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Given the pressures for health care reform, interest in the concept of integrated or organized delivery systems as a means to offer more coordinated cost-effective care is growing. This article has two primary objectives: (1) to clarify the different types of integration associated with the notion of an organized delivery system, and (2) to share the results from an ongoing study of 12 organized delivery systems. The findings indicate a moderate level of integration overall, particularly in the areas of culture, financial planning, and strategic planning. The study found that corporate staff respondents perceive their systems to be more integrated and effective than do operating unit managers, and that some functional integration areas are positively associated with both physician-system and clinical integration that, in turn, are positively related to each other. Overall, perceived integration was found to be positively associated with perceived effectiveness.
A concise derivation of Kirchhoff’s theory for naturally curved and twisted rods is presented as a prelude to the derivation of the theory for the elastic response of rods that have undergone prior plastic deformation.
We consider the problem of service composition in a wide area network, where an end-user can send its packets through intermediate processing points (middleboxes) which can perform a variety of services. Example of such services are filtering, intrusion detection, anonymization, transcoding, and caching. In this paper, we argue that the Internet Indirection Infrastructure (i3)--an overlay network architecture that enables users to locate services and control the path followed by their packets--provides a natural platform for service composition. We discuss the challenges in implementing service compositions on top of i3, and suggest several approaches to address these challenges.
The CNN Universal Machine and Supercomputer [10] is the first stored program analog computing array architecture. Its various implementations, in parts, show that for this new kind of analogic computing we need all the essential programming tools which digital computers have, though in different form. Namely, we need an analogic algorithm (e.g. in a form of a flow diagram), a high level language (e.g. the "Analogic CNN Language (ACL)"), a compiler, an operating system, and a generated machine code. Although they are quite simple in our present phase of making these machines, their existence suggest a similar development to the one we had in the 1970's for microprocessors. The main difference is accounted for by the presence of analog array dynamics as the key instruction/operation in the analogic CNN algorithms [1-8]. In what follows, we outline the main ideas and a simple implementation. Inclusively, we suggest a framework for the implementation of a development system for CNN universal chips