This document summarizes a workshop on roundabouts held in Florida in 2009. It discusses the increasing implementation of roundabouts in the US, providing data on their use by state. It addresses common concerns about roundabouts such as cost and public acceptance. Research shows that after construction, public opinion becomes more positive. The document outlines where roundabouts are particularly advantageous, such as high crash locations. It also discusses roundabout design considerations and new FHWA resources on roundabouts.
Sandra Koch, MD discusses the impact of health care reform on the uninsured. The Affordable Care Act is estimated to reduce the number of uninsured women ages 19-64 from 20% to 8% when fully implemented. However, health care costs and access to providers will still be challenges as millions gain coverage. Electronic health records and data sharing aim to improve care coordination and lower costs but introducing technology brings privacy concerns. Overall the reforms seek to make health insurance and costs more transparent while shifting payment models to value health outcomes over procedures.
TDS provides wireless and wireline telecommunications services through its subsidiaries U.S. Cellular and TDS Telecom. In 2004:
- U.S. Cellular grew revenues 15% and added a record 627,000 net customers, driven by its focus on customer satisfaction and low churn.
- TDS Telecom grew revenues 2.4% by adding 62,000 CLEC access lines and 8,000 ILEC access lines, with data services as a key growth area.
- Both companies aim to meet evolving customer needs through network investments and expanded service offerings like data, pursuing profitable growth.
This document summarizes the work of Sherilyn Pruitt at the Office for the Advancement of Telehealth within the Health Resources and Services Administration. It discusses the office's role in advocating for rural health issues within HHS, conducting research and policy development on rural health topics, and administering grant programs to expand telehealth access. These programs include licensure portability grants, telehealth network grants, telehealth resource centers, and grants to expand rural veterans' healthcare access through telehealth.
Primary framing systems include rigid frames, continuous beam frames, lean-to frames, and post and beam frames. Rigid frames provide clear spans, continuous beam frames are used for wide span buildings, and post and beam frames utilize wall panels for stability and wind resistance rather than being moment resisting. Various options like tapered members, reducing spans, and open web designs can reduce costs for primary framing systems.
The document is a series of maps showing the rise in obesity rates among US adults from 1985 to 2006 based on data from the CDC's Behavioral Risk Factor Surveillance System. The maps show obesity, defined as a BMI of 30 or higher, increasing from below 10% in most states in 1985 to over 30% in many states by 2006, indicating a significant nationwide rise in obesity over the past few decades.
HCA Presents at Bank of America 2008 Credit Conference 20-Nov-2008finance9
HCA Healthcare's management provided forward-looking statements during their presentation that are protected under safe harbor provisions. They cautioned that current plans and financial projections may differ from forward-looking statements due to known and unknown risks and uncertainties. The presentation also included certain non-GAAP financial measures that are reconciled to the most directly comparable GAAP measures.
Sustainable Roundabouts presented to Michigan Association of Planning in a Pe...Evan Pratt
The document discusses roundabouts as a safer and more sustainable alternative to traditional intersections. It notes that about 650 people die each week in traffic accidents in the US, similar to 3 plane crashes per week. Roundabouts have been shown to reduce fatalities by 90% and crashes by 76% compared to traditional intersections. They also have financial benefits through lower construction costs of 75% less and environmental benefits from reduced emissions from less idling. Case studies demonstrate the triple bottom line benefits of roundabouts across social, financial and environmental factors. Larger roundabouts and designs like the HAWK signal have also improved safety for pedestrians.
Green Strategies for Controlling Stormwater and Sewer OverflowSotirakou964
This document discusses the growing problem of urban stormwater and combined sewer overflows (CSOs) and promotes green infrastructure as an effective solution. It contains the following key points:
1. Impervious surfaces in urban areas have increased runoff and pollution, threatening water quality. Green infrastructure like trees and permeable pavement intercepts rainfall and reduces runoff at its source.
2. Case studies show green infrastructure can cost-effectively control stormwater and CSOs while providing additional benefits like improved air and water quality. Cities have established programs using techniques like green roofs, rain gardens, swales, and downspout disconnection.
3. Wider adoption of green infrastructure faces obstacles
Sandra Koch, MD discusses the impact of health care reform on the uninsured. The Affordable Care Act is estimated to reduce the number of uninsured women ages 19-64 from 20% to 8% when fully implemented. However, health care costs and access to providers will still be challenges as millions gain coverage. Electronic health records and data sharing aim to improve care coordination and lower costs but introducing technology brings privacy concerns. Overall the reforms seek to make health insurance and costs more transparent while shifting payment models to value health outcomes over procedures.
TDS provides wireless and wireline telecommunications services through its subsidiaries U.S. Cellular and TDS Telecom. In 2004:
- U.S. Cellular grew revenues 15% and added a record 627,000 net customers, driven by its focus on customer satisfaction and low churn.
- TDS Telecom grew revenues 2.4% by adding 62,000 CLEC access lines and 8,000 ILEC access lines, with data services as a key growth area.
- Both companies aim to meet evolving customer needs through network investments and expanded service offerings like data, pursuing profitable growth.
This document summarizes the work of Sherilyn Pruitt at the Office for the Advancement of Telehealth within the Health Resources and Services Administration. It discusses the office's role in advocating for rural health issues within HHS, conducting research and policy development on rural health topics, and administering grant programs to expand telehealth access. These programs include licensure portability grants, telehealth network grants, telehealth resource centers, and grants to expand rural veterans' healthcare access through telehealth.
Primary framing systems include rigid frames, continuous beam frames, lean-to frames, and post and beam frames. Rigid frames provide clear spans, continuous beam frames are used for wide span buildings, and post and beam frames utilize wall panels for stability and wind resistance rather than being moment resisting. Various options like tapered members, reducing spans, and open web designs can reduce costs for primary framing systems.
The document is a series of maps showing the rise in obesity rates among US adults from 1985 to 2006 based on data from the CDC's Behavioral Risk Factor Surveillance System. The maps show obesity, defined as a BMI of 30 or higher, increasing from below 10% in most states in 1985 to over 30% in many states by 2006, indicating a significant nationwide rise in obesity over the past few decades.
HCA Presents at Bank of America 2008 Credit Conference 20-Nov-2008finance9
HCA Healthcare's management provided forward-looking statements during their presentation that are protected under safe harbor provisions. They cautioned that current plans and financial projections may differ from forward-looking statements due to known and unknown risks and uncertainties. The presentation also included certain non-GAAP financial measures that are reconciled to the most directly comparable GAAP measures.
Sustainable Roundabouts presented to Michigan Association of Planning in a Pe...Evan Pratt
The document discusses roundabouts as a safer and more sustainable alternative to traditional intersections. It notes that about 650 people die each week in traffic accidents in the US, similar to 3 plane crashes per week. Roundabouts have been shown to reduce fatalities by 90% and crashes by 76% compared to traditional intersections. They also have financial benefits through lower construction costs of 75% less and environmental benefits from reduced emissions from less idling. Case studies demonstrate the triple bottom line benefits of roundabouts across social, financial and environmental factors. Larger roundabouts and designs like the HAWK signal have also improved safety for pedestrians.
Green Strategies for Controlling Stormwater and Sewer OverflowSotirakou964
This document discusses the growing problem of urban stormwater and combined sewer overflows (CSOs) and promotes green infrastructure as an effective solution. It contains the following key points:
1. Impervious surfaces in urban areas have increased runoff and pollution, threatening water quality. Green infrastructure like trees and permeable pavement intercepts rainfall and reduces runoff at its source.
2. Case studies show green infrastructure can cost-effectively control stormwater and CSOs while providing additional benefits like improved air and water quality. Cities have established programs using techniques like green roofs, rain gardens, swales, and downspout disconnection.
3. Wider adoption of green infrastructure faces obstacles
Urbanization has significantly increased the amount of impervious surfaces like roads and buildings, altering the natural water cycle. Over 100 million acres in the US are now developed. This causes more stormwater runoff, carrying pollutants directly into waterways. Current stormwater infrastructure is inadequate, as it was designed only to convey runoff efficiently rather than treat pollution. As a result, stormwater is the top pollution source for over half of ocean shorelines and a third of estuaries. Combined sewer overflows also introduce untreated sewage during heavy rains. New approaches are needed to manage stormwater sustainably.
Dokumen tersebut membahas tentang rencana Gubernur DKI Jakarta, Jokowi, untuk membangun taman gantung di gedung-gedung perkantoran di Jakarta setelah terinspirasi oleh taman gantung di Kemendag. Jokowi tertarik dengan konsep taman gantung yang sudah ada di Kemendag dan berencana menerapkannya untuk tata kota Jakarta.
Arizona Manual on Rainwater Harvesting for LandscapeD6Z
This document provides guidance on harvesting rainwater for landscape use. It discusses the components of a rainwater harvesting system, including the water supply (rainfall), plant water demands, and the system to move water. Simple systems can direct roof runoff to landscaped areas using gutters, downspouts and berms. Proper plant selection and constructing basins, swales and spillways can slow and spread rainwater across a site. Regular maintenance keeps the system functioning properly.
Rooftop gardens and the greening of cities - a case study of UKZNFlanna489y
This document provides a summary of a dissertation on rooftop gardens and greening of cities, with a case study of the University of KwaZulu-Natal (UKZN). The dissertation investigates concepts of rooftop gardens and their relationship to urban ecology. It examines the benefits and constraints of implementing rooftop gardens and their future prospects in South Africa. A pilot rooftop garden was constructed on the Memorial Tower Building at UKZN to test claims about rooftop gardens and address questions regarding their ability to reduce temperatures, runoff, and support biodiversity. The dissertation aims to provide insights into the viability of green roof systems in Durban and their significance for sustainable urban environments and mitigating climate change
Albuquerque, New Mexico Rainwater Harvesting ManualD6Z
This document provides a guide for rainwater harvesting systems in Albuquerque, New Mexico. It discusses simple rainwater harvesting systems that consist of a catchment area, distribution system, and landscape holding area. The guide describes how to design and construct simple systems, including using roofing as a catchment, gutters and downspouts as a distribution system, and depressed planting beds as holding areas. It emphasizes using native and drought-tolerant plants suited to intermittent water supplies.
NeoGenomics is a pure play cancer genetics laboratory that provides diagnostic testing services to oncologists, pathologists, and hospitals throughout the US. The company utilizes advanced technologies like cytogenetics, flow cytometry, FISH, and molecular testing to analyze cancer samples. Key growth drivers include the aging US population which is increasing cancer incidence, and frequent discoveries linking new genes to cancer. NeoGenomics aims to accelerate its revenue growth and increase operating leverage through expanding its sales team, test offerings, and geographic reach.
This document maps out each U.S. state's response and stance regarding key aspects of the Affordable Care Act, also known as Obamacare, including whether they have decided to expand Medicaid, who will run their health insurance exchange, and whether they are plaintiffs in any lawsuits against the law. The maps show that 25 states have decided to expand Medicaid, 20 have not, and 6 are uncertain. 18 states will run their own exchange, 7 as a state-federal partnership, and 26 will default to the federal exchange. 27 states in total are involved in lawsuits against Obamacare.
Dealing With Payers With Physician Driven Cost AndWilliam Cockrell
The document provides Medicare cost and discharge data for 17 physicians treating patients with a principal diagnosis of coronary atherosclerosis of the native coronary artery. It includes average length of stay, case mix index, volume of patients, average payment per patient, total actual payment, and discharge disposition breakdown for each physician. Payment amounts ranged from $4,312 to $165,517 across physicians, with most patients being discharged home or to home health.
Medicaid Medical Homes Initiatives: Promising Practices to Inform 2703 SPAsNASHP HealthPolicy
This document summarizes Medicaid medical home initiatives across multiple states. It describes initiatives led by NASHP to inform state plan amendments for health homes under the Affordable Care Act. It provides details on how states define eligible populations, standards for provider infrastructure and payment methodologies. Key challenges for states include integrating care for dual eligibles, behavioral health, and long-term care. The document aims to share promising practices across states.
What is over the Horizin for the CPA Profession? Tom Hood covers the latest developments in the CPA Profession and looks to the future in this four hour (Free CPE) session for members of the Maryland Association of CPAs. It covers the latest in the four major trend areas of Economic, Politica;/Legislative/Regulatory, Social/Demographic, and Technology. He finishes with tools and resources to help CPAs thrive in the "Extreme Future".
The document discusses the Center for Integrated Health Solutions, which provides training and technical assistance to promote integrated primary and behavioral health care. It aims to increase the number of individuals and organizations using integrated care approaches. The center works with SAMHSA and HRSA grantees and provides services like individual technical assistance, webinars, and toolkits to support the integration of physical and mental health care.
Mary Takach, MPH, RN, Program Manager, NASHP moderates and discusses Medical Home Project at webinar New Tactics for Building Medical Homes in State Medicaid and CHIP Programs on December 16, 2010
bStable - Depression and Bipolar Disorder Disease State Management System - P...McGraw Systems LLC
bStable is the only comprehensive personal health record system for patients diagnosed with affective disorders such as Depression and/or Bipolar Disorder, their loved ones, psychiatrists, and psychologists to manage the patient's disease state. Using this patent pending technology, patients and the individuals in the patient's support team use bStable together to collect and analyze data from various angles of the patient's life for optimal patient - clinican communication and as a crisis prevention solution.
In addition to powerful patient monitoring features, bStable includes support for psychotherapeutic approaches such as cognitive behavioral therapy (CBT) and other affective disorders such as: attention deficit hyperactivity disorder (ADHD), social phobia disorder, anxiety disorder, and premenstrual dysphoric disorder. bStable also has support for Chronic Fatigue Syndrome (CFS) monitoring.
View the presentation from the webinar with Woody Dilaha, CEO of Performance Matters, and School Improvement Network. Woody discussed the importance of having an effective multi-measure evaluation tool for meaningful and accurate teacher assessments.
Learn more about this webinar at:
http://www.schoolimprovement.com/resources/webinars/configuring-your-multi-measure-evaluation-system-recform/
Donations Processing: Embracing Efficiency, Security, and Data to Build Your ...NTEN
The document discusses the American Heart Association's efforts to standardize and improve its donations processing systems. It describes how the AHA worked with CDS Global to implement centralized caging, capture, and acknowledgement processes to provide consistency, improve security and data quality, and increase donations. The new system helped process over $425 million in donations and saved over $52,000 in bank fees while improving the donor experience. The AHA then expanded the program to additional revenue streams and piloted remote deposit capture.
How do CPAs stay ahead of the rapidly changing environment? Maryland Association of CPAs offer free four (4) hour professional issues updates for our members every six months.
These engaging and interactive "town hall" format meetings cover the latest developments facing CPAs. The Fall series features updates on the four mega-trends - Economy, Gobalization, technology and the Workforce. In aaddition the latest developments in Regulations and Standards are covered. This edition features many tax and IRS developments (PTIN, 1099) and the latest on financial accounting standards (IFRS, private companies).
We clsoe with a session on leadership in rapidly changing times.
This panel will discuss the latest developments with the IRS including Large Business & International (LB&I) organizational changes and how they affect you.
The document discusses Massachusetts' state fiscal conditions and budgets. It shows that the state faced a large budget gap in FY2009 that was addressed through spending cuts. The state also had preliminary budget gaps in FY2010 that were filled through additional cuts, withdrawals from savings funds, and new revenues. The document includes charts and graphs showing trends in state spending, revenues, taxes, and aid to education, higher education, municipalities, and other areas over time.
NASHP is seeking applications for Consortium membership from states with emerging Medical Home Initiatives. This year-long program will offer assistance to states seeking to strengthen, expand, and sustain their Medicaid and CHIP-focused medical home initiatives. Interested states can submit an application by February 2.
This document is from CBRE's Economic Incentives Group and ranks states based on their overall incentives competitiveness in 2013. It shows a map of the United States color-coded to indicate states that are aggressive, competitive, or not competitive in offering economic incentives like tax credits, payroll rebates, and grants. Other cost factors should also be considered when evaluating the total cost of doing business in a state. Contact information is provided for additional details.
Urbanization has significantly increased the amount of impervious surfaces like roads and buildings, altering the natural water cycle. Over 100 million acres in the US are now developed. This causes more stormwater runoff, carrying pollutants directly into waterways. Current stormwater infrastructure is inadequate, as it was designed only to convey runoff efficiently rather than treat pollution. As a result, stormwater is the top pollution source for over half of ocean shorelines and a third of estuaries. Combined sewer overflows also introduce untreated sewage during heavy rains. New approaches are needed to manage stormwater sustainably.
Dokumen tersebut membahas tentang rencana Gubernur DKI Jakarta, Jokowi, untuk membangun taman gantung di gedung-gedung perkantoran di Jakarta setelah terinspirasi oleh taman gantung di Kemendag. Jokowi tertarik dengan konsep taman gantung yang sudah ada di Kemendag dan berencana menerapkannya untuk tata kota Jakarta.
Arizona Manual on Rainwater Harvesting for LandscapeD6Z
This document provides guidance on harvesting rainwater for landscape use. It discusses the components of a rainwater harvesting system, including the water supply (rainfall), plant water demands, and the system to move water. Simple systems can direct roof runoff to landscaped areas using gutters, downspouts and berms. Proper plant selection and constructing basins, swales and spillways can slow and spread rainwater across a site. Regular maintenance keeps the system functioning properly.
Rooftop gardens and the greening of cities - a case study of UKZNFlanna489y
This document provides a summary of a dissertation on rooftop gardens and greening of cities, with a case study of the University of KwaZulu-Natal (UKZN). The dissertation investigates concepts of rooftop gardens and their relationship to urban ecology. It examines the benefits and constraints of implementing rooftop gardens and their future prospects in South Africa. A pilot rooftop garden was constructed on the Memorial Tower Building at UKZN to test claims about rooftop gardens and address questions regarding their ability to reduce temperatures, runoff, and support biodiversity. The dissertation aims to provide insights into the viability of green roof systems in Durban and their significance for sustainable urban environments and mitigating climate change
Albuquerque, New Mexico Rainwater Harvesting ManualD6Z
This document provides a guide for rainwater harvesting systems in Albuquerque, New Mexico. It discusses simple rainwater harvesting systems that consist of a catchment area, distribution system, and landscape holding area. The guide describes how to design and construct simple systems, including using roofing as a catchment, gutters and downspouts as a distribution system, and depressed planting beds as holding areas. It emphasizes using native and drought-tolerant plants suited to intermittent water supplies.
NeoGenomics is a pure play cancer genetics laboratory that provides diagnostic testing services to oncologists, pathologists, and hospitals throughout the US. The company utilizes advanced technologies like cytogenetics, flow cytometry, FISH, and molecular testing to analyze cancer samples. Key growth drivers include the aging US population which is increasing cancer incidence, and frequent discoveries linking new genes to cancer. NeoGenomics aims to accelerate its revenue growth and increase operating leverage through expanding its sales team, test offerings, and geographic reach.
This document maps out each U.S. state's response and stance regarding key aspects of the Affordable Care Act, also known as Obamacare, including whether they have decided to expand Medicaid, who will run their health insurance exchange, and whether they are plaintiffs in any lawsuits against the law. The maps show that 25 states have decided to expand Medicaid, 20 have not, and 6 are uncertain. 18 states will run their own exchange, 7 as a state-federal partnership, and 26 will default to the federal exchange. 27 states in total are involved in lawsuits against Obamacare.
Dealing With Payers With Physician Driven Cost AndWilliam Cockrell
The document provides Medicare cost and discharge data for 17 physicians treating patients with a principal diagnosis of coronary atherosclerosis of the native coronary artery. It includes average length of stay, case mix index, volume of patients, average payment per patient, total actual payment, and discharge disposition breakdown for each physician. Payment amounts ranged from $4,312 to $165,517 across physicians, with most patients being discharged home or to home health.
Medicaid Medical Homes Initiatives: Promising Practices to Inform 2703 SPAsNASHP HealthPolicy
This document summarizes Medicaid medical home initiatives across multiple states. It describes initiatives led by NASHP to inform state plan amendments for health homes under the Affordable Care Act. It provides details on how states define eligible populations, standards for provider infrastructure and payment methodologies. Key challenges for states include integrating care for dual eligibles, behavioral health, and long-term care. The document aims to share promising practices across states.
What is over the Horizin for the CPA Profession? Tom Hood covers the latest developments in the CPA Profession and looks to the future in this four hour (Free CPE) session for members of the Maryland Association of CPAs. It covers the latest in the four major trend areas of Economic, Politica;/Legislative/Regulatory, Social/Demographic, and Technology. He finishes with tools and resources to help CPAs thrive in the "Extreme Future".
The document discusses the Center for Integrated Health Solutions, which provides training and technical assistance to promote integrated primary and behavioral health care. It aims to increase the number of individuals and organizations using integrated care approaches. The center works with SAMHSA and HRSA grantees and provides services like individual technical assistance, webinars, and toolkits to support the integration of physical and mental health care.
Mary Takach, MPH, RN, Program Manager, NASHP moderates and discusses Medical Home Project at webinar New Tactics for Building Medical Homes in State Medicaid and CHIP Programs on December 16, 2010
bStable - Depression and Bipolar Disorder Disease State Management System - P...McGraw Systems LLC
bStable is the only comprehensive personal health record system for patients diagnosed with affective disorders such as Depression and/or Bipolar Disorder, their loved ones, psychiatrists, and psychologists to manage the patient's disease state. Using this patent pending technology, patients and the individuals in the patient's support team use bStable together to collect and analyze data from various angles of the patient's life for optimal patient - clinican communication and as a crisis prevention solution.
In addition to powerful patient monitoring features, bStable includes support for psychotherapeutic approaches such as cognitive behavioral therapy (CBT) and other affective disorders such as: attention deficit hyperactivity disorder (ADHD), social phobia disorder, anxiety disorder, and premenstrual dysphoric disorder. bStable also has support for Chronic Fatigue Syndrome (CFS) monitoring.
View the presentation from the webinar with Woody Dilaha, CEO of Performance Matters, and School Improvement Network. Woody discussed the importance of having an effective multi-measure evaluation tool for meaningful and accurate teacher assessments.
Learn more about this webinar at:
http://www.schoolimprovement.com/resources/webinars/configuring-your-multi-measure-evaluation-system-recform/
Donations Processing: Embracing Efficiency, Security, and Data to Build Your ...NTEN
The document discusses the American Heart Association's efforts to standardize and improve its donations processing systems. It describes how the AHA worked with CDS Global to implement centralized caging, capture, and acknowledgement processes to provide consistency, improve security and data quality, and increase donations. The new system helped process over $425 million in donations and saved over $52,000 in bank fees while improving the donor experience. The AHA then expanded the program to additional revenue streams and piloted remote deposit capture.
How do CPAs stay ahead of the rapidly changing environment? Maryland Association of CPAs offer free four (4) hour professional issues updates for our members every six months.
These engaging and interactive "town hall" format meetings cover the latest developments facing CPAs. The Fall series features updates on the four mega-trends - Economy, Gobalization, technology and the Workforce. In aaddition the latest developments in Regulations and Standards are covered. This edition features many tax and IRS developments (PTIN, 1099) and the latest on financial accounting standards (IFRS, private companies).
We clsoe with a session on leadership in rapidly changing times.
This panel will discuss the latest developments with the IRS including Large Business & International (LB&I) organizational changes and how they affect you.
The document discusses Massachusetts' state fiscal conditions and budgets. It shows that the state faced a large budget gap in FY2009 that was addressed through spending cuts. The state also had preliminary budget gaps in FY2010 that were filled through additional cuts, withdrawals from savings funds, and new revenues. The document includes charts and graphs showing trends in state spending, revenues, taxes, and aid to education, higher education, municipalities, and other areas over time.
NASHP is seeking applications for Consortium membership from states with emerging Medical Home Initiatives. This year-long program will offer assistance to states seeking to strengthen, expand, and sustain their Medicaid and CHIP-focused medical home initiatives. Interested states can submit an application by February 2.
This document is from CBRE's Economic Incentives Group and ranks states based on their overall incentives competitiveness in 2013. It shows a map of the United States color-coded to indicate states that are aggressive, competitive, or not competitive in offering economic incentives like tax credits, payroll rebates, and grants. Other cost factors should also be considered when evaluating the total cost of doing business in a state. Contact information is provided for additional details.
Connie White Delaney is Professor & Dean, School of Nursing, University of Minnesota. She also serves as Director, Biomedical Health Informatics (BMHI), Associate Director of the CTSI-BMI, and Acting Director of the Institute for Health Informatics (IHI) in the Academic Health Center. Delaney is the first Fellow in the College of Medical Informatics to serve as a Dean of Nursing. Delaney is an appointee to the Health Information Technology Policy Committee, an advisory body established by the American Recovery and Reinvestment Act within the U.S. Government Accountability Office (GAO). Delaney serves on numerous boards, including the Board of the American Association of Colleges of Nursing, Board of LifeScience Alley, the American Medical Informatics Association (AMIA), Premiere Quest National Advisory Panel. ! She is an active researcher and writer in the areas of national standards development for essential nursing care and outcomes/safety data. She holds a BSN with majors in nursing and mathematics, MA in Nursing – Adult Health, Ph.D. Educational Administration and Computer Applications, and completed postdoctoral study in nursing & medical informatics at the University of Utah.
The International Snowmobile Congress will be held June 5-9 in Sturbridge, Mass. The event brings together snowmobile organizations from around the world and offers educational workshops, meetings, and social activities focused on snowmobiling. A typical day includes breakfast, workshops on topics like safety, grooming, land access and politics, and evening social events. The $250 registration provides access to all events and meals over the five-day congress.
The document summarizes how the Affordable Care Act (ACA) affects Medicaid expansion and issues for reporters covering it. Key points include: the ACA expands Medicaid eligibility to 133% of the federal poverty level starting in 2014; full federal funding is provided for newly eligible individuals from 2014-2016; and the Supreme Court ruled that states cannot be penalized for declining the Medicaid expansion. The expansion is estimated to reduce the number of uninsured by nearly half if all states participate. Issues discussed include the costs and health impacts of expansion, eligibility systems, programs for dual eligibles, and reductions in safety net hospital funding.
Similar to Federal Hwy Admin Roundabout Presentation (20)
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive function. Exercise causes chemical changes in the brain that may help protect against developing mental illness and improve symptoms for those who already suffer from conditions like anxiety and depression.
Final sarasota mobility now presentation to cityTHECITYALLIANCE
This document discusses connectivity and mobility projects in Sarasota, Florida. It promotes creating a "context sensitive system of complete streets" to improve safety and connectivity for driving, biking, and walking. It references Sarasota's official 2015 "Complete Streets" policy and advocates for high reward, low cost improvements to better connect areas within a half mile of roundabouts on 10th and 14th streets. The goal is to establish a "roundabout influence zone" with traffic calming measures to improve safety and mobility for all street users.
Urging the earliest application of proven low cost/high reward “best practice” for safer, comfortable, and efficient mobility for all users of Sarasota’s citywide street network.
Roundabout centers as context sensitive iconsTHECITYALLIANCE
This document lists various roundabouts located across the United States and internationally. It includes the names and locations of roundabouts in Midlothian, VA, Fairfield, CA, Irondequoit NY, at the University of Texas at El Paso, Alaska Roundabout Center, Riverbend Park Roundabout in Bend, OR, and Scottsdale, AZ. It also mentions a roundabout in Portugal and notes that a roundabout in the UK won the 2014 Roundabout of the Year award from the UK Roundabout Appreciation Society.
This document contains a list of locations in the United States that have implemented roundabouts in series with short or one block or less separation between the roundabouts. The locations include Windermere, FL, Honore Ave in Sarasota, FL, Avon, CO, University of Nebraska in Lincoln, NE, Sedona, AZ, CHEEKTOWAGA, NEW YORK, Brighton, MI, MALTA, NEW YORK, State Highway 145/USH 41/USH 45 Corridor in Richfield, WI, and I-94 and Pabst Farms Corridor in Oconomowoc, WI.
Roundabout centers as context sensitive iconsTHECITYALLIANCE
Safer Mobility with Public Art in Roundabout Centers as context sensitive Icons for sense-of-self.placemaking.. Each roundabout center becoming a landmark for its location. www.US41Momenttum.com Sarasota FL
This document discusses contributions from various individuals to a roundabout listserv. It mentions John Deskin's and Ken Sides' contributions to the KSU Roundabout Listserv and notes a contribution from Phil Demosthenes. It also references James Brainard, the mayor of Carmel, IN, and encourages readers to feel better and smile more by going to the website www.US41Momentum.com about roundabouts.
Roundabout center as context sensitive iconic signature landmarkTHECITYALLIANCE
USA examples of modern roundabout centers becoming more that just a traffic management device: place making, sense of self, an intersection signature icon with such as sculpture for the vertical element ...posted in a safer mobility context at www.US41Momentum.com Sarasota Florida.
Roundabout centers as context sensitive icons 6 2014THECITYALLIANCE
USA examples of modern roundabout centers becoming more that just a traffic management device: place making, sense of self, an intersection signature icon with such as sculpture for the vertical element ...posted in a safer mobility context at www.US41Momentum.com Sarasota Florida.
Sarasota's US41 Grand Boulevard from University Parkway down the North Trail and along the Bayfront. As planned for safer livability and economic stimulation, and inviting welcome to the Sarasota's amenities as the cultural heart of the state of Florida.
Sarasota's US41 Grand Boulevard from University Parkway down the North Trail and along the Bayfront. As planned for safer livability and economic stimulation, and inviting welcome to the Sarasota's amenities as the cultural heart of the state of Florida.
The document discusses the benefits of exercise for mental health. Regular physical activity can help reduce anxiety and depression and improve mood and cognitive functioning. Exercise causes chemical changes in the brain that may help boost feelings of calmness and well-being.
Roundabout centers as icon update 7 6 2013 jpegTHECITYALLIANCE
Updated with location corrections, now 39 sites, Roundabout Centers as Context Sensitive Iconic Symbolic Sense of a Community;s Self & Place - Each node a marketable signature expressing a City’s unique personality
Roundabout centers as icon update 7 2013 jpegTHECITYALLIANCE
Roundabout Centers as Context Sensitive Iconic Symbolic Sense of a Community;s Self & Place - Each node a marketable signature expressing a City’s unique personality
This document discusses a planned reconfiguration of the University Parkway I-75 interchange in Manatee and Sarasota counties by the Florida Department of Transportation. Specifically, it notes that FDOT is considering a Diverging Diamond Interchange (DDI) design, which was presented to local committees. However, alternatives like roundabouts were not studied as required. The document raises questions about the DDI design related to costs, safety, evacuation capability, and the lack of experience with this design compared to roundabouts. It encourages considering these questions if the interchange comes up at an upcoming MPO meeting.
This document summarizes plans to widen approximately 3.5 miles of I-75 and 1 mile of University Parkway in Sarasota and Manatee counties. The project will add lanes and reconstruct the I-75/University Parkway interchange using a diverging diamond interchange configuration to relieve congestion through 2035. Interim improvements will add one lane to I-75 by 2025 while final construction is planned for 2016. Public involvement includes meetings and a project website.
state after state DOTS are applying the mulitmodal capacity of modern roundabouts, safer than signalized intersections and not subject power outages hindering area evacuation for hurricanes.
USA cities are recognizing the value of marketing the City’s identity expressed in roundabout center treatments....A sense of place, who we are, context sensitive. a signature icon.
Roundabout centers as context sensitive icons THECITYALLIANCE
USA cities are recognizing the value of marketing the City’s identity expressed in roundabout center treatments....A sense of place, who we are, context sensitive. a signature icon.
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3. Progress in building roundabouts
WA MT ND NH
VT
MN
ME
SD WI
OR
ID WY NY
MI
IA MA
NE
PA
IL IN OH
NJ RI
NV
UT CO CT
KS MO WV DE
KY VA
CA MD
OK TN NC DC
AZ NM AR
SC
MS AL
LA GA
TX
AK FL
Substantial
Moderate
Infancy
HI
Disclaimer: This is a highly subjective assessment solely representing the opinion of the presentation author based on
information related to multiple factors. If you have data to suggest revising this assessment, please contact Mark Doctor at
FHWA (mark.doctor@dot.gov)
4. How can we assess the progress?
Number of modern roundabouts built
Number of roundabout projects in design
or planned
State design guidelines
Agency policy on roundabouts
Roundabout web page, video, brochure
Roundabouts in States Driver’s Manual
Statewide Roundabout Steering Group
5. Number of modern roundabouts built
Constantly changing
Differences among State DOT, local
agencies and developers
“Prorate” considerations?
– Per capita
– Per system miles
– % of intersections on network
6. Number of modern roundabouts built
The Centenarians Definitely AARP
(over 100) Club Eligible
7. In Several States the Locals are
“Leading the Way”
Carmel, Indiana (pop 85,000)
– Installed first 2 roundabouts in 1998
– Now has over 40 roundabouts in place
– 99 roundabouts in suburban Indianapolis
– Indiana DOT: 1 roundabout on State system
(6 more planned over next 3 years)
9. Roundabout Policies
Wisconsin DOT Intersection Control Evaluation Policy:
“If an intersection warrants a signal or a four-way stop within the
design life of the proposed project, the modern roundabout shall
be evaluated as an equal alternative.”
“… the roundabout may be a viable alternative for a two-way stop
control in certain circumstances.”
“… roundabouts are a potential intersection control strategy until
such time that the evaluation indicates that the roundabout
alternative is not appropriate.”
Source: Wisconsin DOT Facilities Development Manual
10. Roundabout Policies
Virginia DOT Policy:
“VDOT recognizes that Roundabouts are frequently able to
address safety and operational objectives better than other types
of intersections. Therefore, it is VDOT policy that Roundabouts
be considered when a project includes reconstructing or
constructing new intersections, signalized or unsignalized.”
“When the analysis shows that a Roundabout is a feasible
alternative, it should be considered the Department’s preferred
alternative due to the proven substantial safety and operational
benefits.”
11. Roundabout Policies
Georgia DOT Policy:
“The Georgia Department of Transportation (GDOT) recognizes that the
roundabout is a viable intersection alternative when placed in the
appropriate location, and designed properly for the local conditions.
Guidance Statement/Application
Roundabouts are the preferred safety and operational alternative
for a wide range of intersections of public roads. A roundabout
shall be considered as an alternative in the following instances:
– Any intersection in a project that is being designed as new or is
being reconstructed.
– All existing intersections that have been identified as needing major
safety or operational improvements.
– All signal requests at intersections (provide justification in the Traffic
Engineering Study if a roundabout is not selected).”
12. FHWA Memo
Consideration and Implementation of Proven Safety
Countermeasures; July 10, 2008
GUIDANCE STATEMENT:
Roundabouts are the preferred safety alternative
for a wide range of intersections. Although they
may not be appropriate in all circumstances, they
should be considered as an alternative for all
proposed new intersections on Federally-funded
highway projects, particularly those with major
road volumes less than 90 percent of the total
entering volume.
Roundabouts should also be considered for all
existing intersections that have been identified as
needing major safety or operational improvements.
This would include freeway interchange ramp
terminals and rural intersections.
14. Pick Your Favorite Excuse
“The public will lynch us if
we propose a roundabout.”
“I know how people drive in
my town – they’ll never get
used to a roundabout.”
“We’ll get sued because of all the crashes it
will cause.”
It will cost more than a signal.
16. Myth: The public will never accept roundabouts
Sometimes it takes perseverance!!!
Photo source: NYSDOT
17. Getting Used to
Roundabouts
Washington State DOT engineer Brian Walsh:
“we have had a lot of people not very happy
about the idea of roundabouts, but after
they are constructed, those fears mostly go
away.”
18. FACT: Public Attitude Toward Roundabouts Quickly
Changes After Their Construction
Attitude Before After
Construction Construction
Very Negative 23% 00%
Negative 45% 00%
Neutral 18% 27%
Positive 14% 41%
Very Positive 0% 32%
NCHRP Synthesis 264
19. Drivers Who Favor or Oppose
Roundabouts
70
60 63
50
PERCENT
40
41
30
31
20
10 15
0
Before After Before After
FAVOR STRONGLY
Insurance Institute for
Highway Safety
OPPOSE
20. From Opposition To Support
ITE Journal Sept 2002: Surveys in Kansas, Maryland and Nevada
21. Opponents Can Become
Proponents
Letter to the Editor:
“I must admit it! I was wrong. The roundabout at
Marsh and Hamilton roads appears to be
working. Congrats to the Ingham County Road
Commission and to Meridian Township”
Okemos, MI
22. Cost Considerations
Actual cost will depend on project specific conditions
– Most agencies find the initial construction cost of a roundabout is
comparable to the initial construction cost of a signal
A “life-cycle” cost comparison should be used since
roundabouts do not require signal equipment maintenance
($15,000 + per year)
– Considering operational and maintenance costs, roundabouts are
often less expensive than signals due to reduced costs for signal
power, bulb replacement, loop detection and controller equipment
maintenance (including need to retime signals)
Typically, a roundabout requires fewer turn lanes and
possibly fewer through lanes than needed at a signalized
intersection, so in some instances a roundabout may
actually cost less than a signalized intersection.
23. Benefit Considerations
Safety Benefits
– savings due to substantial reduction in fatal and injury crashes
Operational Benefits
– consider reduction in person-hours of delay and reduced
commercial vehicle delay throughout the day (not just peak hours)
Environmental Benefits
– reduced fuel consumption & improved air quality
– enhanced aesthetic opportunities
24. Myth: Roundabouts are bad for
the nearby businesses
Fact: Most business owners agree that
slower speeds and safer travel enhance
business along the corridor
Fact: Some “blighted” communities have
actually experienced economic
revitalization following roundabout projects
27. Case Study: Golden, CO
South Golden Road – 15,000 ADT
$1.3M project in 1999 to construct four
roundabouts, landscaping, medians & sidewalks
Significant drop in number and severity of crashes
– 1997 crash rate = 5.9 crashes/MVM
– 2004 crash rate = 0.2 crashes/MVM
Slower speeds but faster travel time thru corridor
60% sales tax revenue increase along corridor
– Roundabouts are good for business !!!
28. Where are roundabouts
appropriate?
Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Intersections with a high-crash rate or a
higher severity of crashes
Roundabouts can greatly improve
safety by simplifying traffic
movements, reducing vehicle speeds,
and providing a clearer indication of
the driver’s right of way compared to
other forms of intersection control.
29. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Replacement of all-way stops
Replacement of signalized intersections, especially where
unbalanced movements cause inefficiency
Replacement of two-way stops when side street delay
becomes excessive
Before & After in Asheville, NC College & Oak St.
30. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Intersections with complex geometry, skew
angles, or more than four approaches
Before After
Albuquerque, NM – Central Ave. and 8th
31. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Rural intersections with high-speed
approaches
Elongated splitter
islands with
successive reverse
curvature can greatly
improve safety at high
speed approaches by
alerting drivers to a
changed traffic
condition ahead.
32. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Freeway interchange ramp terminals
Roundabouts
can facilitate
truck turning
movements
and reduce
their need for
stopping.
33. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Intersections with high U-turn movements
Roundabouts
facilitate the use of
raised medians for
access
management along
the roadway by
making U-turn
movements easier
at the intersections.
Malta, NY – State Route 67
34. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
3-leg intersections with heavy left-turn
volumes
Example of a
design using
a through
movement
bypass-lane
35. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Closely spaced intersections with widening constraints
Railroad Underpass
New London, CT
36. Roundabouts should be considered under a wide range
of conditions, but may be particularly advantageous at:
Transitions or “Gateways” from higher
speed to lower speed areas
Where aesthetics are important
Roundabouts make for
good transitions in
speed change
(including rural to
urban transitions).
39. Principles for Good Roundabout
Landscaping
Make the center island more
conspicuous
Minimize roadside hazards
Maintain adequate sight distance
Discourage pedestrian traffic through
the center island
Improve area aesthetics
40. New FHWA sponsored roundabout
tools and resources
• Color brochure: Roundabouts: A Safer Choice – currently available
• National Highway Institute one-day workshop on roundabouts –
currently available
• FHWA Technical summary on roundabout design details, costs, safety
benefits, etc. – late 2009
• FHWA Technical summary on mini-roundabout design details, costs,
safety benefits, etc. – late 2009
• Updated Roundabout Informational Guide including mitigation
measures for vision-impaired pedestrians (NCHRP Project 03-65A) –
late 2009/early 2010
• DVD on the benefits of roundabouts aimed at decision makers – early
2010
UPDATED
• Research studies (NCHRP and others) on roundabout pedestrian
safety and treatments for sight-impaired pedestrians – ongoing
41. For more information ….
Contact:
Mark Doctor
FHWA Resource Center
(404) 562-3732
mark.doctor@dot.gov