Mandating Coverage for Maternity Length of Stays: Certain Problems with the Good Idea

This paper will outline the issues influenced by the Newborns\u27 Act and the Maternity Law, including federalism. Likewise, the paper examines certain shortcomings of the maternity legislation. Section II focuses on Ohio\u27s Maternity Law and whether it will prove effective as exemplified by Cleveland\u27s maternity health care standards. Section III addresses the Newborns\u27 Act and how it will influence federalism. Additionally, section III compares the Newborns\u27 Act to the Maternity Law Section IV explores how the concurrent regulations may affect maternity health care

Mandating Coverage for Maternity Length of Stays: Certain Problems with the Good Idea

This paper will outline the issues influenced by the Newborns\u27 Act and the Maternity Law, including federalism. Likewise, the paper examines certain shortcomings of the maternity legislation. Section II focuses on Ohio\u27s Maternity Law and whether it will prove effective as exemplified by Cleveland\u27s maternity health care standards. Section III addresses the Newborns\u27 Act and how it will influence federalism. Additionally, section III compares the Newborns\u27 Act to the Maternity Law Section IV explores how the concurrent regulations may affect maternity health care

Smaller, Closer, Dirtier: Diesel Backup Generators in California

Quantifies the threat to air quality and human health by backup generators, and examines air quality in Los Angeles, San Diego, Sacramento, and Fresno, with some analysis of San Francisco as well

Screening for childhood adversity: the what and when of identifying individuals at risk for lifespan health disparities.

Existing research on childhood adversity and health risk across the lifespan lacks specificity regarding which types of exposures to assess and when. The purpose of this study was to contribute to an empirically-supported framework to guide practitioners interested in identifying youth who may be at greatest risk for a lifelong trajectory of health disparities. We also sought to identify the point in childhood at which screening for adversity exposure would capture the largest group of at risk individuals for triage to prevention and intervention services. Participants (n = 4036) collected as part of the Midlife in the United States study reported their medical status and history including physical (cardiovascular disease, hypertension, obesity, diabetes, cancer) and mental health (depression, substance use problems, sleep problems). Participants indicated whether they were exposed to 7 adversities at any point in childhood and their age of exposure to 19 additional lifetime adversities before the age of 18. Parent drug abuse, dropping out or failing out of school, being fired from a job, and sexual assault during childhood exhibited the largest effect sizes on health in adulthood, which were comparable to the effects of childhood maltreatment. Childhood adversity screening in early adolescence may identify the largest proportion of youth at risk for negative health trajectories. The results of this descriptive analysis provide an empirical framework to guide screening for childhood adversity in pediatric populations. We discuss the implications of these observations in the context of prevention science and practice

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer.

Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes

Funding models in palliative care: lessons from international experience

Background:Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them.Aim:To assess national models and methods for financing and reimbursing palliative care.Design:Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms.Results:Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following:Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision.Funding is frequently characterised as a mixed system of charitable, public and private payers.The basis on which providers are paid for services rarely reflects individual care input or patient needs.Conclusion:Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest

Using the Power of Questions to Organize for Progressive Education

Progressive education is widely admired and rarely implemented in schools. In this commentary, a group of educators—K-8 teachers and administrators and teacher education students and faculty—discuss their shared journey as they come together to study their own practice in schools committed to this model of teaching and learning. While acknowledging the reality that progressive education is most often found in in areas of economic privilege, they nonetheless challenge teachers to engage in “thoughtful participation, description, and dialogue,” in some fashion, as a means of counteracting the demands of the current reform climate

Leveraging multimission satellite data for spatiotemporally coherent cyanoHAB monitoring

Cyanobacteria harmful algal blooms (cyanoHABs) present a critical public health challenge for aquatic resource and public health managers. Satellite remote sensing is well-positioned to aid in the identification and mapping of cyanoHABs and their dynamics, giving freshwater resource managers a tool for both rapid and long-term protection of public health. Monitoring cyanoHABs in lakes and reservoirs with remote sensing requires robust processing techniques for generating accurate and consistent products across local and global scales at high revisit rates. We leveraged the high spatial and temporal resolution chlorophyll-a (Chla) and phycocyanin (PC) maps from two multispectral satellite sensors, the Sentinel-2 (S2) MultiSpectral Instrument (MSI) and the Sentinel-3 (S3) Ocean Land Colour Instrument (OLCI) respectively, to study bloom dynamics in Utah Lake, United States, for 2018. We used established Mixture Density Networks (MDNs) to map Chla from MSI and train new MDNs for PC retrieval from OLCI, using the same architecture and training dataset previously proven for PC retrieval from hyperspectral imagery. Our assessment suggests lower median uncertainties and biases (i.e., 42% and -4%, respectively) than that of existing top-performing PC algorithms. Additionally, we compared bloom trends in MDN-based PC and Chla products to those from a satellite-derived cyanobacteria cell density estimator, the cyanobacteria index (CI-cyano), to evaluate their utility in the context of public health risk management. Our comprehensive analyses indicate increased spatiotemporal coherence of bloom magnitude, frequency, occurrence, and extent of MDN-based maps compared to CI-cyano and potential for use in cyanoHAB monitoring for public health and aquatic resource managers