Welfare Reform: One State Alternative

Welfare reform has received a great deal of public attention in recent months. Historically, many states have enacted welfare reform legislation, with mixed reviews. The Commonwealth of Pennsylvania implemented a Welfare Reform Act in 1982 which reduced the able-bodied General Assistance population to a maximum of 90 days of cash assistance in any twelve-month period. This study decribes the previous occupations of a segment of the Transitionally Needy in Philadelphia, the Transitionally Needy who did and did not find work, and how many were still receiving some form of in-kind benefits after discontinuance of cash assistance

Energy efficient engine. Fan and quarter-stage component performance report

The fan configuration for the general Electric/NASA Energy Efficient Engine was selected following an extensive preliminary design study. The fan has an inlet radius ratio of 0.342 and a specific flowrate of 208.9 Kg/sec/sq. m (42.8 1bm/sec/sq. ft). The design corrected tip speed is 411.5 m/sec (1350 ft/sec) producing a bypass flow total-pressure ratio of 1.65 and a core flow total-pressure ratio of 1.6. The design bypass ratio is 6.8. The aerodynamic design point corresponds to the maximum climb power setting at Mach 0.8 and 10.67 Km (35,000 ft) altitude. The fully-instrumented fan component was tested in the Lynn Large Fan Test Facility in 1981. The overall performance results, reported herein, showed excellent fan performance with the fan meeting all of its component test goals of flow, efficiency and stall margin

Gastrocutaneous Closure Device

A gastrocutaneous closure device allows gastrocutaneous fistula closure from external abdominal access through the fistula site. Access through the fistula ensures accurate closure placement on the interior lumen wall of the stomach. A closure or clip has a plurality of prongs defined by a deformable material, such that the prongs extend radially from a central hub in an arcuate or curved, semicircular shape. The arcuate shape converges towards a central point or axis at a distal end, and the proximate end of the prongs attaches to the central hub such that the prongs radiate from the hub and the distal end curves back toward the axis through the hub. The deformable prongs may therefore radially compress or retract to define a larger or smaller diameter. The fistula lies on the axis such that the biased, inserted prongs pull the inner stomach wall closed around the healing fistula

A simple method for the determination of refractive indices of (rough) transparent solids

Simple methods for the determination of refractive indices of transparent polymers and inorganic and organic solids of irregular geometry or with scratched or corrugated surfaces are rare. A classical procedure is based on the invisibility of a body immersed in a liquid with the same refractive index as that of the body. In order to avoid the laborious procedure connected with the search for a liquid with matching refractive index and to find an approach which is independent of the observation by eye, we describe here a modified immersion method which allows the ready determination of the refractive index of solids. The present method is based on the interpolation of the maximum transmission (nTmax) of a solid immersed in liquids with different, typically non-matching, refractive indices. Illustrations with quartz glass, crown glass and poly(vinylidene fluoride) (PVDF) films showed that nTmax can be determined with a reproducibility of ± 0.003. By comparison with refractive indices determined by ellipsometry, it was concluded that the refractive index of a solid can be determined with the modified immersion method within an accuracy better than ± 0.01 when systematic errors resulting from the fit method are also taken into consideratio

Job Stability and Wage Progression Patterns among Early TANF Leavers

This article reports on first-year employment experiences of a randomly selected sample of 213 Illinois TANF leavers. Aggregate employment levels were 70 percent at exit, and leavers typically generated earnings from a single full-time job. However, employment often was unstable, so that only about one-fourth of leavers had the same job both at exit and when interviewed 10-11 months later. Employment instability resulted from the marginal or temporary nature of many jobs, as well as employment barriers such as health problems and lack of day care. Average wage levels easily exceeded the minimum wage and grew during the first year after exit, but nonetheless often were insufficient to provide incomes above the poverty level. The findings underscore the need to develop post-employment service strategies that assist persons in accessing work-related benefits such as child care and Medicaid, as well as improved income support strategies such as expansion of the Earned Income Tax Credit

What is the contribution of physician associates in hospital care in England? A mixed methods, multiple case study.

OBJECTIVES: To investigate the deployment of physician associates (PAs); the factors supporting and inhibiting their employment and their contribution and impact on patients' experience and outcomes and the organisation of services. DESIGN: Mixed methods within a case study design, using interviews, observations, work diaries and documentary analysis. SETTING: Six acute care hospitals in three regions of England in 2016-2017. PARTICIPANTS: 43 PAs, 77 other health professionals, 28 managers, 28 patients and relatives. RESULTS: A key influencing factor supporting the employment of PAs in all settings was a shortage of doctors. PAs were found to be acceptable, appropriate and safe members of the medical/surgical teams by the majority of doctors, managers and nurses. They were mainly deployed to undertake inpatient ward work in the medical/surgical team during core weekday hours. They were reported to positively contribute to: continuity within their medical/surgical team, patient experience and flow, inducting new junior doctors, supporting the medical/surgical teams' workload, which released doctors for more complex patients and their training. The lack of regulation and attendant lack of authority to prescribe was seen as a problem in many but not all specialties. The contribution of PAs to productivity and patient outcomes was not quantifiable separately from other members of the team and wider service organisation. Patients and relatives described PAs positively but most did not understand who and what a PA was, often mistaking them for doctors. CONCLUSIONS: This study offers new insights concerning the deployment and contribution of PAs in medical and surgical specialties in English hospitals. PAs provided a flexible addition to the secondary care workforce without drawing from existing professions. Their utility in the hospital setting is unlikely to be completely realised without the appropriate level of regulation and authority to prescribe medicines and order ionising radiation within their scope of practice

Geriatrics Attitudes and Knowledge Among Surgical and Medical Subspecialty House Officers

To examine geriatrics knowledge and attitudes of non-primary care house officers (HOs) before and after a multidisciplinary faculty development program. DESIGN : Serial cross-sectional surveys. PARTICIPANTS : HOs. SETTING : A large midwestern academic medical center. INTERVENTION : Faculty from seven surgical and six medical subspecialties participated in weekly seminars for 9 months and implemented geriatrics curricula in their HO programs. MEASUREMENTS : HO geriatrics attitudes and knowledge were measured using the University of California at Los Angeles Geriatrics Attitudes Scale (GAS; 14 items), two scales of the Maxwell Sullivan test (Therapeutic Potential and Time/Energy; six items each; lower scores denote more-favorable attitudes), and the Geriatrics Clinical Knowledge Assessment (20 multiple choice items; range 0–100%). Repeat surveys were administered in seven disciplines after geriatrics curriculum implementation. RESULTS : Baseline (n=175) geriatrics attitudes were favorable (e.g., 3.7 for GAS; 2.1 for Time/Energy), with more-favorable attitudes among medical subspecialty than surgical HOs (e.g., mean GAS 3.8 and 3.6, respectively; P =.001), and with advanced training. Mean baseline knowledge scores were 65.1% among all HOs. No differences in attitudes or knowledge were observed between the first (n=100) and second (n=90) cohorts in the seven disciplines that administered subsequent tests. CONCLUSION : Geriatrics attitudes of non-primary care HOs are positive, and knowledge is moderate, suggesting need for and potential effect of geriatrics curricula. Demonstrating effects on learner outcomes of faculty development programs may require more than one faculty member per discipline and measures that are curriculum-specific and detailed rather than general and brief.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66180/1/j.1532-5415.2007.01475.x.pd

Expression of complementary RNA from chloroplast transgenes affects editing efficiency of transgene and endogenous chloroplast transcripts

The expression of angiosperm chloroplast genes is modified by C-to-U RNA editing. The mechanism for recognition of the ∼30 C targets of editing is not understood. There is no single consensus sequence surrounding editing sites, though sites can be grouped into small ‘clusters’ of two to five sites exhibiting some sequence similarity. While complementary RNA that guides nucleotides for alteration has been detected in other RNA modification systems, it is not known whether complementary RNA is involved in chloroplast editing site recognition. We investigated the effect of expressing RNA antisense to the sequences −20 to +6 surrounding the RpoB-2 C target of editing, which is a member of a cluster that includes the PsbL-1 and Rps14-1 sites. Previous experiments had shown that chloroplast rpoB transgene transcripts carrying only these 27 nt were edited in vivo at the proper C. Though transcripts carrying sequences −31 to +60 surrounding the RpoB-2 sites were edited in chloroplast transgenic plants, transcripts carrying the −31 to +62 region followed by the 27 nt complementary region were not edited at all. In contrast, a similar construct, in which the C target as well as the preceding and subsequent nucleotides were mismatched within the 27 nt region, was efficiently edited. The presence of any of the four transgenes carrying RpoB-2 sequences in sense and/or antisense orientation resulted in reduced editing at the PsbL-1 site. Chloroplast transgenic plants expressing the three different antisense RNA constructs exhibited abnormal growth and development, though plants expressing the 92 nt sense transcripts were phenotypically normal

Atypisches Erythema induratum Bazin bei tuberkulöser Osteomyelitis

Zusammenfassung: Hauttuberkulosen können sich mit sehr unterschiedlichen klinischen Bildern manifestieren und damit die Diagnosestellung erschweren. Wir stellen den Fall einer 79-jährigen Patientin vor, mit einer atypischen Präsentation eines Erythema induratum Bazin (EIB) am Oberkörper und einer tuberkulösen Osteomyelitis des Olekranon links. Aus den Biopsien der EIB-Knoten konnte M.tuberculosis kulturell nachgewiesen werden. Das widerspricht der klassischen Vorstellung, dass das EIB als Folge einer Hypersensitivitätsreaktion auf Mykobakterien entsteht, und unterstützt die Hypothese, dass das EIB auch durch eine hämatogene oder lymphogene Streuung von lebenden M.tuberculosis entstehen kan