Assisted Living: The Politics of Medicaid and Medicare

In this paper I examine the structure of the current assisted living industry in order to explain how and why it is appealing and effective, as well as look at its limitations. I discuss the politics of Medicaid and Medicare, and how through these programs the federal and state governments are failing to provide adequate care for the nation’s senior population. Like the rest of our health care system, these two public health insurance systems are fragmented, and consequently, financing long-term care is complicated and insufficient. Ultimately, this paper will function as a policy report and I will propose: standardized requirements for assisted living facilities; a stricter and new way to regulate assisted living on the state level; restructured models for the public insurance programs, including Medicaid, Medicare, and the State Children’s Health Insurance Program.

Medical treatment and the good death: an ethical analysis of euthanasia, physician assisted suicide, and the right to die

Frequent advances in medical technologies have brought fonh many innovative treatments that allow medical teams to treal many patients with grave illness and serious trauma who would have died only a few years earlier. These changes have given some patients a second chance at life, but for others. these new treatments have merely prolonged their dying. Instead of dying relatively painlessly, these unfortunate patients often suffer from painful tenninal illnesses or exist in a comatose state that robs them of their dignity, since they cannot survive without advanced and often dehumanizing forms of treatment. Due to many of these concerns, euthanasia has become a central issue in medical ethics. Additionally, the debate is impacted by those who believe that patients have the right make choices about the method and timing of their deaths. Euthanasia is defined as a deliberate act by a physician to hasten the death of a patient, whether through active methods such as an injection of morphine, or through the withdrawal of advanced forms of medical care, for reasons of mercy because of a medical condition that they have. This study explores the question of whether euthanasia is an ethical practice and, as determined by ethical theories and professional codes of ethics, whether the physician is allowed to provide the means to give the patient a path to a "good death," rather than one filled with physical and mental suffering. The paper also asks if there is a relevant moral difference between the active and passive forms of euthanasia and seeks to define requirements to ensure fully voluntary decision making through an evaluation of the factors necessary to produce fully informed consent. Additionally, the proper treatments for patients who suffer from painful terminal illnesses, those who exist in persistent vegetative states and infants born with many diverse medical problems are examined. The ultimate conclusions that are reached in the paper are that euthanasia is an ethical practice in certain specific circumstances for patients who have a very low quality of life due to pain, illness or serious mental deficits as a result of irreversible coma, persistent vegetative state or end-stage clinical dementia. This is defended by the fact that the rights of the patient to determine his or her own fate and to autonomously decide the way that he or she dies are paramount to all other factors in decisions of life and death. There are also circumstances where decisions can be made by health care teams in conjunction with the family to hasten the deaths of incompetent patients when continued existence is clearly not in their best interest, as is the case of infants who are born with serious physical anomalies, who are either 'born dying' or have no prospect for a life that is of a reasonable quality. I have rejected the distinction between active and passive methods of euthanasia and have instead chosen to focus on the intentions of the treating physician and the voluntary nature of the patient's request. When applied in equivalent circumstances, active and passive methods of euthanasia produce the same effects, and if the choice to hasten the death of the patient is ethical, then the use of either method can be accepted. The use of active methods of euthanasia and active forms of withdrawal of life support, such as the removal of a respirator are both conscious decisions to end the life of the patient and both bring death within a short period of time. It is false to maintain a distinction that believes that one is active killing. whereas the other form only allows nature to take it's course. Both are conscious choices to hasten the patient's death and should be evaluated as such. Additionally, through an examination of the Hippocratic Oath, and statements made by the American Medical Association and the American College of physicians, it can be shown that the ideals that the medical profession maintains and the respect for the interests of the patient that it holds allows the physician to give aid to patients who wish to choose death as an alternative to continued suffering. The physician is also allowed to and in some circumstances, is morally required, to help dying patients whether through active or passive forms of euthanasia or through assisted suicide. Euthanasia is a difficult topic to think about, but in the end, we should support the choice that respects the patient's autonomous choice or clear best interest and the respect that we have for their dignity and personal worth.

Plataforma para o suporte de blended peer assisted learning

Este projecto foi realizado na Universidade da Madeira, no âmbito do Mestrado em Engenharia Informática e tem como título “Plataforma para o suporte de Blended Peer Assisted Learning”. Ao longo da nossa pesquisa sobre os vários métodos de aprendizagem online, deparamo-nos com uma grande lacuna que abrange a maior parte dos sistema de ensino assistidos por computador, ou seja, todas elas preocupam-se com a passagem de conhecimentos, mas raras são aquelas que têm em atenção o tipo de utilizador, qual a seu percurso académico e profissional, qual a metodologia que fará com que o mesmo capte melhor os conteúdos, etc. Com este objectivo em mente, e tendo em atenção as diversas plataformas e metodologias de ensino existentes, optou-se por elaborar uma arquitectura de uma plataforma capaz de centralizar na mesma, um conjunto de funcionalidades e metodologias que possibilitassem um acompanhamento mais específico do utilizador, proporcionando um maior conhecimento, através do qual poderia encaminhar o utilizador para a estratégia de aprendizagem que mais se adequasse a um utilizador com as suas características. Como se poderá constatar no decorrer desta dissertação, a plataforma desenhada e o módulo desenvolvido têm como base teórica o Peer Assisted Learning (PAL) e as suas estratégias de aprendizagem. O PAL é um conceito relativamente novo, que se encontra em plena ascensão, sendo cada vez maior o número de instituições/organizações que adoptam o PAL como metodologia de ensino para a formação dos seus membros. Este crescimento deve-se em grande parte às várias estratégias PAL que visam uma maior adequação ao tipo de utilizador, contribuindo assim para uma aprendizagem mais rápida e eficaz. Uma vez que a implementação da plataforma na sua totalidade seria de todo impossível, optouse por desenvolver apenas um dos módulos referente à estratégia de PAL – Peer Tutoring (PT). No final, o objectivo principal, passa não só por fornecer as bases necessárias ao desenvolvimento da referida plataforma, mas também pela disponibilização do módulo de PT que servirá de referência para o desenvolvimento das restantes estratégias. Tendo em atenção toda a investigação efectuada, facilmente se depreende as inúmeras vantagens que podem advir da utilização do PAL, das quais se salienta, a adequação da estratégia PAL mais indicada para cada tipo de utilizador.

Degradação do PMMA através da reação despolimerização uitlizando catalisadores de óxidos mistos

In this work, mixed oxides were synthesized by two methods: polymeric precursor and gel-combustion. The oxides, Niquelate of Lanthanum, Cobaltate of Lanthanum and Cuprate of Lanthanum were synthesized by the polymeric precursor method, and treated at 300 º C for 2 hours, calcined at 800 º C for 6h in air atmosphere. In gel-combustion method were produced and oxides using urea and citric acid as fuel, forming for each fuel the following oxides Ferrate of Lanthanum, Cobaltato of Lanthanum and Ferrato of Cobalt and Lanthanum, which were submitted to the combustion process assisted by microwave power maximum of 10min. The samples were characterized by: thermogravimetric analysis, X-ray diffraction; fisisorção of N2 (BET method) and scanning electron microscopy. The reactions catalytic of depolymerization of poly (methyl methacrylate), were performed in a reactor of silica, with catalytic and heating system equipped with a data acquisition system and the gas chromatograph. For the catalysts synthesized using the polymeric precursor method, the cuprate of lanthanum was best for the depolymerization of the recycled polymer, obtaining 100% conversion in less time 554 (min), and the pure polymer, was the Niquelate of Lanthanum, with 100% conversion in less time 314 (min). By gel-combustion method using urea as fuel which was the best result obtained Ferrate of Lanthanum for the pure polymer with 100% conversion in less time 657 (min), and the recycled polymer was Cobaltate of Lanthanum with 100 % conversion in less time 779 (min). And using citric acid to obtain the best result for the pure polymer, was Ferrate of Lanthanum with 100% conversion in less time 821 (min and) for the recycled polymer, was Ferrate of Lanthanum with 98.28% conversion in less time 635 (min)

Síntese hidrotérmica assistida por micro-ondas de tiO2, e aplicação em nanocompósito

In recent decades have seen a sharp growth in the study area of nanoscience and nanotechnology and is included in this area, the study of nanocomposites with self-cleaning properties. Since titanium dioxide (TiO2) has high photocatalytic activity and also antimicrobial, self-cleaning surfaces in your application has been explored. In this study a comparison was made between two synthesis routes to obtain TiO2 nanoparticles by hydrothermal method assisted by microwave. And after analysis of XRD and SEM was considered the best material for use in nanocomposites. It was deposited nanocomposite film of poly (dimethyl siloxane) (PDMS) with 0.5, 1, 1.5 and 2% by weight of nanoparticles of titanium dioxide (TiO2) by the spraying method. The nanocomposite was diluted with hexane and the suspension was deposited onto glass substrate, followed by curing in an oven with forced air circulation. The photocatalytic activity of the nanocomposite impregnated with methylene blue was evaluated by UV- vis spectroscopy from the intensity variation of absorption main peak at 660nm with time of exposure to the UV chamber. Changes in the contact angle and microhardness were analyzed before and after UV aging test. The effect of ultraviolet radiation on the chemical structure of the PDMS matrix was evaluated by spectrophotometry Fourier transform infrared (FTIR).The results indicated that the addition of TiO2 nanoparticles in the coating PDMS gave high photocatalytic activity in the decomposition of methylene blue, an important characteristic for the development of self-cleaning coatings

Chemical Composition of Lipids Present in Cat and Dog Oocyte by Matrix-Assisted Desorption Ionization Mass Spectrometry (MALDI- MS)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effects of discontinuous Percoll gradient centrifugation on the quality of bovine spermatozoa evaluated with computer-assisted semen analysis and fluorescent probes association

The objective of this study was to evaluate the quality of bovine frozen-thawed sperm cells after Percoll gradient centrifugation. Frozen semen doses were obtained from six bulls of different breeds, including three taurine and three Zebu animals. Four ejaculates per bull were evaluated before and after discontinuous Percoll gradient centrifugation. Sperm motility was assessed by computer-assisted semen analysis and the integrity of the plasma and acrosomal membranes, as well as mitochondrial function, were evaluated using a combination of fluorescent probes propidium iodide, fluorescein isothiocyanate-conjugated Pisum sativum agglutinin and 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide. The procedure of Percoll gradient centrifugation increased the percentage of total and progressive sperm motility, beat frequency, rectilinear motility, linearity and rapidly moving cells. In addition, the percentage of cells with intact plasma membrane and mitochondrial membrane potential was increased in post-centrifugation samples. However, the percentage of sperm cells with intact acrosomal membrane was markedly reduced. The method used selected the motile cells with intact plasma membrane and higher mitochondrial functionality in frozen-thawed bull semen, but processing, centrifugation and/or the Percoll medium caused damage to the acrosomal membrane.

Demecolcine Effects on Microtubule Kinetics and on Chemically Assisted Enucleation of Bovine Oocytes

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Chemically Assisted Enucleation Results in Higher G6PD Expression in Early Bovine Female Embryos Obtained by Somatic Cell Nuclear Transfer

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Validation of microsatellite markers for assisted selection of soybean genotypes resistant to powdery mildew

Powdery mildew is one of the most serious diseases of soybean and is found in all producing countries. The purpose of this study was to validate microsatellite markers previously identified as associated with resistance to powdery mildew in soybean. The study was conducted in two F, parent populations with contrasting resistance to powdery mildew, In the analysis 10 SSR primers were used for the populations. and tour polymorphic markers were identified for cross I (MGBR95-20937 x IAC-Foscarin 31) and three for cross 2 (MGBR-46 x Empresa Brasileira de Pesquisa Agropecuária (EMBRAPA) 48). The Chi-square analysis of the phenotypic evaluation confirmed the expected segregation (3: 1) of a dominant gene related to resistance. The polymorphic markers also segregated as expected (1:2:1). The markers Sat 366 and Sat 393 in the crosses 1 and 2. respectively, located at 9.41 and 12.45 cM from the gene. were considered promising for marker-assisted selection for resistance to powdery mildew in soybean. at a selection efficiency of 92.7% and 60.3% respectively.

Air-assisted boom sprayer and spray deposition on bean plants

A possibilidade do desenvolvimento de técnicas de aplicação de produtos fitossanitários mais seguras, com menores volumes de calda, número de aplicações e deriva, aliados à necessidade de se obter melhores níveis de controle dos agentes nocivos às plantas cultivadas, justificam o uso da assistência de ar junto à barra de pulverização. Com o objetivo de avaliar a deposição da pulverização na cultura do feijoeiro (Phaseolus vulgaris), em presença e ausência da assistência de ar junto à barra de pulverização, com diferentes pontas de pulverização e volumes de calda, foi conduzido um experimento em delineamento inteiramente casualizado, utilizando-se como traçador o óxido cuproso. Alvos artificiais (papel filtro com 3 x 3 cm) foram afixados nas superfícies adaxial e abaxial de folíolos posicionados nos terços superior e inferior de plantas, selecionadas ao acaso, distribuídas perpendicularmente ao deslocamento do pulverizador. Após a aplicação do traçador os coletores foram lavados individualmente em solução extratora de ácido nítrico a 1,0 mol L-1. A determinação quantitativa dos depósitos foi realizada com o uso da espectrofotometria de absorção atômica. A assistência de ar junto à barra de pulverização não aumentou a deposição do traçador em folíolos de feijoeiro, aos 48 dias após a emergência da cultura.

Investigation of microwave dielectric relaxation solid state process in the antiferroelectric phase of NaNbO3 ceramics

This letter reports microwave dielectric measurements performed in the antiferroelectric phase of NaNbO3 ceramics from 100 to 450 K. Remarkable dielectric relaxation was found within the antiferroelectric phase and in the vicinity of the ferroelectric-antiferroelectric phase transition. Such dielectric relaxation process was associated with relaxations of polar nanoregions with strong relaxor-like characteristic. In addition, the microwave dielectric measurements also revealed an unexpected and unusual anomaly in the relaxation strength, which was related to a disruption of the antiferroelectric order induced by a possible AFE-AFE phase transition. (C) 2004 Elsevier Ltd. All rights reserved.

DFT study of the water-assisted tautomerization process between hydrated oxide, MO(H2O)(+), and dihydroxide, M(OH)(2)(+) cations (M = V, Nb and Ta)

Density functional theory (DFT) calculations point out that the participation of water can effectively lower the barrier height for the isomerization process between hydrated oxide cation, MO(H2O)(+), and dihydroxide cation, M(OH)(2)(+), (M = V, Nb and Ta). The catalytic effect is achieved by a water-assisted mechanism in which water acts as proton donor and acceptor, via a transition structure corresponding to a six-membered ring. In the case of vanadium atom, the presence of two water molecules has been taken into account and the tautomerization becomes nearly barrierless, decreasing both the stability of the transition structures relative to intermediates and the depths of wells associated with the intermediates. (C) 2003 Elsevier B.V. All rights reserved.

Conventional and microwave sintering of CaCu(3)Ti(4)O(12)/CaTiO(3) ceramic composites: non-ohmic and dielectric properties

The non-ohmic and dielectric properties as well as the dependence on the microstructural features of CaCu(3)Ti(4)O(12)/CaTiO(3) ceramic composites obtained by conventional and microwave sintering were investigated. It was demonstrated that the non-ohmic and dielectric properties depend strongly on the sintering conditions. It was found that the non-linear coefficient reaches values of 65 for microwave-sintered samples and 42 for samples sintered in a conventional furnace when a current density interval of 1-10 mA cm(-2) is considered. The non-linear coefficient value of 65 is equivalent to 1500 for samples sintered in the microwave if a current interval of 5-30 mA is considered as is shortly discussed by Chung et al (2004 Nature Mater. 3 774). Due to a high non-linear coefficient and a low leakage current (90 mu A) under both processing conditions, these samples are promising for varistor applications. The conventionally sintered samples exhibit a higher relative dielectric constant at 1 kHz (2960) compared with the samples sintered in the microwave furnace (2100). At high frequencies, the dielectric constant is also larger in the samples sintered in the conventional furnace. Depending on the application, one or another synthesis methodology is recommended, that is, for varistor applications sintered in a microwave furnace and for dielectric application sintered in a conventional furnace.

Growth of SrBi4Ti4O15 thin films in a microwave oven by the polymeric precursor method

SrBi4Ti4O15 (SBTi) thin films were obtained by the polymeric precursor method and crystallized in a domestic microwave oven. For comparison, films were also crystallized in a conventional furnace at 700 degrees C for 2 h. Structural and morphological characterization of the SBTi thin films was investigated by X-ray diffraction (XRD) and atomic force microscopy (AFM), respectively. Using platinum coated silicon substrates configuration, ferroelectric properties of the films were determined with remanent\polarization P-r and a coercive field E-c of 5.1 mu C/cm(2) and 135 kV/cm for the film thermally treated in the microwave oven and 5.4 mu C/cm(2) and 85 kV/cm for the film thermally treated in conventional furnace, respectively. The films thermally treated in the conventional furnace exhibited excellent fatigue-free characteristics up to 10(10) switching cycles indicating that SBTi thin films can be a promise material for use in non-volatile memories. (C) 2007 Elsevier B.V. All rights reserved.