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The solvency of the Medicare Trust Fund has been debated for the past twenty-five years and despite various stop-gap measures, fraud and abuse continues. Public policy in the form of Stark legislation, anti-kickback laws, and false claims acts were enacted to reduce over-utilization of services and prohibit self-referral and inducements for patients and services. Despite public policy and continued prosecution of fraud, Medicare reimbursement methods fail to control physician conduct of over-utilization and inducements for referrals. Following the concept of the informed consent doctrine a...

This thesis examines the anatomical locations of the dynamic pressures that create the first five footprints when a standing person starts to walk. It is hypothesized that the primary activity starts with the dorsiflexion or lifting of the great toe. Consequently, the metatarsophalangeal region of the forefoot was studied from three directions. Viewed side-on, the great toe free-body is found from a detailed post hoc analysis of previous kinematic data obtained from cadavers to operate as a cam. The cam model also follows closely from Aristotle's ancient description of the hinged instrument o...

Cardiovascular disease (CVD) is the leading cause of death among women in the US, and African American women (AAW) have a disproportionately high rate of deaths from CVD. Physical inactivity plays a major role in CVD development. It has been reported that some rural women have low rates of physical activity; 39% of White women and 57% of women of color are reported to be physically inactive. Rural AAW have a high mortality and morbidity rate related to CVD and a high rate of physical inactivity. The purpose of this study was to describe rural AAW's perception of wellness in conjunction with t...

In providing a comprehensive investigation of alcohol, cigarette, and marijuana initiation among adolescents, the overarching goals of the research were to build upon extant findings, address important gaps found in the literature, and contribute to the prevention science knowledge base. A four-fold purpose founded the study: 1) provide a systematic review of the soft drug initiation literature; 2) test a modified version of Kandel's (2002) drug sequencing hypothesis; 3) determine if predictors of soft drug initiation differ in kind or saliency by biological age and drug type; and 4) examine a...

Polycyclic Aromatic Hydrocarbons (PAHs) and soot share the same origin (incomplete combustion or pyrolysis) and nature, namely structural and electronic features. The purpose of the research work discussed in this thesis is to offer a theoretical contribution to elucidate some aspects of PAH and soot particle formation. The interest in carrying out such a work lies on one hand in the ubiquitous presence of both species in the environment, on the other hand on the concern for their impact on both human health, specifically involving the respiratory system, and climate, in particular as regards ...

During a conversation, listeners do not assimilate passively all of the speaker's words; they actively participate in the interaction providing information about how they feel and what they think of the speaker's speech. The speaker relies on signals emitted by the listener to know if he is listening or not, understanding or not, agreeing or not, etc. This informs the speaker on the success or failure of the communication and helps him to decide how to carry on with the interaction. In this thesis, to refer to signals provided by listeners, we adopt the term backchannel proposed by Yngve. We d...

In Germany, political foundations (Stiftungen) play an important role in shaping civil society through political democracy education. The foundations, however, have also committed themselves to strengthening democratic political and societal structures abroad. Their joint mission abroad is the contribution to democratic structures, information and debate in the countries and regions they are working in. They complement the official German foreign policy, but choose their own priorities and strategies. The focus of this thesis is the German political foundations as actors in democracy assist...

Data assimilation of satellite-based observations of hydrological variables with full numerical physics models can be used to downscale these observations from coarse to high resolution to improve microwave sensor-based soil moisture observations. Moreover, assimilation can also be used to predict related hydrological variables, e.g., precipitation products can be assimilated in a land information system to estimate soil moisture. High quality spatio-temporal observations of these processes are vital for a successful assimilation which in turn needs a detailed analysis and improvement. In this...

The IP Multimedia Subsystem (IMS) is the basic network architecture for Next Generation Networks (NGN) which is intended to bridge the divide between the traditional circuit switched and packet switched networks, thereby providing a single network capable of providing all service offerings. IMS is based on the IP infrastructure and it enables the convergence of data, speech and video on the same network platform. The IMS forms the basis of Fixed Mobile Convergence (FMC), where fixed-line operators are striving to provide mobile access and mobile operators are trying to provide fixed access. Th...

This study attempts to examine the impact of a trade decontrol policy on food output within the Nigerian macroeconomic context. In other words, the study relates trade liberalization to the national food security situation between 1970 and 2000, by employing descriptive statistics and error correction model (ECM) as the research methodologies. Regional and multilateral trade agreements seem to reduce barriers to the flow of commodities across borders, thus fostering a more efficient allocation of scarce resources as well as raising gross output with positive implications for food security at ...