UPTAKE OF THE PERIODIC HEALTH EXAM AMONG ADULTS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES FROM 2003 TO 2015

Background: Over the past decade, annual heath exams have been de-emphasized for the general population but emphasized for adults with intellectual and developmental disabilities (IDD). The purpose of this project was to determine if there has been an increase in the uptake of the health exam among adults with IDD in Ontario, to what extent, and the effect on the quality of preventive care provided. Methods: Using administrative health data, the proportion of adults (18-64 years old) with IDD who received a health exam (long appointment, general assessment, and “true” health exam), a high value on the primary care quality composite score (PCQS), and a health exam or high PCQS each year was compared to the proportion in a propensity score matched sample of the general population. Negative binomial and segmented negative binomial regression controlling for age and sex were used to determine the relative risk of having a health exam/high PCQS/health exam or PCQS over time. Results: Pre joinpoint, the long appointment and general assessment health exam definitions saw a decrease and the “true” health exam saw an increase in the likelihood of adults having a health exam. Post joinpoint, all health exam definitions saw a decrease in the likelihood of adults having a health exam. Pre joinpoint, all PCQS measures (high PCQS, long appointment or high PCQS, “true” health exam or high PCQS) saw an increase in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Post joinpoint, all PCQS measures saw a decrease in the likelihood for adults to achieve a high PCQS or high PCQS/have a health exam. Achieving a high PCQS was strongly associated with having a health exam regardless of health exam definition or IDD status. Conclusions: Despite the publication of guidelines, only a small proportion of adults with IDD are receiving health exams. This indicates that the publication of guidelines alone was not sufficient to change practice. More targeted measures, such as the implementation of an IDD-specific health exam fee code, should be considered to increase the uptake of the health exam among adults with IDD.

Diversity and Inclusion As the Key to Innovating Talent Management in Law Firms?

In this chapter we argue that there is a need to reconceptualise what we mean by talent in the legal profession beyond a view that the most valuable people are those who have the highest fee-earning potential or the best CV packed with excellent grades and exceptional experiences and extra curricula achievements. And further we need a more sophisticated understanding of how organisational decision-making may be structured to provide developmental opportunities to allow talent to be nurtured and to flourish on individual and team levels. In turn, we suggest that planning, management and accountability cycles within legal entities need to be strengthened so as to ensure creativity and success in a context in which it is possible to deliver on the promise of fair access and promotion. Consequently, this chapter explores the diversity problem within the legal profession(s), further it interrogates what is “talent”, and how and why we should seek to manage and develop it. It then evaluates how talent diversity has been managed in the legal professional context, examined through what we have categorised as three waves of diversity strategies. We interrogate why diversity initiatives have not been more successful given the efforts placed on them by professional bodies and firms themselves. We posit that by using diversity as a case study in talent management legal entities may develop a more effective approach to talent management generally within law firms that will be of benefit to all lawyers and support professionals rather than just those who are from traditionally low participation groups.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

Nursing Facilities Private Room Supplementation Report, May 2015

HF740 directed the Iowa Department of Human Services to begin reimbursing nursing facilities under a modified price-base case-mix reimbursement system beginning July 1, 2001. The components of the case mix reimbursement system resulted from a series of meetings that involved providers industry association representatives advocacy organization and state agency staff.

NT CADCAM Webinar - SOLIDWORKS PDM for managing SOLIDWORKS data

Copy of NT CADCAM Webinar (~Q1 2016) - Managing SOLIDWORKS data with SOLIDWORKS PDM, provided for reference in FEE by Max Templeman, Account Manager for NT CADCAM Ltd

Modelling and estimating models of physician labour supply and productivity

Ma thèse s’intéresse aux politiques de santé conçues pour encourager l’offre de services de santé. L’accessibilité aux services de santé est un problème majeur qui mine le système de santé de la plupart des pays industrialisés. Au Québec, le temps médian d’attente entre une recommandation du médecin généraliste et un rendez-vous avec un médecin spécialiste était de 7,3 semaines en 2012, contre 2,9 semaines en 1993, et ceci malgré l’augmentation du nombre de médecins sur cette même période. Pour les décideurs politiques observant l’augmentation du temps d’attente pour des soins de santé, il est important de comprendre la structure de l’offre de travail des médecins et comment celle-ci affecte l’offre des services de santé. Dans ce contexte, je considère deux principales politiques. En premier lieu, j’estime comment les médecins réagissent aux incitatifs monétaires et j’utilise les paramètres estimés pour examiner comment les politiques de compensation peuvent être utilisées pour déterminer l’offre de services de santé de court terme. En second lieu, j’examine comment la productivité des médecins est affectée par leur expérience, à travers le mécanisme du "learning-by-doing", et j’utilise les paramètres estimés pour trouver le nombre de médecins inexpérimentés que l’on doit recruter pour remplacer un médecin expérimenté qui va à la retraite afin de garder l’offre des services de santé constant. Ma thèse développe et applique des méthodes économique et statistique afin de mesurer la réaction des médecins face aux incitatifs monétaires et estimer leur profil de productivité (en mesurant la variation de la productivité des médecins tout le long de leur carrière) en utilisant à la fois des données de panel sur les médecins québécois, provenant d’enquêtes et de l’administration. Les données contiennent des informations sur l’offre de travail de chaque médecin, les différents types de services offerts ainsi que leurs prix. Ces données couvrent une période pendant laquelle le gouvernement du Québec a changé les prix relatifs des services de santé. J’ai utilisé une approche basée sur la modélisation pour développer et estimer un modèle structurel d’offre de travail en permettant au médecin d’être multitâche. Dans mon modèle les médecins choisissent le nombre d’heures travaillées ainsi que l’allocation de ces heures à travers les différents services offerts, de plus les prix des services leurs sont imposés par le gouvernement. Le modèle génère une équation de revenu qui dépend des heures travaillées et d’un indice de prix représentant le rendement marginal des heures travaillées lorsque celles-ci sont allouées de façon optimale à travers les différents services. L’indice de prix dépend des prix des services offerts et des paramètres de la technologie de production des services qui déterminent comment les médecins réagissent aux changements des prix relatifs. J’ai appliqué le modèle aux données de panel sur la rémunération des médecins au Québec fusionnées à celles sur l’utilisation du temps de ces mêmes médecins. J’utilise le modèle pour examiner deux dimensions de l’offre des services de santé. En premierlieu, j’analyse l’utilisation des incitatifs monétaires pour amener les médecins à modifier leur production des différents services. Bien que les études antérieures ont souvent cherché à comparer le comportement des médecins à travers les différents systèmes de compensation,il y a relativement peu d’informations sur comment les médecins réagissent aux changementsdes prix des services de santé. Des débats actuels dans les milieux de politiques de santé au Canada se sont intéressés à l’importance des effets de revenu dans la détermination de la réponse des médecins face à l’augmentation des prix des services de santé. Mon travail contribue à alimenter ce débat en identifiant et en estimant les effets de substitution et de revenu résultant des changements des prix relatifs des services de santé. En second lieu, j’analyse comment l’expérience affecte la productivité des médecins. Cela a une importante implication sur le recrutement des médecins afin de satisfaire la demande croissante due à une population vieillissante, en particulier lorsque les médecins les plus expérimentés (les plus productifs) vont à la retraite. Dans le premier essai, j’ai estimé la fonction de revenu conditionnellement aux heures travaillées, en utilisant la méthode des variables instrumentales afin de contrôler pour une éventuelle endogeneité des heures travaillées. Comme instruments j’ai utilisé les variables indicatrices des âges des médecins, le taux marginal de taxation, le rendement sur le marché boursier, le carré et le cube de ce rendement. Je montre que cela donne la borne inférieure de l’élasticité-prix direct, permettant ainsi de tester si les médecins réagissent aux incitatifs monétaires. Les résultats montrent que les bornes inférieures des élasticités-prix de l’offre de services sont significativement positives, suggérant que les médecins répondent aux incitatifs. Un changement des prix relatifs conduit les médecins à allouer plus d’heures de travail au service dont le prix a augmenté. Dans le deuxième essai, j’estime le modèle en entier, de façon inconditionnelle aux heures travaillées, en analysant les variations des heures travaillées par les médecins, le volume des services offerts et le revenu des médecins. Pour ce faire, j’ai utilisé l’estimateur de la méthode des moments simulés. Les résultats montrent que les élasticités-prix direct de substitution sont élevées et significativement positives, représentant une tendance des médecins à accroitre le volume du service dont le prix a connu la plus forte augmentation. Les élasticitésprix croisées de substitution sont également élevées mais négatives. Par ailleurs, il existe un effet de revenu associé à l’augmentation des tarifs. J’ai utilisé les paramètres estimés du modèle structurel pour simuler une hausse générale de prix des services de 32%. Les résultats montrent que les médecins devraient réduire le nombre total d’heures travaillées (élasticité moyenne de -0,02) ainsi que les heures cliniques travaillées (élasticité moyenne de -0.07). Ils devraient aussi réduire le volume de services offerts (élasticité moyenne de -0.05). Troisièmement, j’ai exploité le lien naturel existant entre le revenu d’un médecin payé à l’acte et sa productivité afin d’établir le profil de productivité des médecins. Pour ce faire, j’ai modifié la spécification du modèle pour prendre en compte la relation entre la productivité d’un médecin et son expérience. J’estime l’équation de revenu en utilisant des données de panel asymétrique et en corrigeant le caractère non-aléatoire des observations manquantes à l’aide d’un modèle de sélection. Les résultats suggèrent que le profil de productivité est une fonction croissante et concave de l’expérience. Par ailleurs, ce profil est robuste à l’utilisation de l’expérience effective (la quantité de service produit) comme variable de contrôle et aussi à la suppression d’hypothèse paramétrique. De plus, si l’expérience du médecin augmente d’une année, il augmente la production de services de 1003 dollar CAN. J’ai utilisé les paramètres estimés du modèle pour calculer le ratio de remplacement : le nombre de médecins inexpérimentés qu’il faut pour remplacer un médecin expérimenté. Ce ratio de remplacement est de 1,2.

An Interview with Tony David Sampson: Author of Virality: Contagion Theory in the Age of Networks

We are delighted to have the opportunity to talk with Tony about how his work touches on issues of imitation and contagion—a loaded term unpacked within his 2013 book.

Étude sur les variables sociofamiliales associées au placement d'enfants (6-11 ans) en centre de réadaptation

Les recherches recensées sur les variables sociofamiliales associées au placement d'enfants nous apprennent que ces familles sont pauvres, monoparentales, dirigées par des femmes et qu'elles présentent de multiples problèmes tant au niveau familial que personnel des parents. Les objectifs de cette recherche sont de comparer les caractéristiques des familles des enfants (6-11 ans) placés en centre de réadaptation (FEP) (25 enfants) à celles des familles des enfants suivis en services externes (FEE) (25 enfants) et d'identifier, parmi les variables sociofamiliales qui permettent de distinguer ces deux groupes, celles qui prédisent le mieux le placement des enfants en centre de réadaptation. Les résultats obtenus révèlent qu'il n'y a pas de différences significatives entres les deux groupes (FEP et FEE) sur la majorité des variables étudiées, seule la relation avec le voisinage est perçue plus négativement par le groupe (FEE). L'ensemble des familles de notre échantillon présente un portrait similaire à celui des familles d'enfants placés recensé dans la littérature. Ces résultats permettent de mettre en évidence que les variables sociofamiliales ne seraient peut-être pas, comme le laissent entendre la littérature, de si bons prédicteurs de placement d'enfants en milieu substitut.

Submission Fees - A Tool in the Transition to Open Access?

Knowledge Exchange examined different routes in achieving the vision of 'having a layer of scholarly and scientific content openly available in the internet'. One of these routes involves exploring new developments in the future of publishing. Work is being undertaken investigating interesting alternative business models which could contribute to the transition to open access. In this light KE has commissioned a study investigating whether submission fees could play a role in a business model for Open Access journals. The general conclusion of the report bearing the title ‘Submission Fees a tool in the transition to open access?', written by Mark Ware, is that there are benefits to publishers in certain cases to switch to a model in which an author pays a fee when submitting an article. Especially journals with a high rejection rate might be interested in combining submission fees with article processing charges in order to make the transition to open access easier. In certain disciplines, notably economic and finance journals and in some areas of the experimental life sciences, submission fees are already common. Overall there seems to be an interest in the model but the risks, particularly those involved in any transition, are seen by the publishers to outweigh the perceived benefits. There is also a problem in that the advantages offered by submission fees are often general benefits that might improve the system but do not provide publishers and authors with direct incentives to change to open access. To support transition funders, institutions and publication funds could make it clear that submission fees would be an allowable cost. At present this is often unclear in their policies. Author acceptance of submission fees is critical to its success. It is an observable fact that authors will accept them in some circumstances. Author acceptance would require further study though. Based on the interviews and the modelling in the study one model in particular is regarded as the most suitable way to meet the current requirements (i.e. to strengthen open access to research publications). In this model authors pay a submission fee plus an Article Processing Fee and the article is subsequently made available in open access. Both fees are set at levels that balance acceptability with the author community with securing a meaningful mix of revenues for the Publisher.

Opłata planistyczna. Studium finansowoprawne

Wydział Prawa i Administracji: Katedra Prawa Finansowego

Active Data Collection Techniques to Understand Online Scammers and Cybercriminals

Nigerian scam, also known as advance fee fraud or 419 scam, is a prevalent form of online fraudulent activity that causes financial loss to individuals and businesses. Nigerian scam has evolved from simple non-targeted email messages to more sophisticated scams targeted at users of classifieds, dating and other websites. Even though such scams are observed and reported by users frequently, the community’s understanding of Nigerian scams is limited since the scammers operate “underground”. To better understand the underground Nigerian scam ecosystem and seek effective methods to deter Nigerian scam and cybercrime in general, we conduct a series of active and passive measurement studies. Relying upon the analysis and insight gained from the measurement studies, we make four contributions: (1) we analyze the taxonomy of Nigerian scam and derive long-term trends in scams; (2) we provide an insight on Nigerian scam and cybercrime ecosystems and their underground operation; (3) we propose a payment intervention as a potential deterrent to cybercrime operation in general and evaluate its effectiveness; and (4) we offer active and passive measurement tools and techniques that enable in-depth analysis of cybercrime ecosystems and deterrence on them. We first created and analyze a repository of more than two hundred thousand user-reported scam emails, stretching from 2006 to 2014, from four major scam reporting websites. We select ten most commonly observed scam categories and tag 2,000 scam emails randomly selected from our repository. Based upon the manually tagged dataset, we train a machine learning classifier and cluster all scam emails in the repository. From the clustering result, we find a strong and sustained upward trend for targeted scams and downward trend for non-targeted scams. We then focus on two types of targeted scams: sales scams and rental scams targeted users on Craigslist. We built an automated scam data collection system and gathered large-scale sales scam emails. Using the system we posted honeypot ads on Craigslist and conversed automatically with the scammers. Through the email conversation, the system obtained additional confirmation of likely scam activities and collected additional information such as IP addresses and shipping addresses. Our analysis revealed that around 10 groups were responsible for nearly half of the over 13,000 total scam attempts we received. These groups used IP addresses and shipping addresses in both Nigeria and the U.S. We also crawled rental ads on Craigslist, identified rental scam ads amongst the large number of benign ads and conversed with the potential scammers. Through in-depth analysis of the rental scams, we found seven major scam campaigns employing various operations and monetization methods. We also found that unlike sales scammers, most rental scammers were in the U.S. The large-scale scam data and in-depth analysis provide useful insights on how to design effective deterrence techniques against cybercrime in general. We study underground DDoS-for-hire services, also known as booters, and measure the effectiveness of undermining a payment system of DDoS Services. Our analysis shows that the payment intervention can have the desired effect of limiting cybercriminals’ ability and increasing the risk of accepting payments.

The European Journal of Case Reports in Internal Medicine – The First Two Years

The European Journal of Case Reports in Internal Medicine (EJCRIM) is just over two years old. To date 400 reports have been submitted and just under half have been accepted for publication. In order to keep costs down our initial policy was to charge a small fee for all submissions, and a further small publication fee for papers that were accepted. However, we have now abolished the submission charge and replaced it with a single, slightly increased, publication charge for all accepted papers.

Efficient split eld FDTD analysis of third-order nonlinear materials in two-dimensionally periodic media

In this work the split-field finite-difference time-domain method (SF-FDTD) has been extended for the analysis of two-dimensionally periodic structures with third-order nonlinear media. The accuracy of the method is verified by comparisons with the nonlinear Fourier Modal Method (FMM). Once the formalism has been validated, examples of one- and two-dimensional nonlinear gratings are analysed. Regarding the 2D case, the shifting in resonant waveguides is corroborated. Here, not only the scalar Kerr effect is considered, the tensorial nature of the third-order nonlinear susceptibility is also included. The consideration of nonlinear materials in this kind of devices permits to design tunable devices such as variable band filters. However, the third-order nonlinear susceptibility is usually small and high intensities are needed in order to trigger the nonlinear effect. Here, a one-dimensional CBG is analysed in both linear and nonlinear regime and the shifting of the resonance peaks in both TE and TM are achieved numerically. The application of a numerical method based on the finite- difference time-domain method permits to analyse this issue from the time domain, thus bistability curves are also computed by means of the numerical method. These curves show how the nonlinear effect modifies the properties of the structure as a function of variable input pump field. When taking the nonlinear behaviour into account, the estimation of the electric field components becomes more challenging. In this paper, we present a set of acceleration strategies based on parallel software and hardware solutions.

Charakter ekologiczny opłaty produktowej

W niniejszym opracowaniu dokonano analizy opłaty produktowej ponoszonej w przypadku niezapewnienia wymaganego poziomu zbierania zużytych baterii i zużytych akumulatorów przenośnych. Ponadto podjęto próbę zdefiniowania terminu „opłata produktowa”. W opracowaniu przedstawione zostały także cechy tej opłaty oraz jej rola jako rodzaju opłaty ekologicznej. Podstawową metodą badawczą jest metoda analityczna uzupełniona przez metodę dogmatyczno-egzegetyczną. Analizie poddano przede wszystkim poglądy wyrażone w literaturze przedmiotu. Ponadto odwołano się do wykładni przepisów ustawy z dnia 24 kwietnia 2009 r. o bateriach i akumulatorach. Źródłem danych empirycznych były raporty o funkcjonowaniu gospodarki bateriami i akumulatorami oraz zużytymi akumulatorami sporządzone przez Głównego Inspektora Ochrony Środowiska za lata 2010-2014. W opracowaniu uwzględniono stan prawny na dzień 31 marca 2016 r.

As Operações de Transformação Fundiária Resultantes do Loteamento e o (seu) Registo

O presente trabalho corresponde ao Trabalho de Projeto Avançado do Mestrado em Solicitadoria, na área do Registo Predial, apresentado na Escola Superior de Tecnologia e Gestão de Felgueiras, conducente à obtenção do grau de Mestre. Tem como objeto o registo das operações de transformação fundiária resultantes de loteamento. No primeiro capítulo, começamos por abordar, de uma forma geral, a necessidade de lotear e a sua relação com o registo. Tratamos da noção de loteamento, referimos a sua evolução de uma forma breve e desenvolvemos quais as formas de titulação no âmbito do loteamento. Referimos o regime da propriedade horizontal como alternativa ao licenciamento. Para finalizar, e como não podia deixar de ser, explicamos os efeitos reais e registais, bem como as suas implicações jurídicas. No segundo capítulo, centramo-nos nas condições especiais dos loteamentos, nomeadamente as cedências, os negócios jurídicos e a prestação de caução. No que respeita às cedências, fazemos a distinção entre as cedências para o domínio privado ou domínio publico e caracterizamos os inerentes negócios jurídicos, conforme os casos. Analisamos a prestação de caução como garantia de execução das obras de urbanização, fazendo referência ao seu montante. No terceiro capítulo, tratamos da validade e eficácia dos atos, começando pela cassação do título, em que consiste e quando é que a ela há lugar. Tratamos, também, a caducidade, declaração de nulidade e anulação. Quanto à caducidade, identificamos os diferentes tipos e em que momento pode ocorrer. No que respeita à declaração de nulidade, falamos de seu regime, quando é que estamos perante um ato nulo e quais os seus efeitos. Por fim e no que concerne à anulação, caracterizamos a anulabilidade dos atos de controlo prévio das operações urbanísticas. Desenvolvemos, também, o embargo, especificamos em que situações o mesmo se determina, qual o procedimento a adotar e quais os seus efeitos. No quarto e último capítulo, abordamos as operações de transformação fundiária isentas de licença, nomeadamente o destaque, referindo qual a sua natureza jurídica, bem como as suas implicações registais e as outras operações de transformação fundiária isentas de licença. O método usado assenta na análise das questões estudadas, com recurso a autores, doutrina e jurisprudência pertinentes nesta matéria.