928 resultados para Uniform coverage
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Soil treated with self-cementing fly ash is increasingly being used in Iowa to stabilize fine-grained pavement subgrades, but without a complete understanding of the short- and long-term behavior. To develop a broader understanding of fly ash engineering properties, mixtures of five different soil types, ranging from ML to CH, and several different fly ash sources (including hydrated and conditioned fly ashes) were evaluated. Results show that soil compaction characteristics, compressive strength, wet/dry durability, freeze/thaw durability, hydration characteristics, rate of strength gain, and plasticity characteristics are all affected by the addition of fly ash. Specifically, Iowa selfcementing fly ashes are effective at stabilizing fine-grained Iowa soils for earthwork and paving operations; fly ash increases compacted dry density and reduces the optimum moisture content; strength gain in soil-fly ash mixtures depends on cure time and temperature, compaction energy, and compaction delay; sulfur contents can form expansive minerals in soil–fly ash mixtures, which severely reduces the long-term strength and durability; fly ash increases the California bearing ratio of fine-grained soil–fly ash effectively dries wet soils and provides an initial rapid strength gain; fly ash decreases swell potential of expansive soils; soil-fly ash mixtures cured below freezing temperatures and then soaked in water are highly susceptible to slaking and strength loss; soil stabilized with fly ash exhibits increased freeze-thaw durability; soil strength can be increased with the addition of hydrated fly ash and conditioned fly ash, but at higher rates and not as effectively as self-cementing fly ash. Based on the results of this study, three proposed specifications were developed for the use of self-cementing fly ash, hydrated fly ash, and conditioned fly ash. The specifications describe laboratory evaluation, field placement, moisture conditioning, compaction, quality control testing procedures, and basis of payment.
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To provide insight into subgrade non-uniformity and its effects on pavement performance, this study investigated the influence of non-uniform subgrade support on pavement responses (stress and deflection) that affect pavement performance. Several reconstructed PCC pavement projects in Iowa were studied to document and evaluate the influence of subgrade/subbase non-uniformity on pavement performance. In situ field tests were performed at 12 sites to determine the subgrade/subbase engineering properties and develop a database of engineering parameter values for statistical and numerical analysis. Results of stiffness, moisture and density, strength, and soil classification were used to determine the spatial variability of a given property. Natural subgrade soils, fly ash-stabilized subgrade, reclaimed hydrated fly ash subbase, and granular subbase were studied. The influence of the spatial variability of subgrade/subbase on pavement performance was then evaluated by modeling the elastic properties of the pavement and subgrade using the ISLAB2000 finite element analysis program. A major conclusion from this study is that non-uniform subgrade/subbase stiffness increases localized deflections and causes principal stress concentrations in the pavement, which can lead to fatigue cracking and other types of pavement distresses. Field data show that hydrated fly ash, self-cementing fly ash-stabilized subgrade, and granular subbases exhibit lower variability than natural subgrade soils. Pavement life should be increased through the use of more uniform subgrade support. Subgrade/subbase construction in the future should consider uniformity as a key to long-term pavement performance.
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Recent studies have started to use media data to measure party positions and issue salience. The aim of this article is to compare and cross-validate this alternative approach with the more commonly used party manifestos, expert judgments and mass surveys. To this purpose, we present two methods to generate indicators of party positions and issue salience from media coverage: the core sentence approach and political claims analysis. Our cross-validation shows that with regard to party positions, indicators derived from the media converge with traditionally used measurements from party manifestos, mass surveys and expert judgments, but that salience indicators measure different underlying constructs. We conclude with a discussion of specific research questions for which media data offer potential advantages over more established methods.
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The archives of the Prefecture of the Peruvian Ministry of Foreign Affairs provide a perspective from which to reconstruct the broad range of legal circumstances in which Spanish residents in various regions of the country find themselves immersed (assets of relatives who have died without wills or family in Peru, political conflicts, legal problems -whether criminal or civil as a result of business activities- or the requested intervention ofconsular authorities when decisions considered detrimental to their compatriots are made by prefects and sub-prefects). The legal framework protecting Spanish nationals in Peru is analysed to understand the mechanisms of immigration in the country and the mechanisms that led them to keep their Spanish nationality, even after establishing wide-reaching family and business interests
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OBJECTIVE: To assess the association between socio-demographic factors and the quality of preventive care and chronic care of cardiovascular (CV) risk factors in a country with universal health care coverage. METHODS: Our retrospective cohort assessed a random sample of 966 patients aged 50-80years followed over 2years (2005-2006) in 4 Swiss university primary care settings (Basel/Geneva/Lausanne/Zürich). We used RAND's Quality Assessment Tools indicators and examined recommended preventive care among different socio-demographic subgroups. RESULTS: Overall patients received 69.6% of recommended preventive care. Preventive care indicators were more likely to be met among men (72.8% vs. 65.4%; p<0.001), younger patients (from 71.0% at 50-59years to 66.7% at 70-80years, p for trend=0.03) and Swiss patients (71.1% vs. 62.7% in forced migrants; p=0.001). This latter difference remained in multivariate analysis adjusted for gender, age, civil status and occupation (OR 0.68; 95% CI 0.54-0.86). Forced migrants had lower scores for physical examination and breast and colon cancer screening (all p≤0.02). No major differences were seen for chronic care of CV risk factors. CONCLUSION: Despite universal healthcare coverage, forced migrants receive less preventive care than Swiss patients in university primary care settings. Greater attention should be paid to forced migrants for preventive care.
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This research paper provides the basis of a future doctoral thesison the construction of foreign news. We aim to highlight similarities and differences in the online news coverage of the nationalist movments in Scotland and Catalonia in the Canadian Anglophone and Francophone press. Through a qualitative and quantitative content analysis of The Montreal Gazette, The National Post, The Globe and Mail, Le Devoir and La Presse, we attempt to show the frames used in the coverage of the political developments in both “stateless regions” from January 2011 to September 2014, when a referendum on the constitutional status of Scotland has beenagreed on. In parallel to the analysis of daily online newspapers, we will use semi-structured interviews of journalists from each news organization to obtain more in-depth knowledge of the factors influencing the construction of news. Lastly, we want to find out to the extent to which the coverage on the nationalist movements in Scotland and Catalonia serve to revive the debate on the independence question of Québec
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A guide for seniors on medicare and prescription drug plans
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In this paper we propose a method for computing JPEG quantization matrices for a given mean square error or PSNR. Then, we employ our method to compute JPEG standard progressive operation mode definition scripts using a quantization approach. Therefore, it is no longer necessary to use a trial and error procedure to obtain a desired PSNR and/or definition script, reducing cost. Firstly, we establish a relationship between a Laplacian source and its uniform quantization error. We apply this model to the coefficients obtained in the discrete cosine transform stage of the JPEG standard. Then, an image may be compressed using the JPEG standard under a global MSE (or PSNR) constraint and a set of local constraints determined by the JPEG standard and visual criteria. Secondly, we study the JPEG standard progressive operation mode from a quantization based approach. A relationship between the measured image quality at a given stage of the coding process and a quantization matrix is found. Thus, the definition script construction problem can be reduced to a quantization problem. Simulations show that our method generates better quantization matrices than the classical method based on scaling the JPEG default quantization matrix. The estimation of PSNR has usually an error smaller than 1 dB. This figure decreases for high PSNR values. Definition scripts may be generated avoiding an excessive number of stages and removing small stages that do not contribute during the decoding process with a noticeable image quality improvement.
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The mass media are assigned an important role in political campaigns on popular votes. This article asks how the press communicates political issues to citizens during referendum campaigns, and whether some minimal criteria for successful public deliberation are met. The press coverage of all 24 ballot votes on welfare state issues from 1995 to 2004 in Switzerland is examined, distinguishing seven criteria to judge how news coverage compares to idealized notions of the media's role in the democratic process: coverage intensity, time for public deliberation, balance in media coverage, source independence and inclusiveness, substantive coverage, and spatial homogeneity. The results of our quantitative analysis suggest that the press does fulfil these normative requirements to a reasonable extent and that fears about biased or deceitful media treatment of ballot issues are not well-founded. However, some potential for optimizing the coverage of referendum campaigns by the Swiss press does exist
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OBJECTIVE: To investigate the determinants and the 4-year evolution of the forgoing of healthcare for economic reasons in Switzerland. METHOD: Population-based survey (2007-2010) of a representative sample aged 35-74years in the Canton of Geneva, Switzerland. Healthcare forgone, socioeconomic and insurance status, marital status, and presence of dependent children were assessed using standardized methods. RESULTS: A total of 2601 subjects were included in the analyses. Of the subjects, 13.8% (358/2601) reported having forgone healthcare for economic reasons, with the percentage varying from 3.7% in the group with a monthly income ≥13,000CHF (1CHF≈1$) to 30.9% in the group with a monthly income <3000CHF. In subjects with a monthly income <3000CHF, the percentage who had forgone healthcare increased from 22.5% in 2007/8 to 34.7% in 2010 (P trend=0.2). Forgoing healthcare for economic reasons was associated with lower income, female gender, smoking status, lower job position, having dependent children, being divorced and single, paying a higher deductible, and receiving a premium subsidy. CONCLUSION: In a Swiss region with universal health insurance coverage, the reported prevalence of forgoing healthcare for economic reasons was high and greatly dependent on socioeconomic factors. Our data suggested an increasing trend among participants with the lowest income.
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Burn care and research have significantly improved over the past years. However, insurance coverage of such treatments does not reflect the improvements in this multi-disciplinary field. Government insurance policies in first world countries renown for burn care treatment, such as Switzerland and the United States, have not adapted to the complexity and longitudinal nature of burn care. Using case studies from both countries, we have analyzed both the institutional and policy approach to pediatric burn treatment coverage. Subsequently, by presenting the Shriners burn care model, we offer a policy recommendation to both the Swiss and the American governments to better their present legislation and infrastructure on pediatric burn coverage.
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Data from studies in the United States suggest that young people engaging in health-compromising behaviors have lower access to health care. Using data from a Swiss national survey we tested the hypothesis that in a country with universal insurance coverage, adolescents engaging in health-compromising behaviors access primary care to the same extent as those who do not engage in these behaviors.
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BACKGROUND: Frequent emergency department users represent a small number of patients but account for a large number of emergency department visits. They should be a focus because they are often vulnerable patients with many risk factors affecting their quality of life (QoL). Case management interventions have resulted in a significant decrease in emergency department visits, but association with QoL has not been assessed. One aim of our study was to examine to what extent an interdisciplinary case management intervention, compared to standard emergency care, improved frequent emergency department users' QoL. METHODS: Data are part of a randomized, controlled trial designed to improve frequent emergency department users' QoL and use of health-care resources at the Lausanne University Hospital, Switzerland. In total, 250 frequent emergency department users (≥5 attendances during the previous 12 months; ≥ 18 years of age) were interviewed between May 2012 and July 2013. Following an assessment focused on social characteristics; social, mental, and somatic determinants of health; risk behaviors; health care use; and QoL, participants were randomly assigned to the control or the intervention group (n=125 in each group). The final sample included 194 participants (20 deaths, 36 dropouts, n=96 in the intervention group, n=99 in the control group). Participants in the intervention group received a case management intervention by an interdisciplinary, mobile team in addition to standard emergency care. The case management intervention involved four nurses and a physician who provided counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system. The participants' QoL was evaluated by a study nurse using the WHOQOL-BREF five times during the study (at baseline, and at 2, 5.5, 9, and 12 months). Four of the six WHOQOL dimensions of QoL were retained here: physical health, psychological health, social relationship, and environment, with scores ranging from 0 (low QoL) to 100 (high QoL). A linear, mixed-effects model with participants as a random effect was run to analyze the change in QoL over time. The effects of time, participants' group, and the interaction between time and group were tested. These effects were controlled for sociodemographic characteristics and health-related variables (i.e., age, gender, education, citizenship, marital status, type of financial resources, proficiency in French, somatic and mental health problems, and behaviors at risk).
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Vertebral fracture assessments (VFAs) using dual-energy X-ray absorptiometry increase vertebral fracture detection in clinical practice and are highly reproducible. Measures of reproducibility are dependent on the frequency and distribution of the event. The aim of this study was to compare 2 reproducibility measures, reliability and agreement, in VFA readings in both a population-based and a clinical cohort. We measured agreement and reliability by uniform kappa and Cohen's kappa for vertebral reading and fracture identification: 360 VFAs from a population-based cohort and 85 from a clinical cohort. In the population-based cohort, 12% of vertebrae were unreadable. Vertebral fracture prevalence ranged from 3% to 4%. Inter-reader and intrareader reliability with Cohen's kappa was fair to good (0.35-0.71 and 0.36-0.74, respectively), with good inter-reader and intrareader agreement by uniform kappa (0.74-0.98 and 0.76-0.99, respectively). In the clinical cohort, 15% of vertebrae were unreadable, and vertebral fracture prevalence ranged from 7.6% to 8.1%. Inter-reader reliability was moderate to good (0.43-0.71), and the agreement was good (0.68-0.91). In clinical situations, the levels of reproducibility measured by the 2 kappa statistics are concordant, so that either could be used to measure agreement and reliability. However, if events are rare, as in a population-based cohort, we recommend evaluating reproducibility using the uniform kappa, as Cohen's kappa may be less accurate.