The Benefits Planner: Improved Work Incentives in Social Security Disability Insurance Program - Changes Will Make Work More Attractive to SSDI Recipients

This newsletter will provide valuable information on how work for persons with disabilities effects government benefits, with an emphasis on the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) work incentives. Each newsletter will contribute to an ongoing dialogue on topics related to benefits and work.

The Benefits Planner: New York Implements Medicaid Buy-In Program - Program Allows Individuals With Disabilities to Work and Keep Medicaid

This newsletter will provide valuable information on how work for persons with disabilities effects government benefits, with an emphasis on the Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) work incentives. Each newsletter will contribute to an ongoing dialogue on topics related to benefits and work.

Developing Strategic Marketing Plan

This publication is first in a series targeted for Coordinators and Managers within Benefits Planning, Assistance and Outreach Programs concerned with developing continuous quality improvement approaches. This early publication focuses on understanding strategies for market position, strategic planning and provides a tool for conducting an organizational self-assessment along with a stakeholder analysis

Dental health and school-based health education among 15-year-olds in Tehran, Iran

The aim of the present study was to assess dental health and its determinants among 15-year-olds in Tehran, Iran and to evaluate the impact of a school-based educational intervention on their oral cleanliness and gingival health. The total sample comprised 506 students. Data collection was performed through a clinical dental examination and a self-administered structured questionnaire. This questionnaire covered the student s background information, socio-economic status, self-perceived dental health, tooth-brushing, and smoking. The clinical dental examination covered caries experience, gingival status, dental plaque status, and orthodontic treatment needs. Participation was voluntary, and all students responded to the questionnaire. Only three students refused the clinical dental examination. The intervention was based on exposing students to dental health education through a leaflet and a videotape designed for the present study. The outcome examinations took place 12 weeks after the baseline among the three groups of the intervention trial (leaflet, videotape, and control). High participation rates at the baseline and scanty drop-outs (7%) in the intervention speak for reliability of the results. Mean value of the DMFT (D=decayed, M=missing, and F=filled teeth) index of the 15-year-olds was 2.1, which comprised DT=0.9, MT=0.2, and FT=1.0 with no gender differences. Dental plaque existed on at least one index tooth of all students, and healthy periodontium (Community Periodontal Index=0) was found in less than 10% of students. Need for caries treatment existed in 40% of students, for scaling in 24%, for oral hygiene instructions in all, and for orthodontic treatment in 26%. Students with the highest level of parents education had fewer dental caries (36% vs. 48%) and less dental plaque (77% vs. 88%). Of all students, 78% assessed their dental health as good or better. Even more of those with their DMFT=0 (73% vs. 27%) and DT=0 (68% vs. 32%) assessed their dental health as good or better. Smokers comprised 5% of the boys and 2% of the girls. Smoking was common among students of less-educated parents (6% vs. 3%). Of all students, 26% reported twice-daily tooth-brushing; girls (38% vs. 15%) and those of higher socio-economic background (33% vs. 17%) did so more frequently. The best predictors for a good level of oral cleanliness were female gender or twice-daily tooth-brushing. The present study demonstrated that a school-based educational intervention can be effective in the short term in improving the oral cleanliness and gingival health of adolescents. At least 50% reduction in numbers of teeth with dental plaque compared to baseline was achieved by 58% of the students in the leaflet group, by 37% in the videotape group, and by 10% of the controls. Corresponding figures for gingival bleeding were 72%, 64%, and 30%. For improving the oral cleanliness and gingival health of adolescents in countries such as Iran with a developing oral health system, school-based educational intervention should be established with focus on oral self-care and oral health education messages. Emphasizing the immediate gains from good oral hygiene, such as fresh breath, clean teeth, and attractive appearance should be key aspects for motivating these adolescents to learn and maintain good dental health, whilst in planning school-based dental health intervention, special attention should be given to boys and those with lower socio-economic status. Author s address: Reza Yazdani, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O. Box 41, FI-00014 Helsinki, Finland. E-mail: reza.yazdani@helsinki.fi

Long-term repeated burning reduces Lantana camara regeneration in a dry eucalypt forest

Previous short-term studies predict that the use of fire to manage lantana (Lantana camara) may promote its abundance. We tested this prediction by examining long-term recruitment patterns of lantana in a dry eucalypt forest in Australia from 1959 to 2007 in three fire frequency treatments: repeated annual burning, repeated triennial burning and long unburnt. The dataset was divided into two periods (1959–1972, 1974–2007) due to logging that occurred at the study site between 1972 and 1974 and the establishment of the triennial burn treatment in 1973. Our results showed that repeated burning decreased lantana regeneration under an annual burn regime in the pre- and post-logging periods and maintained low levels of regeneration in the triennial burn compartment during the post-logging period. In the absence of fire, lantana recruitment exhibited a dome-shaped response over time, with the total population peaking in 1982 before declining to 2007. In addition to fire regime, soil pH and carbon to nitrogen ratio, the density of taller conspecifics and the interaction between rainfall and fire regime were found to influence lantana regeneration change over time. The results suggest that the reported positive association between fire disturbance and abundance of lantana does not hold for all forest types and that fire should be considered as part of an integrated weed management strategy for lantana in more fire-tolerant ecosystems.

Open-pit block sequencing optimization: A mathematical model and solution technique

This study presents a comprehensive mathematical formulation model for a short-term open-pit mine block sequencing problem, which considers nearly all relevant technical aspects in open-pit mining. The proposed model aims to obtain the optimum extraction sequences of the original-size (smallest) blocks over short time intervals and in the presence of real-life constraints, including precedence relationship, machine capacity, grade requirements, processing demands and stockpile management. A hybrid branch-and-bound and simulated annealing algorithm is developed to solve the problem. Computational experiments show that the proposed methodology is a promising way to provide quantitative recommendations for mine planning and scheduling engineers.

Long-term use of custom-made orthopedic shoes: A 1.5-year follow-up study

This study investigated long-term use of custom-made orthopedic shoes (OS) at 1.5 years follow-up. In addition, the association between short-term outcomes and long-term use was studied. Patients from a previously published study who did use their first-ever pair of OS 3 months after delivery received another questionnaire after 1.5 years. Patients with different pathologies were included in the study (n = 269, response = 86%). Mean age was 63 ± 14 years, and 38% were male. After 1.5 years, 87% of the patients still used their OS (78% frequently [4-7 days/week] and 90% occasionally [1-3 days/week]) and 13% of the patients had ceased using their OS. Patients who were using their OS frequently after 1.5 years had significantly higher scores for 8 of 10 short-term usability outcomes (p-values ranged from <0.001 to 0.046). The largest differences between users and nonusers were found for scores on the short-term outcomes of OS fit and communication with the medical specialist and shoe technician (effect size range = 0.16 to 0.46). We conclude that patients with worse short-term usability outcomes for their OS are more likely to use their OS only occasionally or not at all at long-term follow-up.

Carbon sequestration versus bioenergy: A case study from South India exploring the relative land-use efficiency of two options for climate change mitigation

This case study has been carried out as a comparison between two different land-use strategies for climate change mitigation, with possible application within the Clean Development Mechanisms. The benefits of afforestation for carbon sequestration versus for bioenergy production are compared in the context of development planning to meet increasing domestic and agricultural demand for electricity in Hosahalli village, Karnataka, India. One option is to increase the local biomass based electricity generation, requiring an increased biomass plantation area. This option is compared with fossil based electricity generation where the area is instead used for producing wood for non-energy purposes while also sequestering carbon in the soil and standing biomass. The different options have been assessed using the PRO-COMAP model. The ranking of the different options varies depending on the system boundaries and time period. Results indicate that, in the short term (30 years) perspective, the mitigation potential of the long rotation plantation is largest, followed by the short rotation plantation delivering wood for energy. The bioenergy option is however preferred if a long-term view is taken. Short rotation forests delivering wood for short-lived non-energy products have the smallest mitigation potential, unless a large share of the wood products are used for energy purposes (replacing fossil fuels) after having served their initial purpose. If managed in a sustainable manner all of these strategies can contribute to the improvement of the social and environmental situation of the local community. (C) 2009 Elsevier Ltd. All rights reserved.

Topical tacrolimus in atopic dermatitis : Effects of long-term treatment on skin and respiratory symptoms

Objective: Patients with atopic dermatitis often have a poor long-term response to conventional topical or systemic treatments. Staphylococcal superinfections, skin atrophy due to corticosteroid use, and asthma and allergic rhinitis are common. Only a few, usually short-term, studies have addressed the effects of different treatments on these problems. Tacrolimus ointment is the first topical compound suitable for long-term treatment. The aim of this thesis was to evaluate the effects of long-term topical tacrolimus treatment on cutaneous staphylococcal colonization, collagen synthesis, and symptoms and signs of asthma and allergic rhinitis. Methods: Patients with moderate-to-severe atopic dermatitis were treated with intermittent 0.1% tacrolimus ointment in prospective, open studies lasting for 6 to 48 months. In Study I, cutaneous staphylococcal colonization was followed for 6 to 12 months. In Study II, skin thickness and collagen synthesis were followed by skin ultrasound and procollagen I and III propeptide concentrations of suction blister fluid samples for 12 to 24 months and compared with a group of corticosteroid-treated atopic dermatitis patients and with a group of healthy subjects. Study III was a cross-sectional study of the occurrence of respiratory symptoms, bronchial hyper-responsiveness, and sputum eosinophilia in atopic dermatitis patients and healthy controls. In Study V, the same parameters as in Study III were assessed in atopic dermatitis patients before and after 12 to 48 months of topical tacrolimus treatment. Study IV was a retrospective follow-up of the effect of tacrolimus 0.03% ointment on severe atopic blepharoconjunctivitis and conjunctival cytology. Results: The clinical response to topical tacrolimus was very good in all studies (p≤0.008). Staphylococcal colonization decreased significantly, and the effect was sustained throughout the study (p=0.01). Skin thickness (p<0.001) and markers of collagen synthesis (p<0.001) increased in the tacrolimus-treated patients significantly, whereas they decreased or remained unchanged in the corticosteroid-treated controls. Symptoms of asthma and allergic rhinitis (p<0.0001), bronchial hyper-responsiveness (p<0.0001), and sputum eosinophilia (p<0.0001) were significantly more common in patients with atopic dermatitis than in healthy controls, especially in subjects with positive skin prick tests or elevated serum immunoglobulin E. During topical tacrolimus treatment the asthma and rhinitis (p=0.005 and p=0.002) symptoms and bronchial hyper-responsiveness (p=0.02) decreased significantly, and serum immunoglobulin E and sputum eosinophils showed a decreasing trend in patients with the best treatment response. Treatment of atopic blepharoconjunctivitis resulted in a marked clinical response and a significant decrease in eosinophils, lymphocytes, and neutrophils in the conjunctival cytology samples. No significant adverse effects or increase in skin infections occurred in any study. Conclusions: The studies included in this thesis, except the study showing an increase in skin collagen synthesis in tacrolimus-treated patients, were uncontrolled, warranting certain reservations. The results suggest, however, that tacrolimus ointment has several beneficial effects in the long-term intermittent treatment of atopic dermatitis. Tacrolimus ointment efficiently suppresses the T cell-induced inflammation of atopic dermatitis. It has a normalizing effect on the function of the skin measured by the decrease in staphylococcal colonization. It does not cause skin atrophy as do corticosteroids but restores the skin collagen synthesis in patients who have used corticosteroids. Tacrolimus ointment has no marked systemic effect, as the absorption of the drug is minimal and decreases along with skin improvement. The effects on the airway: decrease in bronchial hyper-responsiveness and respiratory symptoms, can be speculated to be caused by the decrease in T cell trafficking from the skin to the respiratory tissues as the skin inflammation resolves, as well as inhibition of epicutaneous invasion of various antigens causing systemic sensitization when the skin barrier is disrupted as in atopic dermatitis. Patients with moderate-to-severe atopic dermatitis seem to benefit from efficient long-term treatment with topical tacrolimus.

Kantoaalto koulutuksesta työyhteisön viestintäosaamiseen : lyhytkestoisen viestintäkoulutuksen vaikuttavuuden avaintekijät

The purpose of this research is to examine whether short-term communication training can have an impact on the improvement of communication capacity of working communities, and what are prerequisites for the creation of such capacity. Subjects of this research were short-term communication trainings aimed at the managerial and expert levels of enterprises and communities. The research endeavors to find out how communication trainings with an impact should be devised and implemented, and what this requires from the client and provider of the training service. The research data is mostly comprised of quantitative feed-back collected at the end of a training day, as well as delayed interviews. The evaluations have been based on a stakeholder approach, and those concerned were participants to the trainings, clients having commissioned the trainings and communication trainers. The principal method of the qualitative analysis is that of a data-driven content analysis. Two research instruments have been constructed for the analysis and for the presentation of the results: an evaluation circle for the purposes of a holistic evaluation and a development matrix for the structuring of an effective training. The core concept of the matrix is a carrier wave effect, which is needed to carry the abstractions from the training into concrete functions in the everyday life. The relevance of the results has been tested in a pilot organization. The immediate assessment and delayed evaluations gave a very differing picture of the trainings. The immediate feedback was of nearly commendable level, but the effects carried forward into the everyday situations of the working community were small and that the learning rarely was applied into practice. A training session that receives good feedback does not automatically result in the development of individual competence, let alone that of the community. The results show that even short-term communication training can promote communication competence that eventually changes the working culture on an organizational level, provided that the training is designed into a process and that the connections into the participants’ work are ensured. It is essential that all eight elements of the carrier wave effect are taken into account. The entire purchaser-provider -process must function while not omitting the contribution of the participants themselves. The research illustrates the so called bow tie -model of an effective communication training based on the carrier wave effect. Testing the results in pilot trainings showed that a rather small change in the training approach may have a signi¬ficant effect on the outcome of the training as well as those effects that are carried on into the working community. The evaluation circle proved to be a useful tool, which can be used while planning, executing and evaluating training in practice. The development matrix works as a tool for those producing the training service, those using the service as well as those deciding on the purchase of the service in planning and evaluating training that sustainably improves communication capacity. Thus the evaluation circle also works to support and ensure the long-term effects of short-term trainings. In addition to communication trainings, the tools developed for this research are useable for many such needs, where an organization is looking to improve its operations and profitability through training.

A Comparison of Managers’ Perception of Short-Termism in Finland, Sweden and the U.S

Increased media exposure to layoffs and corporate quarterly financial reporting have created arguable a common perception – especially favored by the media itself – that the companies have been forced to improve their financial performance from quarter to quarter. Academically the relevant question is whether companies themselves feel that they are exposed to short-term pressure to perform even if it means that they have to compromise company’s long-term future. This paper studies this issue using results from a survey conducted among the 500 largest companies in Finland. The results show that companies in general feel moderate short-term pressure, with reasonable dispersion across firms. There seems to be a link between the degree of pressure felt, and the firm’s ownership structure, i.e. we find support for the existence of short-term versus long-term owners. We also find significant ownership related differences, in line with expectations, in how such short-term pressure is reflected in actual decision variables such as the investment criteria used.

Eteva Järvenpään perhepalvelukeskuksen lyhytaikaishoidon suunnittelun kehittäminen

Objectives. The thesis objective was to analyze how person-centred planning is applied to develop short term care in interaction between the disabled children, their families and the workers of the family service centre of Eteva Järvenpää. The thesis contributes to developing the methods of person-centred planning. I applied theoretical frameworks of activity theory and developmental work research, family-based work framework and disability phenomenon. The research questions were: What development needs did the families of disabled children have for the services? How were viewpoints of disabled children, their families and Eteva workers noticed in person-centred planning in the interaction between the disabled children, their families and Eteva workers? What disturbances and development challenges emerged during the person-centred planning? Methods. I first analysed the local history of the disability sector and the short term care to analyse challenges arising from the local history. The actural research material consisted of interviews with four families, two person-centred planning discussions and two discussions where the person-centred planning was reflected by the families.I used interaction voice analysis as defined by the activity theory and developmental work research. From the recorded interviews and discussions I analysed scripts, disturbances, innovation attempts and innovations. From the discussions I analysed also the interaction types (cooperation, coordination and communication). Results and conclusions. As problems, the families considered the scarce resources and the inflexibility of services. The challenges of developing the short term care were how to transfer information from short term care to home, how to develop activities for the children and how to take into account the individual needs of the children in the short term care. Both from the local history analysis and from the family interviews arised the conflict between caring and fulfilling the individual needs. In person-centred planning, the voice of the child was either interpreted by other family members or guided by family members or workers. I modelled the progress of person-centred planning in a two-dimensional coordination. Person-centred planning should be deepened in cooperation between the child, the family and the workers in everyday situations at home and during the short term care. The challenge is to expand person-centred planning to become cross-organizational cooperation connecting the actors of the child s service network in everyday life. Avainsanat Nyckelord - Keywords short term care, activity theory and developmental work research, person-centred planning, disability

Non-industrial private forest landowners’ choices of timber management strategies and potential allowable cut.

In the study, the potential allowable cut in the district of Pohjois-Savo - based on the non-industrial private forest landowners' (NIPF) choices of timber management strategies - was clarified. Alternative timber management strategies were generated, and the choices and factors affecting the choices of timber management strategies by NIPF landowners were studied. The choices of timber management strategies were solved by maximizing the utility functions of the NIPF landowners. The parameters of the utility functions were estimated using the Analytic Hierarchy Process (AHP). The level of the potential allowable cut was compared to the cutting budgets based on the 7th and 8th National Forest Inventories (NFI7 and NFI8), to the combining of private forestry plans, and to the realized drain from non-industrial private forests. The potential allowable cut was calculated using the same MELA system as has been used in the calculation of the national cutting budget. The data consisted of the NIPF holdings (from the TASO planning system) that had been inventoried compartmentwise and had forestry plans made during the years 1984-1992. The NIPF landowners' choices of timber management strategies were clarified by a two-phase mail inquiry. The most preferred strategy obtained was "sustainability" (chosen by 62 % of landowners). The second in order of preference was "finance" (17 %) and the third was "saving" (11 %). "No cuttings", and "maximum cuttings" were the least preferred (9 % and 1 %, resp.). The factors promoting the choices of strategies with intensive cuttings were a) "farmer as forest owner" and "owning fields", b) "increase in the size of the forest holding", c) agriculture and forestry orientation in production, d) "decreasing short term stumpage earning expectations", e) "increasing intensity of future cuttings", and f) "choice of forest taxation system based on site productivity". The potential allowable cut defined in the study was 20 % higher than the average of the realized drain during the years 1988-1993, which in turn, was at the same level as the cutting budget based on the combining of forestry plans in eastern Finland. Respectively, the potential allowable cut defined in the study was 12 % lower than the NFI8-based greatest sustained allowable cut for the 1990s. Using the method presented in this study, timber management strategies can be clarified for non-industrial private forest landowners in different parts of Finland. Based on the choices of timber managemet strategies, regular cutting budgets can be calculated more realistically than before.

Climate change and Indian forests

An assessment of the impact of projected climate change on forest ecosystems in India based on climate projections of the Regional Climate Model of the Hadley Centre (HadRM3) and the global dynamic vegetation model IBIS for A1B scenario is conducted for short-term (2021-2050) and long-term (2071-2100) periods. Based on the dynamic global vegetation modelling, vulnerable forested regions of India have been identified to assist in planning adaptation interventions. The assessment of climate impacts showed that at the national level, about 45% of the forested grids is projected to undergo change. Vulnerability assessment showed that such vulnerable forested grids are spread across India. However, their concentration is higher in the upper Himalayan stretches, parts of Central India, northern Western Ghats and the Eastern Ghats. In contrast, the northeastern forests, southern Western Ghats and the forested regions of eastern India are estimated to be the least vulnerable. Low tree density, low biodiversity status as well as higher levels of fragmentation, in addition to climate change, contribute to the vulnerability of these forests. The mountainous forests (sub-alpine and alpine forest, the Himalayan dry temperate forest and the Himalayan moist temperate forest) are susceptible to the adverse effects of climate change. This is because climate change is predicted to be larger for regions that have greater elevations.

Multi-model climate change projections for India under representative concentration pathways

Climate projections for the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC) are made using the newly developed representative concentration pathways (RCPs) under the Coupled Model Inter-comparison Project 5 (CMIP5). This article provides multi-model and multi-scenario temperature and precipitation projections for India for the period 1860-2099 based on the new climate data. We find that CMIP5 ensemble mean climate is closer to observed climate than any individual model. The key findings of this study are: (i) under the business-as-usual (between RCP6.0 and RCP8.5) scenario, mean warming in India is likely to be in the range 1.7-2 degrees C by 2030s and 3.3-4.8 degrees C by 2080s relative to pre-industrial times; (ii) all-India precipitation under the business-as-usual scenario is projected to increase from 4% to 5% by 2030s and from 6% to 14% towards the end of the century (2080s) compared to the 1961-1990 baseline; (iii) while precipitation projections are generally less reliable than temperature projections, model agreement in precipitation projections increases from RCP2.6 to RCP8.5, and from short-to long-term projections, indicating that long-term precipitation projections are generally more robust than their short-term counterparts and (iv) there is a consistent positive trend in frequency of extreme precipitation days (e.g. > 40 mm/day) for decades 2060s and beyond. These new climate projections should be used in future assessment of impact of climate change and adaptation planning. There is need to consider not just the mean climate projections, but also the more important extreme projections in impact studies and as well in adaptation planning.