Measuring the Health Impact of Medical-Legal Interventions on Low-Income Patients

Research shows that nearly all of the low-income people in the United States have at least one civil legal problem that negatively affects their health. Family Advocates of Central Massachusetts (FACM) is a medical-legal partnership that aims to improve the well-being of vulnerable families by helping patients address legal issues linked to health status, such as access to necessary public benefits, substandard housing, education issues, immigration status, and protection from abusive relationships. The partnership includes Community Legal Aid and its subsidiary, Central West Justice Center, and three medical partners: UMass Medical School, UMass Memorial Children’s Medical Center, and Edward M. Kennedy Community Health Center. Medical providers are the sole community connection for many low-income families. Without legal care that is coordinated with medical care, they face an uphill battle in overcoming the social determinants of health that contribute to pervasive race- and class-based health disparities. When families ask their providers for help with issues that cannot be resolved in an exam room or with a prescription, FACM steps in. The poster will facilitate an interdisciplinary community-research dialogue about evaluating the social determinants of health. We are reassessing our existing outcomes measurement tools to better measure, evaluate, and share the health impact of medical-legal interventions. We welcome input from researchers and community organizations about alternative validated measures that may help us measure and demonstrate the connection between access to legal services and improved health

Network Services from Distributed Solar PV and Inverters

Networks Renewed is a major new project funded by the Australian Renewable Energy Agency (ARENA) that aims to demonstrate how solar PV, battery storage and inverters can support distribution networks in managing power quality. The path to implementation will be established by two commercial-scale demonstrations of controlled solar PV and energy storage in the regional Mid North Coast of NSW, and suburban Melbourne in Victoria. At the time of this conference the deployment of inverters and control technologies will have commenced towards pilot-scale demonstrations to test candidate control algorithms, several of which have been published in the engineering literature. These will develop into market-scale demonstrations to achieve useful power quality improvements on selected network segments, and also market trading revenues, should these materially improve the financial returns to customers from inverter control

Porous Silicon Nanoparticles Embedded in Poly(lactic‐ co ‐glycolic acid) Nanofiber Scaffolds Deliver Neurotrophic Payloads to Enhance Neuronal Growth

Scaffolds made from biocompatible polymers provide physical cues to direct the extension of neurites and to encourage repair of damaged nerves. The inclusion of neurotrophic payloads in these scaffolds can substantially enhance regrowth and repair processes. However, many promising neurotrophic candidates are excluded from this approach due to incompatibilities with the polymer or with the polymer processing conditions. This work provides one solution to this problem by incorporating porous silicon nanoparticles (pSiNPs) that are pre-loaded with the therapeutic into a polymer scaffold during fabrication. The nanoparticle-drug-polymer hybrids are prepared in the form of oriented poly(lactic-co-glycolic acid) nanofiber scaffolds. We test three different therapeutic payloads: bpV(HOpic), a small molecule inhibitor of phosphatase and tensin homolog (PTEN); an RNA aptamer specific to tropomyosin-related kinase receptor type B (TrkB); and the protein nerve growth factor (NGF). Each therapeutic is loaded using a loading chemistry that is optimized to slow the rate of release of these water-soluble payloads. The drug-loaded pSiNP-nanofiber hybrids release approximately half of their TrkB aptamer, bpV(HOpic), or NGF payload in 2, 10, and >40 days, respectively. The nanofiber hybrids increase neurite extension relative to drug-free control nanofibers in a dorsal root ganglion explant assay

The 1980-1981 drought in Illinois causes, dimensions, and impact

Hydrologic, meteorological, and climatological aspects of the 1980-1981 drought in Illinois are addressed. The drought is evaluated in terms of precipitation, streamflow, lakes and reservoirs, and groundwater resources of the state. The meteorological conditions that produced the drought also are addressed. Impacts and problems resulting from the drought are discussed along with various actions taken to ameliorate the problems. Although the primary goal of the study was to quantify the drought, primarily in a physical sense, an important secondary goal was to assess the impacts and the actions employed, to derive information needed in future planning and handling of Illinois droughts. The report thus ends with a set of recommendations for coping with future droughts. The 1980-1981 drought was not one of the extreme droughts of record; however, it is important in that it was the most severe drought since those of the early 1950’s. As such, it reflects some new types of impacts on the state’s water resources due to technological, hydrological, and institutional changes since the 1950’s.publishedpeer reviewedOpe

Dallas Bower: a producer for television's early years, 1936-39

Having worked in the film industry as a sound technician and then director, Dallas Bower (1907-99) was appointed in 1936 as one of two senior producers at the start of the BBC Television service. Over the next three years Bower produced as well as directed many ground-breaking live programmes, including the opening-day broadcast on 2 November 1936; the BBC Television Demonstration Film (1937, his only surviving pre-war production); a modern-dress Julius Caesar (1938), in uniforms suggestive of a Fascist disctatorship; Act II of Tristan and Isolde (1938); Patrick Hamilton’s play Rope (1939), utilising extended single camera-shots camera-shots; numerous ballets, among them Checkmate (1938); and ambitious outside broadcasts from the film studios at Denham and Pinewood. Developing the working practices of producing for the theatre, film industry and radio, Bower was a key figure in defining the role of the creative television producer at the start of the medium. Among his innovations, according to his unpublished autobiographical fragment ‘Playback’ (written 1995), was the introduction of a drawn studio plan for the four cameras employed in all live broadcasts from Alexandra Palace. Using Bower’s writings (among them his 1936 book Plan for Cinema), his BECTU History Project interview, the BBC Written Archives and contemporary industry coverage, this article reconstructs the early development of the role of staff television producer in order to consider the questions of autonomy, agency and institutional constraints at the BBC in the pre-war years

Is local review of positron emission tomography scans sufficient in diffuse large B-cell lymphoma clinical trials? A CALGB 50303 analysis

BACKGROUND: Quantitative methods of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) interpretation, including the percent change in FDG uptake from baseline (ΔSUV), are under investigation in lymphoma to overcome challenges associated with visual scoring systems (VSS) such as the Deauville 5-point scale (5-PS). METHODS: In CALGB 50303, patients with DLBCL received frontline R-CHOP or DA-EPOCH-R, and although there were no significant associations between interim PET responses assessed centrally after cycle 2 (iPET) using 5-PS with progression-free survival (PFS) or overall survival (OS), there were significant associations between central determinations of iPET ∆SUV with PFS/OS. In this patient cohort, we retrospectively compared local vs central iPET readings and evaluated associations between local imaging data and survival outcomes. RESULTS: Agreement between local and central review was moderate (kappa = 0.53) for VSS and high (kappa = 0.81) for ∆SUV categories (\u3c66% vs. ≥66%). ∆SUV ≥66% at iPET was significantly associated with PFS (p = 0.03) and OS (p = 0.002), but VSS was not. Associations with PFS/OS when applying local review vs central review were comparable. CONCLUSIONS: These data suggest that local PET interpretation for response determination may be acceptable in clinical trials. Our findings also highlight limitations of VSS and call for incorporation of more objective measures of response assessment in clinical trials

Cardiopulmonary exercise testing and cardiopulmonary morbidity in patients undergoing major head and neck surgery

Cardiopulmonary exercise testing (CPET) is used as a risk stratification tool for patients undergoing major surgery. In this study, we investigated the role of CPET in predicting day five cardiopulmonary morbidity in patients undergoing head and neck surgery. This observational cohort study included 230 adults. We recorded preoperative CPET variables and day five postoperative cardiopulmonary morbidity. Full data from 187 patients were analysed; 43 patients either had incomplete data sets or declined surgery/CPET. One hundred and nineteen patients (63.6%) developed cardiopulmonary morbidity at day five. Increased preoperative heart rate and duration of surgery were independently associated with day five cardiopulmonary morbidity. Those with such morbidity also had lower peak V̇O2 11.4 (IQR 8.4-18.0) vs 16.0 (IQR 14.0-19.7) ml.kg-1.min-1, P<0.0001 and V̇O2 at AT 10.6 (IQR 9.1-13.1) vs 11.5 (IQR 10.5-13.0) ml.kg-1.min-1, p=0.03. Logistic regression model containing peak V̇O2 and duration of surgery demonstrated that increased peak V̇O2 was associated with a reduction in the likelihood of cardiopulmonary complications OR 0.92 (95%CI 0.87 to 0.96), p=0.001. The area under the receiver operating characteristic curve for this model was 0.75(95%CI 0.68 to 0.82), p<0.0001, 64% sensitivity, 81% specificity. CPET can help to predict day five cardiopulmonary morbidity in the patients undergoing head and neck surgery. A model containing peak V̇O2 allowed identification of those with such complications