Days to treatment and early retention among patients in treatment for alcohol and drug disorders

a b s t r a c t a r t i c l e i n f o Objectives: Drug and alcohol treatment programs often have long delays between assessment and treatment admission. The study examined the impact of days to treatment admission on the probability of completing four sessions of care within an addiction treatment program implementing improvements in their admission process. Methods: Mixed-effects logistic regression was used to test the effect of wait time on retention in care. Results: Findings demonstrate a strong decrement in the probability of completing four sessions of treatment with increasing time between the clinical assessment and first treatment session

A Cohort Study of Public Health Insurance Coverage Loss among Oregon Adolescents

ABSTRACT Introduction: Churning on and off and/or experiencing coverage gaps is common among public health insurance recipients. Although the Affordable Care Act (ACA) provisions to extend parental coverage for adolescents transitioning to young adulthood on private insurance plans were implemented in 2010, no such protection was mandated for adolescents with public health insurance. Methods: Oregon public health insurance enrollment and electronic health record data from community health centers were used to conduct a retrospective, observational cohort study of Oregon adolescents (17-19 years of age) with public coverage [January 1, 2011-December 31, 2013 (n=51,988)] to assess loss. Time-to-event methods determined the association of coverage loss with sociodemographic characteristics. Results: Although adolescents are vulnerable to coverage loss as they age out of child public health insurance coverage, \u3e35% of 19 year olds in this study kept their coverage for up to one year after their 19th birthday. Conclusions: Our findings suggest that the support many community health centers offer to help their patients maintain insurance coverage may be having an impact, especially during this important transition period. Additional research to understand how these 19 year olds were able to keep coverage will provide recommendations for future adolescents as they transition to young adulthood

Chaco Research Archive

The Chaco Research Archive is a collaborative effort to create an online archive and analytical database that integrates much of the widely dispersed archaeological data collected from Chaco Canyon from the late 1890s through the first half of the 20th century. Today the ruins of the Chaco Culture National Historical Park hold great meaning and importance to many Native American groups of the Southwest as ancestral sites. Though it has long been recognized as a sacred place by indigenous peoples, its importance was later discovered by Anglo explorers. Having stood the test of time, the ruins of Chaco Canyon entered the broader public consciousness in the late nineteenth century as a vivid symbol of the cultural resources of the United States. History of Exploration and Research Since the founding of the Chaco Canyon National Monument in 1907, Chaco has been at the forefront of the historic preservation movement. Due to the early research efforts of Richard Wetherill, George Pepper, and Edgar Hewett, the monument was created in conjunction with the Federal Antiquities Act of 1906 (the first piece of legislation designed to protect cultural resources). In 1987, Chaco Canyon was designated a UNESCO World Heritage Site signaling its importance as a valued part of international cultural patrimony. Today, Chaco era ruins continue to be a focus of preservation efforts both domestically and abroad. Early excavations of the 1890s and 1920s in Chaco Canyon centered on discovering the genesis and evolution of the prehistoric “Anasazi” inhabitants. These early research efforts, conducted by the American Museum of Natural History, the National Geographic Society, and the Smithsonian, placed Chaco at the center of the evolving discipline of archaeological science. Today, the Chacoan Phenomenon (Irwin-Williams 1978) continues to be a touchstone in debates about prehistoric culture change within the discipline of archaeology. Our Mission In June of 2002, a group of southwestern archaeologists met to examine the potential for creating an on-line Chaco research archive to significantly enhance our ability to answer key research questions by improving access to the full record of surveys and excavations. Such an archive was envisioned as a “virtual” collection of the scattered Chaco information to be integrated in a manner such that scholars could more easily assemble the types of data most relevant to a variety of important research issues. Thus, the Chaco Digital Initiative took shape. Through generous funding from the Andrew Mellon Foundation, the mission of chacoarchive.org is to ensure that the early archaeological research records are preserved for and accessible to future generations. Over the last 7 years, the Chaco Digital Initiative team tackled this monumental task in phases. First, we designed an inventory database to track where relevant information sources were located (institutions, collections, boxes, folders, etc.). Next we visited each institution and combed through all the major collections identifying, entering, and acquiring those information sources. Once those materials were digitized, we indexed them for data processing to track which accessions pertained to which rooms at which sites. With the information sources in hand, we needed to design an analytical database that would allow us to enter and extract relevant pieces of data (features, burials, levels, tree-ring dates, etc.). After another year of additional design work, the CDI/IATH team had a database flexible enough to capture information from the diverse excavations that generated those data. With the database created, so began the arduous task of processing the data room by room. To date, the Chaco Research Archive team has processed over 15,000 images, created an architectural stabilization database of another 10,000 images, entered over 40,000 specimens, and processed nearly 500 rooms from three different sites. We hope by making these legacy data available to a wider body of scholars that this resource will facilitate our ability to answer new questions as research evolves and promote understanding of the full complexity of Chacoan society

Children’s Receipt of Health Care Services and Family Health Insurance Patterns

PURPOSE Insured children in the United States have better access to health care services; less is known about how parental coverage affects children’s access to care. We examined the association between parent-child health insurance coverage patterns and children’s access to health care and preventive counseling services

An Evolved Mxe GyrA Intein for Enhanced Production of Fusion Proteins

Expressing antibodies as fusions to the non-self-cleaving Mxe GyrA intein enables site-specific, carboxy-terminal chemical modification of the antibodies by expressed protein ligation (EPL). Bacterial antibody-intein fusion protein expression platforms typically yield insoluble inclusion bodies that require refolding to obtain active antibody-intein fusion proteins. Previously, we demonstrated that it was possible to employ yeast surface display to express properly folded single-chain antibody (scFv)-intein fusions, therefore permitting the direct small-scale chemical functionalization of scFvs. Here, directed evolution of the Mxe GyrA intein was performed to improve both the display and secretion levels of scFv-intein fusion proteins from yeast. The engineered intein was shown to increase the yeast display levels of eight different scFvs by up to 3-fold. Additionally, scFv- and green fluorescent protein (GFP)-intein fusion proteins can be secreted from yeast, and while fusion of the scFvs to the wild-type intein resulted in low expression levels, the engineered intein increased scFv-intein production levels by up to 30-fold. The secreted scFv- and GFP-intein fusion proteins retained their respective binding and fluorescent activities, and upon intein release, EPL resulted in carboxy-terminal azide functionalization of the target proteins. The azide-functionalized scFvs and GFP were subsequently employed in a copper-free, strain-promoted click reaction to site-specifically immobilize the proteins on surfaces, and it was demonstrated that the functionalized, immobilized scFvs retained their antigen binding specificity. Taken together, the evolved yeast intein platform provides a robust alternative to bacterial intein expression systems