Improving Pathways to Transit for Persons with Disabilities

Persons with disabilities can achieve a greater degree of freedom when they have full access to a variety of transit modes, but this can only be achieved when the pathways to transit – the infrastructure and conditions in the built environment – allow full access to transit stops, stations, and vehicles. Since passage of the Americans with Disabilities Act (ADA) in 1990, many transit agencies and governmental jurisdictions have made significant progress in this area. Policy initiatives, incremental enhancements, modifications, and other measures undertaken by transit agencies and their partners have significantly improved access to transit for persons with disabilities, others who rely on public transportation, and individuals who chose to utilize these services. This research study explores, through case study work, efforts that have been effective in improving pathways to transit. Interviews and site visits were conducted with five transit agencies, along with their partners, that are actively engaged in improving pathways to connect transit consumers – particularly people with disabilities – with transit stations and stops. These agencies are: Broward County Transit (Broward County, FL), Memphis Area Transit Authority (Memphis, TN), NJ TRANSIT (Newark and New Brunswick, NJ), Tri-County Metropolitan Transportation District of Oregon (Portland, OR), and Link Transit (Wenatchee, WA). Promising practices and/or lessons were identified through the case study analysis; these should be considered by any transit agency seeking to create improved access to its services for persons with disabilities

Impact of Temporary Assistance for Needy Families on Poverty Rates in Kansas

The impact of the length of time that Temporary Assistance for Needy Families (TANF) recipients receive benefits on their path out of poverty is not clear. The purpose of this qualitative study with a phenomenological design was to increase understanding of the comparative experiences of TANF recipients who reached their lifetime limit of 60 or 24 months to determine the impact of time limits on their path out of poverty and the fulfillment of the TANF goal and second purpose. Human capital theory provided the framework for the study. Using a purposive, homogenous sampling method, 6 social service professionals were selected to participate in this study. Only social service professionals who began serving in their role prior to November 1, 2011 were considered for participation because that is the date Kansas first reduced maximum TANF eligibility from 60 months. Data were collected from questionnaires and interviews with these 6 social service professionals. Inductive coding and theme analysis indicated that TANF participation did not reduce the dependency of needy parents by promoting job preparation, work, and marriage. Although the reduction in the number of lifetime TANF eligibility months resulted in TANF participants being more focused and intentional in following TANF participation guidelines, poverty persisted. Findings may be used to influence Kansas legislators to enact social service policies at the county and local levels to increase financial self-sufficiency for Kansans exiting TANF

The Meter of Metabolism

The circadian system orchestrates the temporal organization of many aspects of physiology, including metabolism, in synchrony with the 24 hr rotation of the Earth. Like the metabolic system, the circadian system is a complex feedback network that involves interactions between the central nervous system and peripheral tissues. Emerging evidence suggests that circadian regulation is intimately linked to metabolic homeostasis and that dysregulation of circadian rhythms can contribute to disease. Conversely, metabolic signals also feed back into the circadian system, modulating circadian gene expression and behavior. Here, we review the relationship between the circadian and metabolic systems and the implications for cardiovascular disease, obesity, and diabetes

Experience in Production of 68Ga-DOTA-NOC for Clinical Use Under an Expanded Access IND

[68Ga]Ga-DOTA-NOC was produced under an Expanded Access IND for 174 clinical PET/CT studies to evaluate patients with neuroendocrine tumors. Production employed either the TiO2-based Eckert & Ziegler (EZAG) 68Ge/68Ga-generator (with fractionated elution), or the SiO2-based ITG 68Ge/68Ga-generator. In both cases, [68Ga]Ga-DOTA-NOC was reliably produced, without pre-synthesis purification of the68Ga generator eluate, using readily-implemented manual synthesis procedures. [68Ga]Ga-DOTA-NOC radiochemical purity averaged 99.2±0.4%. Administered 68Ga dose averaged 181±22 MBq, and administered peptide mass averaged 43.2±5.2 µg (n=47) and 23.9±5.7 µg (n=127), respectively, using the EZAG and ITG generators. At dose expiration, 68Ge breakthrough in the final product averaged 2.7×10−7% and 5.4×10−5% using the EZAG and ITG generators, respectively

Family Participation and Involvement in Early Head Start Home Visiting Services: Relations with Longitudinal Outcomes Executive Summary

Home visiting is an intervention approach used widely to provide individualized services to families living in poverty and children facing risks for poor development. Home visiting programs are often, by design, an indirect means to promote healthy child development and employ a variety of strategies ranging from checking child health and safety to encouraging positive parenting to helping parents access education and employment opportunities. Most home visiting programs, however, state that promoting child development is their overarching goal. Most home visitors work with parents to facilitate “developmental parenting,” a term introduced by Roggman, Boyce, and Innocenti (2008) to describe healthy parent-child interactions likely to support positive outcomes for their children. Promoting developmental parenting captures the overall approach of Early Head Start (EHS) home-based programs (Administration on Children and Families, 2002), the focus of this report

Combination GLP-1 and Insulin Treatment Fails to Alter Myocardial Fuel Selection Versus Insulin Alone in Type 2 Diabetes

Context Glucagon-like peptide-1 (GLP-1) and the clinically available GLP-1 agonists have been shown to exert effects on the heart. It is unclear whether these effects occur at clinically used doses in vivo in humans, possibly contributing to CVD risk reduction. Objective To determine whether liraglutide at clinical dosing augments myocardial glucose uptake alone or in combination with insulin compared to insulin alone in metformin-treated Type 2 diabetes mellitus. Design Comparison of myocardial fuel utilization after 3 months of treatment with insulin detemir, liraglutide, or combination detemir+liraglutide. Setting Academic hospital Participants Type 2 diabetes treated with metformin plus oral agents or basal insulin. Interventions Insulin detemir, liraglutide, or combination added to background metformin Main Outcome Measures Myocardial blood flow, fuel selection and rates of fuel utilization evaluated using positron emission tomography, powered to demonstrate large effects. Results We observed greater myocardial blood flow in the insulin-treated groups (median[25th, 75th percentile]: detemir 0.64[0.50, 0.69], liraglutide 0.52[0.46, 0.58] and detemir+liraglutide 0.75[0.55, 0.77] mL/g/min, p=0.035 comparing 3 groups and p=0.01 comparing detemir groups to liraglutide alone). There were no evident differences between groups in myocardial glucose uptake (detemir 0.040[0.013, 0.049], liraglutide 0.055[0.019, 0.105], detemir+liraglutide 0.037[0.009, 0.046] µmol/g/min, p=0.68 comparing 3 groups). Similarly there were no treatment group differences in measures of myocardial fatty acid uptake or handling, and no differences in total oxidation rate. Conclusions These observations argue against large effects of GLP-1 agonists on myocardial fuel metabolism as mediators of beneficial treatment effects on myocardial function and ischemia protection

Quantum cosmology of scalar-tensor theories and self-adjointness

In this paper, the problem of the self-adjointness for the case of a quantum minisuperspace Hamiltonian retrieved from a Brans-Dicke (BD) action is investigated. Our matter content is presented in terms of a perfect fluid, onto which the Schutz's formalism will be applied. We use the von Neumann theorem and the similarity with the Laplacian operator in one of the variables to determine the cases where the Hamiltonian is self-adjoint and if it admits self-adjoint extensions. For the latter, we study which extension is physically more suitable.Comment: Latex file, 12 pages. Small changes made in the paper, and a a new appendix adde