Closing the Divide: How Medical Homes Promote Equity in Health Care

Presents findings from the Commonwealth Fund 2006 Health Care Quality Survey, and demonstrates how having stable insurance, a regular provider and, in particular, a medical home, improves health care access and quality among vulnerable populations

Cosmic Strings, Zero Modes and SUSY breaking in Nonabelian N=1 Gauge Theories

We investigate the microphysics of cosmic strings in Nonabelian gauge theories with N=1 supersymmetry. We give the vortex solutions in a specific example and demonstrate that fermionic superconductivity arises because of the couplings and interactions dictated by supersymmetry. We then use supersymmetry transformations to obtain the relevant fermionic zero modes and investigate the role of soft supersymmetry breaking on the existence and properties of the superconducting strings.Comment: 12 pages, RevTex, submitted to Phys. Rev.

Cognitive demands and second-language learners: A framework for analyzing mathematical instructional contexts

The issues involved in teaching English language learners mathematics while they are learning English pose many challenges for mathematics teachers and highlight the need to focus on language-processing issues related to teaching mathematical content. Two realistic-type problems from high-stakes tests are used to illustrate the complex interactions between culture, language, and mathematical learning. The analyses focus on aspects of the problems that potentially increase cognitive demands for second-language learners. An analytical framework is presented that is designed to enable mathematics teachers to identify critical elements in problems and the learning environment that contribute to increased cognitive demands for students of English as a second language. The framework is proposed as a cycle of teacher reflection that would extend a constructivist model of teaching to include broader linguistic, cultural, and cognitive processing issues of mathematics teaching, as well as enable teachers to develop more accurate mental models of student learning

Chiral Vortons and Cosmological Constraints on Particle Physics

We investigate the cosmological consequences of particle physics theories that admit stable loops of current-carrying string - vortons. In particular, we consider chiral theories where a single fermion zero mode is excited in the string core, such as those arising in supersymmetric theories with a D-term. The resulting vortons formed in such theories are expected to be more stable than their non-chiral cousins. General symmetry breaking schemes are considered in which strings formed at one symmetry breaking scale become current-carrying at a subsequent phase transition. The vorton abundance is estimated and constraints placed on the underlying particle physics theories from cosmological observations. Our constraints on the chiral theory are considerably more stringent than the previous estimates for more general theories.Comment: minor corrections made. This version will appear in PR

Spillover adherence effects of fixed-dose combination HIV therapy

The impact of fixed-dose combination (FDC) products on adherence to other, non-fixed regimen components has not been examined. We compared adherence to a third antiretroviral (ART) component among patients receiving a nucleoside reverse transcriptase inhibitor (NRTI) backbone consisting of the FDC Epzicom®, GlaxoSmithKline Inc, Research Triangle Park, NC (abacavir sulfate 600 mg + lamivudine 300 mg; FDC group) versus NRTI combinations taken as two separate pills (NRTI Combo group) using data from a national sample of 30 health plans covering approximately 38 million lives from 1997 to 2005. Adherence was measured as the medication possession ratio (MPR). Multivariate logistic regression compared treatment groups based on the likelihood of achieving ≥95% adherence, with sensitivity analyses using alternative thresholds. MPR was assessed as a continuous variable using multivariate linear regression. Covariates included age, gender, insurance payer type, year of study drug initiation, presence of mental health and substance abuse disorders, and third agent class. The study sample consisted of 650 FDC and 1947 NRTI Combo patients. Unadjusted mean adherence to the third agent was higher in the FDC group than the NRTI Combo group (0.92 vs 0.85; P < 0.0001). In regression analyses, FDC patients were 48% and 39% more likely to achieve 95% and 90% third agent adherence, respectively (P ≤ 0.03). None of the other MPR specifications achieved comparable results. Among managed care patients, use of an FDC appears to substantially improve adherence to a third regimen component and thus the likelihood of achieving the accepted standard for adherence to HIV therapy of 95%

Evaluating Driving as a Valued Instrumental Activity of Daily Living

The purpose of this translational research article is to illustrate how general practice occupational therapists have the skills and knowledge to address driving as a valued occupation using an algorithm based on the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; American Occupational Therapy Association, 2008b). Evidence to support the model is offered by a research study. Participants were compared on their performance of complex instrumental activities of daily living (IADLs) and a behind-thewheel driving assessment. A significant relationship was found between the process skills from the performance assessment and whether the driver passed, failed, or needed restrictions as indicated by the behind-the-wheel assessment. The evidence suggests that occupational therapists using observational performance evaluation of IADLs can assist in determining who might be an at-risk driver. The algorithm addresses how driver rehabilitation specialists can be used most effectively and efficiently with general practice occupational therapy practitioners meeting the needs of senior drivers

Reviews

Reviews Anne E. Mullin. Teaching Writing Creatively. (David Starkey, Ed., 1998). Keith Rhodes. Zen in the Art of Rhetoric: An Inquiry into Coherence. (Mark Lawrence McPhail, 1996). Ellen Davis. Women in Praise of the Sacred: 43 Centuries of Spiritual Poetry by Women. (Jane Hirshfield, Ed., 1994). Jean R. Trounstine. Educational Drama and Language Arts: What Research Shows. (Betty Jane Wagner, 1998)

Moduli-Space Approximation for BPS Brane-Worlds

We develop the moduli-space approximation for the low energy regime of BPS-branes with a bulk scalar field to obtain an effective four-dimensional action describing the system. An arbitrary BPS potential is used and account is taken of the presence of matter in the branes and small supersymmetry breaking terms. The resulting effective theory is a bi-scalar tensor theory of gravity. In this theory, the scalar degrees of freedom can be stabilized naturally without the introduction of additional mechanisms other than the appropriate BPS potential. We place observational constraints on the shape of the potential and the global configuration of branes.Comment: 10 pages, 1 figur

Attitudes of US Obstetricians Toward a Combined Tetanus-Diphtheria-Acellular Pertussis Vaccine for Adults

Objective. To describe obstetricians' perspectives related to tetanus-diphtheria-acellular pertussis (Tdap) vaccination of mothers and other adults in close contact with infants. Methods. Mail survey of national random sample of 400 obstetricians . Results. Response rate was 54%. Most respondents would likely recommend Tdap for women during the postpartum hospital stay (78%) or during pregnancy (69%) if a national recommendation was issued. Expected barriers were knowing the date of patients' most recent Td booster (74%) and patient resistance (46%). Most felt that obstetricians have a role in promoting and administering Tdap vaccine to adults other than mothers likely to come in close contact with infants. Conclusion. Obstetricians are likely to agree with the recent provisional US recommendation to administer Tdap to postpartum mothers and other adults expected to come in close contact with infants. Obstetricians would also be likely to support a potential recommendation to administer Tdap during pregnancy. Barriers to adoption of new Tdap vaccine recommendations should be monitored

Shining Light on Modifications of Gravity

Many modifications of gravity introduce new scalar degrees of freedom, and in such theories matter fields typically couple to an effective metric that depends on both the true metric of spacetime and on the scalar field and its derivatives. Scalar field contributions to the effective metric can be classified as conformal and disformal. Disformal terms introduce gradient couplings between scalar fields and the energy momentum tensor of other matter fields, and cannot be constrained by fifth force experiments because the effects of these terms are trivial around static non-relativistic sources. The use of high-precision, low-energy photon experiments to search for conformally coupled scalar fields, called axion-like particles, is well known. In this article we show that these experiments are also constraining for disformal scalar field theories, and are particularly important because of the difficulty of constraining these couplings with other laboratory experiments.Comment: 20 pages, 10 figures. v2: Matches version accepted by JCAP; additional discussion of the strong coupling scale. Conclusions unchange