Evaluating Effects of Tax Preferences on Health Care Spending and Federal Revenues

In this paper, we calculate the consequences for health spending and federal revenues of an above-the-line deduction for out-of-pocket health spending. We show how the response of spending to this expansion in the tax preference can be specified as a function of a small number of behavioral parameters that have been estimated in the existing literature. We compare our estimates to those from other researchers. And, we use our analysis to derive some implications for tax policy toward HSAs.

The Level-0 Muon Trigger for the LHCb Experiment

A very compact architecture has been developed for the first level Muon Trigger of the LHCb experiment that processes 40 millions of proton-proton collisions per second. For each collision, it receives 3.2 kBytes of data and it finds straight tracks within a 1.2 microseconds latency. The trigger implementation is massively parallel, pipelined and fully synchronous with the LHC clock. It relies on 248 high density Field Programable Gate arrays and on the massive use of multigigabit serial link transceivers embedded inside FPGAs.Comment: 33 pages, 16 figures, submitted to NIM

Establishment of Enabling Technology for Manufacture of Selected Types of Continental and Speciality Cheeses

End of Project ReportThe objectives in the project were the development of the science and technology for speciality cheese manufacture, identification and overcoming of the technical constraints to the manufacture of soft speciality cheeses in Ireland and the development of Moorepark Technology Limited (MTL) pilot plant as an integrated, flexible pre-commercial manufacturing platform with which to evaluate the market for speciality cheese.Department of Agriculture, Food and the Marin

Improving the Quality of European Hard Cheese by controlling interactions between Lactic Acid Bacteria and Propionic Acid Bacteria (LAB/PAB) (Stimulation of Propionic Acid Bacteria by Lactic

End of Project ReportTeagasc acknowledges with gratitude grant aid under the EU Framework Programme (FAIR 96-CT-1024).In the manufacture of Swiss-type cheese two successive fermentations occur. During manufacture, lactic acid bacteria (LAB), particularly Streptococcus thermophilus, Lactobacillus helveticus and Lb. delbrueckii subsp. lactis, convert lactose to lactate while, during ripening, propionic acid bacteria (PAB) convert lactate to propionic acid, acetic acid and carbon dioxide (CO2). CO2 is responsible for eye formation and propionic acid results in the typical nutty flavour of Swiss-type cheese. There have been a few reports of interactions between a small number of LAB and PAB but the compounds involved have not been identified. A better understanding of this phenomenon is necessary to select strains of PAB for cheesemaking and improve the quality of hard cheeses. Cheese cannot be used for such a study because of its complexity and the length of time it is ripened. Hence, a simple whey-based model developed by Piveteau et al (1995) was successfully used to study the interactions between LAB and PAB. In this procedure, the LAB were grown overnight in milk and the whey was collected by centrifugation. After neutralisation and filter-sterilisation, the growth of strains of PAB in this whey and in a control whey produced from the same milk by acidification with lactic acid were compared. The objectives of this study were to refine the model of Piveteau et al (1995) to study the interactions between LAB and PAB and to determine the nature of the stimulant(s) produced by the LAB. * Thirty-two combinations of different commercial strains of PAB and LAB were evaluated in a modified whey model. None showed any inhibition and all showed some degree of stimulation but the extent of the stimulation depended on the particular pair of PAB and LAB used. * An inhibitor of PAB was found in milk, which prevented the growth of PAB from low (105 cfu/ml) but not from high inocula (107 cfu/ml). The inhibitor was heat stable (to autoclaving for 15 min), of low molecular mass and could be removed by pre-growth of some but not all starter LAB in milk. * Growth of P. freudenreichii DPC 3801 in control whey was stimulated by peptone, tryptone, casein hydrolysed by the crude proteinase of Lb. helveticus DPC 4571 and by pre-growth of the lactobacillus in milk, but not by vitamins (riboflavin, thiamine, PABA, Ca panthothenate, biotin and nicotinic acid) or minerals (MgSO4, MnCl2, CoCl2 and CuSO4). * Growth of Lb. helveticus DPC 4571 in milk resulted in significant increases in peptide and amino acid production but the amino acids produced did not stimulate the growth of the PAB. Based on these results it was concluded that the stimulation was due to production of peptides by the LAB from casein. * The whey model developed by Piveteau et al (1995) to study the interactions between PAB and LAB was shown to be reproducible. Adjustment of the pH of the whey to 5.4 rather than 6.0, incubation at 24ºC rather than 30ºC and addition of 1% NaCl, to simulate cheese ripening conditions allowed growth of all the PAB tested. * Several chromatographic procedures, including ion-exchange, gel permeation and reverse-phase, high-pressure liquid chromatography failed to categorically identify the peptide(s) responsible for the stimulation of the PAB. In some of these chromatographic systems,the stimulatory activity was shown to be present in several peaks implying that different peptides were involved.European Unio

Long-term quality of life after en-bloc vertebrectomy: 25 patients followed up for 9 years

AbstractObjectiveAssess quality-of-life results in patients who have undergone extensive curative surgery for spinal tumor and compare them to the general population in France.IntroductionLife expectancy is not the only criterion to assess the outcomes after massive tumor resections. Residual quality of life is also crucial. An indication for major surgery for spinal tumor should take the patient's long-term functional status into account, but the literature is limited on this question.Materials and methodsTwenty-five living patients from a group of 120 operated were assessed, all of whom were operated on by the same surgeon between 1984 and 2007. The mean follow-up was 9 years (range, 3–25 years). The mean age at surgery was 49 years. The patients completed different functional and quality-of-life questionnaires: the Oswestry Disability Index version 2 (ODI), the PROLO, the Karnofsky Index of performance status (KI), the Eastern Cooperative Oncology Group performance status (ECOG), the Short Form-36 Health Survey (SF-36), and the EuroQol-5 Dimensions (EQ5D). In addition, each patient was clinically and radiographically evaluated. Subgroups were identified considering the number of levels resected and histology. Their results on the SF-36 were compared with the results from the general population in France.ResultsThe mean PCS (physical component summary of the SF-36) was 52.4, the MCS (mental component summary, the psychological component of the SF-36) was 47.7, the ODI was 18.2, the PROLO was 7, the ECOG was 1, and the KI was 80%. The resections at three levels were associated with worse results in terms of quality of life, but overall, the results were similar to the French general population data for all categories of the SF-36.ConclusionAppropriate indications for massive spinal resection give good oncological and functional results. Although the expected life expectancy justifies this aggressive surgery, postoperative quality of life shows that it can also be successful on a functional level.Level of evidenceLevel IV; retrospective clinical study

Young people and political action: who is taking responsibility for positive social change?

A human rights perspective suggests that we are all responsible for ensuring the human rights of others, which in turn ensures that our own human rights are respected and protected. A convenience sample of 108 young people (41 males and 67 females) aged between 16 and 25 completed a questionnaire which asked about (a) levels of involvement in political activity and (b) sense of personal responsibility for ensuring that the human rights of marginalised groups (e.g. ethnic minorities, immigrants, lesbians and gay men) are protected. Findings showed that most respondents supported (in principle) the notion of human rights for all, but tended to engage in low key political activity (e.g. signing petitions; donating money or goods to charity) rather than actively working towards positive social change. Qualitative data collected in the questionnaire suggested three main barriers to respondents viewing themselves as agents of positive social change: (1) "It’s not my problem", (2) "It’s not my responsibility", and (3) a sense of helplessness. Suggestions for how political action might best be mobilised among young people are also discussed.</p

The Effect of Medicare Coverage for the Disabled on the Market for Private Insurance

Subsidies for health insurance for chronically ill, high-cost individuals may increase coverage in the broader population by improving the functioning of insurance markets. In this paper, we assess an historical example of a policy intervention of this sort, the extension of Medicare to the disabled, on the private insurance coverage of non-disabled individuals. We use data on insurance coverage from the Panel Study of Income Dynamics from before and after the extension of Medicare to the disabled to estimate the effect of the program on private insurance coverage rates in the broader population. We find that the insurance coverage of individuals who had a health condition that limited their ability to work increased significantly in states with high versus low rates of disability. Our findings suggest that that subsidizing individuals with high expected health costs is an effective way to increase the private insurance coverage of other high-cost individuals.