PubMed · 10132079
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I K Crombie, H T Davies. 1993. Missing link in the audit cycle.. https://doi.org/10.1136/qshc.2.1.47
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Scaffold proteins organize many MAP kinase pathways by interacting with several components of these cascades. Recent studies suggest that scaffold proteins provide local activation platforms that contribute to signal specificity by insulating different MAP kinase pathways.
Under conditions in which the temporal structure of events (e.g., a sequence of tones) is predictable, performing movements in synchrony with this sequence of events (e.g., dancing) is an easy task. A rather simplified version of this task is studied in the sensorimotor synchronization paradigm. Participants are instructed to synchronize their finger taps with an isochronous sequence of signals (e.g., clicks). Although this is an easy task, a systematic error is observed: Taps usually precede clicks by several tens of milliseconds. Different models have been proposed to account for this effect ("negative asynchrony" or "synchronization error"). One group of explanations is based on the idea that synchrony is established at the level of central representations (and not at the level of external events), and that the timing of an action is determined by the (anticipated) action effect. These assumptions are tested by manipulating the amount of sensory feedback available from the tap as well as its temporal characteristics. This article presents an overview of these representational models and the empirical evidence supporting them. It also discusses other accounts briefly in the light of further evidence.
BACKGROUND: Concern has been expressed about whether managed care health plans can successfully meet the special needs of Medicaid beneficiaries. A 1996 survey indicated that state Medicaid agencies had just begun conducting quality oversight and management. Since then the federal government has released guidelines under the Quality improvement System for Managed Care (QISMC) program to assist states with quality management of managed care programs. In 1999 a follow-up telephone survey was conducted with representatives from 45 states to describe the current state of and changes in quality management activities by state Medicaid agencies for Medicaid beneficiaries enrolled in managed care. RESULTS: The 45 states represented a 50% increase between 1995 and 1999. The number of states enrolling the disabled had doubled (from 15 to 30). Most states collecting data on satisfaction and childhood immunizations fed it back to health plans, although feedback of other measures of access and quality occurred less frequently and fewer states provided information to beneficiaries choosing health plans. Fewer than 25% of states reported having even one health plan demonstrate improvement in individual measures of access and quality except for prenatal care (28%) and childhood immunizations (33%). Fewer than half of the states included contractual penalties in their contracts with health plans, and very few (three or fewer per penalty) had over invoked such penalties. CONCLUSIONS: State Medicaid agencies continue to adapt to their new roles as value-based purchasers of health care. Although increasing numbers of states collect data on satisfaction, access, and quality of care, few states have been able to document improved performance in the health plans they oversee.