Medicaid in a Crunch: A Mid-FY 2009 Update on State Medicaid Issues in a Recession

Based on a November 2008 survey of Medicaid directors, examines the impact of the economic downturn on state Medicaid programs midway through fiscal year 2009, including possible cutbacks; the outlook for 2010; and priorities for federal action

Report of the CGIAR/TAC Secretariat Mission to ICIPE, Nairobi

Report of the CGIAR/TAC Secretariat Mission to ICIPE, Nairobi (by J. K. Coulter and B. N. Webster), to discuss possible arrangements for collaborative work between ICIPE and the IARCs. Agenda document presented at TAC's Eleventh Meeting, October 1975

Proposals for Strengthening the Research and Financial Management of WARDA

Draft report of a mission from the CGIAR and TAC secretariats to WARDA from 15 to 29 September 1974. It describes WARDA's rational, structure, and activities, and makes recommendations concerning research management, project integration, CGIAR support, financial planning and budget responsibilities, and the roles and responsibilities of various WARDA units. A certified statement of expenditure for 22 months ended September 1973 is attached. Agenda document presented at CGIAR meeting, October 1974

Prostate cancer radiotherapy: potential applications of metal nanoparticles for imaging and therapy

Prostate cancer (CaP) is the most commonly diagnosed cancer in males. There have been dramatic technical advances in radiotherapy delivery, enabling higher doses of radiotherapy to primary cancer, involved lymph nodes and oligometastases with acceptable normal tissue toxicity. Despite this, many patients relapse following primary radical therapy, and novel treatment approaches are required. Metal nanoparticles are agents that promise to improve diagnostic imaging and image-guided radiotherapy and to selectively enhance radiotherapy effectiveness in CaP. We summarize current radiotherapy treatment approaches for CaP and consider pre-clinical and clinical evidence for metal nanoparticles in this condition

Cost-Effective Method for Producing Self Supported Palladium Alloy Membranes for Use in Efficient Production of Coal Derived Hydrogen

In the past quarter, no technical work has been completed and two ''no cost'' time extensions have been requested and granted to allow Idatech time to complete Task 5 relating to the testing of prototype membrane modules. The scheduled completion date of April 7, 2007 has been confirmed by Idatech

Amorphous Alloy Membranes for High Temperature Hydrogen Separation

At the beginning of this project, thin film amorphous alloy membranes were considered a nascent but promising new technology for industrial-scale hydrogen gas separations from coal- derived syngas. This project used a combination of theoretical modeling, advanced physical vapor deposition fabricating, and laboratory and gasifier testing to develop amorphous alloy membranes that had the potential to meet Department of Energy (DOE) targets in the testing strategies outlined in the NETL Membrane Test Protocol. The project is complete with Southwest Research Institute® (SwRI®), Georgia Institute of Technology (GT), and Western Research Institute (WRI) having all operated independently and concurrently. GT studied the hydrogen transport properties of several amorphous alloys and found that ZrCu and ZrCuTi were the most promising candidates. GT also evaluated the hydrogen transport properties of V, Nb and Ta membranes coated with different transition-metal carbides (TMCs) (TM = Ti, Hf, Zr) catalytic layers by employing first-principles calculations together with statistical mechanics methods and determined that TiC was the most promising material to provide catalytic hydrogen dissociation. SwRI developed magnetron coating techniques to deposit a range of amorphous alloys onto both porous discs and tubular substrates. Unfortunately none of the amorphous alloys could be deposited without pinhole defects that undermined the selectivity of the membranes. WRI tested the thermal properties of the ZrCu and ZrNi alloys and found that under reducing environments the upper temperature limit of operation without recrystallization is ~250 °C. There were four publications generated from this project with two additional manuscripts in progress and six presentations were made at national and international technical conferences. The combination of the pinhole defects and the lack of high temperature stability make the theoretically identified most promising candidate amorphous alloys unsuitable for application as hydrogen separation membranes in coal fire systems

Underrepresented: Descriptive Representation and Political Interest of African Americans and Women in the 2008 Election

- 83 - Representing the Underrepresented: Descriptive Representation and Political Interest of African Americans and Women in the 2008 Election Kristine Coulter University of California, Irvine Jennifer R. Garcia University of California, Irvine Christopher T. Stout Southern Illinois University, Carbondale In this article, we examine the effect of the presidential candidacies of Barack Obama and Hillary Clinton and the vice presidential candidacy of Sarah Palin on change in political interest among African Americans and women over the course of the 2008 election. We also examine the effects of these candidacies on intra-group characteristics in these marginalized groups. Consistent with the descriptive representation literature, we find that descriptive representation has a positive effect on African American’s and women’s levels of political interest. Unlike previous studies, we find that there are intra-group differences in change in political interest among African Americans and women. In particular, we find that age is negatively associated with growth in interest among African Americans and women, indicating that younger African Americans and women experienced the largest growth in interest over the course of the 2008 election. These results suggest that African Americans and women who are not fully socialized into the political system may benefit the most from descriptive representation

New approaches to measurement and management for high integrity health systems

Healthcare economies across the globe are in crisis. High income countries—whether their healthcare economies are market driven like the US or tax funded like the UK—are struggling with relentless demand for more services that are increasingly costly to deliver. Low and middle income countries are struggling to provide better and more equitable access to potentially lifesaving interventions while wisely allocating scarce resources across all sectors that affect human and social development. In rich and poor countries alike, policy makers, citizens, and health professionals are drawn to technology but are not learning how to use it most effectively or from mistakes made when its limits go unrecognised or unheeded.1 Variation in regional rates of therapeutic and diagnostic interventions and hospital based care exists globally with no measurable benefit in populations receiving more services.2345 At the same time effective primary healthcare and social services that can have a greater effect on health and wellbeing are being underused.467 The failure to deliver the right care at the right time in the right place contributes to the waste of as much as 40% of healthcare expenditures.48 Recognition of this waste, which is often associated with harm to patients, has spurred health policy reforms across the globe. One common objective is people centred care, which focuses on the needs and wants of individuals and engages them in management of their own care, including behaviours that promote and sustain health and wellbeing. A policy forum held earlier this year, which included health ministers and other representatives from members of the Organisation for Economic Cooperation and Development and seven other countries, advocated a shift from “a system centred on providers to one centred on people’s individual needs and preferences.” The same shift has been advocated in China and for other countries investing heavily in developing healthcare economies.91011 Reform has been successful in some settings, but nowhere has the scale of reform been sufficient to allay concerns about personalised care or about system sustainability. A high integrity health system is one dedicated to providing services that people need and want—no less but no more—and that puts the interests of patients and the public above those of all other stakeholders.12 In this analysis, we discuss how next generation reforms towards a high integrity health system will need to move from the “what” to the “how” of change, to reflect a greater understanding of the sources of resistance, and to take new approaches to measurement and management to guide system performance and innovation

Validity of the activPAL3 activity monitor in people moderately affected by Multiple Sclerosis

Background: Walking is the primary form of physical activity performed by people with Multiple Sclerosis (MS), therefore it is important to ensure the validity of tools employed to measure walking activity. The aim of this study was to assess the criterion validity of the activPAL3 activity monitor during overground walking in people with MS.\ud Methods: Validity of the activPAL3 accelerometer was compared to video observation in 20 people moderately affected by MS. Participants walked 20-30m twice along a straight quiet corridor at a comfortable speed.\ud Results: Inter-rater reliability of video observations was excellent (all intraclass correlations > 0.99). The mean difference (activPAL3- mean of raters) was -4.70 ± 9.09, -4.55 s ± 10.76 and 1.11 s ± 1.11 for steps taken, walking duration and upright duration respectively. These differences represented 8.7, 10.0 and 1.8% of the mean for each measure respectively. The activPAL3 tended to underestimate steps taken and walking duration in those who walked at cadences of ≤ 38 steps/minute by 60% and 47% respectively.\ud Discussion: The activPAL3 is valid for measuring walking activity in people moderately affected by MS. It is accurate for upright duration regardless of cadence. In participants with slow walking cadences, outcomes of steps taken and walking duration should be interpreted with caution