Long-Term Care Financing Reform: Lessons From the U.S. and Abroad

Outlines the Community Living Assistance Services and Supports (CLASS) Act, which would create a voluntary national long-term care insurance program. Reviews public insurance programs in Europe and Japan and highlights lessons for U.S. policy makers

Let's talk about (safe) sex, baby: a study assessing the relationship between knowing someone with a chronic STID and STID-related stigma, shame, knowledge, and safe sex practices among college students

The United States currently faces a significant problem with sexually transmitted infections and diseases (STIDs). Examples of STDs include human papillomavirus (HPV), herpes simplex virus (HSV-1 [oral] and HSV-2 [genital]), and human immunodeficiency virus (HIV) (Centers for Disease Control and Prevention, 2021a). Examples of STIs include chlamydia, syphilis, and gonorrhea. The distinguishing factor between STIs and STDs is that STDs (e.g., HSV [1 and 2]) are chronic and STIs (e.g., chlamydia) are typically curable with medications. It is well-established that adolescents and young adults (AYAs) currently hold the highest rates of STIDs. Psychological consequences of STIDs include anxiety, depression, self-harming behavior, internalized stigma, and suicidal ideation. Physical consequences of STIDs include painful lesions, sores, infertility, various cancers, and death. The purpose of this study was to explore the relationship between college students who know someone with a chronic STID and their own levels of STID-related stigma and shame. Additionally, this study aimed to explore the relationship between STID-related stigma, shame, knowledge, and college students’ safe sex practices. In this context, a chronic STID is defined as an STD that is unable to be cured with medication. To test the hypotheses, an online survey was distributed to undergraduate students between the ages of 18 and 24 years old who attend Ball State University. Three hierarchical regressions were conducted to determine the relationship between these variables while controlling for gender identity, ethnicity, and religiosity. Results indicated that college students with more STID knowledge reported less STID-related stigma. This finding can inform how college counselors can discuss sexual health with students to provide more competent and inclusive care.Thesis (M.A.

The Ethics of Disobedience in Shakespeare’s Henry V

As we know, one important component of the methodology of deconstruction involves analyzing the logic of binary oppositions, particularly those binaries wielding great cultural and ideological influence, such as presence/absence, speech/writing, male/female, etc. A deconstructive methodology approaches such binaries from a variety of perspectives, including identifying them and explicating the structure in which they mutually function; this structure usually means that one element of the binary pair largely defines the structure of the whole, dominating and marginalizing the other. Deconstruction also incorporates historical processes and does so in at least two ways; first, by what Jacques Derrida in Positions calls "a phase of overturning", an effort to reverse "the hierarchy at a given moment". Perhaps more importantly, however, is the second mode of this Derridean "double science", transcending the very structure of a given binary opposition by articulating "the irruptive emergence of a new 'concept', a concept that can no longer be, and never could be, included in the previous regime" (41–2). In examining the processes of historical change as they relate to binary oppositions, we might look at one of the most powerful binary oppositions characterizing the early modern period: that between obedience and disobedience. In particular, this paper argues that Shakespeare’s Henry V offers a demonstration of the complex interactions between these terms and also outlines ways in which their dynamic was being transformed in the early modern period. Specifically, I argue that in this play, we can observe disobedience becoming a virtue in its own right, an essential quality of the ambitious English individual. In effect, Henry V offers a new pedagogy of obedience and disobedience wherein it becomes less and less possible to distinguish the two traits

Social Influences on Peer Judgments about Chronic Pain and Disability

Chronic pain is a leading cause of work absenteeism and disability compensation. Previous work demonstrates that patients with chronic illness often seek advice, such as whether or not to pursue disability benefits, from peers with similar health conditions. The current study examined the extent that social factors influence patients with chronic pain (“peers”) when making disability judgments and recommendations for other patients with chronic pain. Participants (N = 71) made pain-related and disability ratings for fictional vignette patients that varied in weight (normal vs obese), fault of accident, and physical work demands. Results of repeated measures analyses of variance indicated that participants rated patients with obesity, who were not at fault, and who held a physically demanding job as experiencing more severe pain symptoms and disability and were more likely to recommend they seek disability benefits. Participants who had applied for disability benefits themselves rated patients as more disabled than participants who had not applied for disability. These data suggest that patients with chronic pain are influenced by patient and contextual factors when making pain-related and disability judgments for peers. These judgments may impact patient decision making via peer support programs and online forums

Photonics in photovoltaic systems

This paper gives an overview on photonics for photovoltaic systems. Starting from the spectral and angular distribution of the electromagnetic radiation from the sun, many important optical approaches how to improve the efficiency of solar cells are presented and discussed. Topics include antireflective coatings, various light trapping structures, refractive, reflective and fluorescent concentrators, and components for spectral management. The theoretical background is shortly described and examples of the experimental and also of the commercial realisation are given

Disability Costs and Equivalence Scales in the Older Population in Great Britain

We use a standard of living (SoL) approach to estimate older people's disability costs, using data on 8000 individuals from the U.K. Family Resources Survey. We extend previous research in two ways. First, by allowing for a more flexible relationship between SoL and income, the structure of the estimated disability cost and equivalence scale is not dictated by a restrictive functional form assumption. Second, we allow for the latent nature of disability and SoL, addressing measurement error in the disability and SoL indicators in surveys. We find that disability costs are strongly related to severity of disability, and vary with income in absolute and proportionate terms. Older people above the median disability level require an extra �99 per week (2007 prices) on average to reach the SoL of an otherwise similar person at the median. Costs faced by older people in the highest decile of disability average �180

Burden of cirrhosis on older Americans and their families: Analysis of the health and retirement study

Prevalence of cirrhosis among older adults is expected to increase; therefore, we studied the health status, functional disability, and need for supportive care in a large national sample of individuals with cirrhosis. A prospective cohort of individuals with cirrhosis was identified within the longitudinal, nationally representative Health and Retirement Study. Cirrhosis cases were identified in linked Medicare data via ICD‐9‐CM (International Classification of Diseases, Ninth Revision, Clinical Modification) codes and compared to an age‐matched cohort without cirrhosis. Two primary outcome domains were assessed: (1) patients' health status (perceived health status, comorbidities, health care utilization, and functional disability as determined by activities of daily living and instrumental activities of daily living), and (2) informal caregiving (hours of caregiving provided by a primary informal caregiver and associated cost). Adjusted negative binomial regression was used to assess the association between cirrhosis and functional disability. A total of 317 individuals with cirrhosis and 951 age‐matched comparators were identified. Relative to the comparison group, individuals with cirrhosis had worse self‐reported health status, more comorbidities, and used significantly more health care services (hospitalizations, nursing home stays, physician visits; P < 0.001 for all bivariable comparisons). They also had greater functional disability ( P < 0.001 for activities of daily living and instrumental activities of daily living), despite adjustment for covariates such as comorbidities and health care utilization. Individuals with cirrhosis received more than twice the number of informal caregiving hours per week ( P < 0.001), at an annual cost of US $4700 per person. Conclusion: Older Americans with cirrhosis have high rates of disability, health care utilization, and need for informal caregiving. Improved care coordination and caregiver support is necessary to optimize management of this frail population. (H EPATOLOGY 2012;55:184–191)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/89512/1/24616_ftp.pd

Scientific Opinion on the re-evaluation of hexamethylene tetramine (E 239) as a food additive

Hexamethylene tetramine (HMT) is a food additive, currently only permitted in EU for use in Provolone cheese. The maximum permitted level is 25 mg/kg residual amount, expressed as formaldehyde, the break down product of HMT under acidic conditions. HMT has been previously evaluated by the Joint Expert Committee on Food Additives (JECFA, 1974) who established an ADI of 0.15 mg/kg bw/day based on a reproductive study with a NOEL of 15 mg/kg bw/day. Due to the limitations in the database the Panel could not identify a critical study and therefore to derive an ADI. However, the Panel noted that the exposure to formaldehyde from HMT of high level consumers of Provolone cheese equalled 18 µg formaldehyde/kg bw/day in adults and could be as high as 87 µg formaldehyde/kg bw/day in children according to a theoretical conservative assumption that all ripened cheese consumed was Provolone cheese. Considering the estimated exposure from the very limited permitted use, the toxicological database on HMT, the data from use of HMT therapeutically, the available oral toxicity and toxicokinetic data of formaldehyde and the magnitude of the potential effect on intracellular formaldehyde levels arising from this use of HMT, the Panel concluded that the use of HMT in Provolone cheese at the MPL of 25 mg/kg residual amount, expressed as formaldehyde, would not be of safety concern. However the Panel considered that any increase in the permitted uses of HMT or increases in the MPL of 25 mg /kg residual amount, expressed as formaldehyde would need detailed assessment which might require new toxicity data as well as use levels and/or an evaluation of its impact on formaldehyde levels in vivo

Evaluation of a Rapid Immunochromatographic ODK-0901 Test for Detection of Pneumococcal Antigen in Middle Ear Fluids and Nasopharyngeal Secretions

Since the incidence of penicillin-resistant Streptococcus pneumoniae has been increasing at an astonishing rate throughout the world, the need for accurate and rapid identification of pneumococci has become increasingly important to determine the appropriate antimicrobial treatment. We have evaluated an immunochromatographic test (ODK-0901) that detects pneumococcal antigens using 264 middle ear fluids (MEFs) and 268 nasopharyngeal secretions (NPSs). A sample was defined to contain S. pneumoniae when optochin and bile sensitive alpha hemolytic streptococcal colonies were isolated by culture. The sensitivity and specificity of the ODK-0901 test were 81.4% and 80.5%, respectively, for MEFs from patients with acute otitis media (AOM). In addition, the sensitivity and specificity were 75.2% and 88.8%, respectively, for NPSs from patients with acute rhinosinusitis. The ODK-0901 test may provide a rapid and highly sensitive evaluation of the presence of S. pneumoniae and thus may be a promising method of identifying pneumococci in MEFs and NPSs