Resolución 063 del 27 de mayo de 2013: Por la cual se resuelve un recurso de reposición y en subsidio de apelación

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Medicaid bulletin MB# 12-063

The South Carolina Department of Health and Human Services publishes Medicaid Bulletins to clarify existing policies or explain new policies of the Medicaid program.

Sustainable subdivisions – energy efficient design

Australia’s current pattern of residential development is resulting in urban sprawl and highlights the necessity for development to be more sustainable to avoid unnecessary demand on natural resources and to prevent environmental degradation and to safeguard the environment for future generations. This report summarises the results from a series of cases studies that examined the link between sub-divisional layout and dwelling energy efficiency, the possibility for a lot-rating tool and the potential for on site electricity generation.

Sustainable subdivisions – review of technologies for integrated water services

Water is a current major global, national and local issue. Historic drought and unprecedented restriction levels are now substantially influencing almost all Australia’s major cities. Residential design and adoption of appropriate technologies plays a key role in urban water efficiency. This project, the first of the CRC-CI Sustainable subdivisions program with a focus on water, explores the existing technologies available for sustainable suburbs.

Sustainable suburbs : the developer’s challenge

As our cities expand, developers are transforming more and more land to create our suburbs of the future. Developers and government bodies have a golden opportunity to design suburbs that are not only great places to live, but also are environmentally sensitive and sustainable. This is a unique opportunity, as significant changes after development are constrained by the configuration of the subdivision, and then by the construction of the dwellings. This paper explores some of these issues by presenting initial findings from the CRCCI, Sustainable Subdivisions Project. The Project examines the drivers and barriers that land developers face when trying to achieve sustainable subdivisions. This paper will review the results from a series of industry interviews and workshops and explore possible ways forward. In addition, the possible effect on the way future land subdivision is managed and planned as a result of recent changes in the energy efficiency provisions of the Building Code of Australia will be explored. This paper highlights problems that both builders and land developers may face through poor subdivision design. Finally an innovative program being driven by a major land developer will be introduced. The program aims to deliver over 400 energy and water efficient homes through a series of compulsory and voluntary schemes that the developer is designing, funding and implementing. This program is the first large-scale development in Australia that demonstrates how developers can help achieve environmentally sensitive and sustainable suburbs of the future.

Energy efficient multi storey residential developments

Worldwide, the current pattern of urban development is unsustainable and metropolitan planning and development strategies deliver poor environmental outcomes in relation to energy production. As a result, an increasing number of governments and private sector development companies are initiating projects that aim to deliver enhanced environmental outcomes rather than a ‘business as usual’ approach. This paper will summarise the findings from a study that explored the link between building orientation and energy efficiencies in sub-tropical and tropical climates. The study used a new thermal modelling software tool developed by CSIRO that responds more accurately to residential heating and cooling energy performance in those climate zones. This software tool responds to industry criticisms regarding cold climate modelling systems that do not make sufficient allowance for natural ventilation. The study examined a range of low, medium and high-density dwelling types and investigated the impact of orientation, insulation, ventilation and shading devices on energy efficiencies. This paper will examine the findings from the medium and high-density case study developments as these are relevant to residential developments in many South East Asian countries, such as Singapore, Hong Kong and Malaysia. Finally, the paper will explore the potential benefits that medium and high-density residential developments have in the development of ‘solar cities’ and ‘solar suburbs’.

How to achieve sustainability : regulatory challenges

The importance of designing sustainable buildings is gaining greater acceptance worldwide. Evidence of this is how regulators are incorporating sustainable design principles into building regulations and requirements. The aim being to increase the number of sustainable buildings and move from a traditional voluntary compliance to one that is mandatory. However, developing regulations that actually achieve these aims can be a difficult exercise. Several countries in South East Asia, such as Singapore and Malaysia, have performance based building regulations that are supplemented by prescriptive measures for achieving the desired performance. Australia too has similar building regulations and has had energy efficiency regulations within the Building Code of Australia for over a decade. This paper explores some of the difficulties and problems that Australian regulators have experienced with the performance-based method and the prescriptive or “deemed-to-comply” method and measures that have been taken to try and overcome these problems. These experiences act as a useful guide to all regulators considering the incorporation of sustainable design measures into their countries building regulations. The paper also speculates on future environmental requirements being incorporated into regulations, including the possibility of non-residential buildings being required to meet minimum energy efficiency requirements, and the possible systems that would need to be in place before such requirements were included. Finally, the paper looks at a possible way forward using direct assessment from electronic designs and introduces several software tools that are currently being developed that move towards achieving this goal. Keywords: Sustainable buildings, Performance-based, Regulations, Energy efficiency, Assessment tools.

Sustainable subdivisions : energy-efficient design report to industry

This report summarises the findings from the Sustainable Subdivisions: Energy-Efficient Design project. As new energy-efficiency regulations are developed, there will be a significant demand for information on available assessment tools for rating energy-efficient dwellings, and subdivisional issues such as orientation and solar access will become increasingly important. There will also be increased pressure for products that deliver energy efficiency, such as solar technology, glazing systems, insulation and low-energy building products and materials. The objectives of the Sustainable Subdivisions: Energy-Efficient Design project were to:

Raman spectroscopy of the multi anion mineral arsentsumebite Pb2Cu(AsO4)(SO4)(OH) and in comparison with tsumebite Pb2Cu(PO4)(SO4)(OH)

The mineral arsentsumebite Pb2Cu(AsO4)(SO4)(OH), a copper arsenate-sulfate hydroxide of the brackebuschite group has been characterised by Raman spectroscopy. The brackebuschite mineral group are a series of monoclinic arsenates, phosphates and vanadates of the general formula A2B(XO4)(OH,H2O), where A may be Ba, Ca, Pb, Sr, while B may be Al, Cu2+,Fe2+, Fe3+, Mn2+, Mn3+, Zn and XO4 may be AsO4, PO4, SO4,VO4. Bands are assigned to the stretching and bending modes of SO42- AsO43- and HOAsO3 units. Raman spectroscopy readily distinguishes between the two minerals arsentsumebite and tsumebite. Raman bands attributed to arsenate are not observed in the Raman spectrum of tsumebite. Phosphate bands found in the Raman spectrum of tsumebite are not found in the Raman spectrum of arsentsumebite. Raman spectroscopy readily distinguishes the two minerals tsumebite and arsentsumebite.

Vibrational spectroscopic study of the minerals nekoite Ca3Si6O15•7H2O and okenite Ca10Si18O46•18H2O : implications for the molecular structure

Nekoite Ca3Si6O15•7H2O and okenite Ca10Si18O46•18H2O are both hydrated calcium silicates found respectively in contact metamorphosed limestone and in association with zeolites from the alteration of basalts. The minerals form two-Dimensional infinite sheets with other than six-membered rings with 3-, 4-, or 5-membered rings and 8-membered rings. The two minerals have been characterised by Raman, near-infrared and infrared spectroscopy. The Raman spectrum of nekoite is characterised by two sharp peaks at 1061 and 1092 cm-1 with bands of lesser intensity at 974, 994, 1023 and 1132 cm-1. The Raman spectrum of okenite shows an intense single Raman band at 1090 cm-1 with a shoulder band at 1075 cm-1.These bands are assigned to the SiO stretching vibrations of Si2O5 units. Raman water stretching bands of nekoite are observed at 3071, 3380, 3502 and 3567 cm-1. Raman spectrum of okenite shows water stretching bands at 3029, 3284, 3417, 3531 and 3607 cm-1. NIR spectra of the two minerals are subtly different inferring water with different hydrogen bond strengths. By using a Libowitzky empirical formula, hydrogen bond distances based upon these OH stretching vibrations. Two types of hydrogen bonds are distinguished: strong hydrogen bonds associated with structural water and weaker hydrogen bonds assigned to space filling water molecules.

Methodological challenges when estimating the effects of season and seasonal exposures on birth outcomes

Background Many previous studies have found seasonal patterns in birth outcomes, but with little agreement about which season poses the highest risk. Some of the heterogeneity between studies may be explained by a previously unknown bias. The bias occurs in retrospective cohorts which include all births occurring within a fixed start and end date, which means shorter pregnancies are missed at the start of the study, and longer pregnancies are missed at the end. Our objective was to show the potential size of this bias and how to avoid it. Methods To demonstrate the bias we simulated a retrospective birth cohort with no seasonal pattern in gestation and used a range of cohort end dates. As a real example, we used a cohort of 114,063 singleton births in Brisbane between 1 July 2005 and 30 June 2009 and examined the bias when estimating changes in gestation length associated with season (using month of conception) and a seasonal exposure (temperature). We used survival analyses with temperature as a time-dependent variable. Results We found strong artificial seasonal patterns in gestation length by month of conception, which depended on the end date of the study. The bias was avoided when the day and month of the start date was just before the day and month of the end date (regardless of year), so that the longer gestations at the start of the study were balanced by the shorter gestations at the end. After removing the fixed cohort bias there was a noticeable change in the effect of temperature on gestation length. The adjusted hazard ratios were flatter at the extremes of temperature but steeper between 15 and 25°C. Conclusions Studies using retrospective birth cohorts should account for the fixed cohort bias by removing selected births to get unbiased estimates of seasonal health effects.