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Moreover , they utterly fail * * * Top of Page 25 * * * to grasp that the CWA subsection 309 ( g ) preclusion device is part of a nuanced spectrum of preclusions on EPA and citizen actions in the statutes , rendering the congressional wording of each preclusion to be of particular significance in determining the legislative intent . Accurate document selection is an important factor in determining the usability of a system [ 1 ] . Finally , the section 4390 guidelines list a facility 's accreditation by JCAHO , which is required of all entities participating in Medicare and Medicaid , to be one factor in determining whether the facility is an IMD . Consult with a Office of Student Life staff member for help in determining when this is necessary . Yet our automated tools are of only limited help in determining the cause of performance regressions . I think , number one , we are being asked very strongly by the people who are using these therapies , we are asked for help in determining which of them work and which of them do n't work and in which situations . should be noted that any of these personality traits can appear in either patients with bulimia or anorexia ; some experts believe that the patient 's specific personality disorders , rather than whether they are anorexic or bulimic , may be the more important factor in determining treatment choices . Economic hardship is not a factor in determining repair eligibility . What did change during the course of the selection process was the approach used by the selection board in determining whether a candidate was successful in meeting the qualifications . If you need help in determining the type of journal , see our discussion of Finding Periodical Articles in this guide . The traditional theories for lazy functional languages are based on call-by-name models , and offer no help in determining which transformations do indeed optimize a program . CMS will consider card program sponsor performance under an existing Medicare endorsement as a factor in determining eligibility for endorsement in future annual cycles . With carbohydrate counting the norm in determining mealtime insulin dosing , it 's important to know exactly how many grams of carbohydrates are being eaten .