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Berwick D.M.,MediCaid | Clancy C.M.,Agency for Healthcare Research and Quality AHRQ | Baur C.,Centers for Disease Control and Prevention | Brach C.,Health policy researcher at AHRQ | And 2 more authors.
Health Affairs | Year: 2012

Health literacy is the capacity to understand basic health information and make appropriate health decisions. Tens of millions of Americans have limited health literacy-a fact that poses major challenges for the delivery of high-quality care. Despite its importance, health literacy has until recently been relegated to the sidelines of health care improvement efforts aimed at increasing access, improving quality, and better managing costs. Recent federal policy initiatives, including the Affordable Care Act of 2010, the Department of Health and Human Services' National Action Plan to Improve Health Literacy, and the Plain Writing Act of 2010, have brought health literacy to a tipping point-that is, poised to make the transition from the margins to the mainstream. If public and private organizations make it a priority to become health literate, the nation's health literacy can be advanced to the point at which it will play a major role in improving health care and health for all Americans. © 2012 Project HOPE-The People-to-People Health Foundation, Inc.


Elliott N.,RAND Corporation | Lehrman W.G.,MediCaid | Goldstein E.H.,CMS | Giordano L.A.,Health Services Advisory Group | And 3 more authors.
Health Affairs | Year: 2010

Hospitals are improving the inpatient care experience. A government survey that measures patients' experiences with a range of issues from staff responsiveness to hospital cleanliness-the Hospital Consumer Assessment of Healthcare Providers and Systems survey-is showing modest but meaningful gains. Using data from the surveys reported in March 2008 and March 2009, we present the first comprehensive national assessment of changes in patients' experiences with inpatient care since public reporting of the results began. We found improvements in all measures of patient experience, except doctors' communication. These improvements were fairly uniform across hospitals. The largest increases were in measures related to staff responsiveness and the discharge information that patients received. ©2010 Project HOPE-The People-to-People Health Foundation, Inc.


Sterling A.C.,NASA | Sterling A.C.,Japan Aerospace Exploration Agency | Chifor C.,CMS | Mason H.E.,CMS | And 3 more authors.
Astronomy and Astrophysics | Year: 2010

Aims. We study the onset of a solar eruption involving a filament ejection on 2007 May 20. Methods. We observe the filament in Hα images from Hinode/SOT and in EUV with TRACE and STEREO/SECCHI/EUVI. Hinode/XRT images are used to study the eruption in soft X-rays. From spectroscopic data taken with Hinode/EIS we obtain bulk-flow velocities, line profiles, and plasma densities in the onset region. The magnetic field evolution was observed in SoHO/MDI magnetograms. Results. We observed a converging motion between two opposite polarity sunspots that form the primary magnetic polarity inversion line (PIL), along which resides filament material before eruption. Positive-flux magnetic elements, perhaps moving magnetic features (MMFs) flowing from the spot region, appear north of the spots, and the eruption onset occurs where these features cancel repeatedly in a negative-polarity region north of the sunspots. An ejection of material observed in Hα and EUV marks the start of the filament eruption (its "fast-rise"). The start of the ejection is accompanied by a sudden brightening across the PIL at the jet's base, observed in both broad-band images and in EIS. Small-scale transient brightenings covering a wide temperature range (Log Te = 4.8-6.3) are also observed in the onset region prior to eruption. The preflare transient brightenings are characterized by sudden, localized density enhancements (to above Log ne [cm-3] = 9.75, in Fe xiii) that appear along the PIL during a time when pre-flare brightenings were occurring. The measured densities in the eruption onset region outside the times of those enhancements decrease with temperature. Persistent downflows (red-shifts) and line-broadening (Fe xii) are present along the PIL. Conclusions. The array of observations is consistent with the pre-eruption sheared-core magnetic field being gradually destabilized by evolutionary tether-cutting flux cancelation that was driven by converging photospheric flows, and the main filament ejection being triggered by flux cancelation between the positive flux elements and the surrounding negative field. A definitive statement however on the eruption's ultimate cause would require comparison with simulations, or additional detailed observations of other eruptions occurring in similar magnetic circumstances. © 2010 ESO.


Mauri P.,CNR Institute of Neuroscience | Riccio A.M.,University of Genoa | Rossi R.,CNR Institute of Neuroscience | Di Silvestre D.,CNR Institute of Neuroscience | And 5 more authors.
Immunology Letters | Year: 2014

Asthma is a chronic inflammatory disease. Reticular basement membrane (RBM) thickening is considered feature of airway remodelling (AR) particularly in severe asthma (SA). Omalizumab, mAb to IgE is effective in SA and can modulate AR. Herein we describe protein profiles of bronchial biopsies to detect biomarkers of anti-IgE effects on AR and to explain potential mechanisms/pathways. We defined the bronchial biopsy protein profiles, before and after treatment. Unsupervised clustering of baseline proteomes resulted in very good agreement with the morphometric analysis of AR. Protein profiles of omalizumab responders (ORs) were significantly different from those of non-omalizumab responders (NORs). The major differences between ORs and NORs lied to smooth muscle and extra cellular matrix proteins. Notably, an IgE-binding protein (galectin-3) was reliable, stable and predictive biomarker of AR modulation. Omalizumab down-regulated bronchial smooth muscle proteins in SA. These findings suggest that omalizumab may exert disease-modifying effects on remodelling components. © 2014 The Authors.


Brennan N.,MediCaid | Oelschlaeger A.,CMS | Cox C.,CMS | Tavenner M.,CMS
Health Affairs | Year: 2014

As the largest single payer for health care in the United States, the Centers for Medicare and Medicaid Services (CMS) generates enormous amounts of data. Historically, CMS has faced technological challenges in storing, analyzing, and disseminating this information because of its volume and privacy concerns. However, rapid progress in the fields of data architecture, storage, and analysis-the big-data revolution-over the past several years has given CMS the capabilities to use data in new and innovative ways. We describe the different types of CMS data being used both internally and externally, and we highlight a selection of innovative ways in which big-data techniques are being used to generate actionable information from CMS data more effectively. These include the use of real-time analytics for program monitoring and detecting fraud and abuse and the increased provision of data to providers, researchers, beneficiaries, and other stakeholders. © 2014 by Project HOPE - The People-to-People Health Foundation.


Hartman M.,MediCaid | Martin A.,CMS | Nuccio O.,CMS | Catlin A.,National Health Statistics Group
Health Affairs | Year: 2010

In 2008, U.S. health care spending growth slowed to 4.4 percent-the slowest rate of growth over the past forty-eight years. The deceleration was broadly based for nearly all payers and health care goods and services, as growth in both price and nonprice factors slowed amid the recession. Despite the slowdown, national health spending reached $2.3 trillion, or $7,681 per person, and the health care portion of gross domestic product (GDP) grew from 15.9 percent in 2007 to 16.2 percent in 2008. These developments reflect the general pattern that larger increases in the health spending share of GDP generally occur during or just after periods of economic recession. Despite the overall slowdown in national health spending growth, increases in this spending continue to outpace growth in the resources available to pay for it. © 2010 Project HOPE-The People-to-People Health Foundation, Inc.


Antonelli P.,CMS | Marcati P.,University of L'Aquila
Archive for Rational Mechanics and Analysis | Year: 2012

In this paper we study global existence of weak solutions for the quantum hydrodynamics system in two-dimensional energy space. We do not require any additional regularity and/or smallness assumptions on the initial data. Our approach replaces the WKB formalism with a polar decomposition theory which is not limited by the presence of vacuum regions. In this way we set up a self consistent theory, based only on particle density and current density, which does not need to define velocity fields in the nodal regions. The mathematical techniques we use in this paper are based on uniform (with respect to the approximating parameter) Strichartz estimates and the local smoothing property. © 2011 Springer-Verlag.


Antonelli P.,CMS | Sparber C.,University of Illinois at Chicago
Physica D: Nonlinear Phenomena | Year: 2011

We study a nonlinear Schrdinger equation arising in the mean field description of dipolar quantum gases. Under the assumption of sufficiently strong dipolar interactions, the existence of standing waves, and hence solitons, is proved together with some of their properties. This gives a rigorous argument for the possible existence of solitary waves in BoseEinstein condensates, which originate solely due to the dipolar interaction between the particles. © 2010 Elsevier B.V. All rights reserved.


Fivez J.,CMS | Glorieux C.,Catholic University of Leuven
Journal of Applied Physics | Year: 2010

Starting from the exact solution for the photothermal signal in semi-infinite materials with an exponential and with a piecewise linear thermal conductivity profile, a set of equations valid for a broad class of profiles is derived for the direct computation of the conductivity profile depth and surface conductivity from the properties of the photothermal phase maximum alone. By virtue of the usual anticorrelation between conductivity gradient and hardening gradient, this can be used for the assessment of case depth and surface hardening of case-hardened steels. The results compare very well with the results of Vickers hardness tests. The methodology only applies to concave conductivity profiles, excluding e.g., sigmoidal shapes. © 2010 American Institute of Physics.


Pedley T.J.,CMS
Journal of Fluid Mechanics | Year: 2010

Uniform suspensions of bottom-heavy, upswimming (gyrotactic) micro-organisms that are denser than water are unstable, through a gravitational mechanism first described by Pedley, Hill & Kessler (J. Fluid Mech., vol. 195, 1988, p. 223). Suspensions of downswimming, head-heavy cells do not experience this instability. In the absence of gravity, a uniform suspension of swimming micro-organisms may be unstable because of the particle stresses generated by the swimming cells themselves, each of which acts as a force-dipole or stresslet (Simha & Ramaswamy, Phys. Rev. Lett., vol. 89, 2002, p. 058101). The stresslet strength S is positive for pullers such as algae and negative for pushers such as bacteria or spermatozoa. In this paper, the combined problem is investigated, with attention being paid also to the effect of rotational diffusivity and to whether the probability density function f(e) for the cells' swimming direction e can be approximated as quasi-steady in calculations of the mean swimming direction, which arises in the cell conservation equation, and the particle stress tensor, which appears in the momentum equation. The existence of both the previous instabilities is confirmed at long wavelength. However, the non-quasi-steadiness of the orientation distribution means that the particle-stress-driven instability no longer arises for arbitrarily small |S|, in the Stokes limit, but requires that the dimensionless stresslet strength (proportional to the product of S and the basic state cell volume fraction no) exceed a critical value involving both viscosity and rotational diffusivity. In addition, a new mode of gravitational instability is found for head-heavy cells, even when they exert no particle stresses (S = 0), in the form of weakly growing waves. This is a consequence of unsteadiness in the mean swimming direction, together with non-zero fluid inertia. For realistic parameter values, however, viscosity is expected to suppress this instability. © 2010 Cambridge University Press.

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