B-1 Monthly Report of Medical Services Provided under Title XIX of the Social Security Act, April 2016

B-1 Medicaid Reports -- The monthly Medicaid series of eight reports provide summaries of Medicaid eligibles, recipients served, and total payments by county, category of service, and aid category. These reports may also be known as the B-1 Reports. These reports are each available as a PDF for printing or as a CSV file for data analysis. Report Report name IAMM1800-R001--Medically Needy by County - No Spenddown and With Spenddown; IAMM1800-R002--Total Medically Needy, All Other Medicaid, and Grand Total by County; IAMM2200-R002--Monthly Expenditures by Category of Service; IAMM2200-R003--Fiscal YTD Expenditures by Category of Service; IAMM3800-R001--ICF & ICF-MR Vendor Payments by County; IAMM4400-R001--Monthly Expenditures by Eligibility Program; IAMM4400-R002--Monthly Expenditures by Category of Service by Program; IAMM4600-R002--Elderly Waiver Summary by County.

B-1 Monthly Report of Medical Services Provided under Title XIX of the Social Security Act, January 2016

B-1 Medicaid Reports -- The monthly Medicaid series of eight reports provide summaries of Medicaid eligibles, recipients served, and total payments by county, category of service, and aid category. These reports may also be known as the B-1 Reports. These reports are each available as a PDF for printing or as a CSV file for data analysis. Report Report name IAMM1800-R001--Medically Needy by County - No Spenddown and With Spenddown; IAMM1800-R002--Total Medically Needy, All Other Medicaid, and Grand Total by County; IAMM2200-R002--Monthly Expenditures by Category of Service; IAMM2200-R003--Fiscal YTD Expenditures by Category of Service; IAMM3800-R001--ICF & ICF-MR Vendor Payments by County; IAMM4400-R001--Monthly Expenditures by Eligibility Program; IAMM4400-R002--Monthly Expenditures by Category of Service by Program; IAMM4600-R002--Elderly Waiver Summary by County.

B-1 Monthly Report of Medical Services Provided under Title XIX of the Social Security Act, April 2016

B-1 Medicaid Reports -- The monthly Medicaid series of eight reports provide summaries of Medicaid eligibles, recipients served, and total payments by county, category of service, and aid category. These reports may also be known as the B-1 Reports. These reports are each available as a PDF for printing or as a CSV file for data analysis. Report Report name IAMM1800-R001--Medically Needy by County - No Spenddown and With Spenddown; IAMM1800-R002--Total Medically Needy, All Other Medicaid, and Grand Total by County; IAMM2200-R002--Monthly Expenditures by Category of Service; IAMM2200-R003--Fiscal YTD Expenditures by Category of Service; IAMM3800-R001--ICF & ICF-MR Vendor Payments by County; IAMM4400-R001--Monthly Expenditures by Eligibility Program; IAMM4400-R002--Monthly Expenditures by Category of Service by Program; IAMM4600-R002--Elderly Waiver Summary by County.

luporum : Configuració UCI mitjançant una API REST

L'empresa Routek SL manté una distribució anomenada qMp basada en la distribució OpenWRT. Tant la distribució OpenWRT, com l'ampliació de Routek SL qMp, disposen d'un sistema de configuració anomenat Unified Configuration Interface (UCI). Una de les característiques d'aquest sistema és que les configuracions dels programes que l'usen segueixen una mateixa sintaxi. El projecte luporum descrit en aquesta memòria explica com s'ha realitzat el desenvolupament d'una API REST que facilita que es pugui gestionar aquesta configuració remotament, fent peticions HTTP.

“Weathering a Hidden Storm”: An Application of Andersen’s Behavioral Model of Health, and Health Services Use for Those with Diagnosable Anxiety Disorder

Abstract: Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen’s Behavioral Model of Health Services Use, where predisposing, need and enabling characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well-Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

"Weathering a hidden storm" : an application of Andersen's behavioral model of health, and health services use for those with diagnosable anxiety disorder

"Weathering a Hidden Storm": An App~ication of Andersen's Behaviora~ Mode~ of Hea~th, and Hea~th Services Use for Those With Diagnosab~e Anxiety Disorder Research has primarily focused on depression and mood disorders, but little research has been devoted to an examination of mental health services use amongst those with diagnosable anxiety disorder (Wittchen et al., 2002; Bergeron et al., 2005). This study examined the possible predicting factors for mental health services utilization amongst those with identifiable anxiety disorder in the Canadian population. The methods used for this study was the application of Andersen's Behavioral Model of Health Services Use, where predisposing, need and enabling 111 characteristics were regressed on the dependent variable of mental health services use. This study used the Canadian Community Health Survey (cycle 1.2: Mental Health and Well- Being) in a secondary data analysis. Several multiple logistics models predicted the likelihood to seek and use mental health services. Predisposing characteristics of gender and age, Enabling characteristics of education and geographical location, and those with co-occurring mood disorders were at the greatest increased likelihood to seek and use mental health services.

Prevalencia de los factores de riesgo psicosocial presentes en la población trabajadora de una entidad de salud de segundo nivel en el año 2013

Introducción: Los factores de riesgo psicosocial surgen a partir de una interacción dinámica de las cualidades humanas con el medio ambiente de trabajo, es decir, todas aquellas habilidades, necesidades, expectativas y costumbres de los trabajadores. En efecto, estas interacciones entre las condiciones del medio ambiente laboral y los factores humanos del trabajador, cuando son manejadas de manera negativa, conducen a alteraciones emocionales, problemas de comportamiento y cambios bioquímicos y neurohormonales, que a su vez pueden producir riesgos adicionales de enfermedades mentales y físicas. Objetivo: Determinar las prevalencias de los factores de riesgo psicosocial presentes en la población trabajadora de una entidad de salud de segundo nivel en el año 2013. Metodología: Se llevó a cabo un estudio de corte transversal, utilizando fuentes de datos secundarios de una Empresa de Salud del Estado de nivel II, donde se aplicó el instrumento de la batería de riesgo psicosocial, diseñada por el Ministerio de la Protección Social en asocio con la Pontificia Universidad Javeriana. Durante este período el hospital contaba con la gestión de 155 empleados, de los cuales 54 desempeñaban labores administrativas y 101 prestaban servicios asistenciales. La participación por género se distribuyó así: 104 mujeres y 51 hombres. La prevalencia de los factores de riesgo psicosocial se estimó por medio de los baremos establecidos por el Ministerio de la Protección Social para identificar el nivel de riesgo, los resultados fueron analizados desde estadísticas descriptivas y la aplicación de pruebas estadísticas en la comparación de los puntajes transformados de los dominios y dimensiones de los cuestionarios intra y extralaboral, según las características sociodemográficas y ocupacionales. Resultados: Se identificó una mayor proporción de personas con riesgo psicosocial intralaboral (45,8% riesgo muy alto), mientras que en la evaluación de los factores de riesgo extralaboral el comportamiento fue totalmente opuesto (78.1% sin riesgo), se pudo establecer que una mayor proporción de mujeres ejerce la profesión de la enfermería (71,3% asistencial) y la modalidad de contratación prevalente reportada fue a través de una cooperativa de trabajo asociado (82,2% asistenciales). Se determinó que existen diferencias en la percepción de los factores psicosociales tanto intra como extralaborales en los grupos con diferentes características sociodemográficas y ocupacionales. Conclusión: La investigación evidenció el impacto negativo de los factores de riesgo intralaboral sobre los trabajadores de la E.S.E, condición que afectó la percepción de la vida laboral, la productividad y el nivel de satisfacción de los trabajadores, por lo que se destaca la pertinencia de implementar actividades de intervención y prevención a corto plazo en el marco de un programa de vigilancia epidemiológica.

Routing protocols and quality of services for security based applications using wireless video sensor networks

Wireless video sensor networks have been a hot topic in recent years; the monitoring capability is the central feature of the services offered by a wireless video sensor network can be classified into three major categories: monitoring, alerting, and information on-demand. These features have been applied to a large number of applications related to the environment (agriculture, water, forest and fire detection), military, buildings, health (elderly people and home monitoring), disaster relief, area and industrial monitoring. Security applications oriented toward critical infrastructures and disaster relief are very important applications that many countries have identified as critical in the near future. This paper aims to design a cross layer based protocol to provide the required quality of services for security related applications using wireless video sensor networks. Energy saving, delay and reliability for the delivered data are crucial in the proposed application. Simulation results show that the proposed cross layer based protocol offers a good performance in term of providing the required quality of services for the proposed application.

DiffServer: Application Level Differentiated Services for Web Servers

Web content hosting, in which a Web server stores and provides Web access to documents for different customers, is becoming increasingly common. For example, a web server can host webpages for several different companies and individuals. Traditionally, Web Service Providers (WSPs) provide all customers with the same level of performance (best-effort service). Most service differentiation has been in the pricing structure (individual vs. business rates) or the connectivity type (dial-up access vs. leased line, etc.). This report presents DiffServer, a program that implements two simple, server-side, application-level mechanisms (server-centric and client-centric) to provide different levels of web service. The results of the experiments show that there is not much overhead due to the addition of this additional layer of abstraction between the client and the Apache web server under light load conditions. Also, the average waiting time for high priority requests decreases significantly after they are assigned priorities as compared to a FIFO approach.

Cultural competence in an HIV dedicated dental clinic: Application of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS)

This dissertation investigated perspectives on cultural competence among African-American women patients, staff, and the administrator of a dental clinic serving people living with HIV/AIDS; and evaluated the role of the National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS) in advancing the provision of culturally competent care in the clinic. ^ The study was qualitative with data collection via focus groups and individual interviews with a sample of African-American women patients, and individual interviews with a sample of staff and the clinic administrator. Transcripts were coded and themes identified using the software program ATLAS.ti. A cultural audit template was developed and applied to evaluate cultural competency. ^ Among attitudes and behaviors that contributed to the provision of culturally competent care at the clinic were respect and empathic communication. Formal cultural competency was not featured strongly in the methods by which the staff learned to work with diverse populations. Instead cultural competence among the staff was based on thoughtful hiring practices, natural aptitude and a climate that encouraged learning through informal sharing of experiences. The staff and administrator felt that an African-American dentist would be an asset in improving culturally competent care at the clinic. Previous research and national policy also promote the provider-patient racial/ethnic concordance to improve care. In this study, however, the patients were happy with the care provided regardless of the race/ethnicity of the staff, probably reflecting the well developed cultural competence skills of clinic staff overall. ^ The clinic administrator was unaware of the CLAS standards although the clinic was implicitly operated under their mandates. This occurred because the clinic is supported by federal funding and the CLAS standards were incorporated into the requirements. Incorporation into and monitoring of the CLAS standards in federally funded programs therefore appears to be an effective means for ensuring that they are implemented. ^ This study illustrates that cultural competence, though not universally understood, can be systematically investigated to identify what constitutes appropriate care and the factors that support or inhibit it. Among important elements of culturally competent care are respect and empathic communication. ^

Code and readme of a MATLAB-based graphical user interface program for computing functionals of the geopotential

We present a novel graphical user interface program GrafLab (GRAvity Field LABoratory) for spherical harmonic synthesis (SHS) created in MATLAB®. This program allows to comfortably compute 38 various functionals of the geopotential up to ultra-high degrees and orders of spherical harmonic expansion. For the most difficult part of the SHS, namely the evaluation of the fully normalized associated Legendre functions (fnALFs), we used three different approaches according to required maximum degree: (i) the standard forward column method (up to maximum degree 1800, in some cases up to degree 2190); (ii) the modified forward column method combined with Horner's scheme (up to maximum degree 2700); (iii) the extended-range arithmetic (up to an arbitrary maximum degree). For the maximum degree 2190, the SHS with fnALFs evaluated using the extended-range arithmetic approach takes only approximately 2-3 times longer than its standard arithmetic counterpart, i.e. the standard forward column method. In the GrafLab, the functionals of the geopotential can be evaluated on a regular grid or point-wise, while the input coordinates can either be read from a data file or entered manually. For the computation on a regular grid we decided to apply the lumped coefficients approach due to significant time-efficiency of this method. Furthermore, if a full variance-covariance matrix of spherical harmonic coefficients is available, it is possible to compute the commission errors of the functionals. When computing on a regular grid, the output functionals or their commission errors may be depicted on a map using automatically selected cartographic projection.

A generic preprocessor for program validation and debugging

We present a generic preprocessor for combined static/dynamic validation and debugging of constraint logic programs. Passing programs through the preprocessor prior to execution allows detecting many bugs automatically. This is achieved by performing a repertoire of tests which range from simple syntactic checks to much more advanced checks based on static analysis of the program. Together with the program, the user may provide a series of assertions which trigger further automatic checking of the program. Such assertions are written using the assertion language presented in Chapter 2, which allows expressing a wide variety of properties. These properties extend beyond the predefined set which may be understandable by the available static analyzers and include properties defined by means of user programs. In addition to user-provided assertions, in each particular CLP system assertions may be available for predefined system predicates. Checking of both user-provided assertions and assertions for system predicates is attempted first at compile-time by comparing them with the results of static analysis. This may allow statically proving that the assertions hold (Le., they are validated) or that they are violated (and thus bugs detected). User-provided assertions (or parts of assertions) which cannot be statically proved ñor disproved are optionally translated into run-time tests. The implementation of the preprocessor is generic in that it can be easily customized to different CLP systems and dialects and in that it is designed to allow the integration of additional analyses in a simple way. We also report on two tools which are instances of the generic preprocessor: CiaoPP (for the Ciao Prolog system) and CHIPRE (for the CHIP CLP(FL>) system). The currently existing analyses include types, modes, non-failure, determinacy, and computational cost, and can treat modules separately, performing incremental analysis.

The ciao modular, standalone compiler and its generic program processing library

Ciao Prolog incorporates a module system which allows sepárate compilation and sensible creation of standalone executables. We describe some of the main aspects of the Ciao modular compiler, ciaoc, which takes advantage of the characteristics of the Ciao Prolog module system to automatically perform sepárate and incremental compilation and efficiently build small, standalone executables with competitive run-time performance, ciaoc can also detect statically a larger number of programming errors. We also present a generic code processing library for handling modular programs, which provides an important part of the functionality of ciaoc. This library allows the development of program analysis and transformation tools in a way that is to some extent orthogonal to the details of module system design, and has been used in the implementation of ciaoc and other Ciao system tools. We also describe the different types of executables which can be generated by the Ciao compiler, which offer different tradeoffs between executable size, startup time, and portability, depending, among other factors, on the linking regime used (static, dynamic, lazy, etc.). Finally, we provide experimental data which illustrate these tradeoffs.

Guidelines for the design of an environmental flow regime program at the regional scale: Application of the ELOHA framework in the Ebro River basin

La gestión de los recursos hídricos se convierte en un reto del presente y del futuro frente a un panorama de continuo incremento de la demanda de agua debido al crecimiento de la población, el crecimiento del desarrollo económico y los posibles efectos del calentamiento global. La política hidráulica desde los años 60 en España se ha centrado en la construcción de infraestructuras que han producido graves alteraciones en el régimen natural de los ríos. Estas alteraciones han provocado y acrecentado los impactos sobre los ecosistemas fluviales y ribereños. Desde los años 90, sin embargo, ha aumentado el interés de la sociedad para conservar estos ecosistemas. El concepto de caudales ambientales consiste en un régimen de caudales que simula las características principales del régimen natural. Los caudales ambientales están diseñados para conservar la estructura y funcionalidad de los ecosistemas asociados al régimen fluvial, bajo la hipótesis de que los elementos que conforman estos ecosistemas están profundamente adaptados al régimen natural de caudales, y que cualquier alteración del régimen natural puede provocar graves daños a todo el sistema. El método ELOHA (Ecological Limits of Hydrological Alteration) tiene como finalidad identificar las componentes del régimen natural de caudales que son clave para mantener el equilibrio de los ecosistemas asociados, y estimar los límites máximos de alteración de estas componentes para garantizar su buen estado. Esta tesis presenta la aplicación del método ELOHA en la cuenca del Ebro. La cuenca del Ebro está profundamente regulada e intervenida por el hombre, y sólo las cabeceras de los principales afluentes del Ebro gozan todavía de un régimen total o cuasi natural. La tesis se estructura en seis capítulos que desarrollan las diferentes partes del método. El primer capítulo explica cómo se originó el concepto “caudales ambientales” y en qué consiste el método ELOHA. El segundo capítulo describe el área de estudio. El tercer capítulo realiza una clasificación de los regímenes naturales de la cuenca (RNC) del Ebro, basada en series de datos de caudal mínimamente alterado y usando exclusivamente parámetros hidrológicos. Se identificaron seis tipos diferentes de régimen natural: pluvial mediterráneo, nivo-pluvial, pluvial mediterréaneo con una fuerte componente del caudal base, pluvial oceánico, pluvio-nival oceánico y Mediterráneo. En el cuarto capítulo se realiza una regionalización a toda la cuenca del Ebro de los seis RNC encontrados en la cueca. Mediante parámetros climáticos y fisiográficos se extrapola la información del tipo de RNC a puntos donde no existen datos de caudal inalterado. El patrón geográfico de los tipos de régimen fluvial obtenido con la regionalización resultó ser coincidente con el patrón obtenido a través de la clasificación hidrológica. El quinto capítulo presenta la validación biológica de los procesos de clasificación anteriores: clasificación hidrológica y regionalización. La validación biológica de los tipos de regímenes fluviales es imprescindible, puesto que los diferentes tipos de régimen fluvial van a servir de unidades de gestión para favorecer el mantenimiento de los ecosistemas fluviales. Se encontraron diferencias significativas entre comunidades biológicas en cinco de los seis tipos de RNC encontrados en la cuenca. Finalmente, en el sexto capítulo se estudian las relaciones hidro-ecológicas existentes en tres de los seis tipos de régimen fluvial encontrados en la cuenca del Ebro. Mediante la construcción de curvas hidro-ecológicas a lo largo de un gradiente de alteración hidrológica, se pueden sugerir los límites de alteración hidrológica (ELOHAs) para garantizar el buen estado ecológico en cada uno de los tipos fluviales estudiados. Se establecieron ELOHAs en tres de los seis tipos de RNC de la cuenca del Ebro Esta tesis, además, pone en evidencia la falta de datos biológicos asociados a registros de caudal. Para llevar a cabo la implantación de un régimen de caudales ambientales en la cuenca, la ubicación de los puntos de muestreo biológico cercanos a estaciones de aforo es imprescindible para poder extraer relaciones causa-efecto de la gestión hidrológica sobre los ecosistemas dependientes. ABSTRACT In view of a growing freshwater demand because of population raising, improvement of economies and the potential effects of climate change, water resources management has become a challenge for present and future societies. Water policies in Spain have been focused from the 60’s on constructing hydraulic infrastructures, in order to dampen flow variability and granting water availability along the year. Consequently, natural flow regimes have been deeply altered and so the depending habitats and its ecosystems. However, an increasing acknowledgment of societies for preserving healthy freshwater ecosystems started in the 90’s and agreed that to maintain healthy freshwater ecosystems, it was necessary to set environmental flow regimes based on the natural flow variability. The Natural Flow Regime paradigm (Richter et al. 1996, Poff et al. 1997) bases on the hypothesis that freshwater ecosystems are made up by elements adapted to natural flow conditions, and any change on these conditions can provoke deep impacts on the whole system. Environmental flow regime concept consists in designing a flow regime that emulates natural flow characteristics, so that ecosystem structure, functions and services are maintained. ELOHA framework (Ecological Limits of Hydrological Alteration) aims to identify key features of the natural flow regime (NFR) that are needed to maintain and preserve healthy freshwater and riparian ecosystems. Moreover, ELOHA framework aims to quantify thresholds of alteration of these flow features according to ecological impacts. This thesis describes the application of the ELOHA framework in the Ebro River Basin. The Ebro River basin is the second largest basin in Spain and it is highly regulated for human demands. Only the Ebro headwaters tributaries still have completely unimpaired flow regime. The thesis has six chapters and the process is described step by step. The first chapter makes an introduction to the origin of the environmental flow concept and the necessity to come up. The second chapter shows a description of the study area. The third chapter develops a classification of NFRs in the basin based on natural flow data and using exclusively hydrological parameters. Six NFRs were found in the basin: continental Mediterranean-pluvial, nivo-pluvial, continental Mediterranean pluvial (with groundwater-dominated flow pattern), pluvio-oceanic, pluvio-nival-oceanic and Mediterranean. The fourth chapter develops a regionalization of the six NFR types across the basin by using climatic and physiographic variables. The geographical pattern obtained from the regionalization process was consistent with the pattern obtained with the hydrologic classification. The fifth chapter performs a biological validation of both classifications, obtained from the hydrologic classification and the posterior extrapolation. When the aim of flow classification is managing water resources according to ecosystem requirements, a validation based on biological data is compulsory. We found significant differences in reference macroinvertebrate communities between five over the six NFR types identified in the Ebro River basin. Finally, in the sixth chapter we explored the existence of significant and explicative flow alteration-ecological response relationships (FA-E curves) within NFR types in the Ebro River basin. The aim of these curves is to find out thresholds of hydrological alteration (ELOHAs), in order to preserve healthy freshwater ecosystem. We set ELOHA values in three NFR types identified in the Ebro River basin. During the development of this thesis, an inadequate biological monitoring in the Ebro River basin was identified. The design and establishment of appropriate monitoring arrangements is a critical final step in the assessment and implementation of environmental flows. Cause-effect relationships between hydrology and macroinvertebrate community condition are the principal data that sustain FA-E curves. Therefore, both data sites must be closely located, so that the effects of external factors are minimized. The scarce hydro-biological pairs of data available in the basin prevented us to apply the ELOHA method at all NFR types.