Coordination of Care by Primary Care Practices: Strategies, Lessons and Implications

Documents successful strategies for coordinating care within primary care settings, including family and caregivers; with specialists; with hospital settings; and with community-based services. Discusses challenges, lessons learned, and implications

New Poll: Adults Working With Youths Say Minority Children Face More Obstacles to Health and Success than White Counterparts

Minority children and teenagers have fewer opportunities than white counterparts to be healthy, obtain a quality education and achieve economic success, according to a national survey of adults whose jobs involve children's education, health and economic well-being. The groundbreaking poll was released by the independent W.K. Kellogg Foundation, which sought to gauge the level of disparities affecting children of color

Relaxation dynamics of the Lieb-Liniger gas following an interaction quench: A coordinate Bethe-ansatz analysis

We investigate the relaxation dynamics of the integrable Lieb-Liniger model of contact-interacting bosons in one dimension following a sudden quench of the collisional interaction strength. The system is initially prepared in its noninteracting ground state and the interaction strength is then abruptly switched to a positive value, corresponding to repulsive interactions between the bosons. We calculate equal-time correlation functions of the nonequilibrium Bose field for small systems of up to five particles via symbolic evaluation of coordinate Bethe-ansatz expressions for operator matrix elements between Lieb-Liniger eigenstates. We characterize the relaxation of the system by comparing the time-evolving correlation functions following the quench to the equilibrium correlations predicted by the diagonal ensemble and relate the behavior of these correlations to that of the quantum fidelity between the many-body wave function and the initial state of the system. Our results for the asymptotic scaling of local second-order correlations with increasing interaction strength agree with the predictions of recent generalized thermodynamic Bethe-ansatz calculations. By contrast, third-order correlations obtained within our approach exhibit a markedly different power-law dependence on the interaction strength as the Tonks-Girardeau limit of infinitely strong interactions is approached.Comment: 19 pages, 10 figures. v3: Final version. Typos fixed, and other minor change

Institutional Repositories: Evaluating the reasons for non-use of Cornell University's installation of DSpace

This article reports on a three-part evaluative study of institutional repositories. We describe the contents and participation in Cornell's DSpace and compare these results with seven university DSpace installations. Through in-depth interviews with eleven faculty members in the sciences, social sciences and humanities, we explore their attitudes, motivations, and behaviors for non-participation in institutional repositories

Geodesic geometry of 2+1-D Dirac materials subject to artificial, quenched gravitational singularities

The spatial modulation of the Fermi velocity for gapless Dirac electrons in quantum materials is mathematically equivalent to the problem of massless fermions on a certain class of curved spacetime manifolds. We study null geodesic lensing through these manifolds, which are dominated by curvature singularities, such as nematic singularity walls (where the Dirac cone flattens along one direction). Null geodesics lens across these walls, but do so by perfectly collimating to a local transit angle. Nevertheless, nematic walls can trap null geodesics into stable or metastable orbits characterized by repeated transits. We speculate about the role of induced one-dimensionality for such bound orbits in 2D dirty d-wave superconductivity.Comment: 36 pages, 16 figure

High-throughput sequencing reveals suppressors of Vibrio cholerae rpoE mutations: one fewer porin is enough

Analyses of suppressor mutations have been extremely valuable in understanding gene function. However, techniques for mapping suppressor mutations are not available for most bacterial species. Here, we used high-throughput sequencing technology to identify spontaneously arising suppressor mutations that enabled disruption of rpoE (which encodes σE) in Vibrio cholerae, the agent of cholera. The alternative sigma factor σE, which is activated by envelope stress, promotes expression of factors that help preserve and/or restore cell envelope integrity. In Escherichia coli, rpoE is an essential gene that can only be disrupted in the presence of additional suppressor mutations. Among a panel of independent V. cholerae rpoE mutants, more than 75% contain suppressor mutations that reduce production of OmpU, V. cholerae’s principal outer membrane porin. OmpU appears to be a key determinant of V. cholerae’s requirement for and production of σE. Such dependence upon a single factor contrasts markedly with regulation of σE in E. coli, in which numerous factors contribute to its activation and none is dominant. We also identified a suppressor mutation that differs from all previously described suppressors in that it elevates, rather than reduces, σE’s activity. Finally, analyses of a panel of rpoE mutants shed light on the mechanisms by which suppressor mutations may arise in V. cholerae

The United States Chiropractic Workforce: An alternative or complement to primary care?

UnlabelledBackgroundIn the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation's primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians.MethodsWe used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types.ResultsAccording to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson's correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians.ConclusionThese findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access