930 resultados para supplemental coverage option


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Electrospinning (ES) can readily produce polymer fibers with cross-sectional dimensions ranging from tens of nanometers to tens of microns. Qualitative estimates of surface area coverage are rather intuitive. However, quantitative analytical and numerical methods for predicting surface coverage during ES have not been covered in sufficient depth to be applied in the design of novel materials, surfaces, and devices from ES fibers. This article presents a modeling approach to ES surface coverage where an analytical model is derived for use in quantitative prediction of surface coverage of ES fibers. The analytical model is used to predict the diameter of circular deposition areas of constant field strength and constant electrostatic force. Experimental results of polyvinyl alcohol fibers are reported and compared to numerical models to supplement the analytical model derived. The analytical model provides scientists and engineers a method for estimating surface area coverage. Both applied voltage and capillary-to-collection-plate separation are treated as independent variables for the analysis. The electric field produced by the ES process was modeled using COMSOL Multiphysics software to determine a correlation between the applied field strength and the size of the deposition area of the ES fibers. MATLAB scripts were utilized to combine the numerical COMSOL results with derived analytical equations. Experimental results reinforce the parametric trends produced via modeling and lend credibility to the use of modeling techniques for the qualitative prediction of surface area coverage from ES. (Copyright: 2014 American Vacuum Society.)

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Background Access to health care can be described along four dimensions: geographic accessibility, availability, financial accessibility and acceptability. Geographic accessibility measures how physically accessible resources are for the population, while availability reflects what resources are available and in what amount. Combining these two types of measure into a single index provides a measure of geographic (or spatial) coverage, which is an important measure for assessing the degree of accessibility of a health care network. Results This paper describes the latest version of AccessMod, an extension to the Geographical Information System ArcView 3.×, and provides an example of application of this tool. AccessMod 3 allows one to compute geographic coverage to health care using terrain information and population distribution. Four major types of analysis are available in AccessMod: (1) modeling the coverage of catchment areas linked to an existing health facility network based on travel time, to provide a measure of physical accessibility to health care; (2) modeling geographic coverage according to the availability of services; (3) projecting the coverage of a scaling-up of an existing network; (4) providing information for cost effectiveness analysis when little information about the existing network is available. In addition to integrating travelling time, population distribution and the population coverage capacity specific to each health facility in the network, AccessMod can incorporate the influence of landscape components (e.g. topography, river and road networks, vegetation) that impact travelling time to and from facilities. Topographical constraints can be taken into account through an anisotropic analysis that considers the direction of movement. We provide an example of the application of AccessMod in the southern part of Malawi that shows the influences of the landscape constraints and of the modes of transportation on geographic coverage. Conclusion By incorporating the demand (population) and the supply (capacities of heath care centers), AccessMod provides a unifying tool to efficiently assess the geographic coverage of a network of health care facilities. This tool should be of particular interest to developing countries that have a relatively good geographic information on population distribution, terrain, and health facility locations.

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Terrorists, policy-makers, and terrorism scholars have long assumed that the mere threat of terrorist strikes affects societies that have experienced actual acts of terrorism. For this reason, most definitions of terrorism include the threat of violent political acts against civilians. But so far research has neither validated this conventional wisdom nor demonstrated how actual and mass-mediated threat messages by terrorists and terror alerts and threat assessments by government officials affect the public in targeted states. This paper fills the gap providing evidence that who conveys such messages matters and that mass-mediated threat messages by al Qaeda leaders and announced alerts and threat assessments by U.S. administration officials had a significant impact on the American public’s threat perceptions in the post-9/11 years.

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When I was living in Igboland in 1993 and from 1994 to 1996, there was not much talk about Biafra, the secessionist republic that had been defeated by the Nigerian army in 1970. Not one Igbo politician suggested that his or her people in the southeast of Nigeria should secede again and proclaim a second Biafra. Since 1984, Nigeria had been ruled by the military, and political hopes focused on a return to democracy. Democracy did come in 1999, but it proved a big disappointment. It did not end the marginalisation of the Igbo but led to an increase in the number of ethnic and religious clashes, with Igbo 'migrants' in northern Nigeria as the main victims. It was Nigeria's fourth transition to democracy, and the Igbo lost out again. When I returned to Igboland for brief visits between 2000 and 2007, the option of a new Biafra was widely discussed. Many of my former colleagues at the University of Nsukka seemed to be in favour of the secession project. I talked to supporters of the main separatist organisation, Movement for the Actualisation of a Sovereign State of Biafra (MASSOB), and I discussed the project with members of Ohanaeze, a loose association of Igbo politicians, most of whom had distanced themselves from radical secessionism. In order to learn more about the resurgence of Igbo nationalism, I collected Igbo periodicals. A few of them, such as the New Republic, resembled newspapers; others, like News Round, Eastern Sunset or Weekly Hammer (with eight pages in A4 size), looked more like political pamphlets. Street vendors used back issues as wrapping paper, so they were easy to get. Most of them had been edited not in Igboland, but in Lagos, Nigeria's commercial centre and former capital which is home to a huge Igbo diaspora. Though written in English, these publications are addressed exclusively to an Igbo readership, discussing global and domestic affairs from a nationalist point of view. Articles printed here, no matter their topic, are nationalist in the sense that they assess things from the standpoint of Igbo interests. The same is true of many articles on Igbo websites and of some books and brochures written for an Igbo audience. Another source of information on Igbo nationalism are statements by Igbo governors, ministers, members of parliament and other professional politicians who are quoted in newspapers, such as Vanguard or Guardian, and in weekly magazines such as Newswatch, Tell or The News – all with a Nigeria-wide circulation and a multi-ethnic readership. Nigeria's papers and magazines are among the best in Africa. They try to be balanced in their coverage of ethnic conflicts, and they give reliable information. The same cannot be said of periodicals produced by Igbo nationalists. They provide space for Igbo all over the world to voice their opinions, and they tolerate much controversy, but they are not accurate when reporting facts.

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A feeding trial was conducted with 860-lb yearling steers fed 121 days to evaluate Condensed Porcine Solubles (Porcine Solubles) as a source of supplemental nitrogen for finishing cattle. Diets containing 5% soybean meal, 1.46% urea, and 2% or 4% Porcine Solubles were compared. When first offered, cattle did not want to consume feed containing the Porcine Solubles. Following adaptation, feed containing up to 4% Porcine Solubles was readily consumed. During the first 56 days, steers fed soybean meal gained faster and were more efficient than steers fed urea or Porcine Solubles. At the end of the trial there were no differences among the nitrogen supplements in feed intake, gain, or feed conversion. There were no significant differences in carcass weight or measures of carcass quality.

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Two 3 x 3 latin squares were utilized in an 84-day digestion trial with ruminally- and duodenallycannulated steers. Diets consisted of 73 to 78% whole corn grain, 12.3% corn silage and 2.0% N, with treatment differences being high-oil corn- (HOC), isogenetic typical-corn- (TC), or isogenetic typical-corn + fat- (TC+F) based diets. The HOC and TC+F diets were formulated to provide the same ether extract (EE) content. All diets were fed at 90% of ad libitum intake. Chromic oxide was used as a digestibility marker. Total tract dry matter (DM) (P=.08), organic matter (OM) (P=.08) and nitrogen (N) (P=.06) digestibilities tended to be greater for TC than HOC diets, whereas starch neutral detergent fiber (NDF), acid detergent fiber (ADF), and ether extract digestibilities were similar (P>.10). There were no differences (P>.10) in total tract dry matter, organic matter, starch, NDF, ADF, ether extract, or nitrogen digestibilities between TC+F and HOC diets or TC and TC+F diets. Ruminal digestion of dry matter, organic matter, starch, NDF, ADF, and feed nitrogen was similar (P>.10) among treatments. Microbial-nitrogen flow and efficiencies were also similar (P>.10) among treatments. Results indicate finishing steer diets composed of primarily HOC are equally or less digestible than similar diets composed of TC, and adding fat to TC diets did not affect the digestibility of the diet when fed to finishing steers.

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Forty Hampshire and 40 Suffolk ewes were allotted to one of four groups (VitA, VitE, VitA&E, Control) in a 2 x 2 factorial treatment arrangement to evaluate the effect of supplemental vitamin E (0 or 300 IU) and vitamin A (0 or 250,000 IU) on reproductive performance. Laparoscopy and ultrasonography were used to measure ovulation rate, embryonic loss, and fetal loss. Serum profiles of a-tocopherol (vitamin E) and retinol (vitamin A) also were monitored. There were no differences (P>.05) among treatment groups in any reproductive trait. Suffolk ewes exhibited a higher (P<.02) ovulation rate than Hampshire ewes, and yearling ewes incurred higher (P<.001) embryonic loss than other age groups, resulting in a lower (P<.001) litter size. Serum levels of a-tocopherol were higher (P<.05) for Hampshire than for Suffolk ewes and were lower (P<.001) in yearling ewes versus ewes two years of age and older. Serum levels of a-tocopherol declined (P<.01) throughout the study in VitA and Control ewes but remained unchanged in VitE and VitA&E ewes. Serum level of retinol remained unchanged in VitA ewes, whereas the level increased (P<.01) initially in VitE, VitA&E, and Control ewes before declining toward initial levels. Correlations were detected between ovulation rate and the change of pre-mating a-tocopherol serum level (r=-.29; P<.02), the change in pre-mating retinol serum level (r=-.50; P<.02) and the interval from vitamin A injection (r=-.60; P<.05). These data indicate significant influences of breed, age, and treatment on a-tocopherol and retinol serum levels in ewes and suggest that the timing of vitamin A administration may influence ovulation rate; however, vitamin supplementation, administered at random stages of the estrous cycle, was unable to alter flock reproductive performance.

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Economic comparisons of income on highly erodible land (HEL) in Adams County were made utilizing five years of grazing data collected from a 13- paddock intensive-rotational grazing system and a four-paddock rotational-grazing system and four years of data collected from an 18-paddock intensive-rotational grazing system, all at the Adams County CRP Research and Demonstration Farm near Corning. Net income from the average grazing weight-gain of Angus-sired calves nursing crossbred cows was compared to the net income from grazing yearling steers, to the net income of eight NRCS-recommended crop rotations, and to the Conservation Reserve Program (CRP) option. Results of these comparisons show the 13-paddock intensive rotational grazing system with cow-calf pairs to be the most profitable alternative, with a net return of $19.86 per acre per year. The second most profitable alternative is the CRP option, with a net return of $13.09 per acre, and the third most profitable option is the fourpaddock rotation with cows and calves with a net return of $12.53 per acre. An 18-paddock system returned a net income of $2.47 per acre per year with cows and calves in 1993, but lost an average of $107.69 per acre each year in 1994 and 1995 with yearling steers. Each year, the steers were purchased high and sold low, contributing to the large loss per acre. The following recommended crop rotations all show net losses on these 9-14 % slope, Adair-Shelby Complex soils (ApD3): continuous corn; corn-soybean rotation; corn-soybean rotation with a farm program deficiency payment; corn-corn-corn-oats-meadow-meadow rotation with grass headlands; continuous corn to “T” with grass headlands and buffer strips; continuous corn to “T” with grass headlands, buffer strips, and a deficiency payment; corn-corn-oats-meadow rotation to “T”; and corn-soybeans-oats-meadow-meadow-meadow-meadow rotation to “T”. Per-acre yield assumptions of 90 bushels for corn, 30 bushels for soybeans, 45 bushels for oats, and four tons for alfalfa were used, with per-bushel prices of $2.40 on corn, $5.50 on soybeans, and $1.50 on oats. Alfalfa hay was priced at $40.00 per ton and grass hay at $33.33 per ton. The calf weight-gain in the cow/ calf systems was valued at $.90 per pound. All crop expenses except land costs were calculated from ISU publication Fm 1712, “Estimated Costs of Crop Production in Iowa - 1995.” Land costs were determined by using an opportunity cost and actual property tax figures for the land at the grazing site. In preparation for the end of the CRP beginning in 1996, further economic comparisons will be made after additional grazing seasons and data collection. This project is an interagency cooperative effort sponsored by the Southern Iowa Forage and Livestock Committee which has special permission from the USDA Farm Service Agency (FSA) to use CRP land for research and demonstration.

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OBJECTIVE To explore the levels and determinants of loss to follow-up (LTF) under universal lifelong antiretroviral therapy (ART) for pregnant and breastfeeding women ('Option B+') in Malawi. DESIGN, SETTING, AND PARTICIPANTS We examined retention in care, from the date of ART initiation up to 6 months, for women in the Option B+ program. We analysed nationwide facility-level data on women who started ART at 540 facilities (n = 21 939), as well as individual-level data on patients who started ART at 19 large facilities (n = 11 534). RESULTS Of the women who started ART under Option B+ (n = 21 939), 17% appeared to be lost to follow-up 6 months after ART initiation. Most losses occurred in the first 3 months of therapy. Option B+ patients who started therapy during pregnancy were five times more likely than women who started ART in WHO stage 3/4 or with a CD4 cell count 350 cells/μl or less, to never return after their initial clinic visit [odds ratio (OR) 5.0, 95% confidence interval (CI) 4.2-6.1]. Option B+ patients who started therapy while breastfeeding were twice as likely to miss their first follow-up visit (OR 2.2, 95% CI 1.8-2.8). LTF was highest in pregnant Option B+ patients who began ART at large clinics on the day they were diagnosed with HIV. LTF varied considerably between facilities, ranging from 0 to 58%. CONCLUSION Decreasing LTF will improve the effectiveness of the Option B+ approach. Tailored interventions, like community or family-based models of care could improve its effectiveness.

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OBJECTIVE To assess the association between socio-demographic factors and the quality of preventive care and chronic care of cardiovascular (CV) risk factors in a country with universal health care coverage. METHODS Our retrospective cohort assessed a random sample of 966 patients aged 50-80years followed over 2years (2005-2006) in 4 Swiss university primary care settings (Basel/Geneva/Lausanne/Zürich). We used RAND's Quality Assessment Tools indicators and examined recommended preventive care among different socio-demographic subgroups. RESULTS Overall patients received 69.6% of recommended preventive care. Preventive care indicators were more likely to be met among men (72.8% vs. 65.4%; p<0.001), younger patients (from 71.0% at 50-59years to 66.7% at 70-80years, p for trend=0.03) and Swiss patients (71.1% vs. 62.7% in forced migrants; p=0.001). This latter difference remained in multivariate analysis adjusted for gender, age, civil status and occupation (OR 0.68; 95% CI 0.54-0.86). Forced migrants had lower scores for physical examination and breast and colon cancer screening (all p≤0.02). No major differences were seen for chronic care of CV risk factors. CONCLUSION Despite universal healthcare coverage, forced migrants receive less preventive care than Swiss patients in university primary care settings. Greater attention should be paid to forced migrants for preventive care.

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BACKGROUND To report on anti-CD20 antibody therapy in a patient with uveitis refractive to immunosuppression therapy. METHODS Case report with ophthalmoscopic, optical coherence tomography and fluorescein-angiographic findings. RESULTS A 49-year-old woman was suffering from bilateral, noninfectious chronic anterior uveitis refractive to corticosteroids and immunosuppressive drugs. Bilateral visual acuity was 20/100 due to cataract and cystoid macular edema (CME). After treatment with rituximab, vision and CME improved, and uveitis was stable until the final visit (follow-up at 12 months). CONCLUSION The case report suggests that rituximab may be helpful for selected patients with chronic anterior uveitis refractive to corticosteroids and immunosuppressive medication.

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Seit Jahren ist weltweit ein Anstieg der Inzidenz und Prävalenz der Herzinsuffizienz zu beobachten. Es wird geschätzt, dass zurzeit ungefähr 10 Mio Patienten in Europa an einer Herzinsuffizienz erkrankt sind. In der Schweiz handelt es sich nach Schätzungen um ca. 150'000 Patienten, davon befinden sich zirka 6-7% (10'000 Patienten) in der funktionellen Klasse IV.