4,958 research outputs found
The Impact of the Patient-Centered Medical Home on Health Disparities in Adults: A Systematic Review of the Evidence
Introduction: The objective of this study was to review the empirical evidence on Patient-Centered Medical Home (PCMH) impact on health disparities in adults.
Methods: We searched PubMed, Scopus, and Google Scholar to identify studies on PCMH/health homes and health disparities published in English between January 1, 2009 and December 31, 2014. Articles met inclusion criteria if they investigated at least one component of PCMH or health homes in vulnerable populations, defined by PROGRESS-PLUS criteria, and reported differences in one of five clinical quality measures.
Results: 964 articles were identified through database searching and subsequent snowballing. 60 articles underwent full text screening. Further review eliminated 56 studies. In the final 4 studies, PCMH interventions showed small improvements in health disparities.
Discussion: The PCMH has been suggested as a model for improving health disparities. Given rapid implementation in underserved settings, stakeholders should better understand the impact of the PCMH on health disparities
Web-Based Educational Seminars Compare Favorably with In-House Seminars for Bariatric Surgery Patients
Background
Comprehensive preparative patient education is a key element in bariatric patient success. The primary objective of this study was to compare attrition rates, demographics, and surgery outcomes between patients who participated in the online vs in-house preparative seminars.
Methods
A retrospective chart review was performed involving patients who chose to participate in online vs in-house educational seminar between July of 2014 and December of 2016. The patients were divided into two groups based on their choice of educational seminar and tracked to see how many made it to an initial visit and to surgery. In those who had bariatric surgery, data was collected on age, type of insurance, length of stay (LOS), longest follow-up, and change in body mass index.
Results
Total of 1230 patients were included in this study. There was no difference in attrition rate to initial consultation visit (29.1% vs 29.9%), but there was a statistically higher attrition to surgery in the in-house seminar attendees (72.9%) compared to online participants (66.6%, pโ<โ0.05). Between January 2015 and December 2016, 291 patients underwent primary bariatric surgery. The online group was on average 3 years younger which was statistically significant. There were no differences in LOS, longest follow-up, and weight loss at 12 months between the groups.
Conclusion
When comparing attrition rates and bariatric surgery outcomes, no overall difference was noted between patients who received web- or hospital-based preparative education. Bariatric programs should provide access to online seminars to attract younger population and save resources and cost
Spitzer Mid-Infrared Spectroscopy of Infrared Luminous Galaxies at z~2 II: Diagnostics
We present mid-IR spectral decomposition of a sample of 48 Spitzer-selected
ULIRGs spanning z~1-3 and likely L_IR~10^12-10^13Lsun. Our study aims at
quantifying the star-formation and AGN processes in these sources which recent
results suggest have evolved strongly between the observed epoch and today. To
do this, we study the mid-IR contribution of PAH emission, continuum, and
extinction. About 3/4 of our sample are continuum- (i.e. AGN) dominated
sources, but ~60% of these show PAH emission, suggesting the presence of
star-formation activity. These sources have redder mid-IR colors than typical
optically-selected quasars. About 25% of our sample have strong PAH emission,
but none are likely to be pure starbursts as reflected in their relatively high
5um hot dust continua. However, their steep 30um-to-14um slopes suggest that
star-formation might dominate the total infrared luminosity. Six of our z~2
sources have EW6.2>~0.3um and L_14um>~10^12Lsun (implying L_IR>~10^13Lsun). At
these luminosities, such high EW6.2 ULIRGs do not exist in the local Universe.
We find a median optical depth at 9.7um of =1.4. This is consistent
with local IRAS-selected ULIRGs, but differs from early results on
SCUBA-selected z~2 ULIRGs. Similar to local ULIRGs about 25% of our sample show
extreme obscuration (tau_9.7>~3) suggesting buried nuclei. In general, we find
that our sources are similar to local ULIRGs, but are an order of magnitude
more luminous. It is not clear whether our z~2 ULIRGs are simply scaled-up
versions of local ULIRGs, or subject to fundamentally different physical
processes.Comment: 60 pages, 15 figures, accepted for publication in Ap
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Developmental Fluoride Neurotoxicity: A Systematic Review and Meta-Analysis
Background: Although fluoride may cause neurotoxicity in animal models and acute fluoride poisoning causes neurotoxicity in adults, very little is known of its effects on childrenโs neurodevelopment. Objective: We performed a systematic review and meta-analysis of published studies to investigate the effects of increased fluoride exposure and delayed neurobehavioral development. Methods: We searched the MEDLINE, EMBASE, Water Resources Abstracts, and TOXNET databases through 2011 for eligible studies. We also searched the China National Knowledge Infrastructure (CNKI) database, because many studies on fluoride neurotoxicity have been published in Chinese journals only. In total, we identified 27 eligible epidemiological studies with high and reference exposures, end points of IQ scores, or related cognitive function measures with means and variances for the two exposure groups. Using random-effects models, we estimated the standardized mean difference between exposed and reference groups across all studies. We conducted sensitivity analyses restricted to studies using the same outcome assessment and having drinking-water fluoride as the only exposure. We performed the Cochran test for heterogeneity between studies, Beggโs funnel plot, and Egger test to assess publication bias, and conducted meta-regressions to explore sources of variation in mean differences among the studies. Results: The standardized weighted mean difference in IQ score between exposed and reference populations was โ0.45 (95% confidence interval: โ0.56, โ0.35) using a random-effects model. Thus, children in high-fluoride areas had significantly lower IQ scores than those who lived in low-fluoride areas. Subgroup and sensitivity analyses also indicated inverse associations, although the substantial heterogeneity did not appear to decrease. Conclusions: The results support the possibility of an adverse effect of high fluoride exposure on childrenโs neurodevelopment. Future research should include detailed individual-level information on prenatal exposure, neurobehavioral performance, and covariates for adjustment
Extremal generalized quantum measurements
A measurement on a section K of the set of states of a finite dimensional
C*-algebra is defined as an affine map from K to a probability simplex. Special
cases of such sections are used in description of quantum networks, in
particular quantum channels. Measurements on a section correspond to
equivalence classes of so-called generalized POVMs, which are called quantum
testers in the case of networks. We find extremality conditions for
measurements on K and characterize generalized POVMs such that the
corresponding measurement is extremal. These results are applied to the set of
channels. We find explicit extremality conditions for two outcome measurements
on qubit channels and give an example of an extremal qubit 1-tester such that
the corresponding measurement is not extremal.Comment: 13 pages. The paper was rewritten, reorganized and shortened, the
title changed, references were added. Main results are the sam
Conditions for Successful Environmental Policy Making in Globalized Metropolitan Areas: Understanding Los Angeles County Air Pollution Policies
ํ์๋
ผ๋ฌธ (์์ฌ)-- ์์ธ๋ํ๊ต ๋ํ์ : ์ ์น์ธ๊ตํ๋ถ(์ธ๊ตํ์ ๊ณต), 2013. 8. Stefan Niederhafner.45ํผ์ผํธ์ ์ ์ธ๊ณ ๋๊ธฐ ์ค์ผ ๋ฌผ์ง ๋ฐ ์ด์ํํ์๊ฐ ๋์์์ ๋ฐฐ์ถ๋๋ฏ๋ก ํ๊ฒฝ์ ์ง์ ์ ํ ํนํ ๋๊ธฐ ์ค์ผ์ด ์ ์ธ๊ณ์ ๋์์ ๋์ ๋ณตํฉ ์ง์ญ์ ์ฌ๊ฐํ ์ํ์ ๊ฐํ๊ณ ์๋ค. ์ด ๋
ผ๋ฌธ์์๋ ๋ก์ค์ค์ ค๋ ์ค์์ ์ฑ๊ณต์ ์ธ ์ฒญ์ ๋๊ธฐ ์ ์ฑ
์ฌ๋ก๋ฅผ ์กฐ์ฌํ๊ณ ๋๋ถ์ด ์ง์ญ์ ์ค์ผ์์ ๋์ํ๋ ์ธ๊ณ์ ๋์ ์ ๊ธฐ์ฌํ๋ฉฐ ์ฑ๊ณต์ ์ธ ํ๊ฒฝ ๊ด๋ จ ์ฌ์ ํนํ ์ฒญ์ ๋๊ธฐ ์ ์น ๋ถ์ผ์ ๊ด๋ จ๋ ์กฐ๊ฑด์ ๊ดํด ์์ธํ ์ค๋ช
ํ๋ค. ์ด ์ฐ๊ตฌ์ ์ฃผ์ ๋ชฉํ๋ ์ต์์ ๊ดํ ๋ชจ๋ธ์ ์ธก๋ฉด์์ ๊ฐ์ ๋ฌธ์ ๋ฅผ ๋ค๋ฃจ๋ ๋ค๋ฅธ ์ธ๊ณ ๋์๋ค์ ์ ์ฉ๋ ์ ์๋ ์ ๋ ๋ฐ ์ ์ฐจ์ ์ธ๋ถ ์ฌํญ์ ํ์
ํ๋ ๊ฒ์ด๋ค. ์ ์ฑ
์ฃผ๊ธฐ ๋ถ์๊ณผ ๊ฒฐํฉ๋ ์๋ก์ด ์ ๋ ๊ฐ๋
์ ์ ์ฉํ์ฌ ์ง๋ฐฉ ์ ๋ถ์์์ ๋๊ธฐ ์ค์ผ ๊ด๋ฆฌ์ ์์ฌ ๊ฒฐ์ ๊ณผ์ ๋ฟ๋ง ์๋๋ผ NGO(๋น์ ๋ถ ๊ธฐ๊ตฌ) ๋ฐ ์ฌ๋ก ์ ์ญํ ๊ณผ ์ํฅ์ ์กฐ์ฌํ ์ ์๋ค. ๋ณธ ๋ถ์์ ์ค์ฆ์ ๊ทผ๊ฑฐ๋ ์์น์ฃผ ๊ท์ 5.90์ฅ ๋ฐ ๊ท์น 1143์ ํด๋นํ๋ ๋ ๊ฐ์ง ์ ์ฑ
์ ๋ํ ์ฌ๋ ์๋ ์ฐ๊ตฌ ์ธ๋ค. ์ด ๋ ๊ฐ์ง ๊ฒฝ์ฐ์ ๋ํ ์ฐ๊ตฌ๊ฐ ๋ก์ค์ค์ ค๋ ์ค์์ ์ ์น ์ฒด๊ณ๊ฐ ์ด๋ป๊ฒ ๋๊ธฐ ์ค์ผ์ ์ง์ญ์ ๋ํ ์ํ์ผ๋ก ํ์
ํ๊ณ ํจ๊ณผ์ ์ด๊ณ ์ ํจํ ์ฒญ์ ๋๊ธฐ ์ ์ฑ
์ ํตํด ๋๊ธฐ ์ค์ผ์ ๋์ํ ์ ์์๋์ง๋ฅผ ์ค๋ช
ํ๊ฒ ๋๋ค. ๊ฒฐ๊ณผ์ ์ผ๋ก ์ด ์ฐ๊ตฌ๋ NGO ๋ฐ ํญ๋์ ๋์ค์ ๊ธฐ์ฌ๋ฅผ ์ํ ์ ๋์ ๋ค์ํ ๋ฐ ์ ๋ฌธํ, ๋ฒ์์ ๊ดํ ๊ถ ๋ฐ ์ ์ ๊ณผ ๊ฐ์ ์ธ ๊ฐ์ง ์ฃผ์ ์กฐ๊ฑด์ด ์ฑ๊ณต์ ์ธ ์ฒญ์ ๋๊ธฐ ์ ์ฑ
์ ์ํด ์์ฃผ ์ค์ํจ์ ์ฃผ์ฅํ๋ค. ๊ฒ๋ค๊ฐ ์ด ์ฐ๊ตฌ๋ ์ธ๊ณ ํ๊ฒฝ ๋ฐ ๊ฑด๊ฐ์ ๋ํ ์ํ์ ๋์ํ๋ ๋ฐ ๋ก์ค์ค์ ค๋ ์ค์๊ฐ ์ด๋ป๊ฒ ๊ณตํํ ์ ์๋์ง๋ ์ ์ํ๋ค.Environmental degradation, particularly in air pollution, is posing a serious threat for cities and urban agglomerations around the world since 45 percent of global air pollutants and CO2 emissions stem from cities. By way of investigating the cases of successful clean air policies in the city of Los Angeles, this paper will elaborate on the conditions for successful environmental issues, specifically in clean air politics, in addition to contributing to a global challenge of counteracting against its local origins. The main goal in this study is to identify institutional and procedural specifics that can be transferred in the sense of the best practice model to other global cities dealing with the same problem. By applying a new-institutional concept combined with a policy cycle analysis, this will allow not only an analysis of the decision-making process of air pollution control in the local government, but also to examine the role and the influence of NGOs and public opinion. The empirical basis of the analysis is an in-depth study of two policies, County Code Chapter 5.90 and Rule 1143. Studying these two cases will explain how the political system of Los Angeles was able to identify air pollution as a local threat and to react with effective and efficient clean air policies. As a result, this study argues that three major conditions, institutional diversification and specialization, court jurisdiction and access points for contributions of NGOs and the wider public are crucial for successful clean air policies. Moreover, this study presents how the Los Angeles County can contribute to counteracting global environment and health threats.Table of Contents
Chapter 1 Introduction
1.1 Importance of Globalized Cities
1.2 Purpose and Case Selection
1.3 Literature Review
1.4 Theoretical Framework
1.5 Operationalization
Chapter 2 Political Background and History of Air Pollution
2.1 Demographic and Economy
2.2 Political Structure
2.3 Causes of Air Pollution
2.4 Effects from Air Pollution
Chapter 3 Agenda-Setting in Clean Air Policies
3.1 Board of Supervisors and Chapter 5 of the Los Angeles County Code
3.2 AQMD and Rule 1143
3.3 Coalition for Clean Air
3.4 Conclusion
Chapter 4 Policy Formation in Clean Air Policies
4.1 Board of Supervisors and Chapter 5 of the Los Angeles County Code
4.2 AQMD and Rule 1143
4.3 Conclusion
Chapter 5 Decision-Making and Implementation in Clean Air Policies
5.1 Board of Supervisors and Chapter 5 of the Los Angeles County Code
5.2 AQMD and Rule 1143
5.3 Conclusion
Chapter 6 Evaluation in Clean Air Policies
6.1 Board of Supervisors and Chapter 5 of the Los Angeles County Code
6.2 AQMD and Rule 1143
6.3 Conclusion
Chapter 7 Conclusion
Bibliography
AppendixMaste
How robust are cross-country comparisons of PISA scores to the scaling model used?
The Programme for International Student Assessment (PISA) is an important international study of 15โolds' knowledge and skills. New results are released every 3 years, and have a substantial impact upon education policy. Yet, despite its influence, the methodology underpinning PISA has received significant criticism. Much of this criticism has focused upon the psychometric scaling model used to create the proficiency scores. The aim of this article is to therefore investigate the robustness of crossโcountry comparisons of PISA scores to subtle changes to the underlying scaling model used. This includes the specification of the itemโresponse model, whether the difficulty and discrimination of items are allowed to vary across countries (itemโbyโcountry interactions) and how test questions not reached by pupils are treated. Our key finding is that these technical choices make little substantive difference to the overall countryโlevel results
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