A Federal-State Compact to Review the Great Lakes Region

http://deepblue.lib.umich.edu/bitstream/2027.42/88464/1/2008_Brookings_The_Vital_Center.pd

The Vital Connection: Reclaiming Great Lakes Economic Leadership in the Bi-National US-Canadian Region

http://deepblue.lib.umich.edu/bitstream/2027.42/88349/1/2009_Brookings_The_Vital_Connection.pd

The Challenges of Multimorbidity from the Patient Perspective

BACKGROUND Although multiple co-occurring chronic illnesses within the same individual are increasingly common, few studies have examined the challenges of multimorbidity from the patient perspective. OBJECTIVE The aim of this study is to examine the self-management learning needs and willingness to see non-physician providers of patients with multimorbidity compared to patients with single chronic illnesses. DESIGN. This research is designed as a cross-sectional survey. PARTICIPANTS Based upon ICD-9 codes, patients from a single VHA healthcare system were stratified into multimorbidity clusters or groups with a single chronic illness from the corresponding cluster. Nonproportional sampling was used to randomly select 720 patients. MEASUREMENTS Demographic characteristics, functional status, number of contacts with healthcare providers, components of primary care, self-management learning needs, and willingness to see nonphysician providers. RESULTS Four hundred twenty-two patients returned surveys. A higher percentage of multimorbidity patients compared to single morbidity patients were "definitely" willing to learn all 22 self-management skills, of these only 2 were not significant. Compared to patients with single morbidity, a significantly higher percentage of patients with multimorbidity also reported that they were "definitely" willing to see 6 of 11 non-physician healthcare providers. CONCLUSIONS Self-management learning needs of multimorbidity patients are extensive, and their preferences are consistent with team-based primary care. Alternative methods of providing support and chronic illness care may be needed to meet the needs of these complex patients.US Department of Veterans Affairs (01-110, 02-197); Agency for Healthcare Research and Quality (K08 HS013008-02

Editorial: Ethics, Values, and Designer Responsibility

As we rely upon increasingly complex sociotechnical systems to support ourselves and, by extension, the structures of society, it becomes yet more important to consider how ethics and values intertwine in design activity. Numerous methods that address issues related to ethics and value-centeredness in design activity exist, but it is unclear what role the design research and practice communities should play in shaping the future of these design approaches. Importantly, how might researchers and practitioners become more aware of the normative assumptions that underlie both their design activity and the design artifacts that result

Geographic Analysis of Alcohol-Related Crashes in Nine High-Need Louisiana Parishes

This report examines nine Louisiana communities and their alcohol availability concerns from a public health perspective. The nine communities are part of The Louisiana Partnership for Success II (LPFS ll), a 5-year Substance Abuse and Mental Health Services Administration (SAMHSA) grant. The LPFS ll grant is focused exclusively on addressing underage drinking behaviors, consequences, and risk factors among 9 to 20-year-olds in nine high-need, parish-level communities (HNCs) (Louisiana Department of Health [LDH], 2020a). Communities were selected through a data-driven, participatory process and supported to form a cross-sector coalition to implement interventions within those communities. The process for choosing the high-need communities included seven indicators from the Caring Communities Youth Survey (CCYS) (LDH, 2020b), alcohol-related crash reports, and student alcohol-related suspensions. Three additional indicators were taken from the 2018 County Health Rankings (University of Wisconsin Population Health Institute, 2018) and The Centers for Disease Control and Prevention (CDC) 1991-2017 High School Youth Risk Behavior Survey Data (CDC, 2018). In order to assist these communities with high rates of alcohol-related public health issues, this research project examined the interaction of alcohol outlets, alcohol-related motor vehicle crashes (MVC), and associated demographics and time variables using GIS mapping in order to help with planning the most appropriate and impactful interventions

Nutrient fluxes from recent deposits of fine-grained, organic-rich sediments in a Florida estuary

Nutrient fluxes from fine-grained, organic-rich sediments in estuaries can hasten the onset and progression of eutrophication and harmful algal blooms. Targeted efforts to manage degraded sediments and improve estuarine water quality require a better understanding of physicochemical controls and the relative importance of benthic fluxes. Toward that end, we determined fluxes from organic-rich, high porosity sediments deposited during the past 5-6 decades along 60 km of the Indian River Lagoon, a barrier island lagoon in Florida, USA. Highly bioavailable ammonium and phosphate were the predominant chemical forms of interstitial nitrogen and phosphorus in these highly-reducing sediments. Median fluxes of ammonium and phosphate were 320 µmol m-2 h-1 and 11 µmol m-2 h-1, respectively. Fluxes were 3-10 times greater when sediment temperatures were >28°C and interstitial sulfide concentrations were >1 mM. Temperature-compensated fluxes of ammonium and phosphate were significantly correlated with sediment organic matter content; total organic carbon averaged 5.3 ± 2.4% and the maximum was 12.4% for the sediments studied. Fine-scale physical probing, plus lidar data, showed that these organic-rich sediments covered <10% of our study area; however, fluxes from these sediments were estimated to supply 20-40% of internal + external annual loads of nitrogen and phosphorus. Furthermore, 60% of nitrogen and phosphorus fluxes from sediments in the northern Indian River Lagoon came from just 22% of the total surface area. Lagoon segments with high benthic fluxes overlapped in part with areas prone to harmful algal blooms. Effective strategies to manage degraded sediments in the Indian River Lagoon depend on knowing the relative magnitude of internal loading of nutrients as well as appropriate techniques to mitigate sediment fluxes

Corticosterone Regulates Both Naturally Occurring and Cocaine‐Induced Dopamine Signaling by Selectively Decreasing Dopamine Uptake

Stressful and aversive events promote maladaptive reward‐seeking behaviors such as drug addiction by acting, in part, on the mesolimbic dopamine system. Using animal models, data from our laboratory and others show that stress and cocaine can interact to produce a synergistic effect on reward circuitry. This effect is also observed when the stress hormone corticosterone is administered directly into the nucleus accumbens (NAc), indicating that glucocorticoids act locally in dopamine terminal regions to enhance cocaine\u27s effects on dopamine signaling. However, prior studies in behaving animals have not provided mechanistic insight. Using fast‐scan cyclic voltammetry, we examined the effect of systemic corticosterone on spontaneous dopamine release events (transients) in the NAc core and shell in behaving rats. A physiologically relevant systemic injection of corticosterone (2 mg/kg i.p.) induced an increase in dopamine transient amplitude and duration (both voltammetric measures sensitive to decreases in dopamine clearance), but had no effect on the frequency of transient release events. This effect was compounded by cocaine (2.5 mg/kg i.p.). However, a second experiment indicated that the same injection of corticosterone had no detectable effect on the dopaminergic encoding of a palatable natural reward (saccharin). Taken together, these results suggest that corticosterone interferes with naturally occurring dopamine uptake locally, and this effect is a critical determinant of dopamine concentration specifically in situations in which the dopamine transporter is pharmacologically blocked by cocaine

A safe method of extracting DNA from Coccidioides immitis

Human-pathogenic fungi such as Coccidioides immitis and Histoplasma capsulatum must be handled in Biosafety level 3 containment facilities which make for a very awkward working environment (J.Y. Richmond and R.W. McKinney, eds. Biosafety in Microbiological and Biomedical Laboratories, 3rd ed. NIH, Washington). In this paper we describe a safe and convenient method of extracting DNA from such fungi in which the culture is killed by steaming, allowing removal from the containment facilities, as soon as possible. The method was first developed with the non-pathogen Neurospora crassa, has worked well for both C. immitis and H. capsulatum, and should be useful for extracting DNA from any pathogenic fungus

Validation of frequency and mode extraction calculations from time-domain simulations of accelerator cavities

The recently developed frequency extraction algorithm [G.R. Werner and J.R. Cary, J. Comp. Phys. 227, 5200 (2008)] that enables a simple FDTD algorithm to be transformed into an efficient eigenmode solver is applied to a realistic accelerator cavity modeled with embedded boundaries and Richardson extrapolation. Previously, the frequency extraction method was shown to be capable of distinguishing M degenerate modes by running M different simulations and to permit mode extraction with minimal post-processing effort that only requires solving a small eigenvalue problem. Realistic calculations for an accelerator cavity are presented in this work to establish the validity of the method for realistic modeling scenarios and to illustrate the complexities of the computational validation process. The method is found to be able to extract the frequencies with error that is less than a part in 10^5. The corrected experimental and computed values differ by about one parts in 10^$, which is accounted for (in largest part) by machining errors. The extraction of frequencies and modes from accelerator cavities provides engineers and physicists an understanding of potential cavity performance as it depends on shape without incurring manufacture and measurement costs