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The purpose of this study is to conduct a comparative analysis of the Medicare patients discharged to a long-term (acute) care hospitals (LTCH), skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) following an acute inpatient hospitalization under Medicare-severity diagnosis-related group (MS-DRG) 207. The likelihood of discharge by provider type was also examined to determine criteria informing patient discharge to a LTCH, SNF or IRF for treatment.

Retrospective cohort study, based on secondary data analysis, utilizing Medicare Provider Analysis and Review (MedPAR) File data collected by Centers for Medicare & Medicaid Services for fiscal year 2011, October 1, 2010, through September 30, 2011.

Numerous analyses were conducted upon those patients discharged to a LTCH, SNF or IRF following an acute inpatient hospitalization under MS-DRG 207. Concerning those patients discharged to LTCHs, patients were not significantly older, did not have the highest length of stay and had comparable diagnoses and diagnosis counts to those discharged to SNFs or IRFs. However, costs were significantly higher among discharges to LTCHs. Multinomial logistic regression analyses also indicated numerous associations between certain variables and discharge location.

With the aging of the US population and increasing costs of rendering services, both the Medicare population and Medicare expenditures, already at their highest levels in the history of the program, are projected to rise going forward (The Boards of Trustees, 2012). As such, recent research has focused on Part A hospitals/facilities and the variations in costs submitted and payments received for treatment/services provided. This study aims to address whether patients discharged to LTCHs, which receive higher payment(s) as a result of serving a higher proportion of medically complex beneficiaries, are more medically complex than those discharged to SNFs/IRFs.

The purpose of this paper is to examine the non‐communicable disease (NCD) known as gestational diabetes mellitus (GDM). Specifically, this paper aims to examine the influence of NCDs on health outcomes both worldwide and throughout the Islamic Republic of Iran, to discuss the current issues surrounding GDM and its impact on pregnant women and their children, and to present a new multi‐faceted approach for preventing future occurrences of GDM.

The paper examines the current issues surrounding NCDs and GDM, in terms of its prevalence and risk factors, and the efforts taken by the Iranian government to address the growing problem of GDM, through a comprehensive literature review. Further, this paper presents the basis for a new multi‐faceted approach for addressing and preventing GDM.

GDM is an NCD that can damage the health of both mothers and children. The disease has been linked to macrosomia, congenital cardiac and central nervous system abnormalities, and skeletal muscle deformities among neonates. Pregnant women who develop GDM are more likely to have induced labor, require caesarean section, and develop type 2 diabetes later in life. In the most severe cases, GDM can even result in fetal and maternal mortality. Worldwide prevalence of GDM varies by country, but Iranian women are a particularly high‐risk population. In fact, approximately one of every 20 pregnancies in Iran will be affected by complications and outcomes related to GDM.

In response to growing concerns surrounding the current prevalence of GDM both worldwide and within the Islamic Republic of Iran, along with the associated impact of GDM on health outcomes, the paper presents a multi‐faceted approach for addressing this NCD. This approach will involve a consolidated program of prevention and control with a focus on health‐care solutions which promote both awareness and education.

What copulas are, their estimation, and use is illustrated using a geographical diversification example. To accomplish this, dependencies between county-level yields are calculated for non-irrigated wheat, upland cotton, and sorghum using Pearson linear correlation and Kendall's tau. The use of Kendall's tau allows the implementation of copulas to estimate the dependency between county-level yields. The paper aims to discuss these issues.

Four parametric copulas, Gaussian, Frank, Clayton, and Gumbel, are used to estimate Kendall's tau. These four estimates of Kendall's tau are compared to Pearson's linear correlation, a more typical measure of dependence. Using this information, functions are estimated to determine the relationships between dependencies and changes in geographic and climate data.

The effect on county-level crop yields based on changes of geographical and climate variables differed among the different dependency measures among the three different crops. Implementing alternative dependency measures changed the statistical significance and the signs of the coefficients in the sorghum and cotton dependence functions. Copula-based elasticities are consistently less than the linear correlation elasticities for wheat and cotton. For sorghum, however, the copula-based elasticities are generally larger. The results indicate that one should not take the issue of measuring dependence as a trivial matter.

This research not only extends the current literature on geographical diversification by taking a more detailed examination of factors impacting yield dependence, but also extends the copula literature by comparing estimation results using linear correlation and copula-based rank correlation.

To alert companies and individuals subject to regulation and investigation by the US Securities and Exchange Commission (SEC) of potential arguments to enforce time limits on enforcement actions that have heretofore commonly been ignored.

Analyzes two cases - one recently decided and one pending - in US Courts of Appeals, explains significance of issues at stake.

The Courts of Appeals for District of Columbia Circuit has recently reviewed, and the Court of Appeals for the 11th Circuit will soon decide whether statutory timing provisions effectively remove SEC power to bring enforcement actions past their deadlines, at least in some circumstances.

Depending on the outcomes of the cases, companies and individuals may gain a new procedural defense or two against SEC enforcement actions. They may also expect the SEC to respond by more actively seeking tolling agreements, and/or being more cautious in issuing Wells notices.

Guidance based on pending decisions interpreting US securities law, may bring regulatory adjustments to agency practice and procedure.

At the center of its core, Health Care is the application of a general body of knowledge to the needs of a specific patient. For centuries, this knowledge was generally regarded as the property of the healing professions and the individual clinician, not necessarily of the health care delivery organization. Managerial practice also had a tendency to treat this knowledge as an attribute of the provider, thus focusing on the resources clinicians used as they provided care and on the hotel-type functions associated with inpatient institutions. That is, there was a deliberate differentiation between management practice, focused on business processes, and clinical practice, focused on the activities and decisions of diagnosis and treatment. Though often described as bureaucratic and incrementally changing, health care is also a very dynamic and innovative field. Around the globe, research scientists, private industries, academics, and governmental and nongovernmental agencies continue to work in innovating new ways to provide better care, find cures, and improve health. At the same time, health care delivery has been undergoing a gradual but important change. Patient care, once the domain of the individual practitioner, is becoming the domain of the care delivery organization. Additionally, the mission of these organizations is shifting. As science, technology, care processes, and care teams have become more complex and diverse, the way in which the activities of care are organized and the institutional context in which they occur have become an increasingly important determinant of the effectiveness and efficiency of that care. As a result, the object of management has changed. In response to these changes, health care managers have started focusing on the management of the care as well as the management of the institutions in which the care takes place, thereby creating a set of ‘Best Practices’ which are briefly described in this paper along with how the process of innovation is developing in the health care system.

THE Reference Department of Paisley Central Library today occupies the room which was the original Public Library built in 1870 and opened to the public in April 1871. Since that date two extensions to the building have taken place. The first, in 1882, provided a separate room for both Reference and Lending libraries; the second, opened in 1938, provided a new Children's Department. Together with the original cost of the building, these extensions were entirely financed by Sir Peter Coats, James Coats of Auchendrane and Daniel Coats respectively. The people of Paisley indeed owe much to this one family, whose generosity was great. They not only provided the capital required but continued to donate many useful and often extremely valuable works of reference over the many years that followed. In 1975 Paisley Library was incorporated in the new Renfrew District library service.