FAMILY CHARACTERISTICS, STATE PROGRAM EFFECTIVENESS, AND REPORT OF INADEQUATE CARE AMONG FAMILIES OF YOUNG CHILDREN WITH HEARING LOSS

Approximately 1.6 per 1,000 newborns in the U.S. are born with hearing loss. Congenital hearing loss poses a risk to their speech, language, cognitive, and social-emotional development. Early detection and intervention can improve outcomes. Every state has an Early Hearing Detection and Intervention program (EHDI) to promote and track screening, audiological assessments and linkage to early intervention. However, a large percentage of children are “lost to system (LTS),” meaning that they did not receive recommended care or that it was not reported. This study used data from the 2009-2010 National Survey of Children with Special Health Care Needs and data from the 2011 EHDI Hearing Screening and Follow-Up Survey to examine how 1) family characteristics; 2) EHDI program effectiveness, as determined by LTS percentages; and 3) the family conditions of education and poverty are related to parental report of inadequate care. The sample comprised 684 children between the ages of 0 and 5 years with hearing loss. The results indicated that living in states with less effective EHDI programs was associated with an increased likelihood of not receiving early intervention services (EIS) and of reporting poor family-centered communication. Sibling classification was associated with both receipt of EIS and report of unmet need. Single mothers were less likely to report increased difficulties accessing care. Poor and less educated families, assessed separately, who lived in states with less effective EHDI programs, were more likely to report non-receipt of EIS and less likely to report unmet need as compared to similar families living in states with more effective programs. Poor families living in states with less effective programs were more likely to report less coordinated care than were poor families living in states with more effective programs. This study supports the conclusion that both family characteristics and the effectiveness of state programs affect quality of care outcomes. It appears that less effective state programs affect disadvantaged families’ service receipt report more than that of advantaged families. These findings are important because they may provide insights into the development of targeted efforts to improve the system of care for children with hearing loss.

Map of the Thousand Island Park on Wellesley Island, River S't Lawrence : property of the Thousand Island Camp Meeting Association /

Cadastral map with lot lines and numbers.

Silver Lake Park, on St Mary's Lake, White Plains, New York /

Aerial view to horizon.

Quantum Gate and Quantum State Preparation through Neighboring Optimal Control

Successful implementation of fault-tolerant quantum computation on a system of qubits places severe demands on the hardware used to control the many-qubit state. It is known that an accuracy threshold Pa exists for any quantum gate that is to be used for such a computation to be able to continue for an unlimited number of steps. Specifically, the error probability Pe for such a gate must fall below the accuracy threshold: Pe < Pa. Estimates of Pa vary widely, though Pa ∼ 10−4 has emerged as a challenging target for hardware designers. I present a theoretical framework based on neighboring optimal control that takes as input a good quantum gate and returns a new gate with better performance. I illustrate this approach by applying it to a universal set of quantum gates produced using non-adiabatic rapid passage. Performance improvements are substantial comparing to the original (unimproved) gates, both for ideal and non-ideal controls. Under suitable conditions detailed below, all gate error probabilities fall by 1 to 4 orders of magnitude below the target threshold of 10−4. After applying the neighboring optimal control theory to improve the performance of quantum gates in a universal set, I further apply the general control theory in a two-step procedure for fault-tolerant logical state preparation, and I illustrate this procedure by preparing a logical Bell state fault-tolerantly. The two-step preparation procedure is as follow: Step 1 provides a one-shot procedure using neighboring optimal control theory to prepare a physical qubit state which is a high-fidelity approximation to the Bell state |β01⟩ = 1/√2(|01⟩ + |10⟩). I show that for ideal (non-ideal) control, an approximate |β01⟩ state could be prepared with error probability ϵ ∼ 10−6 (10−5) with one-shot local operations. Step 2 then takes a block of p pairs of physical qubits, each prepared in |β01⟩ state using Step 1, and fault-tolerantly prepares the logical Bell state for the C4 quantum error detection code.

Between Nation and State: Albanian Associations from Ottoman Origins to a Communist Party, 1880 - 1945

This dissertation addresses the broader antecedents of the Communist Party of Albania (CPA) as one of a number of associations whose experience was central to Albanian political history. This long experience dates back to the informal national associations formed in the Ottoman Empire of the late nineteenth century. The dissertation examines the role of these associations which, pursuing language rights and political representation through imperial state reforms, set a pattern that struggled to connect nation and state, rather than asserting the territorial demands for a nation-state familiar across the region. Starting out in the Ottoman Empire, but then maturing in the Albanian diaspora in Romania, Bulgaria, Egypt and the United States, this dissertation shows politically significant processes of longer-term adaptation that created informal associations as institutional structures able to channel collective action. It then traces the reframing of these patterns through their destruction in the Balkan Wars and the First World War to the emergence of communist associations in the interwar period and beyond. This dissertation is a sustained study that traces long-term Ottoman imperial political legacies in the Albanian successor state. The story of the associations, based on hitherto unexamined archival documents, shows that the Albanians possessed a far greater capacity for political mobilization that previously acknowledged by historians. Moreover, the dissertation successfully challenges the conventional wisdom that portrays the Albanians as irreparably divided along sectarian and regional faultlines. It finds that Albanian national activism was civic in character rather than ethnic as elsewhere in the Balkans. The Albanians fought to remain within a multinational framework because this afforded them political security, social advancement and potential economic growth. In the late Ottoman period, this political objective was manifested in the acceptance of the supranational imperial order whereas during the Second World War, in the aspiration to become members of the Comintern internationalist movement. Another important find, is the newly-discovered evidence concerning the founding of the CPA and its wartime conduct as an organization created and led by the Albanians themselves, albeit with Yugoslav ideological assistance under the transnational umbrella of the Comintern.

Who Governs Educational Change? The Paradoxes of State Power and the Pursuit of Educational Reform in Post-Neoliberal Ecuador (2007-2015)

This study identifies and compares competing policy stories of key actors involved in the Ecuadorian education reform under President Rafael Correa from 2007-2015. By revealing these competing policy stories the study generates insights into the political and technical aspects of education reform in a context where state capacity has been eroded by decades of neoliberal policies. Since the elections in 2007, President Correa has focused much of his political effort and capital on reconstituting the state’s authority and capacity to not only formulate but also implement public policies. The concentration of power combined with a capacity building agenda allowed the Correa government to advance an ambitious comprehensive education reform with substantive results in equity and quality. At the same time the concentration of power has undermined a more inclusive and participatory approach which are essential for deepening and sustaining the reform. This study underscores both the limits and importance of state control over education; the inevitable conflicts and complexities associated with education reforms that focus on quality; and the limits and importance of participation in reform. Finally, it examines the analytical benefits of understanding governance, participation and quality as socially constructed concepts that are tied to normative and ideological interests.

Two-State Thermodynamics of Supercooled Water

Water has been called the “most studied and least understood” of all liquids, and upon supercooling its behavior becomes even more anomalous. One particularly fruitful hypothesis posits a liquid-liquid critical point terminating a line of liquid-liquid phase transitions that lies just beyond the reach of experiment. Underlying this hypothesis is the conjecture that there is a competition between two distinct hydrogen-bonding structures of liquid water, one associated with high density and entropy and the other with low density and entropy. The competition between these structures is hypothesized to lead at very low temperatures to a phase transition between a phase rich in the high-density structure and one rich in the low-density structure. Equations of state based on this conjecture have given an excellent account of the thermodynamic properties of supercooled water. In this thesis, I extend that line of research. I treat supercooled aqueous solutions and anomalous behavior of the thermal conductivity of supercooled water. I also address supercooled water at negative pressures, leading to a framework for a coherent understanding of the thermodynamics of water at low temperatures. I supplement analysis of experimental results with data from the TIP4P/2005 model of water, and include an extensive analysis of the thermodynamics of this model.

DEVELOPMENT OF LI+ AND NA+ CONDUCTING CERAMICS AND CERAMIC STRUCTURES FOR USE IN SOLID STATE BATTERIES

A solid state lithium metal battery based on a lithium garnet material was developed, constructed and tested. Specifically, a porous-dense-porous trilayer structure was fabricated by tape casting, a roll-to-roll technique conducive to high volume manufacturing. The high density and thin center layer (< 20 μm) effectively blocks dendrites even over hundreds of cycles. The microstructured porous layers, serving as electrode supports, are demonstrated to increase the interfacial surface area available to the electrodes and increase cathode loading. Reproducibility of flat, well sintered ceramics was achieved with consistent powderbed lattice parameter and ball milling of powderbed. Together, the resistance of the LLCZN trilayer was measured at an average of 7.6 ohm-cm2 in a symmetric lithium cell, significantly lower than any other reported literature results. Building on these results, a full cell with a lithium metal anode, LLCZN trilayer electrolyte, and LiCoO2 cathode was cycled 100 cycles without decay and an average ASR of 117 ohm-cm2. After cycling, the cell was held at open circuit for 24 hours without any voltage fade, demonstrating the absence of a dendrite or short-circuit of any type. Cost calculations guided the optimization of a trilayer structure predicted that resulting cells will be highly competitive in the marketplace as intrinsically safe lithium batteries with energy densities greater than 300 Wh/kg and 1000 Wh/L for under $100/kWh. Also in the pursuit of solid state batteries, an improved Na+ superionic conductor (NASICON) composition, Na3Zr2Si2PO12, was developed with a conductivity of 1.9x10-3 S/cm. New super-lithiated lithium garnet compositions, Li7.06La3Zr1.94Y0.06O12 and Li7.16La3Zr1.84Y0.16O12, were developed and studied revealing insights about the mechanisms of conductivity in lithium garnets.

Multi-level, Multi-stage and Stochastic Optimization Models for Energy Conservation in Buildings for Federal, State and Local Agencies

Energy Conservation Measure (ECM) project selection is made difficult given real-world constraints, limited resources to implement savings retrofits, various suppliers in the market and project financing alternatives. Many of these energy efficient retrofit projects should be viewed as a series of investments with annual returns for these traditionally risk-averse agencies. Given a list of ECMs available, federal, state and local agencies must determine how to implement projects at lowest costs. The most common methods of implementation planning are suboptimal relative to cost. Federal, state and local agencies can obtain greater returns on their energy conservation investment over traditional methods, regardless of the implementing organization. This dissertation outlines several approaches to improve the traditional energy conservations models. Any public buildings in regions with similar energy conservation goals in the United States or internationally can also benefit greatly from this research. Additionally, many private owners of buildings are under mandates to conserve energy e.g., Local Law 85 of the New York City Energy Conservation Code requires any building, public or private, to meet the most current energy code for any alteration or renovation. Thus, both public and private stakeholders can benefit from this research. The research in this dissertation advances and presents models that decision-makers can use to optimize the selection of ECM projects with respect to the total cost of implementation. A practical application of a two-level mathematical program with equilibrium constraints (MPEC) improves the current best practice for agencies concerned with making the most cost-effective selection leveraging energy services companies or utilities. The two-level model maximizes savings to the agency and profit to the energy services companies (Chapter 2). An additional model presented leverages a single congressional appropriation to implement ECM projects (Chapter 3). Returns from implemented ECM projects are used to fund additional ECM projects. In these cases, fluctuations in energy costs and uncertainty in the estimated savings severely influence ECM project selection and the amount of the appropriation requested. A risk aversion method proposed imposes a minimum on the number of “of projects completed in each stage. A comparative method using Conditional Value at Risk is analyzed. Time consistency was addressed in this chapter. This work demonstrates how a risk-based, stochastic, multi-stage model with binary decision variables at each stage provides a much more accurate estimate for planning than the agency’s traditional approach and deterministic models. Finally, in Chapter 4, a rolling-horizon model allows for subadditivity and superadditivity of the energy savings to simulate interactive effects between ECM projects. The approach makes use of inequalities (McCormick, 1976) to re-express constraints that involve the product of binary variables with an exact linearization (related to the convex hull of those constraints). This model additionally shows the benefits of learning between stages while remaining consistent with the single congressional appropriations framework.

MULTI-UNIT ACCIDENT CONTRIBUTIONS TO U.S. NUCLEAR REGULATORY COMMISSION QUANTITATIVE HEALTH OBJECTIVES: A SAFETY GOAL POLICY ANALYSIS USING MODELS FROM STATE-OF-THE-ART REACTOR CONSEQUENCE ANALYSES

The U.S. Nuclear Regulatory Commission implemented a safety goal policy in response to the 1979 Three Mile Island accident. This policy addresses the question “How safe is safe enough?” by specifying quantitative health objectives (QHOs) for comparison with results from nuclear power plant (NPP) probabilistic risk analyses (PRAs) to determine whether proposed regulatory actions are justified based on potential safety benefit. Lessons learned from recent operating experience—including the 2011 Fukushima accident—indicate that accidents involving multiple units at a shared site can occur with non-negligible frequency. Yet risk contributions from such scenarios are excluded by policy from safety goal evaluations—even for the nearly 60% of U.S. NPP sites that include multiple units. This research develops and applies methods for estimating risk metrics for comparison with safety goal QHOs using models from state-of-the-art consequence analyses to evaluate the effect of including multi-unit accident risk contributions in safety goal evaluations.

Phylogenetics, Ancestral State Reconstruction, And A New Infrafamilial Classification Of The Pantropical Ochnaceae (medusagynaceae, Ochnaceae S.str., Quiinaceae) Based On Five Dna Regions.

Ochnaceae s.str. (Malpighiales) are a pantropical family of about 500 species and 27 genera of almost exclusively woody plants. Infrafamilial classification and relationships have been controversial partially due to the lack of a robust phylogenetic framework. Including all genera except Indosinia and Perissocarpa and DNA sequence data for five DNA regions (ITS, matK, ndhF, rbcL, trnL-F), we provide for the first time a nearly complete molecular phylogenetic analysis of Ochnaceae s.l. resolving most of the phylogenetic backbone of the family. Based on this, we present a new classification of Ochnaceae s.l., with Medusagynoideae and Quiinoideae included as subfamilies and the former subfamilies Ochnoideae and Sauvagesioideae recognized at the rank of tribe. Our data support a monophyletic Ochneae, but Sauvagesieae in the traditional circumscription is paraphyletic because Testulea emerges as sister to the rest of Ochnoideae, and the next clade shows Luxemburgia+Philacra as sister group to the remaining Ochnoideae. To avoid paraphyly, we classify Luxemburgieae and Testuleeae as new tribes. The African genus Lophira, which has switched between subfamilies (here tribes) in past classifications, emerges as sister to all other Ochneae. Thus, endosperm-free seeds and ovules with partly to completely united integuments (resulting in an apparently single integument) are characters that unite all members of that tribe. The relationships within its largest clade, Ochnineae (former Ochneae), are poorly resolved, but former Ochninae (Brackenridgea, Ochna) are polyphyletic. Within Sauvagesieae, the genus Sauvagesia in its broad circumscription is polyphyletic as Sauvagesia serrata is sister to a clade of Adenarake, Sauvagesia spp., and three other genera. Within Quiinoideae, in contrast to former phylogenetic hypotheses, Lacunaria and Touroulia form a clade that is sister to Quiina. Bayesian ancestral state reconstructions showed that zygomorphic flowers with adaptations to buzz-pollination (poricidal anthers), a syncarpous gynoecium (a near-apocarpous gynoecium evolved independently in Quiinoideae and Ochninae), numerous ovules, septicidal capsules, and winged seeds with endosperm are the ancestral condition in Ochnoideae. Although in some lineages poricidal anthers were lost secondarily, the evolution of poricidal superstructures secured the maintenance of buzz-pollination in some of these genera, indicating a strong selective pressure on keeping that specialized pollination system.

Emergent Antiferromagnetism Out Of The Hidden-order" State In Uru2si2: High Magnetic Field Nuclear Magnetic Resonance To 40 T."

Very high field (29)Si-NMR measurements using a fully (29)Si-enriched URu(2)Si(2) single crystal were carried out in order to microscopically investigate the hidden order (HO) state and adjacent magnetic phases in the high field limit. At the lowest measured temperature of 0.4 K, a clear anomaly reflecting a Fermi surface instability near 22 T inside the HO state is detected by the (29)Si shift, (29)K(c). Moreover, a strong enhancement of (29)K(c) develops near a critical field H(c) ≃ 35.6 T, and the ^{29}Si-NMR signal disappears suddenly at H(c), indicating the total suppression of the HO state. Nevertheless, a weak and shifted (29)Si-NMR signal reappears for fields higher than H(c) at 4.2 K, providing evidence for a magnetic structure within the magnetic phase caused by the Ising-type anisotropy of the uranium ordered moments.

[impact Variables On The Decline In Infant Mortality In The State Of São Paulo, Brazil: 1998-2008].

This is an ecological, analytical and retrospective study comprising the 645 municipalities in the State of São Paulo, the scope of which was to determine the relationship between socioeconomic, demographic variables and the model of care in relation to infant mortality rates in the period from 1998 to 2008. The ratio of average annual change for each indicator per stratum coverage was calculated. Infant mortality was analyzed according to the model for repeated measures over time, adjusted for the following correction variables: the city's population, proportion of Family Health Programs (PSFs) deployed, proportion of Growth Acceleration Programs (PACs) deployed, per capita GDP and SPSRI (São Paulo social responsibility index). The analysis was performed by generalized linear models, considering the gamma distribution. Multiple comparisons were performed with the likelihood ratio with chi-square approximate distribution, considering a significance level of 5%. There was a decrease in infant mortality over the years (p < 0.05), with no significant difference from 2004 to 2008 (p > 0.05). The proportion of PSFs deployed (p < 0.0001) and per capita GDP (p < 0.0001) were significant in the model. The decline of infant mortality in this period was influenced by the growth of per capita GDP and PSFs.

[diet Quality And Associated Factors Among The Elderly: A Population-based Study In Campinas, São Paulo State, Brazil].

The aim of this study was to assess the quality of diet among the elderly and associations with socio-demographic variables, health-related behaviors, and diseases. A population-based cross-sectional study was conducted in a representative sample of 1,509 elderly participants in a health survey in Campinas, São Paulo State, Brazil. Food quality was assessed using the Revised Diet Quality Index (DQI-R). Mean index scores were estimated and a multiple regression model was employed for the adjusted analyses. The highest diet quality scores were associated with age 80 years or older, Evangelical religion, diabetes mellitus, and physical activity, while the lowest scores were associated with home environments shared with three or more people, smoking, and consumption of soft drinks and alcoholic beverages. The findings emphasize a general need for diet quality improvements in the elderly, specifically in subgroups with unhealthy behaviors, who should be targeted with comprehensive strategies.

A New Species Of Pseudopaludicola Miranda-ribeiro, 1926 (anura: Leptodactylidae: Leiuperinae) From Northwestern State Of São Paulo, Brazil.

A new species of Pseudopaludicola is described from human-altered areas originally covered by Semideciduous Forest in northwestern state of São Paulo, southeastern Brazil. Morphologically, the new species differs from four species belonging to the P. pusilla group by the absence of either T-shaped terminal phalanges or toe tips expanded, and from all other congeners except P. canga and P. facureae by possessing an areolate vocal sac, with dark reticulation. The higher duration (300-700 ms) of each single, pulsed note (9-36 nonconcatenated pulses) that compose the call in the new species distinguishes it from all other 14 species of Pseudopaludicola with calls already described (10-290 ms). Absence of harmonics also differ the advertisement call of the new species from the call of its sister species P. facureae, even though these two species presented unexpected low genetic distances. Although we could not identify any single morphological character distinguishing the new species from P. facureae, a PCA and DFA performed using 12 morphometric variables evidenced significant size differences between these two species.