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HIPAA, employers must inform employees in advance about how any personal health information collected will be used and must strictly maintain the privacy of the information. Record handling has to be done with extraordinary care, Goldman notes. Invasion-of-privacy claims that can result from mistakes can be extremely expensive, because there is no cap on damages. FEW EMPLOYERS ABSORB HEALTH CARE COST INCREASES The business climate has changed considerably since 2000, making employers increasingly reluctant to pick up rising health care costs. In 2000, 52% of employers said they would absorb any health care cost increases. This year, that figure has dropped to 29%. The change in attitude is understandable. Annual increases ranging from 13% to 18% have made health care costs double in the past five years. Although the rate of health care benefits cost increases slowed from a median of 13% in 2003 to 12% in 2004, increases of this magnitude would double costs in a mere six years; these were the findings of New Reality, New Choices, the ninth annual survey report of the National Business Group on Health (Washington, D.C.) and Watson Wyatt. Forty-one percent of respondents reported that their health care benefits costs were over budget last year. As for 2004, median cost increases for different plans were: All plans: 12% Point-of-service plans: 12% Preferred provider organizations: 13% Indemnity plans: 14% HMOs: 14%
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FIGURE 4.4.2 Schematic of (a) three single-level, (b) six bilevel, and (c) six trilevel interconnection con gurations.
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spreading of the beam depend on the size and density of the light-diffracting particles. In the case of illuminated specimens in the microscope, there are therefore two primary sites of diffraction: one at the specimen itself and another in the aperture of the objective lens. Image formation by a lens is critically dependent on these events. If light passes through an object but does not become absorbed or diffracted, it remains invisible. It is the spreading action or diffraction of light at the specimen that allows objects to become visible, and the theory of image formation is based on this principle. Just as diffraction describes the scattering of light by an object into divergent waves, interference describes the recombination and summation of two or more superimposed waves, the process responsible for creating the real intermediate image of an object in the focal plane of a microscope. In a real sense, diffraction and interference are manifestations of the same process. The traditional way of describing interference is to show the recombination of waves graphically in a plot depicting their amplitude, wavelength, and relative phase displacement (Fig. 5-3). The addition of two initial waves produces a resultant wave whose amplitude may be increased (constructive interference) or diminished (destructive interference). The term interference is frequently taken to mean that waves annihilate each other if they are out of phase with each other by /2, and indeed a graphical depiction of interfering waves reinforces this idea. However, since it can be demonstrated that all of the photon energy delivered to a diffracting object such as a diffraction grating can be completely recovered (e.g., in a resultant diffraction pattern), it is clear that photons do not self-annihilate; rather their energies become redistributed (channeled) during diffraction
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Compensation by the method of de S narmont requires a fixed quarter-wave plate ( /4 plate) and a rotatable analyzer. Since /4 plates are designed for use at a specific wavelength, microscope illumination must be monochromatic, typically at the 546 nm green line of a mercury lamp, although /4 plates intended for use with other wavelengths, such as the 589 nm yellow line of the mercury lamp, are also available. S narmont compensation is commonly used to measure the amount of retardation in biological specimens, such as cell organelles, plant cell walls, and muscle fibers, that induce retardations between /20 and 1 . As explained, this compensator is also used to improve the visibility of birefringent specimens, because birefringent objects can be made to produce bright and dark contrast patterns against a medium gray background (Fig. 9-1). The retarder ( /4 plate) is mounted in a fixed orientation between two crossed polars, usually between the back aperture of the objective lens and the analyzer (Fig. 9-6). The analyzer is rotatable and is marked in degrees around its circumference so that the angle of rotation can be precisely determined. The /4 plate is made of a birefringent material such as quartz and is prepared so that the optic axis of the plate is parallel to the
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The four Franco-German demonstrators Manufacturers Alcatel/SEL/ANT/SAT Philips (Tekade) Access technique Wideband TDMA (24 channels per carrier, 1.65 MHz spacing a) combined with spectrum spreading Downlink: wideband TDMA (32 channels per carrier, 1.25 MHz spacing) combined with spectrum spreading Uplink: FDMA (25 kHz spacing) Narrowband TDMA (ten channels per carrier, 250 kHz or 150 kHz spacing) Narrowband TDMA (three channels, 150 kHz spacing) combined with slow frequency hopping
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There is a metal encasement that envelopes the turbine. This encasement is sealed to ensure that the steam remains within its prescribed pathway. There are inlet and outlet sectors leading into and away from the turbine. These sectors must be coupled to the entrance and exit steam pathways. Between the inlet and outlet is a series of rotating and xed blades arranged in rows. All rows of rotating blades are mounted to a single rotating shaft that spins the generator. The motion of the steam imparts a force on the blades that causes the blades to rotate. Between the rotating blades are xed blades. Their function is to maintain an optimal ow pattern for the steam. To ensure that steam does not exit the ow path through the rotating shaft, this shaft must be sealed. Additionally, there is a control valve at the inlet sector. The control valve provides control over the steam inlet, allowing for mechanical control of power output and turbine speed. In emergencies this can be used to quickly take a unit of ine. The turbine is divided into different sectors, a high-pressure sector, a mediumpressure sector, and a low-pressure sector. The high-pressure sector is located toward the inlet, and the low-pressure sector is located toward the outlet. The blade sizes within these sectors vary. Blades within the high-steam pressure sector are smaller than those in the low-steam pressure sector. Turbine malfunctions become apparent through excessive vibrations and performance reductions. Turbine vibrations are monitored by engineering staff. Vibrations beyond operational tolerances require immediate unit shutdown. Cycling a unit off and on increases strain on the turbine in two ways. Thermal stress from the heating and cooling of the turbine causes cracks in the turbine casing and blades. Additionally, cycling of a unit also increases mechanical stress on the turbine as the generator is brought to its minimum power. Mechanical stress evidenced by vibrations during the start-up phase also fatigues the sealed bearings that encase the rotating shaft at the point where the shaft exits the turbine. Outages due to turbine problems typically last longer than other types of outages. On detection of a problem, a decision must be made to perform a visual inspection or to do further diagnostic testing. A visual inspection requires opening the external casting that envelopes the turbine. If this is necessary, the unit will be out for a long time, perhaps a month. The process will require opening the casting, inspecting the entire turbine, performing any repairs or maintenance, cleaning deposition, and closing and resealing the casting. Diagnostic testing involves running the turbine at speci ed temperature and pressure levels and examining the output as well as measuring vibrations. The output and vibrations should be at prescribed levels. Modern machines have continuous monitoring capability. Computer systems interpret data in real time. Data may also be stored and subjected to further analysis at a later time; as a result, a modern turbine undergoes continuous testing during its normal operations. Below is a list of common turbine problems. Cracking in turbine case: Cracks are caused by thermal stress. Blade chipping: Chipping is caused by particles emitted from the boiler. The inner surface of boiler pipes can oxidize, creating a rustlike coating. The
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The essence of a QALY is that it takes a year of healthy life expectancy to be worth 1, but regards a year of unhealthy life expectancy as worth less than 1. Its precise value is lower the worse the quality of life of the unhealthy person (which is what the quality adjusted bit is all about). If being dead is worth zero, it is, in principle, possible for a QALY to be negative, i.e. for the quality of a person s life to be judged worse than being dead.
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35. PV P
The necessary inputs to the saddlepoint approximation are the CGF, K(s), and its rst and second derivatives. The CGF is K(s) = log( ) log( s) + log( ) log( s) s The saddlepoint equation, K ( ) = t, is given by ( s ) 1 + ( s ) 1 = t The second derivative at the saddlepoint is s K ( ) = ( s ) 2 + ( s ) 2 . Figures 5.18, 5.19, and 5.20 give the Bayes predictive density, predictive survivor, and predictive hazard functions, respectively. Table 5.1 gives the predictive CDF values. The exact, presented for comparison, is computed via numerical for s < min( , ). (5.58) for s < min( , ). (5.57)
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