More than just methods: Data and insights guide vowel acoustics research.

The Reflections series takes a look back on historical articles from The Journal of the Acoustical Society of America that have had a significant impact on the science and practice of acoustics.

Nursing Home Compare Star Rankings and the Variation in Potentially Preventable Emergency Department Visits and Hospital Admissions.

Measurement of the quality of US health care increasingly emphasizes clinical outcomes over clinical processes. Nursing Home Compare Star Ratings are provided by Medicare to help select better nursing home care. The authors determined the rates and types of 2 important clinical outcomes-potentially preventable hospital admissions and potentially preventable emergency department (ED) visits-for a subset of 439,011 long-term nursing homes residents residing in 12,883 nursing homes throughout the United States over a 2-year period (2010-2011) and compared them with the Star Rating system.

A compliance assessment of midpoint formative assessments completed by APPE preceptors.

Introduction: Experiential pharmacy preceptors should provide formative and summative feedback during a learning experience. Preceptors are required to provide colleges and schools of pharmacy with assessments or evaluations of students' performance. Students and experiential programs value on-time completion of midpoint evaluations by preceptors.

Regional dialect perception across the lifespan: Identification and discrimination.

Although adult listeners can often identify a talker's region of origin based on his or her speech, young children typically fail in dialect perception tasks, and little is known about the development of regional dialect representations from childhood into adulthood. This study explored listeners' understanding of the indexical importance of American English regional dialects across the lifespan. Listeners between 4 and 79 years old in the Midwestern United States heard talkers from the Midland, Northern, Southern, and New England regions in two regional dialect perception tasks: identification and discrimination.

The Development of Regional Dialect Locality Judgments and Language Attitudes Across the Life Span.

The development of language attitudes and perception of talker regional background was investigated across the life span (N = 240, age range = 4-75 years). Participants rated 12 talkers on dimensions of geographic locality, status, and solidarity. Children could classify some dialects by locality by age 6-7 years and showed adult-like patterns by age 8 years.

How Encouraging Provider Collaboration and Financial Incentives Can Improve Outcomes for Persons With Severe Psychiatric Disorders.

This Open Forum addresses the challenging situation involving decisions about when to hospitalize patients for psychiatric care. Because the evidence base for when to hospitalize patients is incomplete, current practice is to hospitalize only patients who are in crisis. This Open Forum provides a suggested set of payment options that can provide financial incentives to change practice patterns and lead to better clinical outcomes.

Rethinking Medicare Payment Adjustments for Quality.

Payment reforms aimed at linking payment and quality have largely been based on the adherence to process measures. As a result, the attempt to pay for value is getting lost in an overly complex attempt to measure value. The "Incentivizing Health Care Quality Outcomes Act of 2014" (HR 5823) proposes to replace the existing patchwork of process and outcomes quality measures with a uniform, coordinated, and comprehensive outcomes-based quality measurement system.

Hospital readmission rates: the impacts of age, payer, and mental health diagnoses.

We examine impacts of age, payer, and mental health conditions upon hospital readmissions and the comparability of same-hospital and multiple-hospital readmission rates. Medicaid primary payment and extreme age are associated with significantly higher readmission rates. We find low correlation between same-hospital and multiple-hospital readmission rates and identify urban hospitals with high proportions of Medicaid patients and mental health admissions as factors driving the use of multiple hospitals within readmission chains.

Impact of advanced pharmacy practice experience placement changes in colleges and schools of pharmacy.

Objective: To document the annual number of advanced pharmacy practice experience (APPE) placement changes for students across 5 colleges and schools of pharmacy, identify and compare initiating reasons, and estimate the associated administrative workload.

Methods: Data collection occurred from finalization of the 2008-2009 APPE assignments throughout the last date of the APPE schedule. Internet-based customized tracking forms were used to categorize the initiating reason for the placement change and the administrative time required per change (0 to 120 minutes).

Impact of the transition to ICD-10 on Medicare inpatient hospital payments.

Objective: On October 1, 2013, the reporting of diagnoses and procedures in the U.S. will transition from the clinical modification of the ninth revision of the International Classification of Diseases (ICD-9-CM) to the tenth revision (ICD-10).

Challenges and benefits of adding laboratory data to a mortality risk adjustment method.

Background: There is increased interest in improving the clinical acceptance and statistical performance of hospital mortality rate comparisons. This study assessed the feasibility of linking separate electronic feeds of laboratory data and claims-based information and, if successful, to identify laboratory data elements that significantly improved mortality rate predictions for All-Patient Refined Diagnosis Related Groups (APRDRGs), a risk of mortality (ROM) classification tool in regular use for public reporting purposes.

Methods: The Florida Agency for Health Care Administration recruited 15 hospitals to supply computerized administrative and laboratory information that could be linked at the patient level.

Consortium-based approach to an online preceptor development program.

Objective: To describe the implementation process of a consortium-based preceptor development program and to review completion and assessment data over the first 27 months.

Design: Five 1-hour, Web-based preceptor development modules were developed using streaming media technologies. Modules were released using a password-protected Internet site and were free to consortium-affiliated preceptors.

A new approach to reducing payments made to hospitals with high complication rates.

This article proposes a redesign of the Medicare inpatient prospective payment system to reduce payments made to hospitals with high complication rates. We compute risk-adjusted, expected complication rates for hospitals and compare them to actual complication rates in order to determine the number of excess complications. Hospital payment reductions then are computed based on the number of excess complications in a hospital.

Achieving cost control, care coordination, and quality improvement through incremental payment system reform.

The healthcare reform goal of increasing eligibility and coverage cannot be realized without simultaneously achieving control over healthcare costs. The reform of existing payment systems can provide the financial incentive for providers to deliver care in a more coordinated and efficient manner with minimal changes to existing payer and provider infrastructure. Pay for performance, best practice pricing, price discounting, alignment of incentives, the medical home, payment by episodes, and provider performance reports are a set of payment reforms that can result in lower costs, better coordination of care, improved quality of care, and increased consumer involvement.

Barriers to expanding advanced pharmacy practice experience site availability in an experiential education consortium.

Objectives: To compare 2006-2007 and projected 2010-2011 advanced pharmacy practice experience (APPE) availability and needs for 4 colleges and schools of pharmacy in Georgia and Alabama and to examine barriers and offer potential solutions to increase APPE site and preceptor availability.

Methods: Data on APPE needs and availability were gathered prospectively and evaluated relative to current and projected enrollment and planned programmatic changes.

Results: Combined 2006-2007 non-community APPE needs and availabilities were 3,590 and 4,427, respectively, with a surplus availability of 837.

Estimating the costs of potentially preventable hospital acquired complications.

California and Maryland hospital data are used to estimate the incremental cost associated with 64 categories of hospital acquired complications. The reason for admission, severity of illness at admission and the presence of hospital acquired complications are used in a linear regression model to predict incremental per patient cost yielding an adjusted R2 of 0.58 for Maryland data and 0.

Redesigning the Medicare inpatient PPS to reduce payments to hospitals with high readmission rates.

A redesign of the Medicare inpatient prospective payment system (IPPS) that reduces payments to hospitals that have high-risk adjusted readmission rates is proposed. The redesigned IPPS uses a readmission performance standard from best practice hospitals to determine the risk-adjusted number of excess readmissions in a hospital and determines the payment reduction for a hospital based on its excess number of readmissions. Extrapolating from Florida Medicare 2004-2005 discharge data, the redesigned IPPS is estimated to reduce overall annual Medicare inpatient expenditures nationally by $1.

Hospital complications: linking payment reduction to preventability.

The Center for Medicare & Medicaid Services (CMS) policy of denying payment for certain in-hospital complications should be modified, given that complications are not always preventable.

Determining temperature ratings for children's cold weather clothing.

This study examined the physical and physiological differences between children and adults that affect body heat generation and losses and then developed a heat loss model for determining the temperature ratings of cold weather clothing designed for use by children of various ages. The thermal insulation values of selected jackets were measured using a heated manikin dressed in two base ensembles, and the temperature ratings were calculated using the model. The results indicated that the type of garments used in the base ensemble had a major effect on jacket ensemble insulation and the predicted comfort temperature.

Identifying potentially preventable readmissions.

The potentially preventable readmission (PPR) method uses administrative data to identify hospital readmissions that may indicate problems with quality of care. The PPR logic determines whether the reason for readmission is clinically related to a prior admission, and therefore potentially preventable. The likelihood of a PPR was found to be dependent on severity of illness, extremes of age, and the presence of mental health diagnoses.

The longitudinal development of clusters in French.

Studies of English and German find that children tend to acquire word-final consonant clusters before word-initial consonant clusters. This order of acquisition is generally attributed to articulatory, frequency and/or morphological factors. This contrasts with recent experimental findings from French, where two-year-olds were better at producing word-initial than word-final clusters (Demuth & Kehoe, 2006).

The prosodic (re)organization of children's early English articles.

Researchers have long been puzzled by children's variable omission of grammatical morphemes, often attributing this to a lack of semantic or syntactic competence. Recent studies suggest that some of this variability may be due to phonological constraints. This paper explored this issue further by conducting a longitudinal study of five English-speaking one- to two-year-olds' acquisition of articles.

Apparent evaporative resistance at critical conditions for five clothing ensembles.

A limiting factor for clothing ensembles inherent during heat stress exposures is the evaporative resistance, which can be used to compare candidate ensembles and in rational models of heat exchange. In this study, the apparent total evaporative resistance of five clothing ensembles (cotton work clothes, cotton coveralls, and coveralls made of Tyvek 1424 and 1427, NexGen and Tychem QC was estimated empirically from wear trials using a progressive heat stress protocol and from clothing insulation adjustments based on ISO 9920 (2007) and wetness. The metabolic rate was moderate at 165 W m(-2) and relative humidity was held at 50%.