Trends in technology, trade and consumption likely to impact on microbial food safety

Current and potential future trends in technology, consumption and trade of food that may impact on food-borne disease are analysed and the key driving factors identified focusing on the European Union and, to a lesser extent, accounting for the United States and global issues. Understanding of factors is developed using system-based methods and their impact is discussed in relation to current events and predictions of future trends. These factors come from a wide range of spheres relevant to food and include political, economic, social, technological, regulatory and environmental drivers. The degree of certainty in assessing the impact of important driving factors is considered in relation to food-borne disease. The most important factors driving an increase in the burden of food-borne disease in the next few decades were found to be the anticipated doubling of the global demand for food and of the international trade in food next to a significantly increased consumption of certain high-value food commodities such as meat and poultry and fresh produce. A less important factor potentially increasing the food-borne disease burden would be the increased demand for convenience foods. Factors that may contribute to a reduction in the food-borne disease burden were identified as the ability of governments around the world to take effective regulatory measures as well as the development and use of new food safety technologies and detection methods. The most important factor in reducing the burden of food-borne disease was identified as our ability to first detect and investigate a food safety issue and then to develop effective control measures. Given the global scale of impact on food safety that current and potentially future trends have, either by potentially increasing or decreasing the food-borne disease burden, it is concluded that a key role is fulfilled by intergovernmental organisations and by international standard setting bodies in coordinating the establishment and rolling-out of effective measures that, on balance, help ensure long-term consumer protection and fair international trade. Keywords: Microbial food safety; Food technology; Globalizatio

SHUT-DOWN COOLING OF ORR

Information is presented that may be used in estimating the magnitude of the shutdown cooling problem in the ORR at various power levels. The information used in the investigation was obtained from other research reactors. (W.L.H.

Portable treatment systems study

In developing their Site Treatment Plans (STPs), many of the Department of Energy installations identified some form of portable treatment, to facilitate compliant disposition of select mixed low-level wastestreams. The Environmental Management Office of Science and Technology requested that a systems study be performed to better define the potential role of portable treatment with respect to mixed low-level waste, highlight obstacles to implementation, and identify opportunities for future research and development emphasis. The study was performed by first establishing a representative set of mixed waste, then formulating portable treatment system concepts to meet the required processing needs for these wastes. The portable systems that were conceptualized were evaluated and compared to a fixed centralized treatment alternative. The system evaluations include a life-cycle cost analysis and an assessment of regulatory, institutional, and technical issues associated with the potential use of portable systems. The results of this study show that when all costs are included, there are no significant cost differences between portable systems and fixed systems. However, it is also emphasized that many uncertainties exist that could impact the cost of implementing portable treatment systems. Portable treatment could be made more attractive through private sector implementation, although there is little economic incentive for a commercial vendor to develop small, specialized treatment capabilities with limited applicability. Alternatively, there may also be valid reasons why fixed units cannot be used for some problematic wastestreams. In any event, there are some site-specific problems that still need to be addressed, and there may be some opportunity for research and development to make a positive impact in these areas

Radio Frequency Nonionizing Radiation in a Community Exposed to Radio and Television Broadcasting

Exposure to radio frequency (RF) nonionizing radiation from telecommunications is pervasive in modern society. Elevated disease risks have been observed in some populations exposed to radio and television transmissions, although findings are inconsistent. This study quantified RF exposures among 280 residents living near the broadcasting transmitters for Denver, Colorado. RF power densities outside and inside each residence were obtained, and a global positioning system (GPS) identified geographic coordinates and elevations. A viewshed model within a geographic information system (GIS) characterized the average distance and percentage of transmitters visible from each residence. Data were collected at the beginning and end of a 2.5-day period, and some measurements were repeated 8–29 months later. RF levels logged at 1-min intervals for 2.5 days varied considerably among some homes and were quite similar among others. The greatest differences appeared among homes within 1 km of the transmitters. Overall, there were no differences in mean residential RF levels compared over 2.5 days. However, after a 1- to 2-year follow-up, only 25% of exterior and 38% of interior RF measurements were unchanged. Increasing proximity, elevation, and line-of-sight visibility were each associated with elevated RF exposures. At average distances from > 1–3 km, exterior RF measurements were 13–30 times greater among homes that had > 50% of the transmitters visible compared with homes with ≤ 50% visibility at those distances. This study demonstrated that both spatial and temporal factors contribute to residential RF exposure and that GPS/GIS technologies can improve RF exposure assessment and reduce exposure misclassification

Magnetic fields and Sunyaev-Zel'dovich effect in galaxy clusters

In this work we study the contribution of magnetic fields to the Sunyaev Zeldovich (SZ) effect in the intracluster medium. In particular we calculate the SZ angular power spectrum and the central temperature decrement. The effect of magnetic fields is included in the hydrostatic equilibrium equation by splitting the Lorentz force into two terms one being the force due to magnetic pressure which acts outwards and the other being magnetic tension which acts inwards. A perturbative approach is adopted to solve for the gas density profile for weak magnetic fields (< 4 micro G}). This leads to an enhancement of the gas density in the central regions for nearly radial magnetic field configurations. Previous works had considered the force due to magnetic pressure alone which is the case only for a special set of field configurations. However, we see that there exists possible sets of configurations of ICM magnetic fields where the force due to magnetic tension will dominate. Subsequently, this effect is extrapolated for typical field strengths (~ 10 micro G) and scaling arguments are used to estimate the angular power due to secondary anisotropies at cluster scales. In particular we find that it is possible to explain the excess power reported by CMB experiments like CBI, BIMA, ACBAR at l > 2000 with sigma_8 ~ 0.8 (WMAP 5 year data) for typical cluster magnetic fields. In addition we also see that the magnetic field effect on the SZ temperature decrement is more pronounced for low mass clusters ( ~ 2 keV). Future SZ detections of low mass clusters at few arc second resolution will be able to probe this effect more precisely. Thus, it will be instructive to explore the implications of this model in greater detail in future works.Comment: 20 pages, 8 figure

Impact of Medicare Part D on mental health treatment and outcomes for dual eligible beneficiaries with HIV

Depression is common among women with HIV and untreated depression can result in poor quality of life and worsen HIV outcomes. Women with HIV who are dually enrolled in Medicaid and Medicare faced a potential disruption in medication access when Medicare Part D was implemented in 2006. The goal of this study was to estimate the effects of Medicare Part D implementation on antidepressant use, depressive symptoms, and hospitalization in Medicaid-Medicare dual eligible women with HIV. This study used 2003–2008 data from the Women's Interagency HIV Study. The effects of Medicare Part D were estimated using a difference-in-differences approach, adjusting for temporal trends using a matched control group of Medicaid-only enrollees. Before Medicare Part D implementation, dual eligibles differed from Medicaid-only enrollees in antidepressant use and hospitalization, despite having identical prescription drug coverage through Medicaid. For dual enrollees, the transition to Medicare Part D was not associated with changes in antidepressant use, depressive symptoms, or hospitalization. We did not find disruptive effects on antidepressant use and related outcomes among dual eligibles in this study. Stable antidepressant use may be due to better access to medical care for dual eligibles through Medicare both before and after Medicare Part D implementation, which may have eclipsed any effects of the transition. It may also signal that classification of antidepressants as a protected drug class under Medicare Part D was effective in preventing psychiatric medication disruption

Evidence of the Purely Leptonic Decay B- --> tau- nu_tau-bar

We present the first evidence of the decay B- --> tau- nu_tau-bar using 414 fb^-1 of data collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric-energy e+e- collider. Events are tagged by fully reconstructing one of the B mesons in hadronic modes. We detect the signal with a significance of 3.5 standard deviations including systematics, and measure the branching fraction to be Br(B- --> tau- nu_tau-bar) = (1.79 +0.56-0.49(stat) +0.46-0.51(syst))*10^-4. This implies that f_B = 0.229 +0.036-0.031(stat) +0.034-0.037(syst) GeV and is the first direct measurement of this quantity.Comment: 6 pages, 3 figures, to appear in Physical Review Letter

Associations between Medicare Part D and Out-of-Pocket Spending, HIV Viral Load, Adherence, and ADAP Use in Dual Eligibles with HIV

Background: The implementation of Medicare part D on January 1, 2006 required all adults who were dually enrolled in Medicaid and Medicare (dual eligibles) to transition prescription drug coverage from Medicaid to Medicare part D. Changes in payment systems and utilization management along with the loss of Medicaid protections had the potential to disrupt medication access, with uncertain consequences for dual eligibles with human immunodeficiency virus (HIV) who rely on consistent prescription coverage to suppress their HIV viral load (VL). Objective: To estimate the effect of Medicare part D on self-reported out-of-pocket prescription drug spending, AIDS Drug Assistance Program (ADAP) use, antiretroviral adherence, and HIV VL suppression among dual eligibles with HIV. Methods: Using 2003–2008 data from the Women’s Interagency HIV Study, we created a propensity score–matched cohort and used a difference-in-differences approach to compare dual eligibles’ outcomes pre-Medicare and post-Medicare part D to those enrolled in Medicaid alone. Results: Transition to Medicare part D was associated with a sharp increase in the proportion of dual eligibles with self-reported out-of-pocket prescription drug costs, followed by an increase in ADAP use. Despite the increase in out-of-pocket costs, both adherence and HIV VL suppression remained stable. Conclusions: Medicare part D was associated with increased out-of-pocket spending, although the increased spending did not seem to compromise antiretroviral therapy adherence or HIV VL suppression. It is possible that increased ADAP use mitigated the increase in out-of-pocket spending, suggesting successful coordination between Medicare part D and ADAP as well as the vital role of ADAP during insurance transitions

Effects of Health Insurance Interruption on Loss of Hypertension Control in Women with and Women Without HIV

Background: Among low-income women with and without HIV, it is a priority to reduce age-related comorbidities, including hypertension and its sequelae. Because consistent health insurance access has been identified as an important factor in controlling many chronic diseases, we estimated the effects of coverage interruption on loss of hypertension control in a cohort of women in the United States. Methods: We analyzed prospective, longitudinal data from the Women's Interagency HIV Study. HIV-infected and HIV-uninfected women were included between 2005 and 2014 when they reported health insurance at consecutive biannual visits and had controlled hypertension, and were followed for any insurance break and loss of hypertension control. We estimated hazard ratios (HRs) by Cox proportional hazards regression with inverse-probability-of-treatment-and censoring weights (marginal structural models), and plotted the cumulative incidence of hypertension control loss. Results: Among 890 HIV-infected women, the weighted HR for hypertension control loss comparing health insurance interruption to uninterrupted coverage was 1.37 (95% confidence interval [CI], 0.99-1.91). Inclusion of AIDS Drug Assistance Program (ADAP) participation with health insurance modestly increased the HR (1.47; 95% CI, 1.04-2.07). Analysis of 272 HIV-uninfected women yielded a similar HR (1.39; 95% CI, 0.88-2.21). Additionally, there were indications of uninterrupted coverage having a protective effect on hypertension when compared with the natural course in HIV-infected (HR, 0.82; 95% CI, 0.61-1.11) and HIV-uninfected (HR, 0.78; 95% CI, 0.52-1.19) women. Conclusions: This study provides evidence that health insurance continuity promotes hypertension control in key populations. Interventions that ensure coverage stability and ADAP access should be a policy priority

Comparing neighborhood and state contexts for women living with and without HIV: Understanding the southern HIV epidemic

In the South, people living with HIV experience worse health outcomes than in other geographic regions, likely due to regional political, structural, and socioeconomic factors. We describe the neighborhoods of women (n = 1,800) living with and without HIV in the Women’s Interagency HIV Study (WIHS), a cohort with Southern sites in Chapel Hill, NC; Atlanta, GA; Birmingham, AL; Jackson, MS; and Miami, FL; and non-Southern sites in Brooklyn, NY; Bronx, NY; Washington, DC; San Francisco, CA; and Chicago, IL. In 2014, participants’ addresses were geocoded and matched to several administrative data sources. There were a number of differences between the neighborhood contexts of Southern and non-Southern WIHS participants. Southern states had the lowest income eligibility thresholds for family Medicaid, and consequently higher proportions of uninsured individuals. Modeled proportions of income devoted to transportation were much higher in Southern neighborhoods (Location Affordability Index of 28–39% compared to 16–23% in non-Southern sites), and fewer participants lived in counties where hospitals reported providing HIV care (55% of GA, 63% of NC, and 76% of AL participants lived in a county with a hospital that provided HIV care, compared to >90% at all other sites). Finally, the states with the highest adult incarceration rates were all in the South (per 100,000 residents: AL 820, MS 788, GA 686, FL 644). Many Southern states opted not to expand Medicaid, invest little in transportation infrastructure, and have staggering rates of incarceration. Resolution of racial and geographic disparities in HIV health outcomes will require addressing these structural barriers