Making Work Pay II: Comprehensive Health Insurance for Low-Income Working Families

Assesses the lack of health insurance and poor health among low-income families, and outlines a strategy to address their healthcare needs by expanding coverage through state-based purchasing pools, subsidies, an individual mandate, and cost containment

A New Method for Laminar Boundary Layer Transition Visualization in Flight: Color Changes in Liquid Crystal Coatings

The visualization of laminar to turbulent boundary layer transition plays an important role in flight and wind tunnel aerodynamic testing of aircraft wing and body surfaces. Visualization can help provide a more complete understanding of both transition location as well as transition modes; without visualization, the transition process can be very difficult to understand. In the past, the most valuable transition visualization methods for fight applications included sublimating chemicals and oil flows. Each method has advantages and limitations. In particular, sublimating chemicals are impractical to use in subsonic applications much above 20,000 feet because of the greatly reduced rates of sublimation at lower temperatures (less than -4 degrees Fahrenheit). Both oil flow and sublimating chemicals have the disadvantage of providing only one good data point per flight. Thus, for many important flight conditions, transition visualization has not been readily available. This paper discusses a new method for visualizing transition in fight by the use of liquid crystals. The new method overcomes the limitations of past techniques, and provides transition visualization capability throughout almost the entire altitude and speed ranges of virtually all subsonic aircraft flight envelopes. The method also has wide applicability for supersonic transition visualization in flight and for general use in wind tunnel research over wide subsonic and supersonic speed ranges

Predictors of incident herpes simplex virus type 2 infections in young women at risk for unintended pregnancy in San Francisco.

BackgroundYoung women receiving family planning services are at risk for both unintended pregnancy and herpes simplex virus type 2 (HSV-2) infection.MethodsWe performed a secondary analysis using data from a previously published randomized controlled trial evaluating access to emergency contraception on reproductive health outcomes. Women aged 15 to 24 years were recruited from two Planned Parenthood clinics and two community health clinics in San Francisco. Demographic information and sexual history were obtained by interview. HSV-2 seropositivity was determined by fingerstick blood test. New pregnancies were measured by self-report, urine testing and medical chart review. Subjects were evaluated for incident HSV-2 infection and pregnancy at a 6-month follow-up appointment. Women who were pregnant or intending to become pregnant at enrolment were excluded.ResultsAt enrolment 2,104 women were screened for HSV-2 and 170 (8.1%) were seropositive. Eighty-seven percent of initially seronegative women completed the study (n = 1,672) and 73 (4.4%) became HSV-2 seropositive. HSV-2 seroincidence was 7.8 cases per 100 person-years. One hundred and seventeen women (7%) became pregnant and 7 (6%) of these had a seroincident HSV-2 infection during the study. After adjustment for confounders, predictors of incident HSV-2 infection were African American race and having multiple partners in the last six months. Condom use at last sexual encounter was protective.ConclusionHSV-2 seroincidence and the unintended pregnancy rate in young women were high. Providers who counsel women on contraceptive services and sexually transmitted infection prevention could play an expanded role in counselling women about HSV-2 prevention given the potential sequelae in pregnancy. The potential benefit of targeted screening and future vaccination against HSV-2 needs to be assessed in this population

Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017

Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre–post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptions (post-OSI). No changes in nonsteroidal anti-inflammatory drug prescribing were seen. A small rise in the percentage of those reporting pain but not mean pain intensity ratings continued over the study period with no changes associated with OSI. Changes in analgesic prescribing trends were not paralleled by changes in reported pain intensity for older veterans with osteoarthritis

Stream nutrient enrichment has a greater effect on coarse than on fine benthic organic matter

Author Posting. © Society for Freshwater Science, 2013. This article is posted here by permission of Society for Freshwater Science for personal use, not for redistribution. The definitive version was published in Freshwater Science 32 (2013): 1111-1121, doi:10.1899/12-049.1.Nutrient enrichment affects bacteria and fungi associated with detritus, but little is known about how biota associated with different size fractions of organic matter respond to nutrients. Bacteria dominate on fine (1 mm) fractions, which are used by different groups of detritivores. We measured the effect of experimental nutrient enrichment on fungal and bacterial biomass, microbial respiration, and detrital nutrient content on benthic fine particulate organic matter (FPOM) and coarse particulate organic matter (CPOM). We collected FPOM and CPOM from 1 reference and 1 enriched stream. CPOM substrates consisted of 2 litter types with differing initial C:nutrient ratios (Acer rubrum L. and Rhododendron maximum L.). Fungal and bacterial biomass, respiration, and detrital nutrient content changed with nutrient enrichment, and effects were greater on CPOM than on FPOM. Fungal biomass dominated on CPOM (99% total microbial biomass), whereas bacterial biomass dominated on FPOM (95% total microbial biomass). These contributions were unchanged by nutrient enrichment. Bacterial and fungal biomass increased more on CPOM than FPOM. Respiration increased more on CPOM (up to 300% increase) than FPOM (50% increase), indicating important C-loss pathways from these resources. Microbial biomass and detrital nutrient content were positively related. Greater changes in nutrient content were observed on CPOM than on FPOM, and changes in detrital C:P were greater than changes in detrital C:N. Threshold elemental ratios analyses indicated that enrichment may reduce P limitation for shredders and exacerbate C limitation for collector-gatherers. Changes in CPOM-dominated pathways are critical in predicting shifts in detrital resource quality and C flow that may result from nutrient enrichment of detritus-based systems.This study and preparation of this manuscript were supported by National Science Foundation grants DEB-0318063 (to ADR, K. Suberkropp, B. Wallace, and M. Black) and DEB-0918894 (to ADR, J. Benstead, V. Gulis, and J. Maerz) and an Odum School of Ecology Graduate Research grant to CJT.2014-09-1

An Exploratory Investigation of the Ethical Behavior of Engineering Undergraduates

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95635/1/j.2168-9830.2012.tb00053.x.pd