999 resultados para CR863.009 A663s


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Fondo Margaritainés Restrepo

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

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A purified commercial double-walled carbon nanotube (DWCNT) sample was investigated by transmission electron microscopy (TEM), thermogravimetry (TG), and Raman spectroscopy. Moreover, the heat capacity of the DWCNT sample was determined by temperature-modulated differential scanning calorimetry in the range of temperature between -50 and 290 °C. The main thermo-oxidation characterized by TG occurred at 474 °C with the loss of 90 wt% of the sample. Thermo-oxidation of the sample was also investigated by high-resolution TG, which indicated that a fraction rich in carbon nanotube represents more than 80 wt% of the material. Other carbonaceous fractions rich in amorphous coating and graphitic particles were identified by the deconvolution procedure applied to the derivative of TG curve. Complementary structural data were provided by TEM and Raman studies. The information obtained allows the optimization of composites based on this nanomaterial with reliable characteristics.

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Background: Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. Objectives: The study aim was to evaluate as cheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients’ rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients’, visitors’ and health professionals’ satisfaction, and organisational functioning. Design: The study was a multi-centred non-randomised parallel group trial. Settings: The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. Participants: All patientsadmitted to the two wards in the5-month period of the study were invited to participate, withafinalsample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Methods: Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and well being were collected using previously validated instruments: a Castle Model 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Results: Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a ‘perceived’ difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. Conclusions: The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.

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Driving under the influence (DUI) is a major road safety problem. Historically, alcohol has been assumed to play a larger role in crashes and DUI education programs have reflected this assumption, although recent evidence suggests that younger drivers are becoming more likely to drive drugged than to drive drunk. This is a study of 7096 Texas clients under age 21 who were admitted to state-funded treatment programs between 1997 and 2007 with a past-year DUI arrest, DUI probation, or DUI referral. Data were obtained from the State’s administrative dataset. Multivariate logistic regressions models were used to understand the differences between those minors entering treatment as a DUI as compared to a non-DUI as well as the risks for completing treatment and for being abstinent in the month prior to follow-up. A major finding was that over time, the primary problem for underage DUI drivers changed from alcohol to marijuana. Being abstinent in the month prior to discharge, having a primary problem with alcohol rather than another drug, and having more family involved were the strongest predictors of treatment completion. Living in a household where the client was exposed to alcohol abuse or drug use, having been in residential treatment, and having more drug and alcohol and family problems were the strongest predictors of not being abstinent at follow-up. As a result, there is a need to direct more attention towards meeting the needs of the young DUI population through programs that address drug as well as alcohol consumption problems.

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In this article I outline and demonstrate a synthesis of the methods developed by Lemke (1998) and Martin (2000) for analyzing evaluations in English. I demonstrate the synthesis using examples from a 1.3-million-word technology policy corpus drawn from institutions at the local, state, national, and supranational levels. Lemke's (1998) critical model is organized around the broad 'evaluative dimensions' that are deployed to evaluate propositions and proposals in English. Martin's (2000) model is organized with a more overtly systemic-functional orientation around the concept of 'encoded feeling'. In applying both these models at different times, whilst recognizing their individual usefulness and complementarity, I found specific limitations that led me to work towards a synthesis of the two approaches. I also argue for the need to consider genre, media, and institutional aspects more explicitly when claiming intertextual and heteroglossic relations as the basis for inferred evaluations. A basic assertion made in this article is that the perceived Desirability of a process, person, circumstance, or thing is identical to its 'value'. But the Desirability of anything is a socially and thus historically conditioned attribution that requires significant amounts of institutional inculcation of other 'types' of value-appropriateness, importance, beauty, power, and so on. I therefore propose a method informed by critical discourse analysis (CDA) that sees evaluation as happening on at least four interdependent levels of abstraction.

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High resolution thermogravimetry has been used to evaluate the carbonaceous content in a commercial sample of single-walled carbon nanotube (SWNT). The content of SWNTs in the sample was found to be at least 77mass% which was supported by images obtained with scanning and transmission electron microscopies (SEM and TEM). Furthermore, the influence of SWNT addition on the thermal stability of graphite in mixtures of SWNT/graphite at different proportions was investigated. The graphite stability decreased with the increased of SWNT content in the overall range of composition. This behavior could be due to the close contact between these carbonaceous species as determined by SEM analysis.

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Scott A. Shane is the 2009 winner of the Global Award for Entrepreneurship Research. In this article we discuss and analyze Shane’s most important contributions to the field of entrepreneurship. His contribution is extraordinarily broad in scope, which makes it difficult to pinpoint one or a few specifics that we associate with Shane’s scholarship. Instead, they can be summarized in the following three points. First, he has influenced what we view as central aspects of entrepreneurship. Shane has been a leading figure in redirecting the focus on entrepreneurship research itself. Second, he has influenced how we view entrepreneurship. Shane’s research is arguably theory driven and it applies and develops theoretical lenses that greatly improve our understanding of entrepreneurship. Third, he has contributed to how we conduct entrepreneurship research. Shane has been a forerunner in examining relevant units of analysis that are difficult to sample; research designs and databases specifically designed for studying entrepreneurial processes; and sophisticated analytical methods. This has contributed to advancing the methodological rigor of the field. Summing them up, the contributions are very impressive indeed.

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Objective: This paper explores the effects of perceived stage of cancer (PSOC) on carers' anxiety and depression during the patients' final year. Methods: A consecutive sample of patients and carers (N=98) were surveyed at regular intervals regarding PSOC, and anxiety and depression using the Hospital Anxiety and Depression Scale. Means were compared by gender using the Mann-Whitney U-test. The chi-square was used to analyse categorical data. Agreement between carers' and patients' PSOC was estimated using kappa statistics. Correlations between carers' PSOC and their anxiety and depression were calculated using the Spearman's rank correlation. Results: Over time, an increasing proportion of carers reported that the cancer was advanced, culminating at 43% near death. Agreement regarding PSOC was fair (kappa=0.29-0.34) until near death (kappa=0.21). Carers' anxiety increased over the year; depression increased in the final 6 months. Females were more anxious (p=0.049, 6 months; p=0.009, 3 months) than males, and more depressed until 1 month to death. The proportion of carers reporting moderate-severe anxiety almost doubled over the year to 27%, with more females in this category at 6 months (p=0.05). Carers with moderate-severe depression increased from 6 to 15% over the year. Increased PSOC was weakly correlated with increased anxiety and depression. Conclusions: Carers' anxiety exceeded depression in severity during advanced cancer. Females generally experienced greater anxiety and depression. Carers were more realistic than patients regarding the ultimate outcome, which was reflected in their declining mental health, particularly near the end.

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A small group of companies including Intel, Microsoft, and Cisco have used "platform leadership" with great effect as a means for driving innovation and accelerating market growth within their respective industries. Prior research in this area emphasizes that trust plays a critical role in the success of this strategy. However, many of the categorizations of trust discussed in the literature tend to ignore or undervalue the fact that trust and power are often functionally equivalent, and that the coercion of weaker partners is sometimes misdiagnosed as collaboration. In this paper, I use case study data focusing on Intel's shift from ceramic/wire-bonded packaging to organic/C4 packaging to characterize the relationships between Intel and its suppliers, and to determine if these links are based on power in addition to trust. The case study shows that Intel's platform leadership strategy is built on a balance of both trust and a relatively benevolent form of power that is exemplified by the company's "open kimono" principle, through which Intel insists that suppliers share detailed financial data and highly proprietary technical information to achieve mutually advantageous objectives. By explaining more completely the nature of these inter-firm linkages, this paper usefully extends our understanding of how platform leadership is maintained by Intel, and contributes to the literature by showing how trust and power can be used simultaneously within an inter-firm relationship in a way that benefits all of the stakeholders.

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There are two key ways in which the Australian Uniform Consumer Credit Code seeks to protect consumers in relation to consumer credit transactions. The first is by means of disclosure regulation where information is required to be disclosed to the consumer before the credit contract is entered into and the second is by way of “safety net” provisions, where contracts can be varied or set aside in the event of hardship, a finding that the transaction was unjust, or a finding of unconscionable fees or charges. This article explores the limitations of both of these means of protection, particularly in the case of vulnerable, low-income consumers. In order to highlight the inadequacies of these forms of consumer protection and the need for regulatory reform, we draw on interviews conducted with 30 low-income consumers who had recently signed a credit contract, focusing on their understanding of information disclosed in the contract, as well as their responses to hypothetical unfair terms and their understanding of their rights, for example in the event of an unjust transaction. These interviews were conducted as part of a joint research project between Brotherhood of St Laurence and Griffith University’s Centre for Credit and Consumer Law, funded by Consumer Affairs Victoria.