Although the United States Congress has attempted to ameliorate some of the adverse impacts of the Balanced Budget Act through the 1999 Balanced Budget Refinement Act, the final results of the reforms to Medicare rema...
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This article considers the recent emphasis on the importance and value of citizen participation, involvement, and engagement in local government and how active participation extends to public budgeting. The inclusion ...
This article considers the recent emphasis on the importance and value of citizen participation, involvement, and engagement in local government and how active participation extends to public budgeting. The inclusion of citizen participation in local government budget processes challenges the traditional budget discourse between managers and representatives. Active citizen participation provides valuable comments and insight as well as complexity and challenges to administrative processes. This article discusses the themes, opportunities, techniques and strategies developed in this symposium to expand citizen participation in public budgeting. Continued discussion and innovation in active citizen participation in budgeting is encouraged.
This paper focuses on the concept of ESI (early simultaneous influence) as a cornerstone of concurrent engineering. How much influence downstream functions such as manufacturing engineering should exert in product des...
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This paper focuses on the concept of ESI (early simultaneous influence) as a cornerstone of concurrent engineering. How much influence downstream functions such as manufacturing engineering should exert in product design decisions is investigated by stage of development. Six stages were defined as: (1) research, (2) product concept, (3) prototype and test, (4) final design, (5) tooling and facilities, and (6) ramp-up to full production. Performance is measured as time compression at the tooling and facilities stage and reduction in manufactured cost. Results from analysis of 74 companies suggest that manufacturing influence has significant effects on performance at the first three stages. Its peak impact is at the third stage, a crossroads of work by up and downstream functions. If the design is new, however, the peak impact of ESI is earlier as indicated by significant interaction effects at the research and product concept stages. We also show that high levels of manufacturing influence at the end stage have a weak negative interaction effect with performance when designs are new. To the extent that high levels of manufacturing influence within their own domain preclude reciprocal influence by upstream functions, this result is consistent with the notion of concurrency as simultaneous influence by multiple functions at all points along the value chain.
There is no doubt that the Internet has become one of the main channels of distribution for a variety of hospitality and tourism-related companies. Because of cost efficiency and ease of access, such electronic distri...
{\it Objective.} To determine the reliability of tibial flexural wave propagation velocity (FWPV) and the effect of overlying soft-tissues on the result.{\it Design.} The velocity of tibial flexural wave propagation w...
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{\it Objective.} To determine the reliability of tibial flexural wave propagation velocity (FWPV) and the effect of overlying soft-tissues on the result.{\it Design.} The velocity of tibial flexural wave propagation was repeatedly measured in healthy subjects.{\it Background.} The tibia is the most frequently stress-fractured bone of runners and in military training populations. Developing techniques to measure tibial bone strength and, thereby, fracture resistance may be useful in pre-participation examinations in order to identify at-risk individuals. One such method, tibial flexural wave propagation velocity (FWPV) has been reported to be a measure of tibial stiffness.{\it Methods.} The tibial FWPV was measured 80 times per subject (10 trials X 2 setups/day X 4 days) in a sample of 25 young women. Two methods of calculating FWPV were used (Peak method time domain and Phase method frequency domain). Intraclass correlations (ICCs) were calculated.{\it Results.} The results demonstrated that the peak method was more reliable then the phase method. The ICCs ranged from 0.81--0.96 for the peak method and from 0.59--0.89 for the phase method. The 95% confidence intervals demonstrated that the FWPV could discriminate between subjects with low, medium, or high velocity values with reasonable accuracy and confidence. The soft-tissue overlying the tibia was not significantly (p = 0.63) correlated with FWPV.{\it Conclusion.} In summary, it is possible to discriminate between varying levels of tibial FWPV. Furthermore, if FWPV is related to bone stress fracture resistance, then this method may be useful in determining stress fracture risk prior to intensive physical activity.{\it Relevance.} The tibia is the most frequently stress-fractured bone of runners and in military training populations. This study explores the feasibility of tibial FWPV as a potential method to assess tibial stress fracture resistance.
The administrative prescriptions promoted by the National Performance Review were targeted toward intra-agency organizational elements such as work processes, group structures, culture, and job scope. The traditional,...
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The administrative prescriptions promoted by the National Performance Review were targeted toward intra-agency organizational elements such as work processes, group structures, culture, and job scope. The traditional, top-down implementation strategy employed was not well suited, however, to this set of “microlevel” prescriptions. Despite the various executive orders and directives that were issued, there was a high degree of variation across agencies in the extent to which the various prescriptions were adopted. This study finds that this variation was attributable to both agency attributes and elements of agency context. A conclusion is that top-level policy makers seeking microlevel change need to take anenablingrather than adirectiveapproach to implementation.
With a defined population served, contracted provider panels and the nature of care delivery integration, managed care has provided a solution, though not a panacea, to provide equitable services, standardized and pre...
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A new methodology for developing theories of action has recently emerged which provides means for formally evaluating the correctness of such theories. Yet, for a theory of action to qualify as a solution to the frame...
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