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Facebook. Entfernen. Wir verwenden Cookies, um Inhalte zu personalisieren, Werbeanzeigen ma. Wenn du auf unsere Webseite klickst oder hier navigierst, stimmst du der Erfassung von Informationen durch Cookies auf und au. Weitere Informationen zu unseren Cookies und dazu, wie du die Kontrolle dar. Program description of The Peacemakers Program: Violence Prevention for Students in Grades 4-8. The Programs that Work section of the Promising Practices Network (PPN) site features descriptions of evaluated programs that.
Since its inception in 2006, the goal of the Peacemakers afterschool program – an initiative of the Leahy Community Health and Family Center – has been to provide a space and experience where children can. Program Details : Contact Us: The most cutting edge, synergistic, multi-disciplined approach to reducing violence in schools! Home Page : Program Details : Contact Us Home Page Home Page.
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Green auctions arty rain barrels. Central Ohio Rain Garden Initiative. Check out this app from the University of Connecticut! Helps guide homeowners through the process. Folks, the machines are taking over. Crest Gastropub. Columbus, Ohio. Installed spring 2. First Unitarian Universalist Church. Columbus, Ohio. Stratford Ecological Center is hosting a rain water harvesting workshop. More details: Statford Eco Farms program. Residents of Columbus who become GreenSpot members are invited to buy a. First Rain Barrel Installed!! Another benefit of this program is that you automatically become a member of the Tool. Columbus, Ohio 43219 Phone: (614). Thank you attendees and presenters for a successful day! Read More. Thank you to our partners and friends who attended our fall Social on the 2. CORGI appreciates being part of the big picture that includes stormwater management, habitat, and community initiatives alike. That is exactly the role our suburban landscapes are now playing, and will play even more critically in the near future. Columbus Ohio Rain Barrel Program Los AngelesIf this is news to you, it’s not your fault.” Gardening. Life. DTallamy. Central Ohio Rain Garden Initiative (CORGI) is working with several local garden centers to promote native plants and rain gardens. Check out our displays at Kurtz Bros. Rain Brothers, LLC - Sustainable Construction Services. Rain Brothers, LLC - Sustainable Construction. Project will place rain barrels at Clintonville homes. Dozens of Clintonville residents will take part in a pilot rain barrel. Ohio EPA Awards $93,800 in Environmental Education Grants to Franklin County Organizations. The Central Ohio Rain Garden. Folks from around the state involved at various levels in rain garden program planning, design, and technical support joined together to share their strengths and weaknesses for the betterment of all in attendance.
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Black Hole Astrophysics. Meier, David L.). Schulthess Buchhandlungen. Black Holes - The Ultimate Engines is about cosmic black holes and how they generate the most powerful observed phenomena in the universe. It begins by reviewing the most important of these (quasars, microquasars, and gamma- ray bursts) and explains why we believe that black holes are responsible for them. The book then introduces the properties of simple, isolated black holes, then adds in complications such as rotation, accretion, radiation and magnetic fields, finally arriving at an understanding of how these objects work. Throughout the book the close relationship between terrestrial engines and these ultimate, cosmic engines is exploited. A key feature of the book is its discussion and explanation of the violent and spectacular outflows (winds and jets) that are generated by black hole accretion. This is currently a very active area of research in the astronomical community. The book is written in a relaxed style, with the level of mathematics used within the text appropriate for final year university students in the USA, incorporating algebra, matrices, vector calculus, ordinary and partial differential equations. Tensor calculus is kept to a minimum, but when necessary it employs readable matrix equations, rather than the more daunting summation convention. Compact objects in astrophysics white dwarfs neutron stars and black holes PDF observational astrophysics astronomy and astrophysics.Black Hole Astrophysics: The Engine Paradigm (Springer Praxis Books / Astronomy and Planetary Sciences) Path Integrals in Quantum Mechanics. PDF File: Black Hole Astrophysics The Engine Paradigm - PDF-BHATEP14-UBRG7 2/4 Black Hole Astrophysics The Engine Paradigm INTRODUCTION This particular Black Hole Astrophysics The Engine Paradigm PDF start with Introduction. Black hole physics PDF black hole physics basic concepts and new developments 1st edition PDF modeling black hole evaporation PDF black hole astrophysics the engine paradigm PDF. Black hole astrophysics the engine paradigm PDF. Black Hole Astrophysics The Engine Paradigm. Black Hole Astrophysics. Title: Black Hole Astrophysics The Engine Paradigm Author: Stephan Freytag Subject: black hole astrophysics the engine paradigm Keywords: Read Online black hole astrophysics the engine paradigm, black hole astrophysics the. Black Hole Astrophysics The Engine Paradigm av David L. The Schwarzschild Metric and Black Holes.
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ANSI 8. 34 File Layout. HIPAA ANSI 8. 34 File Layout: The 8. HIPAA Transaction Standard Companion Guide. Date expressed in format CCYYMMDD File Effective Date DTP03 Date Time Period Format. 834 ELIGIBILITY ENROLLMENT AND MAINTENANCE. Beginners Guide to EDI X12 (including HIPAA). There is an example of typical EDI X12 file. Standard EDI X12 format data is text file separated by segment. HIPAA: Electronic Data Interchange (EDI). The EDI rule is a set of data transmission specifications that strictly govern the way. The EDI 834 transaction set represents a Benefit Enrollment and Maintenance document. It is commonly used to communicate health plan enrollment information. Sample File Output. INS*Y*1. 8*0. 30*XN*A*E**FT~REF*OF*1. REF*1. L*Blue~DTP*3. The HIPAA 834 EDI is changing are you prepared? By Carolyn Cozart on Jul 21, 2011. The Secretary of the Department of Health and Human Services.The data layout of an 837 file may look confusing at first due to the electronic format, but the data are the same data. Use the HIPAA Implementation Guide and the 837. 834 Benefit Enrollment Example for HIPAA Summit 2/01 New Add. ST*834*0001~ 834 is the Transaction Set Identifier Cod e for Benefit. D8 is the Date Time Period Format Qualifier. D8*2. 00. 70. 10. NM1*IL*1*BLUTH*LUCILLE****3. N3*2. 24 N DES PLAINES*6. TH FLOOR~N4*CHICAGO*IL*6. USA~DMG*D8*1. 97. F*M~HD*0. 30**VIS**EMP~DTP*3. D8*2. 01. 11. 01. INS*N*1. 9*0. 30*XN*A*E***N*N~REF*OF*1. REF*1. L*Blue~DTP*3. D8*2. 01. 11. 01. NM1*IL*1*BLUTH*BUSTER~N3*2. N DES PLAINES*6. TH FLOOR~N4*CHICAGO*IL*6. USA~DMG*D**1. 99. M- HD*0. 30**VIS~DTP*3. D8*2. 01. 10. 10. DTP*3. 49*D8*2. 01. INS*YMember Level Detail. REF*OFSubscriber Number. REF*1. LGroup Sub- location Division (GSD)DTP*3. Hire date. NMIEmployee Name. N3. Employee Street Address. N4. Employee City, State, Zip, Country. DMGMember Demographics. HDCoverage Data. DTP*3. Coverage Dates. DTP*3. Coverage End Date. INS*NDependent. Segment Details – Member Level Detail INS*Y*1. XN*A*E**FT~INSConstant Value. Y or NY = subscriber (Employee); N= dependent. Relationship Code = 1. Employee; 0. 1=Spouse; 1. Child. 03. 00. 30=Full File. XNReason Code. AStatus Code A=Active; C=COBRAEMedicare Plan Code E=No Medicare; D= Medicare. COBRA Qualifying. FTEmployee Status FT= Full- Time; PT=Part- Time. REF*OF – Subscriber Number REF*OF*1. REFConstant Value. OFConstant Value. Employees SSN — no dashes (Does not pad with zeros)REF*1. L – Account Structure. REF*1. L*Blue~REFConstant Value. LConstant Value. Blue. Value determined by vendor/client. DTP*3. 36 – Hire Date. DTP*3. 36*D8*2. 00. DTPConstant Value. Constant Value. D8. Constant Value. 20. YYYYMMDD – Most recent hire date. NM1 – Employee Name. NM1*IL*1*BLUTH*LUCILLE****3. NM1. Constant Value. ILConstant Value. Constant Value. BLUTHEmployee Last Name. LUCILLEEmployee First Name. Middle Name. Prefix. Suffix. 34. Constant Value (SSN coming)1. Member SSNN3 – Employee Street Address N3*2. N DES PLAINES*6. TH FLOOR~N3. Constant Value. 22. N DES PLAINESEmployee Address Line 1 (No punctuation)6. TH FLOOREmployee Address Line 2 (No punctuation)N4 – Employee City, State, Zip N4*CHICAGO*IL*6. USA~N4. Constant Value. CHICAGOEmployee Address City. ILEmployee Address State. Employee Address Zip Code. USAEmployee Address Country. DMG*8 – Member Demographics. DMG*D8*1. 97. 20. F*M~DMGConstant Value. D8. Constant Value. Date of Birth. FGender F=Female; M=Male; U=Unknown. MMarital Status M=Married; I=Single; D=Divorced; X=Legally Separated; R=Unreported. HD – Health Coverage. HD*0. 30**VIS**EMP~HDConstant Value. Full File. Reason – may not be required. VISInsurance Code – see Specs. Coverage Description – may not be required. MPCoverage Level/Tier EMP=Employee; ESP= Employee + Spouse; FAM = Family; ECH = Employee + Children; TWO = Employee & 1 Dep; E1. D = Employee & 1 Child. DTP*3. 48 – Health overage Dates. DTP*3. 48**D8. 20. DTPConstant Value. Constant Value. D8. Constant Value. 20. Benefit Begin Date. DTP*3. 49 – Health Coverage End Dates. DTP*3. 49*D8*2. 01. DTPConstant Value. Constant Value. D8. Constant Value. 20. Benefit Termination Date. INS Segment – Member Level Detail INS*N*1. XN*A*E***N*N~INSConstant Value. NN= dependent. 18. Relationship Code = 1. Employee; 0. 1=Spouse; 1. Child. 03. 00. 30=Full File. XNReason Code (may or may not be used)AStatus Code A=Active; C=COBRA; S=Surviving Spouse. EMedicare Plan Code E=No Medicare; B= Medicare Part B; D= Medicare. COBRA Qualifying Event. Employee Status FT= Full- Time; PT=Part- Time. Student Status F=Full Time; N= Not a Student. Handicap Indicator Y=Yes; N= No. Segments repeat for the dependent.
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How to connect Vyatta to Cisco using Virtual. Box and GNS3“Vyatta is. By deploying Vyatta, users benefit from a flexible enterprise- class routing and security feature set capable of scaling from DSL to 2. Brocade Vyatta 5400 Virtual Router on vSphere. How to Install the Vyatta 5400. Download the Brocade Vyatta 5400 ISO from the Brocade website (requires. Using Vyatta as a Virtual Router within VMWare ESXi. The Stifford Academy is a project of the Stifford Centre. Networking & Virtualization & Linux. In this tutorial I would like to show install Vyatta 6.6 Core Virtualization ISO on Qemu image and run it from GNS3. Gbps performance at a fraction of the cost of proprietary solutions.”Shortly, you take this piece of software, install it on a x. PC with quality network card will do) and have yourself a network device capable to support dynamic routing protocol, policy routing, Qo. S and many more features. The best part (at least for guys like me) is that Vyatta is offering a free package that you can download on their website. This free version is without the commercial support, but you can find plenty support in the Vyatta community. Why I would be interested in Vyatta when I can have Cisco devices and can emulate Cisco IOS with GNS3? I don’t have an evolved response to this question, butmainly because I was bored and wanted to try something new, but still related to Cisco. I arrived to the conclusion that I should test how Cisco can interact with 3rd party devices. I choose Vyatta as 3rd party device, because it is a turn key network solution. Vyatta Virtual Router. I will be using the Open Source router from Vyatta. Vyatta is basically routing software that you can install on a PC or virtual machine. I\'ll be using the virtual machine version for this setup. Host: Ubuntu 9.10 server (headless) VM: Vyatta 5.02 Live CD (installed) This is my first attempt at installing Virtual Box on a headless host. I have installed vyatta from a live cd iso image successfully however I am unable. Posts about Vyatta written by Antti. The two “sites” are my laptops and the hosts and routers running in these “sites” are Virtualbox guests. Router guests are Vyatta 6.5. Router running on VMware Workstation - Part 1 basic networking. Vyatta - Router running on VMware Workstation - Part 1 basic networking. Install Brocade 5400 vRouter in VirtualBox Brocade v5400. Install the Brocade vRouter onto the virtual harddisk # install image. Note down the password you enter during. Of course, you can take all the included software in Vyatta and build your own box based on whatever Linux distribution you want, but why to do this if you have a free solution which already works? I plan to test more about Vyatta and Cisco integration, but for today. First you need to download the image from Vyatta and build yourself a working box. You can download the Live CD image which allow you to boot from it and then install, or an image for your virtualization system (VMware of Citrix). Create a Virtual Machine where to install Vyatta system. From my test environment I chose to create a Virtual Machine using Virtual. Box with the following settings: Minimum settings are Memory 5. How to install Vyatta on VMware.wmv. Install Vyatta on Hyper-V - Duration: 3:45. Installing Vyatta on VirtualBox - Duration: 9:09. MB and Storage 2. GB. The rest of the settings are optional, but if you would like to test some network stuff, then I recommend at leas 1 Network Adapter. I have 2 in this image, because one will be connected to the virtual network cloud (tap. I can access remotely this system. Install Vyatta system. Download your copy of Vyatta, add the ISO image to the IDE Secondary Master (CD/DVD) and boot your virtual machine. It should read the image and boot until to arrive to a Linux style prompt that ask for username and password (vyatta / vyatta by default). Login and install Vyatta from Live. CD. You can also work directly from Live. CD, but then the changes will not be permanent. The persistent installation can be image- based or system- based: – Image- based install. The simplest, most flexible, and most powerful way to install a Vyatta system is using a binary system image. With this method, you can install multiple versions of the Vyatta system as images and switch between the images simply and easily. You install the image from a Live. CD, reboot your system and it runs the image. At the command prompt type: install- image– Disk- based install. Installation from a Live. CD onto a persistent device such as a hard disk partition. However, unlike an image- based install, a disk- based install uses a traditional layout of files on the disk. Additional system images may be added at a later time to a system created using a disk- based install. At the command prompt type: install- system. To be honest, in the test environment, it doesn’t make much of a difference if you use the image or system installation. I used image as it’s the simplest one, as Vyatta recommend. Connect Vyatta with GNS3. Then you need a system with GNS3 installed. I’m using the same system on which Virtual. Box is installed. I that post I used an Ubuntu system, instead of Vyatta, but the principle is the same. Basic network configuration of Vyatta system. If you work more with Cisco, like I do, then you’ll find the configuration mode a little bit different that Cisco’s standard IOS CLI. If you work with Juniper, than this might look familliar as the configuration commands and the config files look pretty much like the Juniper ones. By default no remote access is enabled, so you’ll have to access this device over console. In Virtual. Box case, you’ll have a tab there with Console. If you access it, you’ll be able to login. This is not in the default config, but I have changed something there to secure my Vyatta installation. Now you know how the config look. Enter the configuration mode: @vyatta: ~$ configure. Depending of your own IP address subnet, you’ll need to customize the command below to meet your requirements: set interfaces ethernet eth. Now, you might wonder, how in the name of God I suppose to know that command. The answer is read the documentation, or do what I did. Press key TAB at the command prompt to check your options. All configuration command start with set and then press TAB key: @vyatta# setcluster. In the middle of a command keyword, if you press TAB key it will autocomplete the word, exactly like in Cisco CLI. It’s preety simple. If you get stuck somewhere, get back to documentation or ask in the comments here. Add a default gateway if you want to be able to access your system from anywhere (optional)@vyatta# set protocols static route 0. Configure the second interface (LAN)Configure the second interface (bridged to tap. This one will be connected to your Cisco router in GNS3. You’ll need to have the same IP subnet on both ends (Vyatta and Cisco), but I believe you already know this. Follow the same steps like in 4. Commit your changes. No matter what configuration you set, it will not become active until you commit: @vyatta# commit. Save your configuration@vyatta# save. Saving configuration to . You have configured Vyatta basic network system. Now configure the Cisco router in GNS3. I believe you know how to do that. Test connection between Vyatta and Cisco router. I have 1. 0. 8. 6. Vyatta eth. 1 adapter and 1. Cisco router@vyatta: ~$ ping.
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Medicare may cover up to 10 hours of initial DSMT. National Diabetes Education Program. Stanford Small-Group Self-Management Programs in English. Chronic Disease Self-Management Program (CDSMP). The Diabetes Self-Management Program. Online Diabetes Self- Management Program . In addition, participants randomized to listserve reinforcement would have better 1.
RESEARCH DESIGN AND METHODS A total of 7. This sample included 1. Diabetes self-management program helps at-risk teens and their families make healthier choices. Lia Steakley on September 18, 2014.American Indians/Alaska Natives (AI/ANs). Analyses of covariance models were used at the 6- and 1. RESULTS At 6 months, A1. C, patient activation, and self- efficacy were improved for program participants compared with usual care control subjects (P < 0. There were no changes in other health or behavioral indicators. The AI/AN program participants demonstrated improvements in health distress and activity limitation compared with usual- care control subjects. The subgroup with initial A1. C > 7% demonstrated stronger improvement in A1. C (P = 0. 0. 1). At 1. Reinforcement showed no improvement. CONCLUSIONS An online diabetes self- management program is acceptable for people with type 2 diabetes. Although the results were mixed they suggest 1) that the program may have beneficial effects in reducing A1. C, 2) AI/AN populations can be engaged in and benefit from online interventions, and 3) our follow- up reinforcement appeared to have no value. Type 2 diabetes affects 9. While the need for self- management support is well documented, most diabetes education studies have taken place in clinical settings and targeted those who have a high A1. C (usually . Recent community- level, peer- led, small- group diabetes self- management programs have shown promise (2,3). However, not all patients with type 2 diabetes are willing or able to participate in small- group programs, nor are such programs likely to be available in all locations. There are few studies of community- based diabetes education programs for American Indians/Alaskan Natives (AI/ANs). We report on a randomized, controlled trial of an Internet- based diabetes self- management program (IDSMP) including AI/ANs. This was the first study, to our knowledge, examining such a program among AI/ANs. The Cochrane Collaboration reviewed group- based training for type 2 diabetes (4). They found 1. 1 studies that met their criteria. Eight of these were randomized studies and three were controlled studies. All of the interventions were taught by health professionals. One study took place in a community setting, and one reported a mean baseline A1. C < 7%. Jacksan et al. They found four articles involving patient education. In an early study, (6) groups were randomized to basic diabetes information, tailored online coaching, or peer support. Improvement in health behaviors and psychological outcome were found in all three groups, with no differences between groups. In a low- intensity computer program study, short- term outcomes were promising but not significant (8). Wengberg (9), utilizing an computer diabetes intervention, has suggested that self- efficacy may function as a moderator for diabetes behavior change, and Gerber et al. In summary, Internet- based educational programs have been demonstrated to change behaviors and sometimes health status. We were unable to find computer- based studies demonstrating changes in A1. C. RESEARCH DESIGN AND METHODSWe report on a randomized 6- month trial of the IDSMP, with an 1. We hypothesized that participants in the IDSMP, compared with usual- care control subjects, would demonstrate 1) reduced A1. C at 6 and 1. 8 months, 2) have fewer symptoms, 3) have increased exercise, and 4) have improved self- efficacy and patient activation. We also hypothesized that participants randomized to a follow- up listserve, peer- support group would have better 1. The IDSMPThe asynchronous, 6- week, IDSMP is based on English- and Spanish- language peer- led small- group diabetes self- management programs (2,3). The IDSMP consists of six weekly sessions. Participants logged on individually to the sessions, which were available for the entire week. The topics covered are shown in online appendix Table A1 (available in the online appendix at http: //care. DC1). A password- protected homepage provides access to the weekly activities, including The Learning Center, where the program content is offered in 2. Web pages weekly. Each week, participants are asked to reply to a question such as “What problems do you have because of your diabetes?” and to make a specific action plan. The questions and action plans are posted on bulletin boards in the Discussion Center, where they can be seen by all participants. The Discussion Center is made up of four interactive threaded bulletin boards (Action Planning, Problem Solving, Difficult Emotions, and Celebrations) populated by responses made in the Learning Center, as well as new threads started by participants whenever they wish. A typical program of 2. My Tools consists of exercise and medication logs, audio relaxation exercises, meal planning, and glucose- monitoring tools and links to other diabetes- related Web sites. Post Office is a section where participants and facilitators can write private, individual messages to each other. Help is a section where participants can e- mail the moderators or program administrators. The latter is also available via a toll- free telephone line. In addition to the Web program, each participant received a copy of the book, Living a Healthy Life with Chronic Conditions (1. Specific sections of this book are referenced in the Learning Center. The book is used as a reference not as a text. Thus, the program consists of the online interactive training plus the book. Facilitators. Two peers facilitate each program. Facilitators were previously trained as self- management small- group leaders and had taken the IDSMP (as nonstudy subjects). Facilitators assist participants by reminding them to log on, modeling action planning and problem- solving, offering encouragement, and posting to the bulletin boards. They also monitor the daily posts for safety and report inappropriate posts to the investigators. All facilitation takes place online, mainly via posts within the program pages. Each participant receives personalized responses from facilitators during each weekly session. Unlike the small- group program, facilitators do not deliver content, as this is scripted in the Learning Center. Programs were facilitated by 1. Each program has at least one facilitator with diabetes. The study was approved by the Stanford School of Medicine Institutional Review Board. Participants and data collection. Participants were aged . Recruitment was largely via the Internet, although print and broadcast media were also utilized. Special effort was made to recruit AI/AN participants using Web sites and media associated with tribal and AI/AN organizations. This was accomplished utilizing the expertise of an AI/AN researcher (1. All consents and questionnaires were administered online. Participants contacted the study by going to the Web site, where they were screened for eligibility and were asked to complete consent and baseline questionnaires. A1. C was obtained using mailed self- administered BIOSAFE kits (1. After returning A1. C kits, participants were randomized using a random- numbers table. Roughly two- thirds became treatment subjects and one- third continued with usual care (no program or other treatment offered). Treatment subjects were further randomized one for one to receive follow- up reinforcement (membership in a listserve discussion group) or no reinforcement. Usual care consisted of whatever care participants had been previously receiving and ranged from community clinics to specialist care. Usual- care participants were not restricted from seeking additional care or programs. All participants received a $1. Amazon. com certificate after completing each questionnaire and returning their A1. C sample. Randomized study. The randomized IDSMP group was compared with the usual- care control group at 6 months. If the reinforcement study (below) had shown that reinforcement participants had greater improvements than unreinforced IDSMP participants, the two IDSMP groups would be compared with control participants separately. If there were few differences, the two randomized IDSMP groups would be combined and compared with the usual- care control group. After 6 months, usual- care participants recruited as part of the AI/AN subgroup were offered the program. All other usual- care participants continued as control subjects through the 1. Follow- up data collected at 1. IDSMP participants to usual- care subjects, excluding the AI/AN subset. Reinforcement study. The reinforcement study compared IDSMP treatment participants who had no reinforcement with those who had been randomized to a listserve discussion group. The discussion group was intended to reinforce any benefits of the program by providing peer support. Comparisons were made at 6 and at 1. The AI/AN participants were included in the 1. AI/AN study. AI/AN participants were randomized with other participants but entered the randomized study for only 6 months, after which time AI/AN usual- care participants were offered an opportunity to take the IDSMP. The lack of adequate usual medical care and chronic health disparities among the AI/AN subset, as well as the longstanding mistrust of research in many AI/AN communities, were reasons the AI/AN subset was randomized using the waitlist control design. A pilot study of 2. AI/AN and 2. 7 non- AI/AN participants with diabetes had confirmed the feasibility of the online programs for this population (1. Health status, health behaviors, health care utilization, patient activation, and self- efficacy were measured at each time point. The specific measures were based on diabetes- related problems identified in participant focus groups and on self- efficacy theory (1. The primary outcome measure was A1. C, measured using capillary blood obtained with self- administered BIOSAFE kits. These have an expected nondiabetic range of 3. National Glycohemoglobin Standardization Program standards (1. Diabetes DSME Resource - National Association of Chronic Disease Directors. Recommend a Resourcee. Pace: Sustainable Diabetes Self- Management Education, September 1. Pace is an online training. Diabetes Training and Technical Assistance Center (DTTAC) at. Emory University with support from the Division of Diabetes Translation at. CDC. Materials and video of presentations from the September 2. Pace website. The following materials are available on the e. Pace website. Training pre- work, which outlines many basics of DSME from the definition to outlining the National Standards (pre- work is also provided below)Two speaker presentations. Introduction to DSME and Barriers. Access, Speaker: Amparo. Gonzales, MPH, RN, CDE, FAADE9 Multi- faceted strategies to. Improve DSMT Program, Speaker. Mary Ann Hodorowicz, RD, LDN, MBA, CDESpeaker Question and Answer. All session handouts and slides e. Pace: Expanding Access and Promoting Reimbursement Pre- Work. Diabetes. self- management education and training (DSME/T) is a collaborative process through which. This process incorporates the needs, goals, and life experiences of the person with diabetes and is guided by evidence- based standards. The overall objectives of DSME are to. Self- care. behaviors. Problem- solving. Facilitating. positive self- care behaviors directed at successful diabetes self- management. DSME/T in 2. 00. 2. Seven specific self- care behaviors developed. American Association of Diabetes Educators, known collectively as the. AADE7. Specific. self- care behaviors. Healthy. eating. Being active. Monitoring. Taking medication. Problem solving. Healthy coping. Reducing risks. Back to Top. National. Standards for Diabetes Education and Support were. The Standards are reviewed. Organizations seeking Medicare reimbursement for DSME/T must meet the. National Standards. Five. guiding principles inform. National DSME/T Standard. Five guiding principles. Diabetes. is effective for improving clinical outcomes and quality of life, at least in. DSME/T. evolved from primarily didactic presentations to more theoretically based. There. show that culturally and age- appropriate programs improve outcomes and that. Ongoing. is critical to sustain progress made by participants during the DSME program. Behavioral. is an effective strategy to support self- management behaviors. The 1. 0 Standards of DSME/TThe 1. Standards can be found in the article,National Standards for Diabetes Self- Management Education and Support. Practice Guidelines Overview. The. Practice Guidelines support the delivery of DSME/T within the framework of the. AADE7 Self- Care Behaviors and The National Standards for Diabetes. Self- Management Education and Support. The AADE Guidelines for the Practice of Diabetes Self- Management Education and Training (DSME/T) describe the implementation of The Scope of Practice, Standards of Practice and Standards of Professional Performance for Diabetes Educators. AADE. The five domain competencies are specific skills needed across the continuum of care for the various levels of practice, from novice to clinical expert. Domain I: Pathophysiology, Epidemiology, and Clinical Guidelines of Diabetes. Domain II: Culturally Competent Supportive Care Across the Lifespan. Domain III: Teaching and Learning Skills. Domain IV: Self- Management Education. Domain V: Program and Business Management Back to Top. In. 1. 99. 7, the federal Balanced Budget Act passed, permitting the U. S. Health Care. Finance Administration (HCFA). Both AADE and ADA require a fee. The certifying bodies also require annual reports and. Both also. offer multi- site recognition/accreditation. Although their terminology differs, the programs. Previously, Medicare reimbursement was. Diabetes outpatient self- management services may be covered by Medicare. When. a beneficiary has not yet received initial training, they are eligible to. The. 1. 2- month period does not need to be on a calendar- year basis. The 1. 0. hours of initial training may be provided in any combination of half- hour. Nine. hours of the initial training must be. Medicare beneficiaries unless the provider certifies that a special. For. all beneficiaries, one hour of initial training may be provided on an. Medicare. covers 2 hours of follow- up training each year starting with the calendar year. The. 2- hours of training may be given in any combination of half- hour increments. Beneficiaries. for Coverage. Medicare. Part B covers 1. Diabetes. is diabetes mellitus, a condition of abnormal glucose metabolism diagnosed. A. fasting blood sugar greater than or equal to 1. L on. two different occasions; A 2. L on 2. different occasions; or. A random glucose test over 2. L for a person with symptoms of. Documentation. that the beneficiary is diabetic is maintained in the beneficiary. CMS accepts recognition by. ADA or accreditation by the AADE as meeting the National Standards for. Diabetes Self- Management Training Programs. Back to Top. In. 2. Medicare beneficiaries, with a special focus on. Two methods were used to. Diabetes. program coordinators (DCPCs) in each of the 5. District of. Columbia were surveyed to understand problems with obtaining ADA recognition. Medicare reimbursement, differences in obtaining ADA recognition by rural. Medicare patients. Second, information about perceived barriers to. ADA- recognized diabetes education facilities. Results. indicated that most DCPCs believed it was more difficult for rural providers to. ADA recognition than for urban providers; the largest barriers were. The top barriers for rural providers. DCPCs were the shortage of designated specialists, fewer. ADA recognition. Barriers. ADA- recognized programs included staffing/institutional support. Medicare reimbursement, lack of hours covered, and transportation. For. example, the number of multiple hospitalizations is 8. Medicaid than for their privately insured counterparts. Yet, many state. Medicaid programs do not include DSME/T as a covered service for their. For this reason, several. DPCPs are working with state diabetes coalitions and other partner. Medicaid reimbursement for DSME/T. AADE. Guidelines for the Practice of Diabetes Self- Management Education and Training. DSME/T). American Association of Diabetes Educators, Chicago, Illinois. National Standards for Diabetes Self- Management Education and Support. Diabetes. Care. 2. Nov; 3. 5 (1. 1): 2. Mar- Apr; 3. 6(2): 2. See also Overview Comparison of National Accreditation. Powell. MP, Glover SH, Probst JC, Laditka SB. Nov- Dec; 3. 1(6): 8. US. Department of Health and Human Services. Expanded coverage for diabetes. Program memorandum B- 0. To be effective, the curriculum must meet the National. Standards for Diabetes Self- Management Education and Support. Many curriculum are. Curricula have been developed for specific. Below is not a comprehensive. Diabetes Conversation Map Program, published by Healthy Interactions, Inc. Back to Top Prepared by the Vermont DPCP, this document uses. Diabetes Self- Management Education, Chronic Disease Self- Management. Program, and Diabetes Self- Management Program. Back to Top American Diabetes Association. American Association of Diabetes Educators accreditation. National Standards for. DSME. It is also a requirement for Medicare reimbursement. To find out how these organizations. Overview Comparison of National Accreditation. AADE accredited programs. ADA recognized programs Back to Top To ensure access to DSME/T, health insurance coverage is. Below is information about health insurance coverage based on. Medicare, Medicaid, and commercial insurance. Even with health insurance. Administration on Aging Resource. Diabetes Self- Management Training Initiative. The Administration on Aging developed a DSMT. Toolkit to provide Area Agencies on Aging, community planners, and healthcare. DSMT programs that can meet CMS requirements for. Medicare reimbursement. Diabetes. Self- Management Training Initiative (has links to toolkit chapters and other. Toolkit(pdf file of Toolkit) Medicare. Medicare covers outpatient diabetes. See description of coverage. Pace prework. Despite. Medicare beneficiaries. The. Administration on Aging is working to expand access to DSME/T. One model uses. Area Agency on Aging as delivery sites for DSMT. Medicaid. See also e. Pace prework. The National Council of State Legislatures tracks diabetes coverage and has some information for Medicaid related to. State by state tables outline State Insurance and Medicaid. Requirements and Programs. As a condition for receipt of. While services such. Other details of benefits such as prescribed. Medicaid policy and are listed by state. View the National Council. State Legislatures website. Coverage of Community Health Workers and Peer Leaders for DSMEDSME has show to be effective using. The Stanford Patient Education. Research Center offers evidence- based programs using peer leaders for people. The Diabetes Self- Management Program is offered in both English and Spanish (Programa de Manejo Personal de la Diabetes). The webinar by Tim Mc. Neil titled, Diabetes Self Management Training. How it Benefits Seniors and Steps to Reimbursement, focuses on DSMT. NCOA\'s sustainability web page. Back to Top. Building. Case for Diabetes Self- Management: A Handbook for Program Managers (2. This handbook outlines how to calculate a. DSME program. It addresses the rational for. Invited Commentaryby April. Reese in the NC Medical Journal. Reese discusses approaches to reduce. NC. Diabetes self- management is a required benefit of. Medicare, Medicaid, and private insurance in NC. Benefit Cost Analysis. This document outlines how the State derived their final. Diabetes Education Recognition Programs offers a +2. Back to Top. Indian Health Service Division of Diabetes Treatment and. Prevention (DDTP). The sites has best practices, curricula, and. Diabetes Self- Management Education (DSME): Establishing a Community- Based DSME Program for Adults with Type 2 Diabetes to Improve Glycemic Control. \n
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