Idaho: Carefully and Cautiously Progressing

In Idaho, the FY18 budget drew upon the usual agency requests, executive recommendation, and legislative appropriation activities. However, less business-as-usual was the judicial branch involvement due to the post-sine die transmittal, and subsequent veto, of a bill to eliminate the sales tax on food. Citing the implications for General Fund revenue and fiscal challenges from extreme weather conditions in early 2017, Governor Otter vetoed the sales tax repeal sparking a legal challenge from legislators. The Idaho Supreme Court upheld the executive veto in a 4‒1 decision. The robust individual income and sales tax collections reported at close of FY17 exceeded the projections used to develop the FY18 budget, prompting automatic transfers to Idaho’s “savings accounts.” This outcome has great significance for the FY18 budget and will almost certainly flavor anticipated FY19 budget discussions in the 2018 legislative session due to residual frustration over tax reforms passed, not passed, and vetoed from the 2017 session. In terms of FY18, the budget balanced without infusion from Idaho’s savings funds, basic services continued, and modest progress continued in education, economic development, and physical and technology infrastructure. However, the FY18 budget did not reflect important issues including needed regulatory action, tax, and rate reforms intended to catalyze economic development, tax repeals advocated by certain constituencies, medical care access and affordability, and sustainable state capacity. As most of these have long-term budget implications, state government (elected and appointed) will not be able to avoid action indefinitely

Providing Shelter for the Homeless: Faith-Based Organizations as Instruments of the Public Good

Networked public service delivery requires attention to accountability and implementation in the public interest. Using the case of transitional housing in a western US community, we review the challenges of goal incongruence between network members and the resulting management problems. In addition, this case illustrates the role that local governments may play in promoting the primacy of one network member over others through collaborations, contract arrangements and nonmonetary resources and the resulting political and judicial difficulties. The complexity of networked service delivery is compounded when the individual missions of network members supersede public policy goals. In many communities, FBOs, as critical partners in a social service delivery network, may face great variation in expectations about how their organizational mission/faith relates to policy goals. Effective network coordination demands that each network partner recognizes and adapts, when appropriate, to the differing missions/goals of other network partners. However, when public resources are used to bolster the stability of alternative service providers, especially faith-based providers, governmental partners must maintain adequate oversight, with or without the benefit of specific contract provisions

High School Exit Examinations: When Do Learning Effects Generalize?

This paper reviews international and domestic evidence on the effects of three types of high school exit exam systems: voluntary curriculum-based external exit exams, universal curriculum-based external exit exam systems and minimum competency tests that must be passed to receive a regular high school diploma. The nations and provinces that use Universal CBEEES (and typically teacher grades as well) to signal student achievement have significantly higher achievement levels and smaller differentials by family background than otherwise comparable jurisdictions that base high stakes decisions on voluntary college admissions tests and/or teacher grades. The introduction of Universal CBEEES in New York and North Carolina during the 1990s was associated with large increases in math achievement on NAEP tests. Research on MCTs and high school accountability tests is less conclusive because these systems are new and have only been implemented in one country. Cross-section studies using a comprehensive set of controls for family background have not found that students in MCT states score higher on audit tests like the NAEP that carry no stakes for the test taker. The analysis reported in table 1 tells us that the five states that introduced MCTs during the 1990s had significantly larger improvements on NAEP tests than states that made no change in their student accountability regime. The gains, however, are smaller than for the states introducing Universal CBEEES. New York and North Carolina. The most positive finding about MCTs is that students in MCT states earn significantly more during the first eight years after graduation than comparable students in other states suggesting that MCTs improve employer perceptions of the quality of the recent graduates of local high schools

The effects of stand characteristics on the understory vegetation in Quercus petraea and Q. cerris dominated forests

The shelterwood system used in Hungary has many effects on the composition and structure of the herb layer. The aim of our study was to identify the main variables that affect the occurence of herbs and seedlings in Turkey oak-sessile oak (Quercus cerris and Q. petraea) stands. The study was carried out in the Bükk mountains, Hungary. 122 sampling plots were established in 50-150 year old oak forests, where we studied the species composition and structure of the understorey and overstorey. The occurence of herbs was affected by canopy closure, the heterogenity and patchiness of the stand, the slope and the east-west component of the aspect. The composition of saplings was significantly explained by the ratio of the two major oak species in the stand and the proximity of the adult plants. An important result for forest management was that sessile oaks were able to regenerate almost only where they were dominant in the overstorey

Estimating HIV transmissions in a large U.S. clinic-based sample: effects of time and syndemic conditions

Introduction: Little is known about onward HIV transmissions from people living with HIV (PLWH) in care. Antiretroviral therapy (ART) has increased in potency, and treatment as prevention (TasP) is an important component of ending the epidemic. Syndemic theory has informed modelling of HIV risk but has yet to inform modelling of HIV transmissions. Methods: Data were from 61,198 primary HIV care visits for 14,261 PLWH receiving care through the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) at seven United States (U.S.) sites from 2007 to 2017. Patient-reported outcomes and measures (PROs) of syndemic conditions – depressive symptoms, anxiety symptoms, drug use (opiates, amphetamines, crack/cocaine) and alcohol use – were collected approximately four to six months apart along with sexual behaviours (mean = 4.3 observations). Counts of syndemic conditions, HIV sexual risk group and time in care were modelled to predict estimated HIV transmissions resulting from sexual behaviour and viral suppression status (HIV RNA \u3c 400/mL) using hierarchical linear modelling. Results: Patients averaged 0.38 estimated HIV transmissions/100 patients/year for all visits with syndemic conditions measured (down from 0.83, first visit). The final multivariate model showed that per 100 patients, each care visit predicted 0.05 fewer estimated transmissions annually (95% confidence interval (CI): 0.03 to 0.06; p \u3c 0.0005). Cisgender women, cisgender heterosexual men and cisgender men of undisclosed sexual orientation had, respectively, 0.47 (95% CI: 0.35 to 0.59; p \u3c 0.0005), 0.34 (95% CI: 0.20 to 0.49; p \u3c 0.0005) and 0.22 (95% CI: 0.09 to 0.35; p \u3c 0.005) fewer estimated HIV transmissions/100 patients/year than cisgender men who have sex with men (MSM). Each within-patient syndemic condition predicted 0.18 estimated transmissions/100 patients/year (95% CI: 0.12 to 0.24; p \u3c 0.0005). Each between-syndemic condition predicted 0.23 estimated HIV transmissions/100 patients/year (95% CI: 0.17 to 0.28; p \u3c 0.0005). Conclusions: Estimated HIV transmissions among PLWH receiving care in well-resourced U.S. clinical settings varied by HIV sexual risk group and decreased with time in care, highlighting the importance of TasP efforts. Syndemic conditions remained a significant predictor of estimated HIV transmissions notwithstanding the effects of HIV sexual risk group and time in care

Lancet Glob Health

BackgroundAs mobile phone access continues to expand globally, opportunities exist to leverage these technologies to support demand for immunisation services and improve vaccine coverage. We aimed to assess whether short message service (SMS) reminders and monetary incentives can improve immunisation uptake in Kenya.MethodsIn this cluster-randomised controlled trial, villages were randomly and evenly allocated to four groups: control, SMS only, SMS plus a 75 Kenya Shilling (KES) incentive, and SMS plus 200 KES (85 KES\u2008=\u2008USD$1). Caregivers were eligible if they had a child younger than 5 weeks who had not yet received a first dose of pentavalent vaccine. Participants in the intervention groups received SMS reminders before scheduled pentavalent and measles immunisation visits. Participants in incentive groups, additionally, received money if their child was timely immunised (immunisation within 2 weeks of the due date). Caregivers and interviewers were not masked. The proportion of fully immunised children (receiving BCG, three doses of polio vaccine, three doses of pentavalent vaccine, and measles vaccine) by 12 months of age constituted the primary outcome and was analysed with log-binomial regression and General Estimating Equations to account for correlation within clusters. This trial is registered with ClinicalTrials.gov, number NCT01878435.FindingsBetween Oct 14, 2013, and Oct 17, 2014, we enrolled 2018 caregivers and their infants from 152 villages into the following four groups: control (n=489), SMS only (n=476), SMS plus 75 KES (n=562), and SMS plus 200 KES (n=491). Overall, 1375 (86%) of 1600 children who were successfully followed up achieved the primary outcome, full immunisation by 12 months of age (296 [82%] of 360 control participants, 332 [86%] of 388 SMS only participants, 383 [86%] of 446 SMS plus 75 KES participants, and 364 [90%] of 406 SMS plus 200 KES participants). Children in the SMS plus 200 KES group were significantly more likely to achieve full immunisation at 12 months of age (relative risk 1\ub709, 95% CI 1\ub702\u20131\ub716, p=0\ub7014) than children in the control group.InterpretationIn a setting with high baseline immunisation coverage levels, SMS reminders coupled with incentives significantly improved immunisation coverage and timeliness. Given that global immunisation coverage levels have stagnated around 85%, the use of incentives might be one option to reach the remaining 15%.FundingBill & Melinda Gates Foundation.2017-03-11T00:00:00Z28288747PMC5348605789

Preliminary Polarization Results at Fermilab Energies

This paper describes the jet target, the superconducting spectrometer and the polarimeter used to measure the recoil proton polarization in an Indiana University experiment at the Fermi National Accelerator Laboratory. Analysis procedures and data checks are explained and preliminary results are presented and compared with model predictions. The future plans of the experiment are also discussed

Acute and Chronic Effects of Whole-Body Vibration on Balance, Postural Stability, and Mobility in Women With Multiple Sclerosis

The acute and chronic effects of whole-body vibration (WBV) on balance, postural stability, and mobility were evaluated in 21 women with relapsing-remitting multiple sclerosis (MS) randomly assigned to control (n = 9) or experimental (n = 12) groups. To assess acute responses, outcome variables were assessed before and immediately after a session of WBV (five 30-second bouts of vibration; frequency 30 Hz; amplitude 3 mm; 1-minute rest intervals) during their first visit (week 1) using field (Timed-Up and Go; 500-m walk; Berg Balance Scale) and laboratory tests (NeuroCom Balance Master and EquiTest System—Sensory Organization Test, Adaptation Test, Limits of Stability, Modified Clinical Test for Sensory Integration of Balance, Unilateral Stance, Tandem Walk, Step/Quick Turn). Acute responses were also measured after their fifth visit for only the Adaptation and Sensory Organization tests. For the chronic responses, participants were exposed to the WBV protocol once a week, for a total of 5 weeks, and then at week 5, were reassessed with the Adaptation and the Sensory Organization tests. Neither acute nor chronic exposure to the WBV protocols used in this study resulted in significant improvements (P > .05) in balance, postural stability, or mobility as assessed by either field or laboratory tests. However, based on promising results from other studies that have used WBV with other clinical populations, either alone or in conjunction with exercise, additional studies that increase the dose of vibration exposure, both acutely and chronically, should be conducted in patients with MS.Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) received no financial support for the research, authorship, and/or publication of this article.Ye