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The percentage of participants that increase income from entry to follow up/exit is at least 20 percent symptoms in spanish buy cheap calcitriol online. The percentage of participants that obtained or maintained mainstream cash income sources at follow-up or project exit is at least 56 percent treatment brown recluse bite best 0.25 mcg calcitriol. Grantee shall provide a monthly report summarizing the contract activities symptoms 5 days post embryo transfer cheap calcitriol 0.25mcg with visa, referencing the tasks as described in the Service Objectives and Outcome Objectives sections treatment 5 of chemo was tuff but made it buy calcitriol 0.25mcg amex. Grantee shall provide a quarterly report of activities, referencing the tasks as described in the Service Objectives and Outcome Objectives sections. Number of households that received direct services and number of direct service contacts. Grantee shall provide an annual report summarizing the contract activities, referencing the tasks as described in the Service Objectives and Outcome Objectives sections. This report will also include accomplishments and challenges encountered by the Grantee. Number of households showing housing instabllity that remained stably housed; and 4. Grantee shall participate in quarterly Time Study reports and Eviction and Exit Survey reports. Examples of critical incidents include death, fire, acts of violence, significant damage to the building, or incidents involving emergency. Grantee or Contractor agrees to meet the requirements of and participate in the evaluation program and management information systems of the City. The City agrees that any final reports generated through the evaluation program shall he made available to Contractor within thirty working days of receipt of any evaluation report and such response will become part of the official report. Program Monitoring: Program monitoring will include review of client eligibility, client files, and back-up documentation for reporting progress towards meeting service and outcome objectives. Purpose of Grant the purpose ofthe grant is to provide supportive services to adults residing in the 84 single occupancy units at the Essex Hotel. The goals of these services are to empower tenants to become self-sufficient and retain their housing or move to other appropriate housing; promote community building and tenant participation; and maintain a safe, supportive and stable environment that fosters Independence. Target Population Grantee shall serve formerly homeless adults and adult couples residing at the Essex Hotel. Case Management: Grantee shall provide on-going meetings and counseling services with a tenant to establish goals, support individualized action and service plans, and track progress toward meeting the goals. This can also include assistance in identifying, applying for and establishing appointments with available services such as food programs, medical clinics and in~home support. Referrals: Grantee shall assist clients to identify and access services available within the community that meet specific needs or support progress toward identified goals. This can include helping a client understand the meaning of messages/letters/warnings from property managem~nt, assisting a tenagt to write requests, respons~s or complain~s, and partidpating in meetings between the tenant and property management to assist the tenant in communicating with property management. Conflict Resolution: Grantee shall offer to meet with two or inore tenants to assist in problem solving and resolution of conflicts. Support Groups, Social Events and Organized Tenant Activities: Grantee shall provide clients with opportunities to participate in organized gatherings for peer support, to gain information from presenters and each other, to form social connections with other tenants/staff, or to celebrate/commemorate significant individual, holiday and community events. Wellness Checks: Grantee shall use passive observation of the tenant population and coordinating with property management to identify clients who have not been seen or have shown signs of concern to staff on at least a weekly basis. Monthly Community Meetings: Grantee shall conduct monthly community meetings for tenants. Support Services: Support services staff will outreach to all tenants who display indications of housing instability. This includes but is not limited to discontinuance from benefits, non-payment of rent, lease violations or warnings from Property Management, and conflicts with staff or other tenants. Grievance Procedure: Grantee agrees to establish and maintain a written Tenant Grievance Procedure which shall include the following elements as well as others that may be appropriate to the services: 1. Grantee shall provide a quarterly report of activities, referencing the tasks as descrihed in the Se. Number of Households that Received Direct Services and Number of Direct Service Contacts C. Examples of critical incidents include death, fire, acts of violence, significant damage to the building, or incidents involving emergency responders.

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Since I64 is listed as a subaddress to G839 in the causation table symptoms pulmonary embolism cheap calcitriol online american express, use G839 as the code for general paresis treatment uveitis cheap 0.25mcg calcitriol with amex. Code T144 (Paralysis medicine assistance programs buy cheap calcitriol 0.25mcg line, traumatic) when reported due to or on the same line with a nature of injury or external cause medicine the 1975 purchase online calcitriol. The codes S00-T98 are invalid for underlying cause so the external cause code is selected. Viral Hepatitis (B161, B169, B171-B179) Code: For Viral Hepatitis in Categories B161 B169 B171 Chronic Viral Hepatitis B180 B181 B182 B172 B178 B179 B188 B188 B189 When reported as causing liver conditions in: K721, K7210 K740-K742 K744-K746 I (a) Cirrhosis of liver (b) Viral hepatitis B Codes for Record K746 B181 Code to chronic viral hepatitis B (B181). Code I(b) as chronic viral hepatitis B, since reported as causing a condition classified to K746. In order to apply the correct instruction, it is also necessary to know how the organisms are classified. There are separate instructions depending on whether the organism is bacterial, viral or other organisms. Escherichia coli Haemophilus influenzae Pneumococcal Staphylococcal Streptococcal Infectious conditions Viral organisms classified to B34. Adenovirus Coronavirus Coxsackie Enterovirus Parvovirus Organisms classified other than A49. In order to arrive at the correct underlying cause, the medical entities must first be coded correctly. The following instructions demonstrate how to assign the codes for the record when dealing with infectious conditions. Once the codes for the record are assigned, the selection and modification rules are applied to determine the underlying cause. In order to determine which infection instruction to use, refer to the Index under the named organism or under Infection, named organism. Bacterial organisms and infections classified to A49 and Viral organisms and infections classified to B34 (1) When an infectious or inflammatory condition is reported and (a) Is preceded or followed by a condition classified to A49 or B34 or (b) A condition classifiable to A49 or B34 is reported as the only entry or the first entry on the next lower line or (c) Is followed by a condition classified to A49 or B34 separated by a connecting term not indicating a due to relationship (i) If a single code is provided for the infectious or inflammatory condition modified by the condition classified to A49 or B34, use this code. It may be necessary to use "due to" or "in" in the Index to assign the appropriate code. Code for Record J129 I (a) Pneumonia (b) Viral infection Code to viral pneumonia, unspecified (J129). Assign the codes for the record following the Index under Meningitis, Haemophilus (influenzae) and Septicemia, Haemophilus influenzae. Code for Record A412 I (a) Sepsis with staph Code to septicemia due to unspecified staphylococcus (A412). I (a) Coxsackie virus pneumonia Code for Record J128 Code to other viral pneumonia (J128). Code for Record K650 I (a) Peritonitis (b) Campylobacter Code to acute peritonitis (K650). Since Campylobacter is not specifically listed under peritonitis, code as indexed under Peritonitis, bacterial. Code for Record J128 I (a) Pneumonia with coxsackie virus Code to other viral pneumonia (J128). I (a) Klebsiella urinary tract infection Code for Record N390 Code to urinary tract infection (N390). The Index does not provide a code for Infection, urinary tract specified as bacterial, infectious, infective, or Klebsiella; therefore, code as indexed under Infection, urinary tract. Code for Record N12 I (a) Pyelonephritis (b) Staphylococcus Code to pyelonephritis, unspecified (N12). Code for Record N12 I (a) Pyelonephritis and pseudomonas Code to pyelonephritis, unspecified (N12). Organisms and infections classified to categories other than A49 and B34 (1) When an infectious or inflammatory condition is reported and (a) Is preceded by a condition classifiable to Chapter I other than A49 or B34 (i) Refer to the Index under the infectious or inflammatory condition. If a single code is provided for this condition, modified by the condition from Chapter I, use this code.

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The unanimous acceptance medicine 3202 generic calcitriol 0.25mcg, community buy-in medicine 44-527 buy generic calcitriol on-line, and follow-on use of the project data demonstrate the importance of early and extensive community outreach (Gambill 2016) medications used to treat bipolar buy calcitriol canada. Visualizations are an effective tool for communicating risk Common wisdom asserts that a picture is worth a thousand words symptoms 2 months pregnant buy 0.25mcg calcitriol with amex, and Georgia Sea Grant discovered that simulated pictures are also an effective way to meaningfully communicate the risk of sea level rise. Georgia Sea Grant took an existing picture of a bridge and dock on the coast and simulated pictures of the same location with different levels of sea level rise. These visualizations were very helpful for communicating the actual impact of different future scenarios to local residents (Gambill 2016). This direct financial benefit to property owners was a significant driver of participation in the program, and an important incentive for other communities to participate in additional projects with Georgia Sea Grant. Large projects drive research and monitoring needs the Savannah Harbor Extension Project is driving significant work to address science and data gaps in the region. For example, the project includes an oxygen injection system whose effectiveness is still unknown. The system will be installed in 2018, and significant studies will be in place to measure dissolved oxygen in the Savannah River. The Army Corps is also working with the South Carolina Department of Natural Resources to conduct fishing surveys, in particular to understand the state of the sturgeon population. Finally, the Army Corps needed to be certain that the deepening would not cut into the confining unit of the aquifer, and thus needed to conduct research to better understand and locate the aquifer confines. Building adaptive management into big projects can improve the state of science and monitoring in the region and help to inform larger coastal vulnerability and risk management questions, not just the issues specific to the project. Gulf Coast Houston/Galveston Area Natural Landscape Galveston Bay is the largest of seven estuaries in Texas (Texas A&M University 2016). The Galveston Bay watershed extends inland up to the Dallas-Forth Worth Metroplex, covering 24,000 square miles with 120,000 acres of wetland (Galveston Bay Keeper; Galveston Bay Estuary Program 2013). Multiple rivers and bayous, including the Trinity and San Jacinto Rivers, discharge into Galveston Bay estuary. Galveston Bay is composed of four sub-bays: the Galveston, Trinity, East, and West bays. The estuary is varied with both aquatic and terrestrial habitats: wetlands, uplands, oyster reefs, intertidal mudflats, seagrass meadows, coastal prairie, and riparian forest (Galveston Bay Estuary Program 2013). The climate in the area is subtropical and averages 47 inches of rain annually (United States Geological Survey). The Texas coast experiences a hurricane or tropical storm once every two years, on average (Coplin and Galloway n. Human Landscape Galveston Bay is contained within the Houston-Galveston metropolitan area, which boasts a total population of approximately 6. The region contains over 75% of the coastal population in Texas (Houston-Galveston Area Council 2016; Galveston Bay Estuary Program 2013). The region is growing rapidly; the population rose 12% from 2010 to 2015 (Houston-Galveston Area Council 2016). The western side of the bay is heavily populated while the eastern side is largely undeveloped and rural (Galveston Bay Estuary Program 2013). Congress, Galveston Bay provides both economic and ecosystem services to the surrounding areas (Galveston Bay Foundation 2016). Galveston Bay is the most biologically productive ecosystem in the state (Galveston Bay Estuary Program 2013). Economically, it provides for the shipping, industrial, agricultural, fishing, and recreational sectors. Through these sectors, Galveston Bay supports the employment of tens of thousands of people and contributes billions to the regional economy (Galveston Bay Estuary Program 2013). The Port of Houston, connected to Galveston Bay via the Buffalo Bayou and San Jacinto River, is the largest port in the United States for waterborne commerce and the second largest port by tonnage of shipment (Galveston Bay Foundation 2016). Commercial seafood harvesting is also a large part of the local economy, with a focus on shrimp and blue crab (Galveston Bay Estuary Program 2013). Major Issues Galveston Bay faces numerous threats, both natural and anthropogenic. Past subsidence was caused largely by high levels of groundwater pumping as well as oil and gas extraction, leading to flooding, shifting coastlines, and wetland loss (Coplin and Galloway n.

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I (a) Bowel obstruction (b) Metastatic adenocarcinoma of bowel Codes for Record K566 C260 (c) Metastatic sarcoma of uterus C55 Code to malignant neoplasms of independent (primary) multiple sites (C97) symptoms hiv cheap 0.25mcg calcitriol mastercard. If a morphology implying site and an independent anatomical site are both qualified as metastatic medicine doctor buy calcitriol american express, code to malignant neoplasm without specification of site (C80) 97110 treatment code buy cheap calcitriol 0.25mcg on line. I (a) Metastatic colonic and renal cell carcinoma Codes for Record C785 C790 Code to malignant neoplasm without specification of site (C80) medicine 6 year in us order discount calcitriol on-line. If all sites are qualified as metastatic or on the list of common sites of metastases, including lung, code to malignant neoplasm without specification of site (C80). I (a) Metastatic carcinoma of stomach (b) Carcinoma of gallbladder (c) Metastatic carcinoma of colon Codes for Record C788 C23 C785 Code to malignant neoplasm of gallbladder (C23). Codes for Record C796 C780 C798 I (a) Metastatic carcinoma of ovary (b) Carcinoma of lung (c) Metastatic cervical carcinoma Code to malignant neoplasm without specification of site (C80). I (a) Metastatic carcinoma of stomach (b) Metastatic carcinoma of breast (c) Metastatic carcinoma of lung Codes for Record C788 C798 C780 Code to malignant neoplasm without specification of site (C80), since breast and stomach do not belong to the same anatomical system and lung is on the list of common sites of metastases. Primary site unknown If the statement, "primary site unknown," or its equivalent, appears anywhere on a certificate, code to the category for unspecified site for the morphological type involved (e. Source (Questionable source) Undetermined origin Undetermined primary Undetermined site Undetermined source Unknown origin Unknown primary Unknown site Unknown source I (a) Secondary carcinoma of liver (b) Primary site unknown (c) Codes for Record C80 C787 Code to carcinoma without specification of site (C80). Codes for Record C80 C439 C798 I (a) Generalized metastases (b) Melanoma of back (c) Primary site unknown Code to malignant melanoma of unspecified site (C439). Sites with prefixes or imprecise definitions Neoplasms of sites prefixed by "peri," "para," "pre," "supra," "infra," etc. I (a) Fibrosarcoma in the region of the leg Code for Record C492 Code to malignant neoplasm of connective and soft tissue of lower limb (C492). Code for Record C761 I (a) Carcinoma in the lung area Code to malignant neoplasm of other and ill-defined sites within the thorax. Doubtful diagnosis Malignant neoplasms described as one site "or" another, or if "or" is implied, should be coded to the category that embraces both sites. If no appropriate category exists, code to the unspecified site of the morphological type involved. This rule applies to all sites whether they are on the list of common sites of metastases or not. I (a) Carcinoma of ascending or descending colon Code to malignant neoplasm of colon, unspecified (C189). I (a) Osteosarcoma of lumbar vertebrae or sacrum Code to malignant neoplasm of bone, unspecified (C419). Malignant neoplasms of unspecified site with other reported conditions When the site of a primary malignant neoplasm is not specified, no assumption of the site should be made from the location of other reported conditions such as perforation, obstruction, or hemorrhage. I (a) Obstruction of intestine (b) Carcinoma Codes for Record K566 C80 Code to malignant neoplasm without specification of site (C80). Mass or lesion with malignant neoplasms When mass or lesion is reported with malignant neoplasms, code the mass or lesion as indexed. I (a) Lung mass (b) Carcinomatosis Codes for Record R91 C80 Code to carcinomatosis (C80). F03-F09 Organic, including symptomatic, mental disorders Not to be used if the underlying physical condition is known. F10-F19 use X40-X49 X60-X69 X85-X90 Y10-Y19 Mental and behavioral disorders due to psychoactive substance with mention of: (Accidental poisoning by and exposure to noxious substances), code X40-X49 (Intentional self-poisoning by and exposure to noxious substances), code X60-X69 (Assault by noxious substances), code X85-X90 (Poisoning by and exposure to drugs, chemicals and noxious substances), code Y10-Y19 Fourth character. If there is a resulting complication, consider as drug therapy and apply instructions under Y40-Y59, Drugs, medicaments and biological substances causing adverse effects in therapeutic use. F70-F79 Mental retardation Not to be used if the underlying physical condition is known. Multiple heart conditions with one heart condition specified as rheumatic: If rheumatic fever or any disease of the heart is stated to be of rheumatic origin or is specified to be rheumatic, such qualifications will apply to each specific heart condition reported (classified to I300-I319, I339, I340-I38, I400-I409, I429, I514-I519), even though it is not so qualified, unless another origin such as arteriosclerosis is mentioned. I (a) Acute bacterial endocarditis (b) Mitral insufficiency (c) Rheumatic endocarditis Codes for Record I330 I051 I091 Code to rheumatic mitral insufficiency (I051).

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