State-based Approaches Research Articles

Medicaid Payment Innovations to Financially Sustain Comprehensive Childhood Asthma Management Programs at Federally Qualified Health Centers

Background. One in 7 children in the United States is diagnosed with asthma, the leading cause of chronic childhood disease. Although a manageable condition when recommended medication regimens are followed and environmental control measures implemented, asthma remains the third most common reason for hospitalization among non-newborn hospital stays. As the primary health care home to a fifth of all low-income children who are especially vulnerable to asthma, federally qualified health centers play a critical role in providing comprehensive and preventive asthma care to their pediatric patients. Many health centers rely on the asthma education and counseling services of traditional and nontraditional providers, such as clinicians and community health workers, who may or may not be certified as asthma educators, as essential elements of asthma management and control. Asthma counselors are particularly valuable for patient home assessments and tailored education and counseling that are recommended components of evidence-based asthma care. Yet sustainable reimbursement for their services is a frequent challenge. Methods. We conducted an environmental scan of innovative approaches to securing adequate Medicaid reimbursement for asthma educator services provided as part of asthma management and control. Results. We identified a number of models at the individual health center, Medicaid health plan, and Medicaid state program level for securing sustainable reimbursement for asthma educators. Whereas state-based approaches are preferable to more incremental options at the health center and health plan level, local approaches may be more feasible for some health centers. Conclusion. Asthma educators provide essential, cost-effective services as part of childhood asthma care management. This analysis identifies creative solutions for health centers and other health care organizations to consider as mechanisms for sustaining the important services of these providers.

A Benchmark for Conflict Detection Components of Model Versioning Systems

In the past years, the model-based development paradigm enjoyed an ever increasing adoption in academia and industry projects. This increasing adoption lead to several diverse approaches of socalled model versioning systems that support collaborative model-based development: multiple developers apply concurrent changes to potentially overlapping parts of the same model and model versioning systems merge their changes to obtain a new consolidated version of the model. One of the most crucial components in such model versioning systems is responsible for detecting conflicts among concurrent changes to avoid the loss of changes and corrupted models. However, due to the diversity of existing conflict detection components, their relative quality in terms of functional and nonfunctional properties is hard to determine. To address this issue, we propose a benchmark enabling the automatic evaluation of their accuracy, as well as their execution time, whereas both state-based approaches and operation-based approaches are supported alike.

Globalizing Savigny? The State in Savigny's Private International Law and the Challenge of Europeanization and Globalization

How can conflict of laws respond to the challenges from globalization? Some argue that state-based approaches like governmental interest analysis are inadequate, and advocate a return to the approach taken by the German scholar Savigny in the 19th century. The article shows that the assumption is correct: state-based approaches have indeed become problematic. However, a return to Savigny's approach will not help: While Savigny's approach is multilateral and pays little regard to governmental interest, closer analysis reveals how central the state is to his theory. The consequences are shown in an analysis of a recent European case. It follows that we will have to think more radically about proper conflict of laws responses to globalization if we want to overcome the centrality of the state.

Analytical framework for measuring network security using exploit dependency graph

Attack graph is a popular tool for modelling multi-staged, correlated attacks on computer networks. Attack graphs have been widely used for measuring network security risks. Majority of the works on attack graph use host-based or state-based approaches. These attack graph models are either too restrictive or too resource consuming. Also, a significant portion of these works have used ‘probability of successfully exploiting a network’ as the metric. This approach requires that the ‘probability of successfully exploiting individual vulnerabilities’ be known a priori. Finding such probabilities is inherently difficult. This present study uses exploit dependency graph, which is a space efficient and expressive attack graph model. It also associates an additive cost with executing individual exploits, and defines a security metric in terms of the ‘minimum cost required to successfully exploit the network’. The problem of calculating the said metric is proved to be NP-complete. A modified depth first branch and bound algorithm has been described for calculating it. This study also formulates, a linear-time computable, security metric in terms of the ‘expected cost required to successfully exploit the network’ assuming a random attacker model and an uncorrelated attack graph.

Integrating Biodiversity Management and Indigenous Biopiracy Protection to Promote Environmental Justice and Global Health

Many potentially useful medicines arise from developing countries' biodiverse environments and indigenous knowledge. However, global intellectual property rules have resulted in biopiracy, raising serious ethical concerns of environmental justice, exploitation, and health disparities in these populations. Furthermore, state-based approaches have not led to adequate biodiversity protection, management, or resource sharing, which affect access to lifesaving drugs. In response, country delegates adopted the Nagoya Protocol, which aims at promoting biodiversity management, combating biopiracy, and encouraging equitable benefits sharing with indigenous communities. However, the effectiveness of this framework in meeting these objectives remains in question. To address these challenges, we propose a policy building on the Nagoya Protocol that employs a World Health Organization-World Trade Organization Joint Committee on Bioprospecting and Biopiracy.

Governing nanotechnologies with civility

Nanotechnologies have clearly begun to make their way out of the laboratories and into today's commercial life. While they promise significant benefits to society, their very development and commercialisation appear to be challenging state-based regulatory regimes. With many governments currently appearing to be taking a non-interventionist approach to expressly regulating this technology, it is unsurprising that there is increasing global discourse about how we might best govern certain 'nano-frontiers'. This article argues that in light of the current regulatory status quo, a unique opportunity exists for civil society actors to place themselves at the forefront of the unfolding nano-regulation debate through strategically partnering with other actors. By building on the conceptual model proposed by Brinkerhoff, the article illustrates how civil society actors will, in all likelihood, be central players in governing nanotechnologies. While these arrangements may lack the legitimacy of traditional state-based regulatory approaches, the paper argues that these 'soft' regulatory arrangements will nevertheless be crucial components of the evolving nano-regulatory frameworks.

Stochastic learning and optimization—A sensitivity-based approach

We introduce a sensitivity-based view to the area of learning and optimization of stochastic dynamic systems. We show that this sensitivity-based view provides a unified framework for many different disciplines in this area, including perturbation analysis, Markov decision processes, reinforcement learning, identification and adaptive control, and singular stochastic control; and that this unified framework applies to both the discrete event dynamic systems and continuous-time continuous-state systems. Many results in these disciplines can be simply derived and intuitively explained by using two performance sensitivity formulas. In addition, we show that this sensitivity-based view leads to new results and opens up new directions for future research. For example, the n th bias optimality of Markov processes has been established and the event-based optimization may be developed; this approach has computational and other advantages over the state-based approaches.

Stream- and State-Based Semantics of Hierarchy in Block Diagrams

Abstract Block diagrams are often used in embedded system design for modeling both plant and controller, typically with continuous and discrete modeling, respectively. Though easy to use, advanced users and implementers of these languages often run afoul of subtle semantic problems these seemingly simple languages can have. Based on the stream- and state-based approaches, this paper discusses how the specialized state-based semantics of continuous-time block diagrams can interoperate hierarchichally with discrete-time block diagrams. The languages presented may serve as a reference of sorts, helping to clarify some of the underlying choices in block diagram language design, and in the process shedding light on the differences between, and limitations of, existing block diagram languages.

Stochastic Learning and Optimization - A Sensitivity-Based Approach

We introduce a sensitivity-based view to the area of learning and optimization of stochastic dynamic systems. We show that this sensitivity-based view provides a unified framework for many different disciplines in this area, including perturbation analysis, Markov decision processes, reinforcement learning, and identification and adaptive control. Many results can be simply derived and intuitively explained by using two performance sensitivity formulas. In addition, we show that this sensitivity-based view opens up new directions for future research. For example, the event-based optimization, which has advantages over the state-based approaches, may be developed with this sensitivity-based view.

Uniformity and Efficiency in Insurance Regulation: Consolidation and Outsourcing of Regulatory Activities at the State Level

An intense debate over the choice of regulatory authority, e.g., state vs. federal regulation, continues in the U.S. The debate not only exhibits the diversity of political and economic interests of various groups such as the federal government, state governments and the NAIC, insurance companies and their associations, and policyholders and the general public. It also reflects the need of all parties of interest to align U.S. regulation with the changes in the financial services market and to preserve competitiveness of U.S. insurance companies in the domestic and foreign markets. This study summarizes the general directions of regulatory reforms internationally, reexamines the political history of insurance regulation in the U.S. to identify the motives behind each call for reform, and evaluates the current state-based approaches in comparison to proposed alternatives. The paper concludes that the current state-based system is preferred to any other forms of regulation in the U.S., provided that state regulators unify their activities and improve regulatory efficiency and that the NAIC positions itself as a true association of member regulators and is financially supported primarily by the members.

Concurrent software verification with states, events, and deadlocks

Abstract We present a framework for model checking concurrent software systems which incorporates both states and events. Contrary to other state/event approaches, our work also integrates two powerful verification techniques, counterexample-guided abstraction refinement and compositional reasoning. Our specification language is a state/event extension of linear temporal logic, and allows us to express many properties of software in a concise and intuitive manner. We show how standard automata-theoretic LTL model checking algorithms can be ported to our framework at no extra cost, enabling us to directly benefit from the large body of research on efficient LTL verification. We also present an algorithm to detect deadlocks in concurrent message-passing programs. Deadlock- freedom is not only an important and desirable property in its own right, but is also a prerequisite for the soundness of our model checking algorithm. Even though deadlock is inherently non-compositional and is not preserved by classical abstractions, our iterative algorithm employs both (non-standard) abstractions and compositional reasoning to alleviate the state-space explosion problem. The resulting framework differs in key respects from other instances of the counterexample-guided abstraction refinement paradigm found in the literature. We have implemented this work in the magic verification tool for concurrent C programs and performed tests on a broad set of benchmarks. Our experiments show that this new approach not only eases the writing of specifications, but also yields important gains both in space and in time during verification. In certain cases, we even encountered specifications that could not be verified using traditional pure event-based or state-based approaches, but became tractable within our state/event framework. We also recorded substantial reductions in time and memory consumption when performing deadlock-freedom checks with our new abstractions. Finally, we report two bugs (including a deadlock) in the source code of Micro-C/OS versions 2.0 and 2.7, which we discovered during our experiments.

Individual and Societal Dimensions of Security

Despite the prevalence of state-based approaches to security studies during the Cold War, alternative ways of thinking about security—focusing on the individual and society—also developed during this time period. However, in the post-Cold War era the primacy of the state in considerations of security has come under increasing challenge from a variety of perspectives. In this essay, the development of the study of individual and societal dimensions of security is traced and discussed against the background of the end of the Cold War. The first part of the essay examines the evolution of thinking about individual and societal dimensions of security during the Cold War. The second part focuses on the post-Cold War revival in thinking about these aspects of security. The essay concludes by considering the future of world politics conceived of as a “risk society” and the implications for individual and societal dimensions of security.

State-Based versus Federal-Based Approaches to Reducing the Medicare Pharmaceutical Coverage Gap

A state-based approach, such as the Immediate Helping Hand proposal put forward by the Bush administration, is likely to be less effective than a federal-based approach at reducing the Medicare pharmaceutical coverage gap. In addition, the voluntary nature of a state-based approach, coupled with variations across states in existing coverage benefits and the limited reach of state pharmacy assistance programs, would likely lead to a perpetuation of uneven coverage. This article argues in favor of adding a federal-based universal prescription drug benefit to Medicare on the grounds of both equity and empirical evidence. Adding a universal drug benefit to the currently existing Medicare program would extend application of the social insurance concept across hospital care, physician service, and prescription drug coverage components of Medicare. As a result, a more equitable distribution of prescription drug coverage would be promoted while mitigating the effects of selection risk.

NGOs and Reconstructing Civil Society in Bosnia and Herzegovina

By examining the work of several NGOs in the context of post-conflict reconstruction in Bosnia and Herzegovina (BiH), this essay scrutinizes both the potential and limits of NGO contributions to peace-settlements and long-term stability. While their ability to specialize and reach the grassroots level is of great practical significance, the contribution of NGOs to the reconstruction of war-torn societies is often idealized. NGOs remain severely limited by ad hoc and project-specific funding sources, as well as by the overall policy environment in which they operate. Unless these underlying issues are addressed, NGOs will ultimately become little more than extensions of prevalent multilateral and state-based approaches to post-conflict reconstruction.

Simple, state-based approaches to program-based anomaly detection

This article describes variants of two state-based intrusion detection algorithms from Michael and Ghosh [2000] and Ghosh et al. [2000], and gives experimental results on their performance. The algorithms detect anomalies in execution audit data. One is a simply constructed finite-state machine, and the other two monitor statistical deviations from normal program behavior. The performance of these algorithms is evaluated as a function of the amount of available training data, and they are compared to the well-known intrusion detection technique of looking for novel n -grams in computer audit data.

ANALYSIS OF HABITAT-SELECTION RULES USING ANINDIVIDUAL-BASED MODEL

Despite their promise for simulating natural complexity, individual-based models (IBMs) are rarely used for ecological research or resource management. Few IBMs have been shown to reproduce realistic patterns of behavior by individual organisms. To test our IBM of stream salmonids and draw conclusions about foraging theory, we analyzed the IBM's ability to reproduce six patterns of habitat selection by real trout in simulations contrasting three alternative habitat-selection objectives: maximizing current growth rate, current survival probability, or ''expected maturity'' (EM). EM is the product of (1) pre­ dicted survival of starvation and other mortality risks over a future time horizon, and (2) the fraction of reproductive size attained over the time horizon. Minimizing the ratio of mortality risk to growth rate was not tested as a habitat-selection rule because it produces nonsensical results when any habitat yields negative growth rates. The IBM simulates habitat selection in response to spatial and temporal variation in mortality risks and food availability as fish compete for food. The model fish move each daily time step to maximize their habitat-selection objective with no other restrictions (e.g., territoriality) imposed. Simulations with habitat selected to maximize growth reproduced three of the six habitat- selection patterns; maximizing survival reproduced two patterns; and maximizing EM re- produced all six patterns. Two patterns (shifts in habitat with changes in temperature and food availability) were not reproduced by the objectives that consider only current growth and risk but were explained by the EM objective that considers how future starvation risk depends on current energy reserves and energy intake. In 75-d simulations, population- level survival and biomass accumulation were highest for fish moving to maximize EM. These results support the basic assumptions of state-based dynamic-modeling approaches to habitat selection. Our IBM appears successful because it avoids restrictive assumptions, incorporates competition for food, assumes salmonids make good habitat-selection decisions at a daily time step, and uses a habitat objective (EM) that provides reasonable trade-offs between growth and mortality risks.

Joint message-passing decoding of LDPC codes and partial-response channels

Ideas of message passing are applied to the problem of removing the effects of intersymbol interference (ISI) from partial-response channels. Both bit-based and state-based parallel message-passing algorithms are proposed. For a fixed number of iterations less than the block length, the bit-error rate of the state-based algorithm approaches a nonzero constant as the signal-to-noise ratio (SNR) approaches infinity. This limitation can be removed by using a precoder. It is well known that low-density parity-check (LDPC) codes can be decoded using a message-passing algorithm. Here, a single message-passing detector/decoder matched to the combination of a partial-response channel and an LDPC code is investigated.

A Topological Approach to Distributed Computing

In several state-based approaches to distributed computing, e.g., action systems, or UNITY, the computing nodes are commonly left unspecified or implicit. For instance, an action system comes with an informal description on how the system is supposed to be mapped into the network. The purpose of this paper is to make this mapping explicit so that we are provided with means on the language level to reason about the location of a system in a network. We define the notion of a topological action system that carries with it information about its location within the network. The action system itself can model some active execution or merely a repository of data or any combination of these. We also show how our approach leads to action systems with data and/or code mobility.This work has been supported by the Academy of Finland. We would like to thank the anonymous referees for their useful comments on the first version of this paper.

Action systems for security specification

To be generally useful a theory must be both theoretically sound and practically applicable. We consider the noninterference approach to security specification, focusing in particular on Roscoe's work on nondeterminism. This provides a starting point

Parallel composition of assumption-commitment specifications

We unify the parallel composition rule of assumption-commitment specifications for respectively state-based and message-based concurrent processes. Without providing language-dependent definitions, we first assume that the model of a process can be given as a set of 'sequences' (e.g., traces, state sequences). Then we assume the existence of a merging operator that captures the compositionality of that model. On this basis, we formulate a semantic parallel composition rule for assumption-commitment specifications wherein the merging operator behaves as a parameter. Then, by providing suitable language-specific definitions for the model of a process and the merging operator, we transform the semantic rule into syntactic ones, both for the state-based and message-based approaches to concurrency.