a mixed formula and find that a hybrid risk adjustment model increasesincentives for efficiency in the provision of low risk individuals at health organizations not only asa whole but also at each internal department compared to only prospective models by reducingwithin-group variation of drug expenditures.

2009 State of Iowa Employee Benefits Handbook, October 2008

Examples of the information available include: • Links to health and dental plans • Health plan comparisons • Health and Dependent Care Flexible Spending Account information • Deferred Compensation information • Life and Long Term Disability insurance information • Link to Employee Assistance Program (EAP) Web site • Link to Employee Discount Program • Link to Wellness Web site which includes information about - Smoking Cessation Program - Prescription Drug information - Wellness activities

Access to a simulator is not enough: the benefits of virtual reality training based on peer-group-derived benchmarks--a randomized controlled trial.

BACKGROUND: Virtual reality (VR) simulators are widely used to familiarize surgical novices with laparoscopy, but VR training methods differ in efficacy. In the present trial, self-controlled basic VR training (SC-training) was tested against training based on peer-group-derived benchmarks (PGD-training). METHODS: First, novice laparoscopic residents were randomized into a SC group (n = 34), and a group using PGD-benchmarks (n = 34) for basic laparoscopic training. After completing basic training, both groups performed 60 VR laparoscopic cholecystectomies for performance analysis. Primary endpoints were simulator metrics; secondary endpoints were program adherence, trainee motivation, and training efficacy. RESULTS: Altogether, 66 residents completed basic training, and 3,837 of 3,960 (96.8 %) cholecystectomies were available for analysis. Course adherence was good, with only two dropouts, both in the SC-group. The PGD-group spent more time and repetitions in basic training until the benchmarks were reached and subsequently showed better performance in the readout cholecystectomies: Median time (gallbladder extraction) showed significant differences of 520 s (IQR 354-738 s) in SC-training versus 390 s (IQR 278-536 s) in the PGD-group (p < 0.001) and 215 s (IQR 175-276 s) in experts, respectively. Path length of the right instrument also showed significant differences, again with the PGD-training group being more efficient. CONCLUSIONS: Basic VR laparoscopic training based on PGD benchmarks with external assessment is superior to SC training, resulting in higher trainee motivation and better performance in simulated laparoscopic cholecystectomies. We recommend such a basic course based on PGD benchmarks before advancing to more elaborate VR training.

A dynamic analysis of human welfare in a warming planet

Climate science indicates that climate stabilization requires low GHG emissions. Is thisconsistent with nondecreasing human welfare?Our welfare or utility index emphasizes education, knowledge, and the environment. Weconstruct and calibrate a multigenerational model with intertemporal links provided by education,physical capital, knowledge and the environment.We reject discounted utilitarianism and adopt, first, the Pure Sustainability Optimization (orIntergenerational Maximin) criterion, and, second, the Sustainable Growth Optimization criterion,that maximizes the utility of the first generation subject to a given future rate of growth. We applythese criteria to our calibrated model via a novel algorithm inspired by the turnpike property.The computed paths yield levels of utility higher than the level at reference year 2000 for allgenerations. They require the doubling of the fraction of labor resources devoted to the creation ofknowledge relative to the reference level, whereas the fractions of labor allocated to consumptionand leisure are similar to the reference ones. On the other hand, higher growth rates requiresubstantial increases in the fraction of labor devoted to education, together with moderate increasesin the fractions of labor devoted to knowledge and the investment in physical capital.

Socio-economic benefits of using space technologies to monitor and respond to earthquakes

Earthquakes represent a major hazard for populations around the world, causing frequent loss of life,human suffering and enormous damage to homes, other buildings and infrastructure. The Technology Resources forEarthquake Monitoring and Response (TREMOR) Team of 36 space professionals analysed this problem over thecourse of the International Space University Summer Session Program and published their recommendations in the formof a report. The TREMOR Team proposes a series of space- and ground-based systems to provide improved capabilityto manage earthquakes. The first proposed system is a prototype earthquake early-warning system that improves theexisting knowledge of earthquake precursors and addresses the potential of these phenomena. Thus, the system willat first enable the definitive assessment of whether reliable earthquake early warning is possible through precursormonitoring. Should the answer be affirmative, the system itself would then form the basis of an operational earlywarningsystem. To achieve these goals, the authors propose a multi-variable approach in which the system will combine,integrate and process precursor data from space- and ground-based seismic monitoring systems (already existing andnew proposed systems) and data from a variety of related sources (e.g. historical databases, space weather data, faultmaps). The second proposed system, the prototype earthquake simulation and response system, coordinates the maincomponents of the response phase to reduce the time delays of response operations, increase the level of precisionin the data collected, facilitate communication amongst teams, enhance rescue and aid capabilities and so forth. It isbased in part on an earthquake simulator that will provide pre-event (if early warning is proven feasible) and post-eventdamage assessment and detailed data of the affected areas to corresponding disaster management actors by means of ageographic information system (GIS) interface. This is coupled with proposed mobile satellite communication hubs toprovide links between response teams. Business- and policy-based implementation strategies for these proposals, suchas the establishment of a non-governmental organisation to develop and operate the systems, are included.

Disabilities Benefits for Special Services Disability, July 2008

IPERS provides the security you need through guaranteed benefits. With IPERS, unlike other retirement plans, benefits aren’t tied to the performance of the stock market and you don’t need to be an experienced investor to make your retirement dreams a reality. Your IPERS benefits are only one part of your overall retirement savings. Your total retirement income will come from a combination of your IPERS benefits, social security, personal savings, and any other retirement plan benefits.

Disabilities Benefits for Special Services Disability, July 2008

IPERS provides the security you need through guaranteed benefits. With IPERS, unlike other retirement plans, benefits aren’t tied to the performance of the stock market and you don’t need to be an experienced investor to make your retirement dreams a reality. Your IPERS benefits are only one part of your overall retirement savings. Your total retirement income will come from a combination of your IPERS benefits, social security, personal savings, and any other retirement plan benefits.

A Brief Survey of Child Welfare in Iowa, 1937-1940

History of Child Welfare in Iowa and the studies pertaining to it for the years 1937 and 1940. Includes a table showing number of children and money paid per child through Widow's Pensions for the year 1939.

The History of the Establishment of the Division of Child Welfare of the Social Welfare Department of the State of Iowa, 1938

History of Child Welfare Legislation in the State of Iowa 1838-1898; Establishment of the Iowa State board of Control in 1898 and its influence on Child Welfare Legislation until 1925; Immediate background, organizing and the administration functions of the Child Welfare Division of the Social Welfare Department of the State of Iowa. NOTE: This document has pagination errors.

Report of the Section of Agencies and Institutions Division of Child Welfare State Department of Social Welfare, 1943

History of child and social welfare in the State of Iowa including legal responsibilities, rules and regulations, inspections and licensing and supervision. it also covers cooperation with state agencies. It also describes in detail the histories, functions and problems of individual welfare homes and schools.

Estratègies de cura i presa de decisions en persones grans amb dependència ingressades en una unitat geriàtrica d'atenció intermèdia : estudi descriptiu

Aquest estudi té com objectiu observar les relacions entre les estratègies de cura (formal, informal, mixta) que fan servir els cuidadors de persones grans dependents, la seva situació social i les seves motivacions per la decisió respecte a com fan la cura. L’estat del tema destaca el predomini de les cures informals sobre les formals en els models de benestar mediterranis i la rellevància de la interacció entre factors personals socioculturals i les polítiques socials en la presa de decisions individuals sobre la cura de la dependència. La llei de la dependència, de recent implementació a l’Estat espanyol, ha universalitzat l’accés als recursos formals, creant un nou paradigma d’interacció cuidadors-recursos. Es tracta d’un estudi observacional, transversal, descriptiu de tipus mixt quantitatiu/qualitatiu realitzat a partir d’entrevistes individuals als cuidadors de dependents ingressats en una unitat geriàtrica d’atenció intermèdia. Es recullen dades sobre el context sociofamiliar, l’estratègia de cura, l’autopercepció i les motivacions. Els resultats mostren que els cuidadors combinen prestacions econòmiques i serveis (públics i privats) per adaptar al màxim l’estratègia a les condicions del dependent i a les seves pròpies. Tenen la convicció generalitzada que l’atenció cal fer-la al domicili per motius de reciprocitat i respecte a la persona cuidada. El pas a l’atenció residencial és una decisió molt difícil pels cuidadors. La implantació de la llei de la dependència ha normalitzat la relació entre cuidadors i recursos formals, però la burocratització i la insuficiència de l’oferta de serveis no afavoreixen canvis substancials en la provisió de l’ajut, que continua essent majoritàriament informal. La millora en la percepció de continuïtat d’atenció entre el domicili i la residència, i també en la gestió i l’oferta de serveis formals públics es presenten com a reptes de treball importants al nostre país.

Uses and Benefits of Aviation in Iowa: Executive Summary, 2009

Air transportation is a key contributor to Iowa’s economy. The Iowa Department of Transportation’s Office of Aviation developed this 2009 report to evaluate and analyze the uses and benefits of aviation in Iowa. The statewide economic impact study shows how aviation serves as an economic engine, documents various ways air transportation is used in Iowa, and discusses other benefits that air transportation supports. Aviation related economic benefits measured in this study fall into two categories. In one category, benefits are measured in terms of jobs, payroll, and annual economic activity that various aviation and air transportation groups support. In the other category, added efficiency that businesses realize from their use of aviation is estimated in terms of increased productivity. Many of the economic benefits identified in this study are associated with commercial and general aviation airports that serve communities throughout Iowa. Beyond the boundaries of the airports are other aviation related activities that also add significant value to Iowa’s economy. Both types of economic benefit are discussed in this summary report.