Hospital and Physician Capacity Update

Offers an alternative view of healthcare costs by examining trends in hospital capacity and healthcare labor across regions. Outlines how effective management of healthcare capacity would enable affordable quality care that meets patient needs and wants

Democracy, governance and political parties in India: an introduction

The party political domain of India is replete with a large number of parties representing the tapestry of Indian society. Many of them are based in specific regions and states, built around social and linguistic identities. While this enhanced the representative character of the parties, it also contributed to varied patterns of political competition and unstable governments. The two major national parties – the Congress and the Bharatiya Janata Party – becoming coalitionable heralded an era of coalition governments both at the Centre and states, enabling parties to increase their power and their pay-offs. Parties across the political spectrum have tended to converge on macro-economic policy, but continue to diverge on social policies and larger issues that confront India, such as nation building and secularism. Chronic lack of internal democracy coupled with the rise of political corruption and clientelist practices are matters of serious concern. A broader view of governance, resisting temptations to concentrate power and pursue personal enrichment, would enable parties to deliver policies for a better, more just society

Trends and Variation in End-of-Life Care for Medicare Beneficiaries With Severe Chronic Illness

Provides an updated analysis of regional and hospital variations in end-of-life care for Medicare beneficiaries with chronic illnesses, including percentage of hospital deaths, days in intensive care units, and physician labor per patient

The Effects of the Transcription Factor IRF-3 in Pam2ODN Microbial Resistance

https://openworks.mdanderson.org/sumexp23/1092/thumbnail.jp

A Comparison of Spectroscopic versus Imaging Techniques for Detecting Close Companions to Kepler Objects of Interest

(Abbreviated) Kepler planet candidates require both spectroscopic and imaging follow-up observations to rule out false positives and detect blended stars. [...] In this paper, we examine a sample of 11 Kepler host stars with companions detected by two techniques -- near-infrared adaptive optics and/or optical speckle interferometry imaging, and a new spectroscopic deblending method. We compare the companion Teff and flux ratios (F_B/F_A, where A is the primary and B is the companion) derived from each technique, and find no cases where both companion parameters agree within 1sigma errors. In 3/11 cases the companion Teff values agree within 1sigma errors, and in 2/11 cases the companion F_B/F_A values agree within 1sigma errors. Examining each Kepler system individually considering multiple avenues (isochrone mapping, contrast curves, probability of being bound), we suggest two cases for which the techniques most likely agree in their companion detections (detect the same companion star). Overall, our results support the advantage the spectroscopic deblending technique has for finding very close-in companions ($\theta \lesssim$0.02-0.05") that are not easily detectable with imaging. However, we also specifically show how high-contrast AO and speckle imaging observations detect companions at larger separations ($\theta \geq$0.02-0.05") that are missed by the spectroscopic technique, provide additional information for characterizing the companion and its potential contamination (e.g., PA, separation, $\Delta$m), and cover a wider range of primary star effective temperatures. The investigation presented here illustrates the utility of combining the two techniques to reveal higher-order multiples in known planet-hosting systems.Comment: Accepted to AJ. 40 pages, 12 figure

Observations of Binary Stars with the Differential Speckle Survey Instrument. V. Toward an Empirical Metal-Poor Mass-Luminosity Relation

In an effort to better understand the details of the stellar structure and evolution of metal poor stars, the Gemini North telescope was used on two occasions to take speckle imaging data of a sample of known spectroscopic binary stars and other nearby stars in order to search for and resolve close companions. The observations were obtained using the Differential Speckle Survey Instrument, which takes data in two filters simultaneously. The results presented here are of 90 observations of 23 systems in which one or more companions was detected, and 6 stars where no companion was detected to the limit of the camera capabilities at Gemini. In the case of the binary and multiple stars, these results are then further analyzed to make first orbit determinations in five cases, and orbit refinements in four other cases. Mass information is derived, and since the systems span a range in metallicity, a study is presented that compares our results with the expected trend in total mass as derived from the most recent Yale isochrones as a function of metal abundance. These data suggest that metal-poor main-sequence stars are less massive at a given color than their solar-metallicity analogues in a manner consistent with that predicted from the theory

Information-Driven Inverse Approach to Disordered Solids: Applications to Amorphous Silicon

© Physical Review Materials Publisher\u27s Versio

Tracking the Care of Patients with Severe Chronic Illness - The Dartmouth Atlas of Health Care 2008

In 2001 the Institute of Medicine (IOM) issued Crossing the Quality Chasm, a report that sent a wake-up call to patients, providers, and policy makers about the poor quality of American health care. The IOM argued that one of the central drivers of poor quality has been the unsystematic and fragmentary nature of our health care delivery system. Nowhere are the system’s failings more apparent than in the care of the chronically ill. More than 90 million Americans live with at least one chronic illness, and seven out of ten Americans die from chronic disease. Among the Medicare population, the toll is even greater: about nine out of ten deaths are associated with just nine chronic illnesses, including congestive heart failure, chronic lung disease, cancer, coronary artery disease, renal failure, peripheral vascular disease, diabetes, chronic liver disease, and dementia

Improvement in word recognition following treatment failure for sudden sensorineural hearing loss

AbstractObjectivesPatients with sudden sensorineural hearing loss (SSNHL) may have word recognition scores (WRS) that correlate with pure tone average (PTA). We hypothesize that there is a subset of patients with SSNHL who have improved WRS despite stable PTA.MethodsRetrospective case review at a tertiary otolaryngology practice.ResultsWe identified 13 of 113 patients with SSNHL whose WRS increased despite overall stable pure tone averages. There was an observed average improvement in WRS by 23.8 points in this patient cohort at follow-up, with mean initial PTA in the affected ear at 48.7 dB.ConclusionsWe identify a novel cohort of SSNHL patients that have failed treatment as measured by PTA, but who have increased WRS over time. These data have implications for patient counseling and lend insight into the pathophysiology of SSNHL

The effect of socio-economic status on severity of periocular basal cell carcinoma at presentation

Purpose: To evaluate the influence of socio-economic factors on size of periocular basal cell carcinoma at presentation. Methods: All periocular basal cell carcinoma cases receiving treatment from the oculoplastics team in South Glasgow Hospitals NHS Trust, Glasgow, between 1999 and 2009, were identified retrospectively. Information collected included demographic details of patients, side and site of lesions, type of lesions, and size of lesions. The size of lesion was defined as small for any dimension not exceeding 5 mm, medium for dimensions between 6 mm and 10 mm, and large for dimensions exceeding 11 mm. Home address was used to determine the Scottish Index of Multiple Deprivation rank. The demographics, size of lesion, and Scottish Index of Multiple Deprivation rank were investigated using the general linear regression modelling. Results: Of the 67 cases, 24 were men and 43 were women. The mean age was 71.5 years. There were a total of 67 identified cases, of which 38 presented with small-size lesions, 24 with medium-size lesions, and 5 with large-size lesions. Scottish Index of Multiple Deprivation is related to the presenting incidence of basal cell carcinoma, with the lower ranks presenting more frequently. Conclusions: Socio-economic deprivation is associated with larger and more frequent presentation of periocular basal cell carcinoma. This highlights the importance of raising awareness among populations of the more deprived areas of the significance of lumps and bumps within the periocular regions