2016 Quarter 2 Managed Care Ombudsman Program Quarterly Report

This report provides an update on the following items for the first programmatic quarter (July, August and September 2016): • 2nd Quarter Overview • Systemic Trends • Community Partnerships and Outreach • Managed Care Ombudsman Program Administrative Update

2016 Quarter 1 Managed Care Ombudsman Program Quarterly Report

he Managed Care Ombudsman Program provides various services including education and information regarding managed care plans, services, care and processes, advocacy and outreach on behalf of members, and appeals assistance and complaint resolution for members needing assistance with resolving issues with their managed care plan or navigating the managed care system. This report provides an update on the following items for the first programmatic quarter (April, May and June 2016): • 1st Quarter Overview • Systemic Trends • Community Partnerships and Outreach • Managed Care Ombudsman Program Administrative Update

Review of Program Integrity Operations At Six Managed Care Organizations Delivering Medicaid Services under a Contract with the South Carolina Department of Health & Human Services

The State contracted with six managed care organizations to deliver Medicaid managed care at an annual cost of $2.7 billion, representing 10% of the State’s annual budget, to 750,000 Medicaid beneficiaries in South Carolina. This review’s scope and objectives were: Test the six MCOs’ compliance and effective execution of the SCDHHS’s managed care contract “Section 11 - Program Integrity” focusing on the operational components of pre-payment review and post-payment review. Identify opportunities to improve SCDHHS’s biennial managed care contract, contract monitoring, and MCO compliance and effective execution of the contract.

Fish assemblages of shallow intertidal habitats of the Ria Formosa lagoon (South Portugal): influence of habitat and season

Fish assemblages in seagrass and unvegetated habitats located in shallow intertidal creeks within the saltmarsh area of the Ria Formosa coastal lagoon were sampled with a Riley push net at 3 sites on a monthly basis over a 1 yr period. The objective was to test if both habitats support similar fish assemblages in terms of abundance, diversity, assemblage structure, and size distribution, and to investigate how site and season affect the assemblages. Fish assemblages associated with these habitats were significantly different in terms of diversity, abundance, and assemblage structure. Seagrass supported a larger number of species and greater diversity, while unvegetated habitat supported greater fish numbers but only of a few species. The habitats were dominated by different groups of resident species that were responsible for major differences in fish assemblage structure between habitats. Pomatoschistus microps and young-of-the-year (YOY) Atherina presbyter dominated the unvegetated habitat, while seagrass was dominated by a diverse group of species, in particular syngnathids and small labrids, revealing different habitat preferences. Site and season were determinant factors conditioning the role of habitat in structuring fish assemblages. Distance between habitats, site elevation, and the amount of marsh drained affected fish assemblages in both habitats. Seasonal fluctuations in the presence and abundance of YOY from marine migrant and resident species were responsible for comparable changes in fish assemblage structure in both habitats. Both habitats provide a distinctive nursery area for different species, while common species reveal ontogenic distributional changes between habitats, where smaller fish appear first in unvegetated creeks.

Home range, residency and movements of Diplodus sargus and Diplodus vulgaris in a coastal lagoon: Connectivity between nursery and adult habitats

Acoustic telemetry and standard tag-recapture were used to determine the home range and residency of juveniles and sub-adults of Diplodus sargus and Diplodus vulgaris in the Ria Formosa (Portugal) coastal lagoon. Maximum time between recaptures for the standard tag-recapture method was 128 days for D. sargus and 30 days for D. vulgaris. The majority of the fish were recaptured in the vicinity of the tagging location. Fish tagged with acoustic transmitters had a maximum period of time between first and last detections of 62 days for D. sargus and 260 days for D. vulgaris. Minimum convex polygons areas ranged between 148 024 m(2) and 525 930 m(2) for D. sargus and between 23 786 m(2) and 42134 m(2) for D. vulgaris. Both species presented a high residency index between first and last detections. Two D. sargus tagged with acoustic tags were recaptured by fishermen outside the coastal lagoon at distances of 12 km and 90 km from the tagging position, providing evidence that this species leaves the Ria Formosa during the winter time for the adjacent coastal waters. The results of this study reinforce the importance of Ria Formosa as a nursery for D. sargus and D. vulgaris in the south coast of Portugal. (C) 2009 Elsevier Ltd. All rights reserved.

Use of different intertidal habitats by faunal communities in a temperate coastal lagoon

The faunal communities of four intertidal habitats namely sand, mud, seagrass (Zostera noltii) and seagrass patches (mixSM) of a temperate coastal lagoon, Ria Formosa (southern Portugal), were sampled. A total of 47 species were taken in 428 bottomless drop sampler samples, with the highest number of species and the more commonly occurring species belonging to the Mollusca phylum. The dominance of these gastropod species underlines the importance of the grazing food chain in these habitats. Bittium reticulatum was the most abundant species, being especially abundant in the seagrass habitat. The most frequent and highest biomass species in the community was Carcinus maenas, a predator that makes use of the available resources and that is adapted to the highly variable intertidal environment. Pomatoschistus microps was the most abundant fish species, with highest densities in the mud habitat, which demonstrates an ability to occupy a low depth area. The seagrass; habitat had the highest diversity, abundance and biomass, followed by the mixSM habitat and was different from all the others. Assemblages were highly influenced by the presence of vegetation, providing forage and refuge from predation. A well defined summer group was identified in all habitats. These results highlight the importance of seagrass beds and the idea that their decrease implies the decrease of lagoon production through the impoverishment of the trophic structure of the lagoon. (C) 2008 Elsevier Ltd. All rights reserved.

Herbivores strongly influence algal recruitment in both coral- and algal-dominated coral reef habitats

Coral reefs can exist as coral- and macroalgae-dominated habitats often separated by only a few hundred metres. While herbivorous fish are known to depress the abundance of algae and help maintain the function of coral-dominated habitats, less is known about their influence in algae-dominated habitats. Here, we quantified herbivorous fish and benthic algal communities over a 6 mo period in coral-dominated (back-reef) and algal-dominated (lagoon) habitats in a relatively undisturbed fringing coral reef (Ningaloo, Western Australia). Simulta - neously, we tested the effects of herbivorous fish on algal recruitment in both habitats using recruitment tiles and fish exclusion cages. The composition of established algal communities differed consistently between habitats, with the back-reef hosting a more diverse community than the Sargassum-dominated lagoon. However, total algal biomass and cover only differed between habitats in autumn, coinciding with maximum Sargassum biomass. The back-reef hosted high coral cover and a diverse herbivorous fish community, with herbivore biomass an order of magnitude greater than the lagoon. Despite these differences in herbivore composition, exclusion of large herbivores had a similar positive effect to foliose macroalgae recruitment on experimental tiles in both back-reef and lagoon habitats. Additionally, territorial damselfish found in the backreef increased turf algae cover and decreased crustose coralline algae cover on recruitment tiles. Collectively, our results show that disparate herbivorous fish communities in coral- and algaedominated habitats are similarly able to limit the recruitment of foliose macroalgae, but suggest that when herbivorous fish biomass and diversity are relatively low, macroalgal communities are able to escape herbivore control through increased growth.

Broad-scale mapping of seafloor habitats in the north-east Atlantic using existing environmental data

If marine management policies and actions are to achieve long-term sustainable use and management of the marine environment and its resources, they need to be informed by data giving the spatial distribution of seafloor habitats over large areas. Broad-scale seafloor habitat mapping is an approachwhich has the benefit of producing maps covering large extents at a reasonable cost. This approach was first investigated by Roff et al. (2003), who, acknowledging that benthic communities are strongly influenced by the physical characteristics of the seafloor, proposed overlaying mapped physical variables using a geographic information system (GIS) to produce an integrated map of the physical characteristics of the seafloor. In Europe the method was adapted to the marine section of the EUNIS (European Nature Information System) classification of habitat types under the MESH project, andwas applied at an operational level in 2011 under the EUSeaMap project. The present study compiled GIS layers for fundamental physical parameters in the northeast Atlantic, including (i) bathymetry, (ii) substrate type, (iii) light penetration depth and (iv) exposure to near-seafloor currents andwave action. Based on analyses of biological occurrences, significant thresholds were fine-tuned for each of the abiotic layers and later used in multi-criteria raster algebra for the integration of the layers into a seafloor habitat map. The final result was a harmonised broad-scale seafloor habitat map with a 250 m pixel size covering four extensive areas, i.e. Ireland, the Bay of Biscay, the Iberian Peninsula and the Azores. The map provided the first comprehensive perception of habitat spatial distribution for the Iberian Peninsula and the Azores, and fed into the initiative for a pan- European map initiated by the EUSeaMap project for Baltic, North, Celtic and Mediterranean seas.

Vegetation series as a basis for habitats and species conservation: methodological aspects

Vegetation series, defined as the sequence of stages in a sucession, and know as sigmetum (synassociation), describes the set of plant communities or stages that can be found in similar tesselar spaces as a result of the sucession process. This establishes the concept of vegetation series; a climatophilous series is one that depends on the climate, whereas an edaphoxerophilous series depends on the dryness of the soil, and is found on crests, spurs, ledges and limestone and siliceous rock fields. Edaphohygrophilous series are located in valleys, dry water courses and river terraces, and depend on the water present in the soil, which may become temporarily flooded and thus condition the temporihygrophilous series; they represent the transition between the clearly edaphohygrophilous and climatophilous series. The vegetation permaseries represents the perennial communities of permatesselae or similar permatesselar complexes, as occurs in polar territories, hyperdesert, high-mountain peaks, and non-stratified communities lacking in serial communities. The edaphoxerophilous series may include -in addition to the series head- permaseries (permanent communities) and other habitats, such as annual and crevice habitats. A territory behaves undergoes soil-loss phenomena it may become an edaphoseries, if the loss of the soil factor produces a situation of rocky crest. Thus the edaphoseries may act as dynamic transitional stage between the climatophilous series and the permaseries.

Stylosanthes guianensis cv. BRS Bela managed as organic fodder bank for supplementation of lactation crossbred cows in the Cerrado.

2016

Mitigation of clayey soil compaction managed under no-tillage.

2015

A methodological framework to assess the carbon balance of tropical managed forests.

Background: Managed forests are a major component of tropical landscapes. Production forests as designated by national forest services cover up to 400 million ha, i.e. half of the forested area in the humid tropics. Forest management thus plays a major role in the global carbon budget, but with a lack of unified method to estimate carbon fluxes from tropical managed forests. In this study we propose a new time- and spatially-explicit methodology to estimate the above-ground carbon budget of selective logging at regional scale. Results: The yearly balance of a logging unit, i.e. the elementary management unit of a forest estate, is modelled by aggregating three sub-models encompassing (i) emissions from extracted wood, (ii) emissions from logging damage and deforested areas and (iii) carbon storage from post-logging recovery. Models are parametrised and uncertainties are propagated through a MCMC algorithm. As a case study, we used 38 years of National Forest Inventories in French Guiana, northeastern Amazonia, to estimate the above-ground carbon balance (i.e. the net carbon exchange with the atmosphere) of selectively logged forests. Over this period, the net carbon balance of selective logging in the French Guianan Permanent Forest Estate is estimated to be comprised between 0.12 and 1.33 Tg C, with a median value of 0.64 Tg C. Uncertainties over the model could be diminished by improving the accuracy of both logging damage and large woody necromass decay submodels. Conclusions: We propose an innovating carbon accounting framework relying upon basic logging statistics. This flexible tool allows carbon budget of tropical managed forests to be estimated in a wide range of tropical regions

Reproductive seasonality in Saanen goats managed in southeast Brazil.

The aim of this study was to characterize the reproductive seasonality during the period of one year in Saanen goats managed in southeastern Brazil These results endorse hormonal methods (estrus synchronization and induction of synchronized estrus) or natural (male effect, flushing or light treatment) more appropriate according to the time of year in the region. Saanen goats, managed under tropical climate in southeastern Brazil, have a breeding season set from March until mid-August with the transitional phase to the anestrus in September. It is extends to mid-December at the new one transition phase for the reproductive season in March.

Health information management : What business are we in?

Developments in information technology will drive the change in records management; however, it should be the health information managers who drive the information management change. The role of health information management will be challenged to use information technology to broker a range of requests for information from a variety of users, including he alth consumers. The purposes of this paper are to conceptualise the role of health information management in the context of a technologically driven and managed health care environment, and to demonstrat e how this framework has been used to review and develop the undergraduate program in health information management at the Queensland University of Technology.

Building a supportive environment for teaching and learning : a reflective commentary

Universities are increasingly caught in the transition between college institutions of independant academics to become managed businesses of research and teaching and learning. This is introducing substantial issues with the work, approach and personal development needs of individual academics. It is causing even greater concerns for managers within universities. The developments in University Management have increasingly become driven towards issues of finance, quality and marketing. Organizational development in teaching and learning practices has been less commonly a point of focus. This paper outlines developments of this nature at the University of Salford. Through its combination of authors it does so at whole University, Faculty and School levels. It outlines the variety of ways in which teaching and learning developments can be supported within an organisation.