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CMS calculates the payment reduction and component results for each hospital based on its performance during a rolling performance period. The payment adjustment factor is the form of the payment reduction CMS uses to reduce hospital payments. Payment reductions are applied to all Medicare fee-for-service base operating diagnosis-related group payments during the FY (October 1 to September 30). The payment reduction is capped at 3 percent (that is, a payment adjustment factor of 0.97).


CMS sends confidential Hospital-Specific Reports (HSRs) to hospitals annually. CMS gives hospitals 30 days to review their HRRP data as reflected in their HSRs, submit questions about the calculation of their results, and request calculation corrections. The Review and Correction period for HRRP is only for discrepancies related to the calculation of the payment reduction and component results.

The Climate Pollution Reduction Grants (CPRG) program will provide grants to states, local governments, tribes, and territories to develop and implement plans for reducing greenhouse gas emissions and other harmful air pollution. Section 60114 of the Inflation Reduction Act provides an investment of $5 billion to support efforts by states, municipalities, air pollution control agencies, tribes, and groups thereof to develop and implement strong, local greenhouse gas reduction strategies. This two-staged grant program provides funding of $250 million for noncompetitive planning grants, and $4.6 billion for competitive implementation grants.

Americans are consuming too much sodium in their diet, and the majority comes from processed, packaged and prepared foods, not the salt shaker. That is why we developed the final guidance with sodium reduction targets to encourage industry to gradually reduce sodium in a wide range of foods over the next 2.5 years.

A TUR Plan is a document that provides both economic and technical evaluations of the toxics use reduction opportunities available to a company, and identifies those methods, if any, that the company intends to implement. The plan must contain:

The JDK contains many terminal operations (such asaverage,sum,min,max, andcount) that return one value by combining the contents of a stream. These operations are called reduction operations. The JDK also contains reduction operations that return a collection instead of a single value. Many reduction operations perform a specific task, such as finding the average of values or grouping elements into categories. However, the JDK provides you with the general-purpose reduction operationsreduce andcollect, which this section describes in detail.

TheStream.reduce method is a general-purpose reduction operation. Consider the following pipeline, which calculates the sum of the male members' ages in the collection roster. It uses theStream.sum reduction operation:

identity: The identity element is both the initial value of the reduction and the default result if there are no elements in the stream. In this example, the identity element is 0; this is the initial value of the sum of ages and the default value if no members exist in the collection roster.

accumulator: The accumulator function takes two parameters: a partial result of the reduction (in this example, the sum of all processed integers so far) and the next element of the stream (in this example, an integer). It returns a new partial result. In this example, the accumulator function is a lambda expression that adds two Integer values and returns an Integer value:

Consider how to find the average of values in a stream. You require two pieces of data: the total number of values and the sum of those values. However, like the reduce method and all other reduction methods, the collect method returns only one value. You can create a new data type that contains member variables that keep track of the total number of values and the sum of those values, such as the following class,Averager:

TheCollectors class contains many useful reduction operations, such as accumulating elements into collections and summarizing elements according to various criteria. These reduction operations return instances of the class Collector, so you can use them as a parameter for the collect operation.

ThegroupingBy operation in this example takes two parameters, a classification function and an instance of Collector. The Collector parameter is called a downstream collector. This is a collector that the Java runtime applies to the results of another collector. Consequently, this groupingBy operation enables you to apply a collect method to the List values created by the groupingBy operator. This example applies the collector mapping, which applies the mapping function Person::getName to each element of the stream. Consequently, the resulting stream consists of only the names of members. A pipeline that contains one or more downstream collectors, like this example, is called a multilevel reduction.

The World Health Organization (WHO) has developed this report to monitor progress and identify areas for actionin the implementation of sodium reduction policies and other measures within Member States and acrossWHO regions and World Bank income groups. For the first time, a Sodium Country Score from 1 (the lowestlevel) to 4 (the highest level) is allocated to each Member State based on the level of implementation of sodiumreduction policies and other measures. The Sodium Country Score is used to estimate the impact of policy progresson population dietary sodium intake and cardiovascular disease.

This report provides an update on the use of harm reduction in tobacco smoking, in relation to all non-tobacco nicotine products but particularly e-cigarettes. It shows that, for all the potential risks involved, harm reduction has huge potential to prevent death and disability from tobacco use, and to hasten our progress to a tobacco-free society.

'The next steps in the long journey to tobacco harm reduction' - Professor John Britton, the RCP's special adviser on tobacco, reflects on recent developments in tobacco control and the introduction of standardised packaging.

Harm reduction in nicotine addiction: helping people who can't quit - A report by the Tobacco Advisory Group of the RCP, published October 2007, which argued for the application of harm-reduction strategies to tobacco dependence.

The National Salt and Sugar Reduction Initiative (NSSRI) is a partnership of organizations and health authorities from across the country (PDF), convened by the NYC Health Department. The initiative sets voluntary reduction targets for sugar and salt and asks food and beverage companies to commit to meeting them.

The NSSRI released two rounds of preliminary sugar categories and draft targets for technical comment in 2018 and 2019. In February 2021 the initiative released its targets for sugar reduction across 15 categories of foods and beverages.

After reviewing and integrating two rounds of industry comments, the initiative revised the categories and targets (PDF) and set sugar reduction targets that are gradual and achievable. Industry feedback has helped inform the categories and targets.

The initial phase of this effort, the National Salt Reduction Initiative, tracked nation-wide progress of sodium reduction in packaged and restaurant foods. Between 2009 and 2014, there was a 6.8% reduction in sodium levels in the U.S. food supply.

Nutrient reduction is being accomplished through existing programs at the local, state and federal level that either regulate point sources or promote conservation practices by agricultural non-point sources. Most importantly, implementation is occurring at the watershed scale through partnerships between municipalities/sanitary districts, county land and water conservation departments, farmers, environmental/watershed groups, UW-Extension and state/federal agencies to improve water quality. With partners working together, outreach and education are provided, planning is accomplished and practices are implemented that lead to measurable reductions in nutrient losses.

An initial analysis shows that existing Wisconsin point source and nonpoint source programs can meet the Gulf Hypoxia goal of 45 percent load reduction for phosphorus using 1995 as a base year. For the Mississippi River Basin, about a 23 percent reduction has already been achieved through implementation of Wisconsin's point source phosphorus removal requirements and through a number of nonpoint source management programs. For the Lake Michigan Basin, an estimated 27 percent reduction has been achieved.

The project will implement a residential curbside food waste collection program, boost community composting efforts, and develop an overall local food waste strategy. Community outreach will include educational materials promoting the importance of food waste reduction, benefits of composting, and farm use of compost.

Harm reduction is an approach that emphasizes engaging directly with people who use drugs to prevent overdose and infectious disease transmission, improve the physical, mental, and social wellbeing of those served, and offer low-threshold options for accessing substance use disorder treatment and other health care services.

Harm reduction services save lives by being available and accessible in a matter that emphasizes the need for humility and compassion toward people who use drugs. Harm reduction plays a significant role in preventing drug-related deaths and offering access to healthcare, social services, and treatment. These services decrease overdose fatalities, acute life-threatening infections related to unsterile drug injection, and chronic diseases such as HIV/HCV.

A comprehensive prevention strategy, harm reduction is part of the continuum of care. Harm reduction approaches have proven to prevent death, injury, disease, overdose, and substance misuse. Harm reduction is effective in addressing the public health epidemic involving substance use as well as infectious disease and other harms associated with drug use. Specifically, harm reduction services can: 041b061a72


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