"Streamlined auditing and monitoring of community based services: first steps toward a more efficient system for providers, state government, and the community" : report to the Illinois General Assembly as required by PA 96-1141 /

The Steering Committee recognizes that the Departments may need to implement reviews necessary to address specific Federal requirements and that while consolidated reporting should be used when possible, the review and reporting processes should facilitate the ability to garner Federal funding. However, the analysis thus far confirms the need for change and a significant potential to reduce redundant monitoring and reporting. At the end of this Executive Summary, there is a summary presentation, including a timeline and progress indicators, that gives more details on these recommendations.

Report of the Community Integrated Living Arrangement Nursing Services Reimbursement Work Group to the Secretary of the Department of Human Services, the Illinois General Assembly, and the Honorable Rod R. Blagojevich, Governor : in response to Senate Resolution 514 /

This report presents the findings and recommendations of the Work Group; it evaluates the Division of Developmental Disabilities' CILA rate model in terms of the sufficiency of nursing services included in the model, as well as the competitiveness of the wage levels assumed by the model for nurses working in the CILAs. In accordance with Resolution 514, the report is the product of the Working Group's discussions and requests for information and has been facilitated by the Department of Human Services, Division of Developmental Disabilities. As such, the report does not represent the recommendations of the Department of Human Services, nor can the Department of Human Services make any commitment to implement any of the report recommendations or commit funding without executive and legislative direction and a funding appropriation. However, the recommendations of the Work Group are consistent with the nursing services structures of the CILA rate-model and would enhance nursing services reimbursement in CILA, if adopted.

What is the Community Services Block Grant Program?

The Community Services Block Grant (CSBG) Program was created by the federal Omnibus Budget Reconciliation Act of 1981. The CSBG Program provides a range of services which assist low-income people to attain the skills, knowledge and motivation necessary to achieve self-sufficiency. The program also may offer low-income people immediate life necessities such as food, shelter, medication, etc.

Plaque with the Journey to Emmaus and Noli Me Tangere

Ivory, Spanish, 12C; 10 5/8 in.x 5 9/32 in.x 3/4 in.; ivory, traces of gilding

Plaque with the Crucifixion between Longinus and Stephaton and Personifications of the Sun and Moon

9 1/16 in.x 7 43/64 in.x 5/16 in.; champlevé enamel, copper

Plaque with the Crucifixion between Longinus and Stephaton and Personifications of the Sun and Moon: detail

champlevé enamel, copper

Plaque with the Journey to Emmaus and Noli Me Tangere: top

Ivory, Spanish, 12C; ivory, traces of gilding

Plaque with the Journey to Emmaus and Noli Me Tangere: bottom

Ivory, Spanish, 12C; ivory, traces of gilding

The answer of Mr. Sullivan, to the letter and mis-statements of the Hon. Cadwallader D. Colden, in his "Brief exposition" of himself as the advocate of monopoly. The unconstitutionality or limitation of the monopoly demonstrated. The bad policy and injurious effects of it on the community exposed. The legality of an extension of the term of time of a patent when for the good of a state; and the just views and claims of patentees in steam navigation fully explained.

Pages 29-34 contain "Mr. Duer's opinion on the claim of Mr. Sullivan as a patentee, to navigate with steam boats, the waters of the state of New-York."

Ice-atmosphere interactions and sea ice predictability at multiple resolutions in the Community Earth System Model

Thesis (Master's)--University of Washington, 2016-06

The individual within the group: Balancing the need to belong with the need to be different

Many theorists have wrestled with the notion of how people balance their need to be included in social groups with their need to be different and distinctive. This question is particularly salient to researchers from the social identify perspective, who have traditionally viewed individual differentiation within groups as being inimical to group identification. In this article we present a number of strategies that people can use to balance their need to belong and their need to be different, without violating social identity principles. First, drawing from optimal distinctiveness theory, we discuss 4 ways in which the need for belonging and the need to be different can be resolved by maximizing group distinctiveness. We then discuss 4 ways in which it is possible to achieve individual differentiation within a group at the same time demonstrating group identification. These strategies are discussed and integrated with reference to recent empirical research and to the social identity perspective.

Diversity of polyketide synthase genes from bacteria associated with the marine sponge Pseudoceratina clavata: culture-dependent and culture-independent approaches

Diverse ketosynthase (KS) genes were retrieved from the microbial community associated with the Great Barrier Reef sponge Pseudoceratina clavata. Bacterial isolation and metagenomic approaches were employed. Phylogenetic analysis of 16S rRNA of culturable sponge-associated bacterial communities comprised eight groups over four phyla. Ten KS domains were amplified from four genera of isolates and phylogenetics demonstrated that these KS domains were located in three clusters (actinobacterial, cyanobacterial and trans-AT type). Metagenomic DNA of the sponge microbial community was extracted to explore community KS genes by two approaches: direct amplification of KS domains and construction of fosmid libraries for KS domain screening. Five KS domains were retrieved from polymerase chain reaction (PCR) amplification using sponge metagenome DNA as template and five fosmid clones containing KS domains found using multiplex PCR screening. Analysis of selected polyketide synthase (PKS) from one fosmid showed that the PKS consists of two modules. Open reading frames located up- and downstream of the PKS displayed similarity with membrane synthesis-related proteins such as cardiolipin synthase. Metagenome approaches did not detect KS domains found in sponge isolates. All KS domains from both metagenome approaches formed a single cluster with KS domains originating from metagenomes derived from other sponge species from other geographical regions.

Characteristics of left ventricular diastolic dysfunction in the community: an echocardiographic survey

Objective: To determine the prevalence and predictors of left ventricular (LV) diastolic dysfunction in older adults. Design, setting and participants: A cross-sectional survey of 1275 randomly selected residents of Canberra, aged 60 to 86 years (mean age 69.4; 50% men), conducted between February 2002 and June 2003. Main outcome measures: Prevalence of LV diastolic dysfunction as characterised by comprehensive Doppler echocardiography. Results: The prevalence of any diastolic dysfunction was 34.7% (95% CI 32.1% to 37.4%) and that of moderate to severe diastolic dysfunction was 7.3% (95% CI 5.9% to 8.9%). Of subjects with moderate to severe diastolic dysfunction, 77.4% had an LV ejection fraction (EF) > 50% and 76.3% were in a preclinical stage of disease. Predictors of diastolic dysfunction were higher age (p < 0.0001), reduced EF (p < 0.0001), obesity (p < 0.0001) and a history of hypertension (p < 0.0001), diabetes (p = 0.02) and myocardial infarction (p = 0.003). Moderate to severe diastolic dysfunction with normal EF, although predominantly preclinical, was independently associated with increased LV mass (p < 0.0001), left atrial volume (p < 0.0001), and circulating amino-terminal pro-B-type natriuretic peptide concentrations (p < 0.0001), and with decreased quality of life (p < 0.005). Conclusion: Diastolic dysfunction is common in the community and often unaccompanied by overt congestive heart failure. Despite the lack of symptoms, advanced diastolic dysfunction with normal EF is associated with reduced quality of life and structural abnormalities that reflect increased cardiovascular risk.

What does the community think about lifespan extension technologies? The need for an empirical base for ethical and policy debates

Objectives: This paper examines public understandings of possibilities for increasing life expectancy, interest in taking up lifespan-extending interventions, and motivations influencing these intentions. Methods: Structured interviews were conducted with 31 adults, aged 50 and over. Results: Participants believed that technological advances would increase life expectancy but questioned the value of quantity over quality of life. Life in itself was not considered valuable without the ability to put it to good use. Participants would not use technologies to extend their own lifespan unless the result would also enhance their health. Conclusions: These findings may not be generalisable to the general public but they provide the first empirical evidence on the plausibility of common assumptions about public interest in 'anti-ageing' interventions. Surveys of the views of representative samples of the population are needed to inform the development of a research agenda on the ethical, legal and social implications of lifespan extension.

The utility of aminoterminal pro-B-type natriuretic peptide for the detection of preclinical systolic and diastolic dysfunction in the community

Background: There is scant data regarding methods to identify subjects in the community with preclinical left ventricular (LV) systolic and diastolic dysfunction. Methods: A population-based sample of 1229 older adults underwent examination with transthoracic echocardiography and measurement of circulating aminoterminal pro-Btype natriuretic peptide (N-BNP) levels. Heart failure status was ascertained according to past history and clinical examination. The ability of N-BNP to detect preclinical LV ejection fraction (EF)