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They developed theoretical models describing ­ among many other issues ­ how insurance affects the use of services (moral hazard); how private information can affect the functioning of insurance markets (adverse selection); how payment incentives affect physician and hospital behavior; how regulation of markets can improve efficiency when information on quality of care is difficult and costly to womens health medical group fort worth discount 35 mg alendronate otc obtain; and the interplay among financing mechanisms menopause urinary incontinence order 35mg alendronate fast delivery. The insights of these various theoretical models suggested new directions for policy development breast cancer bras buy alendronate 70 mg on-line. The research flowing from the human capital tradition considered how individuals make trade-offs among leisure, consumption, and health in allocating their time and resources, a process labeled health production. Good health could be understood as one among these enjoyment-producing products and services ­ but, products and services that were bad for health, such as tobacco, alcohol, and laziness, might also be among these enjoymentproducers. In this rational utility maximizing framework, raising the price of such "bads" could induce individuals to change the tradeoffs they made, without requiring that they alter their underlying preferences about what did or did not give them enjoyment. Recently, this approach has been extended to take account of addictive behavior, consumer short-sightedness, and other forms of irrational behavior. In health economics, the application of theoretical models was almost immediately tied to empirical analyses that could directly inform public policy through estimation of the magnitude of theoretically-posited effects. The best known example of these efforts was the 1979 Health Insurance Experiment, which randomly assigned households to different levels of insurance coverage and measured spending and health outcomes. As we discuss in detail below, economists, using a variety of experimental and quasi-experimental methods, have assessed the magnitude of many of these effects, and these findings have better equipped private and public policymakers to design institutions and health policies. In some cases, empirical analyses of existing behaviors have been used to forecast the effects of future policy changes. In other cases, evaluations of policy changes that had been implemented have led to improvements and modifications. Empirical estimates have also been incorporated into cost-benefit and cost-effectiveness analyses that directly assess the net impact of a new technology or a policy change. But in similarly tangible ways, the theoretical and empirical findings of health economics research in behavioral health have given consumers, providers, insurers, and local, State, and Federal policymakers insights and a medicine chest of tools and techniques to improve behavioral health outcomes. It led to a rich body of research on how changes in the price of "bads, " induced by changing taxes or penalties, might affect individual Health Economics and Improvements in Behavioral Health 294 behavior. Changes in use could be generated through legal restrictions that raised the cost of obtaining alcohol for at-risk populations (teenagers), and they could also be produced through increases in penalties associated with excessive alcohol use (sanctions on driving, criminal penalties). One strand of this research took advantage of existing variation in the level of alcohol and beer taxes across States and localities within the United States. Quasi-experimental analyses exploiting this variation found that raising alcohol taxes led to reductions in alcohol consumption, as might be expected. For example, zero tolerance laws, adopted by a number of States, reduced heavy episodic drinking by under-age males by 13 percent. States that raise alcohol taxes see reductions in teenage pregnancies and abortions. Similar results were found from studies of other interventions that raise the effective price of alcohol to particular groups. Raising the minimum drinking age, which increases the price at which adolescents and young adults can gain access to alcohol, is associated with reductions in traffic fatalities and in crime. More recent research building on this framework has relaxed the assumption that actors are always fully rational. In these analyses, policies enable myopic and otherwise rationally constrained consumers to improve their own self-interested behavior. People know more about their own health than their insurers or providers do, and providers know more about the care they are providing than consumers do. The problems that Arrow identified in the general health sector, however, are compounded in the arena of behavioral health. Because the extent of behavioral health problems can rarely be measured with a physical diagnostic test and because behavioral health treatments often cannot be readily quantified either, information asymmetries are generally more complex and serious in behavioral health than in general health. The particular challenges of behavioral health make it more difficult to design optimal financing and delivery incentives in this arena. As a consequence, considerable economic research has focused on addressing problems of moral hazard in the design of behavioral health insurance benefits; adverse selection in competitive behavioral health insurance markets; and agency in the payment of providers and programs that deliver behavioral health services.

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Give the approximate x- and y-coordinates for the nation that has the highest number of broadband subscribers women's health clinic gillette wy 70mg alendronate with visa. If you recalculated the correlation coefficient after removing the two observations you identified in part d menopause pain cheap 35 mg alendronate otc, how would you expect the resulting coefficient to breast cancer awareness day buy discount alendronate 35 mg on-line compare to the one obtained in part c? Your friend, Joe, argues that the correlation between the two variables must be 1 since they are both measuring the same thing. The correlation between political ideology and religiosity (how often attend religious services) is 0. For this sample, which explanatory variable, newspaper reading or religiosity, seems to have a stronger association with y? In Example 7, we found the correlation between Internet use and Facebook use (measured in percentages of the population) to be 0. Why does the correlation between total number of Internet users and Facebook users differ from that of Internet use and Facebook use? If one pair of (x, y) values is removed, the correlation for the remaining four pairs equals 1. Correlation inappropriate Describe a situation in which it is inappropriate to use the correlation to measure the association between two quantitative variables. A lighter bike is often preferred, but do lighter bikes tend to be more expensive? For the county represented by the most outlying observation, about how many votes would you have expected Buchanan to get if the point followed the same pattern as the rest of the data? When the relationship has a straight-line pattern, the correlation describes it numerically. We can analyze the data further by finding an equation for the straight line that best describes that pattern. This equation predicts the value of the variable designated as the response variable from the value of the variable designated as the explanatory variable. Regression Line: An Equation for Predicting the Response Outcome In Words n the symbol y, which denotes the predicted value of y, is pronounced y-hat. The regression line predicts the value for the response variable y as a straight-line funcn tion of the value x of the explanatory variable. Example 8 Predict an outcome Height Based on Human Remains Picture the Scenario Anthropologists can reconstruct information using partial human remains at burial sites. For instance, after finding a femur (thighbone), they can predict n how tall an individual was. Questions to Explore How can we graph the line that depicts how the predicted height depends on the femur length? For simplicity in plotting the line, we start with x = 0, although in practice this would not be an observed femur length. Regardless of the notation, the interpretation of the y-intercept and slope are the same. Insight A regression equation is often called a prediction equation since it predicts the value of the response variable y at any value of x. Sadly, this particular prediction equation had to be applied to bones found in mass graves in Kosovo, to help identify Albanians who had been executed by Serbians in 1998. Slope = rise/run = change in y/change in x Interpreting the y-Intercept and Slope the y-intercept is the predicted value of y when x = 0. This fact helps us plot the line, but it may not have any interpretative value if no observations had x values near 0. It does not make sense for femur length to be 0 cm, so the y-intercept for n the equation y = 61. The slope is the change in the predicted value n y of the response variable for a 1-unit increase in the explanatory variable x. For an increase in femur length from 50 cm to 51 cm, the predicted height increases by 2.

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Enhanced electronic and self-report measures of physical activity could improve all facets of physical activity research women's health ketone advanced buy cheap alendronate 35 mg on line, with the most critical contributions likely being (1) updating physical activity guidelines and (2) evaluating interventions zanaflex menstrual cramps purchase alendronate 70mg free shipping. Almost all epidemiologic studies of physical activity and health outcomes used in creating physical activity guidelines were based on self-report measures women's health center phone number purchase alendronate 35mg overnight delivery, mainly of leisure time activity. It is important to apply objective and domain-specific selfreport measures in epidemiological studies to refine understanding of dose-response relations that could lead to updated physical activity recommendations. Limited use of objective measures in intervention studies and excessive use of unvalidated self-reports likely lead to interpretation errors in intervention studies and underestimates of effects. Thus, better physical activity measures in intervention studies could enhance confidence in the results and perhaps reduce inconsistent findings across studies. Though many effective interventions have been developed, there is a continuing need for stronger interventions as well as interventions tailored to high-risk populations, including demographic subgroups at high risk of inactivity-related diseases. A general recommendation for intervention research is to include cost-effectiveness analyses to assist practitioners and policymakers in selecting among intervention options. Research on individually-targeted interventions should focus on those that integrate technology, because Web- and mobile-based interventions have the potential for widespread impact at modest cost. Technology-based interventions should be assessed among people with low educational attainment, because graphics, photos, and videos may have special appeal for people with limited reading skills. However, these interventions present several inherent design and methodological challenges, so special funding initiatives will be required to support progress, and more creative, rigorous, and long-term natural experiments are needed. Because multi-level physical activity interventions require collaborations with decisionmakers in non-health sectors of society, research on effective communication of evidence-based strategies and their benefits to decisionmakers might accelerate the translation of research to practice and policy. Since many evidence-based interventions for increasing population levels of physical activity exist, current research should focus on identifying how to more effectively translate these interventions into widespread practice. This requires testing implementation and dissemination strategies and adapting interventions for a new population or for scaling up activities. Because of the profound health consequences, low prevalence rates, and unfavorable trends, a much higher priority on physical activity research is justified. Sallis, PhD, Department of Family and Preventive Medicine, University of California, San Diego. Carlson, PhD, Department of Family and Preventive Medicine, University of California, San Diego Address correspondence to: James F. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. Effects of physical activity on cognition, well-being, and brain: human interventions. The effects of exercise training on elderly persons with cognitive impairment and dementia: a metaanalysis. The relationship between physical activity and cognition in children: a meta-analysis. The effect of acute treadmill walking on cognitive control and academic achievement in preadolescent children. Exercising your brain: a review of human brain plasticity and training-induced learning. New neurons and new memories: how does adult hippocampal neurogenesis affect learning and memory? Declining rates of physical activity in the United States: what are the contributors? Correlates of physical activity: why are some people physically active and others not? The effectiveness of urban design and land use and transport policies and practices to increase physical activity: a systematic review. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association. Physical activity guidelines for Americans mid-course report: strategies to increase physical activity among youth. Educating the student body: taking physical activity and physical education to school. State policies about physical activity minutes in physical education or during the school day.

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Firearm suicides declined slightly in the mid-2000s lynn women's health center boca raton buy alendronate 35 mg overnight delivery, with an uptick in the most recent years menopause weight gain on abdomen purchase alendronate 35mg without a prescription. Finally menstruation question discount alendronate 35mg without prescription, deaths due to poisoning (Figure 1f) increased dramatically over the past 20 years. The vast bulk of this is overdose of drugs, particularly prescription opioid medications, which has more than quadrupled since 1999. While the dramatic rate of increase in drug deaths slowed slightly from 2006 to 2010, during this time the rate of alcohol poisoning suddenly increased among all age groups. Explanations for this include increased frequency of binge drinking during the Great Recession of late 2007 to mid-200944 and increased use of caffeinated energy drinks containing alcohol; these energy drinks increase consumption of alcohol during binge drinking by masking the depressive effect of alcohol. Health, United States, 2011: With Special Feature on Socioeconomic Status and Health. Figure 1b: Trend in mortality rate from motor vehicle accidents, 1960-2010 Note: Mortality rates from U. Includes deaths resulting from collisions of all types of road vehicles, including collision of these vehicles with pedestrians and bicycles. The counterfactual trend reflects the increase in deaths that would have occurred if the death rate per mile had remained at the 1960 rate while driving rates (number of miles driven) increased over time. The drop in this trend in 2007-2009 reflects a decline in miles driven, coinciding with the Great Recession. From the National Health Examination Survey and the National Health and Nutrition Examination Survey, National Center for Health Statistics. Population Health 280 Figure 1e: Trend in mortality rate from firearm suicide and homicide, 1960-2010 Note: Includes intentional self-harm and assault using all types of firearms. Current smokers had the greatest relative risks of death, followed by those who were morbidly obese and heavy drinkers. As expected, mean quality of life was worse for current smokers than never smokers. Current smokers were those who had smoked at least 100 cigarettes in their lifetime and smoked now. Separate regression models were fit for deaths that occurred before and at/after age 65. Deaths among those under age 65 were left censored in the first model, and deaths among age 65+ were right censored in the second. Those lost to followup were assigned a survival time of Ѕ the possible survival interval before the time when they were lost but were censored on mortality. Models also included race: white (including Hispanic), black, and other, and age in 5-year age groups (coefficients not shown). These analyses omit those under age 25 and those who died within the first 4 years of followup. Heavy alcohol use was defined as 15+ drinks/week for men and 8+ drinks/week for women. Reductions in motor vehicle fatalities affected fewer individuals but also had an important effect of improving population life expectancy, by 0. Accounting for the contribution of medical advances to improved survival of poisoning victims over time means that poisoning events occurred even more frequently than the mortality data indicate. In this case because the effect of behavioral change for poisoning was negative, we accounted for the improvement in medical care by increasing the behavioral effect to 125 percent. The results of our sensitivity analyses on the proportion of mortality improvement attributable to medical care are shown in Table 6. Whether medical care accounts for as little as 10 percent or as much as 50 percent of the improvement, the remaining improvement in motor vehicle mortality attributable to public health and behavioral change remains large, accounting for a gain in life expectancy between one-half and one-third of a year from 1960 to 2010. The total net effect of public health and behavioral change on life expectancy for all six factors was estimated to vary between 0. Table 6: Sensitivity analyses on the proportion of change in life expectancy at age 25 due to medical care improvement between 1960 and 2010 Life Expectancy Improvement Risk Factor Motor Vehicle Accidents Poisoning Total net effect of all six factors Point Estimate 25% 0. For poisoning deaths, we assume that mortality would have worsened even more than observed if not for the effect of medical care; thus we model an increase in the effect of behavioral change and public health interventions (125%, 110%, and 150%). Last row shows the net effect on life expectancy change of all six risk factors we considered. Population Health 284 Impact of Reversing Trends Table 7 shows the results of simulated improvements for obesity, poisoning, and firearm suicide/ homicide.

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Presentation at the Universities Space Research Association pregnancy uti treatment buy generic alendronate 70mg online, Division of Space Life Sciences pregnancy zits cheap alendronate 35 mg mastercard, Brown Bag Seminars menopause night sweats relief order 70mg alendronate visa. Acknowledgments the following individuals contributed to the preparation of this report: Johnny Conkin, Ph. These evaluations must be performed by astronauts or test subjects whose skills are limited to microgravity and/or simulated partial-gravity environments ­ far from equivalent to the skilled pilot population for whom the Cooper-Harper scale was originally designed. Using this scale, a rating of 2 during a suited experimental trial is perceived by the subject to be equivalent to his/her unsuited performance of the same task in 1g, thereby providing a quantitative rating of desired task performance in the suit. Making the exercise more efficient may allow similar beneficial effects to be achieved more simply, and in shorter time, which would provide more crew time for operational support. Benchmarking crew strength requirements, and testing exercise equipment and regimens against these benchmarks, will promote the development of more efficient, yet equally safe, exercise regimens. Exercise is performed in space to promote musculoskeletal, cardiovascular, and psychological health. Research efforts seek to optimize exercise hardware, prescriptions, and physiological performance targets to support the provision of activities promoting health and fitness without compromising crew time or operations. Present exercise prescriptions present a large burden on the overall mission timeline. In addition, the exercise volume that is required to maintain fitness and performance will be further optimized through the activities that are associated with the risk of impaired performance errors due to reduced muscle mass, strength, and endurance. This almost daily time commitment is significant and represents a potential risk to the accomplishment of other mission operational tasks. While no evidence exists that the currently required exercise regimen has negatively impacted mission operations, future missions would benefit from optimized exercise protocols that provide needed outcomes in a shorter time period, thus allowing crew members more time in which to complete mission operations. The development of a benchmark for the requisite level of crew strength and endurance is required to accomplish this objective. Once this benchmark is developed, exercise hardware and safe exercise regimens with equivalent or improved benefits that reduce the time that is dedicated to daily physical exercise must be created. Such efforts should have a high priority, particularly if operational time requirements for future missions are predicted to increase substantially over current levels. This period includes the time that is needed for hardware setup, stowage, and personal hygiene. To our knowledge, the current exercise time requirements have Risk of Operational Impact of Prolonged Daily Required Exercise 361 Chapter 15 Human Health and Performance Risks of Space Exploration Missions not negatively impacted mission operations, but such a risk exists, particularly if the time that is needed to complete future daily mission operations increases above that of present levels. The long daily sessions of scheduled exercise do represent a risk to the accomplishment of other tasks, however, particularly within the confines of the flight rules that define the crew duty day that are available for all scheduled activities. In brief, crew members are scheduled daily for an 8-hour sleep period, leaving a 16-hour duty day. That duty day is divided into a post-sleep period with time for personal hygiene and a morning meal, a midday meal, and a pre-sleep period with further time for an evening meal and other activities. Time for daily planning conferences, private medical conferences, and other activities is also scheduled. Generally, the rest of the 16-hour duty date is allocated to mission operations (6. Thus, the potential exists for competition between scheduled mission tasks and exercise sessions. Computer-based Simulation Information No computer-based simulation pertaining to this risk is available. Risk in Context of Exploration Mission Operational Scenarios Without knowledge of the details of Exploration mission operational scenarios, assessing the level of risk that prolonged periods of daily exercise might represent is difficult. Thus, the time that is spent for daily exercise sessions will decrease by an equivalent amount to the time that is available in which to complete mission operational tasks. Conclusion Prolonged daily exercise sessions compete with the time that is available for mission operations and thus represent a potential risk to the timely completion of mission objectives. Key gaps exist in our knowledge concerning the level of skeletal muscle strength and endurance that should be maintained by crew members during long-duration space flight and how to optimize exercise hardware and protocols to achieve and maintain that maintenance level. Research is needed to define a skeletal muscle performance benchmark and to develop exercise hardware and regimens that will allow the benchmark to be met and sustained for future human space flight missions. Kaiser, Mary Keeton, Kathryn Khan-Mayberry, Noreen Kim, Myung-Hee Klerman, Elizabeth Leveton, Lauren B. Perchonok, Michele Appendices 365 Authors and Affiliations Human Health and Performance Risks of Space Exploration Missions Risin, Diana Scheuring, Richard A.

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Genuineness consists of wide variety of concepts ranging from nonverbal behaviors to geriatric women's health issues buy discount alendronate 70 mg on-line overt statements womens health ri order alendronate 35 mg without prescription. Examples of factors related to 3 menstrual cycles in 1 month buy generic alendronate 35mg on-line genuineness include: Supporting nonverbal behavior includes behaviors like keeping eye contact, giving a patient your full attention, and nodding in agreement or understanding. Therapists that stress their authority in and between sessions with patients 14 can cause a patient to feel inferior or intimidated. Congruence: Making sure that your words, nonverbal behavior, and feelings match each other is referred to as congruence. Not demonstrating congruence of your feelings and thoughts can become confusing or misleading to a patient. Spontaneity: this concept deals with the way the therapist speaks and the timeliness of responses. Responses and feedback provided "in the moment" are more valuable than feedback provided at a later time. Positive Regard Positive regard simply means showing all patients the respect they deserve. Patients who feel that their thoughts and feelings are acknowledged and understood often share more and feel more connected to the therapist and the therapeutic process. Communicating positive regard may be harder than it seems, especially if you hold some negative beliefs about the person you are trying to help, which can be a common experience for therapists. Sharing any negative feelings or beliefs about your patients with your supervisor or consultant can be an excellent method to ensure that you develop and demonstrate genuine positive regard toward your patients. Commitment to the patient means that you are dedicated to working with the patient on whatever issues he or she is bringing to therapy. Having a nonjudgmental attitude towards the thoughts, feelings, and actions of the patient is essential. It is possible to accept and understand a perspective without necessarily agreeing with it. Warmth can be displayed through tone of voice, facial expressions and body postures, or the thoughtfulness of your responses. Active listening is a useful technique to communicate the nonspecific factors of empathy, genuineness, and positive regard. Active Listening Listening to your patients is the foundation of all therapeutic approaches. Listening is made up of three steps: receiving a message, processing it, and sending it back. Therapists should attempt to remain open to all messages from their patients (both verbal and nonverbal), and attempt to process as many messages as possible. Clarification: Since we all speak from our own frame of reference, messages we send to others may not be received in the way we intended. Clarification can be used to help simplify a message that is being sent by the patient or to help confirm the accuracy of what the therapist thinks he or she understood. Do you mean giving up on your goal to complete college; or are you referring to something different, like giving up on life and possibly harming yourself? I am not referring to suicide, if that is what you mean, but I am feeling really depressed. When I said "give up, " I guess I was referring to not wanting to face all the struggles I face in life. Patient: Notice that the clarifying statement and question helped the therapist and patient to more fully explore her feelings and thoughts. You are really struggling to feel better, and much of your pain comes from the grief and loss you feel from losing your fiancй. You may even be questioning whether or not this pain will subside because it is getting unmanageable. The pain I feel comes from my intense feelings of loss, but this pain is also because I miss all the things he meant to me, and the joy he brought to my life. I am really struggling because I do not want to let go of him, but holding on hurts so much. Therapist: Patient: In this example of paraphrasing, the therapist gives back to the patient what he or she heard, which allows the patient to hear her own words and react with a more detailed response. The use of paraphrasing in this example facilitated a deeper understanding of the issue but also conveyed to the patient a feeling of being heard and understood. Listening for Themes and Summary Statements: Often, patients express thoughts, feelings, and behaviors that become thematic across situations.

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Applying the National Quality Forum Preferred Practices for Palliative and Hospice Care: A social work perspective women's health clinic northfield alendronate 70 mg amex. An interdisciplinary care approach for integration of palliative care in lung cancer women's health blood in the urine order alendronate 35 mg without prescription. Global efforts to breast cancer death rate buy alendronate 35mg on line improve palliative care: the international end-of-life nursing education consortium training programme. Geriatric Training Program: Improving palliative care in community geriatric care settings. End-of-life nursing education consortium: 5 years of educating graduate nursing faculty in excellent palliative care. Seven years and 50 courses later: End-of-life nursing education consortium continues commitment to provide excellent palliative care education. Oncology end-of-life nursing education consortium training program: Improving palliative care in cancer. The national agenda for quality palliative care: the National Consensus Project and the National Quality Forum. Disseminating end-of-life education to cancer centers: Overview of program and of evaluation. Prospective integration of cultural consideration in biomedical research for patients with advanced cancer: Recommendations from an international conference on malignant bowel obstruction in palliative care. The impact of culture on pain management, the Pain Practitioner: Special Edition, 17(2), Summer. Evaluation of end-of-life nursing education for continuing education and clinical staff development educators. Appraisal of the graduate end-of-life nursing education consortium training program. Social work values, pain, and palliative care Journal of Social Work in End-of-Life & Palliative Care, 1(4), 3-6. Evaluation of the end-of-life nursing education consortium undergraduate faculty training program. Teaching Symptom Management in End-of-Life Care: the didactic content and teaching strategies based on the end-of-life nursing education curriculum. Ethical and legal issues in end-of-life care: Content of the End-of-Life Nursing Education Consortium curriculum and teaching strategies. Learning pain assessment and management: A goal of the End-of-Life Nursing Education Consortium. Principles and Practice of Palliative Care and Supportive Oncology, 4th Edition Berger, A. Grief and Loss: Theories and Skills for Helping Professionals, 2nd Edition Walsh, K. Conversations in Palliative Care: Questions and Answers with the Experts, 3rd Edition Panke, J. Swallowed by a Snake: the Gift of the Masculine Side of Healing, 2nd Edition Golden, T. Living with Grief: Diversity and End-of-Life Care Yearly book published by the Hospice Foundation of America. Topics include: Cancer and End-of-Life Care Diversity and End-of-Life Care Children and Adolescents Before and After Death Ethical Dilemmas at the End of Life After Sudden Loss Website: store. Researching breathlessness in palliative care: Consensus statement of the National Cancer Research Institute Palliative Care Breathlessness Subgroup. Research in pediatric palliative care: Closing the gap between what is and is not known. Handbook of Bereavement Research and Practice: Advances in Theory and Intervention Stroebe, M. Creating a palliative and end-of-life program in a cure-oriented pediatric setting: the zig-zag method. Hospice and Palliative Nursing: Scope and Standards of Practice, 4th Edition Hospice and Palliative Nurses Association. Responding to desire to die statements from patients with advanced disease: Recommendations for health professionals. Proposed quality measures for palliative care in the critically ill: A consensus from the Robert Wood Johnson Foundation Critical Care Workgroup.

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A registration for this type of work covers the new music that the author added to menstrual cycle days 1-5 purchase alendronate 35 mg with visa the work women's health center reno buy alendronate 35 mg visa. A musical setting of Biblical or other preexisting text may be registered if the music represents sufficient original authorship breast cancer 5k nyc order alendronate 70mg. In the Material Excluded field the applicant should identify the preexisting text, and in the New Material Included field the applicant should check the box for "music. The Office may register such works based on the original new music or lyrics that the author added to the work, but not based on the use of the sample. Moreover, use of more than a de minimis amount of recognizable sample may be questioned for lawful inclusion. Small changes, however, such as substituting "he" for "she" in each incidence in a song would not be considered sufficient authorship to support a new claim. Editing also may consist of textual notes on performance practice or historical background for a musical composition. To assert a claim to copyright in this type of authorship, the applicant may use the term "musical editing" in the Other field of the online application or space 2 of the paper application. These types of works may be registered only if the underlying authorship has been used lawfully. When asserting a claim to copyright in these types of works, the applicant may use the term "musical editing" or may provide a more specific description of the new material that the author contributed to the work. Method books typically contain common property elements such as scales, arpeggios, chord charts, and musical examples taken from preexisting sources. They also may contain original elements, such as instructional text, new music, and original musical exercises. If a method book contains sufficient copyrightable text and/or new music, the application will be accepted on that basis. A method book that contains only previously published material or chords, scales, exercises, and other information that is common property may be registered as a compilation. For example, a compilation of all the diatonic major and minor scales would not constitute sufficient creative compilation authorship, because the selection and arrangement is dictated by the Western musical scale system. Examples of collective musical works include the following types of works: A quarterly journal of contemporary art songs. Collective musical works potentially contain two types of copyrightable authorship: (i) the compilation authorship involved in selecting, coordinating, and/or arranging a number of separate and independent musical works and assembling them into the collective whole; and (ii) the authorship involved in creating the music and/or lyrics for the individual musical works. If the owner of the individual musical works does not own the copyright in the collective work as a whole, then each musical work must be registered separately as an individual contribution to a collective work. For example, the song "America the Beautiful" and a recording of Whitney Houston singing "America the Beautiful" are two distinct works. Likewise, a registration for a recording of a particular musical work covers the performance and production authorship involved in creating that recording, but does not cover the music or lyrics embodied in the underlying composition. A musical work and a sound recording of that work may be registered with one application and one filing fee if the composition and the recording are embodied in the same phonorecord and if the claimant owns the copyright in both works. If the copyright in the musical work and the sound recording are owned by different parties, a separate application and filing fee must be submitted for each work. It also may be possible to register multiple musical works together with a sound recording of each work if the compositions and the recordings are owned by the same claimant and if they were packaged or physically bundled together as a single unit and first published on the same date. N O T E: Examples: Louise and Stan co-created a song and co-produced a recording of their composition. Louise and Stan co-own the copyright in both the song and the sound recording; therefore, both works may be registered with the same application. Renuka wrote the music and lyrics for a song, and she owns the copyright in her composition. Renuka and Gopal co-produced a sound recording of this song, and they co-own the copyright in that recording. Transcribing or fixing a musical work in and of itself does not constitute authorship. Creating a recording of a musical work is not a form of musical work authorship in and of itself, although it may be a form of sound recording authorship if it contains sufficient creativity to constitute a copyrightable sound recording. If there is a discrepancy between the individuals identified as authors on the application and the individuals identified as authors on the deposit copy(ies), the registration specialist will communicate with an applicant, unless this information is clarified elsewhere in the registration materials. Historically, songs with different composers of music and lyrics have been registered as joint works. Where separate applications are received for the lyrics and the music of a song, the registration specialist may communicate with the applicant to inquire whether the authors intended to merge their contributions into a unitary whole.

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The mean (also called expected value) for a discrete random variable is = xP(x) womens health center shelton ct alendronate 35mg low price, the normal distribution is the probability distribution of a continuous random variable that has a symmetric bell-shaped graph specified by the parameters mean and standard deviation womens health kp buy alendronate 35mg fast delivery. For any z menopause vegas show discount alendronate 70 mg online, the probability within z standard deviations of is the same for every normal distribution. For a normal distribution, the z-scores have the standard normal distribution, which has mean = 0 and standard deviation = 1. The binomial distribution is the probability distribution of the discrete random variable that measures the number of successes X in n independent trials, with probability p of a success on a given trial. According to recent General Social Surveys, its probability distribution is approximately P(0) = 0. Show that the probabilities satisfy the two conditions for a probability distribution. Suppose your birthday is May 14, and like many people, you decide to bet $1 on your birthday number. If you choose to play straight, you win $500 if and only if the number chosen is 514. If you choose to play boxed, you win $80 if the number chosen contains the digits 5, 1, and 4 in any order. Two possible strategies are (a) to pick three different digits, or (b) to pick the same digit three times. You need to choose between two alternative programs for dealing with the outbreak of a deadly disease. In program 2, there is a 2/3 chance that no one is saved and a 1/3 chance that 600 people are saved. Now you need to choose between program 3, in which 400 people will die, and program 4, in which there is a 1/3 chance that no one will die and a 2/3 chance that 600 people will die. If a flyer dies on a given flight (from a plane crash), the policy gives $100, 000 to the chosen beneficiary. Records show that a passenger has about a one in a million chance of dying on any given flight. Specify the probability distribution of the amount of money the beneficiary makes from your policy. Find the z-score for the number that is less than only 1% of the values of a normal distribution. Find the z-scores corresponding to the (i) 90th and (ii) 99th percentiles of a normal distribution. If the distribution of water use is normal, what proportion of households receives this note? Global warming Suppose that weekly use of gasoline for motor vehicle travel by adults in North America has approximately a normal distribution with a mean of 20 gallons and a standard deviation of 6 gallons. Many people who worry about global warming believe that Americans should pay more attention to energy conservation. Assuming that the standard deviation and the normal shape are unchanged, to what level must the mean reduce so that 20 gallons per week is the third quartile rather than the mean? Find the probability that the restaurant loses money on a given day (that is, daily profit less than 0). Find the probability that the restaurant makes money for the next seven days in a row. If the machine is operating properly, find the probability that a ball manufactured with this machine satisfies the rules. A study of postmenopausal women reported a mean of 220 and standard deviation of 40. If the total cholesterol scores have a normal distribution, what proportion of the women fall in the high-risk category? Repeat parts a­c for North American males, the heights of whom are normally distributed with = 70 inches and = 4 inches. Water consumption A study of water use in Gainesville, Florida, indicated that in 2006 residential water consumption had a mean of 78 and a standard deviation of 119, in thousands of gallons.

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Numerous intervention types were judged to women's health center yonkers ny cheap 70 mg alendronate otc have sufficient evidence to menstrual jokes arent funny period buy cheap alendronate 35 mg justify widespread implementation breast cancer zippered checkbook covers discount 35 mg alendronate otc. Some findings confirmed results of "Community Guide" reviews: signs encouraging stair use, enhanced school physical education, and community-scale land use and walkability. Other recommended interventions reflected more recent evidence for schools (comprehensive multi-behavior programs, improved playgrounds and equipment, classroom activity breaks), worksites (comprehensive multi-behavior programs, scheduled time for physical activity at work, fitness centers at work), and communities (improved access to parks, improved safety of pedestrian facilities to support walking to school, improved traffic safety, improved aesthetics). Various interventions in preschool and Physical Activity: Numerous Benefits and Effective Interventions 178 community built environment strategies had suggestive evidence. After school programs, familybased programs, and interventions in primary care had insufficient evidence (see Table 2). Although there is some disagreement across reviews regarding support for specific intervention types, all reviews identified multiple interventions with strong evidence of increasing physical activity. Strategies targeting individuals, organizations, and community built environments were found to be effective. Thus, interventions need to be carefully selected for further implementation, and continued research is needed for understudied approaches and those with conflicting results. Effective Strategies Not Implemented Despite the availability of evidence-based and cost-effective interventions targeting individuals, groups, organizations, communities, and built environments, there is little indication that any of these interventions are being widely implemented in the United States. However, it is difficult to know with certainly because there is little surveillance of physical activity intervention implementation. There seems to be no systematic implementation of individually-tailored counseling or group behavior change programs. Even the most cost-effective intervention, signs encouraging stair use, is rarely applied. Almost all community-wide physical activity campaigns in the United States have been conducted in the context of research. Investment in pedestrian and bicycle facilities has remained less than 1 percent of Federal transportation funds, with the exception of a spike to 2 percent investment during the American Recovery and Reinvestment Act in 2009-2010. Though most States have physical education requirements, they vary widely and mainly address minutes of class time. Most physical education is not consistent with evidence-based practices of optimizing physical activity, and there is substantial evidence that on average, only about one-third of physical education class time is spent in physical activity. Though this attention to physical activity in schools is encouraging, none of the regulations provide sufficient monitoring, consequences, or funding. There have been some recent major funding programs for environment, policy, and systems approaches to obesity prevention that included physical activity. Both programs provided hundreds of millions of dollars for cities and States to support environment and policy interventions that were likely to be consistent with recent evidence, 34 so these programs may be among the largest commitments to physical activity interventions in U. Unfortunately, it is not clear how much of the funding was devoted to physical activity interventions, to what extent evidence-based interventions were supported, or what the effects were. Conclusions the current status of the physical activity field is that the tremendous potential for public health benefit has not been achieved due to failure to widely implement the many evidence-based interventions. Physical inactivity is the fourth leading cause of death in the United States and worldwide, 2, 5 and physical activity appears to be unique as a behavior that positively affects so many major diseases and conditions. Thus, the physical activity research field has had dramatic successes in building evidence in several critical areas, though many questions remain. The biggest problem in the physical activity field is the failure to act on the evidence and make serious and well-funded efforts to implement evidence-based interventions. Recommendations for Practice Increased commitment to physical activity promotion is needed in the government, non-profit, and private sectors. Increased funding for physical activity in all of these agencies is a prerequisite for making progress. The lack of commitment also can be seen in the private sector, with most physical activity enterprises such as health clubs, dance studios, and Web sites not implementing evidence-based strategies. Insurance companies rarely pay for physical activity interventions, except for timelimited programs for people with specific diagnoses such as cardiac rehabilitation. These industries are encouraged to commit to broad implementation of evidence-based interventions. Partnerships with the public health sector and scientific community are encouraged to increase uptake of evidence-based interventions.

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