The Shadows of Life: Medicaid\u27s Failure of Health Care\u27s Moral Test

North Carolina Medicaid covers one-fifth of the state’s population and makes up approximately one-third of the budget. Yet the state has experienced increasing costs and worsening health outcomes over the past decade, while socioeconomic disparities persist among communities. In this article, the authors explore the factors that influence these trends and provide a series of policy lessons to inform the state’s current reform efforts following the recent approval of North Carolina’s Section 1115 waiver by the Centers for Medicare and Medicaid Services. The authors used health, social, and financial data from the state Department of Health and Human Services, the Robert Wood Johnson Foundation, and the University of North Carolina to identify the highest cost counties in North Carolina. They found higher per beneficiary spending to be inversely related to population health, with many counties with the most expensive beneficiaries also reporting poor health outcomes. These trends appear to be attributed to a breakdown in access to basic health services, with high cost counties often lacking adequate numbers of health care providers and possessing limited health care services, leading patients to primarily engage the health care system in a reactive manner and predominantly in institutional care settings. To illustrate this pattern, the authors developed case studies of Tyrrell County and Graham County, which respectively are home to the state’s worst health outcomes and most expensive Medicaid beneficiaries. The authors combined stories of these counties with the larger historical trends to offer policy recommendations to help reorient North Carolina Medicaid around patient needs. The results shed light on traditionally understudied hotspots of cost and poor outcomes in North Carolina, while proposing tangible steps to support reform

Assessment of antimicrobial prescribing and rationality of drug usage in general practitioners in Pune city, India

Background: Most of the common ailments are managed by general practitioners (GPs). GPs prescribe major bulk of the drugs sold in the market. Naturally, irrational use of drugs at this level could lead to disastrous consequences. So this study was undertaken to determine prescribing pattern of Antimicrobials (AMA) and the rationality of drug usage by GPs in Pune city.Methods: It was a cross-sectional study. Pune city was divided into 5 zones. MBBS, BAMS and BHMS GPs doing Allopathic practice were selected randomly. 2 GPs of each specialty per zone were selected; this gave us 10 GPs of each degree – so total 30 GPs.30 Prescriptions at each GP were collected – total 900 prescriptions. The following parameters were studied- Diagnosis of patient, Average no. of drugs/prescription Percentage of AMAs prescribed, Rationality of AMA, Selection of AMAs diagnosis wise, Rationality of Prescription.Results: More than 75% patients coming to GPs were suffering from communicable diseases. Average no. of drugs / prescription and percentage of prescription with AMAs was high in all GPs. Macrolides was the most common group of AMA used by MBBS whereas Cephalosporins was used by BAMS and BHMS. Irrational use of AMAs was high in BHMS GPs. Use of irrational FDCs, banned drugs, steroids was high in BAMS GPs.Conclusions: There are deficiencies in prescription practices among all GPs. Not only are GPs prescribing the highest number of  AMAs  per prescription anywhere, their prescription practices for common health problems are highly inappropriate. High level of irrational use of drugs by BAMS and BHMS GPs are cause of concern

Effect of practicing Yoga on Aerodynamic measures of Voice

Yoga is a Sanskrit word which interprets to the meaning “the unity of body and mind”. It is a blend of breathing drills, physical stances, and contemplation, and has been practiced in eastern conventional medicine for more than thousands of years [1]. A modest effort was taken in this study to examine the effect of Long term yoga training on Aerodynamic measures and also to compare and contrast these measures between individuals who practice yoga and who don’t. A total of 120 phonation samples were obtained from participants who practice yoga and who don’t between the age ranges of 20-40 years. Samples assessing respiratory capacities were also taken from the above subjects. Statistical analysis showed a significant difference [p<0.05] between control group and experimental group for all parameters. Significant difference was also seen between genders [p<0.05]. Significant difference was seen in gender within control group [p=0.02] and also within experimental group [p=0.00]. The prevailing study establishes a positive correlation between practicing yoga and betterment in aerodynamic capacities. The results declare that there was significant escalation in vital capacity, maximum phonation duration, phonation quotient and mean air flow rate for individuals who practice regular yoga when compared to people who don’t. The outcome of the present study is a preliminary step towards creating evidence base for the practice of yoga towards overall aerodynamic improvement in healthy adult

Effect of practicing Yoga on Aerodynamic measures of Voice

Yoga is a Sanskrit word which interprets to the meaning “the unity of body and mind”. It is a blend of breathing drills, physical stances, and contemplation, and has been practiced in eastern conventional medicine for more than thousands of years [1]. A modest effort was taken in this study to examine the effect of Long term yoga training on Aerodynamic measures and also to compare and contrast these measures between individuals who practice yoga and who don’t. A total of 120 phonation samples were obtained from participants who practice yoga and who don’t between the age ranges of 20-40 years. Samples assessing respiratory capacities were also taken from the above subjects. Statistical analysis showed a significant difference [p<0.05] between control group and experimental group for all parameters. Significant difference was also seen between genders [p<0.05]. Significant difference was seen in gender within control group [p=0.02] and also within experimental group [p=0.00]. The prevailing study establishes a positive correlation between practicing yoga and betterment in aerodynamic capacities. The results declare that there was significant escalation in vital capacity, maximum phonation duration, phonation quotient and mean air flow rate for individuals who practice regular yoga when compared to people who don’t. The outcome of the present study is a preliminary step towards creating evidence base for the practice of yoga towards overall aerodynamic improvement in healthy adult

Management of Rust in Pearl millet caused by Puccinia substriata var. penicillariae using Plant Product, Bioagent and Fungicides

Rust caused by Puccinia substriata var. penicillariae is one of the major disease affecting both forage and grain production in pearl millet. An attempt was made to manage pearl millet rust using plant product, bioagent and fungicides under screen house and field conditions. The experiment was conducted on susceptible hybrid HHB 197 both under screen house and field condition with eight treatments. Observation on rust severity recorded at grain filling stage. The experiment results indicated that all the treatments were effective in managing the disease but amongst them minimum disease severity (11.7%) and (21.7%) was contracted under screen house and field conditions respectively in treatment of Propiconazole 25% EC (0.1%) followed by Hexaconazole 5% EC (0.1%) and Copper oxychloride 50% WP (0.2%), Carbendazim 50% WP (0.2%), Mancozeb 75% WP (0.2%), Azadirachtin 0.15% (1500 ppm), Trichoderma viride (3%) treated pots and plot. Maximum grain yield (514.7 kg/acre), test weight (8.13 g) and Benefit: cost 3.98: 1 was observed in Propiconazole 25% EC (0.1%) sprayed plot followed by Hexaconazole 5% EC (0.1%) under field conditions

Evaluation of concrete corrosion using EMI sensor

Reinforced Concrete (RC) is globally used to make the building structure strong and more durable. Civil and structural engineers face major challenges as concrete structures deteriorate and get weaker. Recent development in field of assessing and monitoring the health condition of the building structure have shown that corrosion in concrete reinforcement is the cause of failure. Thus, there lies a better research opportunity in the field of monitoring and assessing health condition of the building structure. This paper presents an innovative technique of initial monitoring of corrosion in concrete structures using Non-Destruction Evaluation (NDE). An early monitoring sensor was developed using Faradays law of electromagnetic induction (EMI) principle, multiple loop coil (MLC) acts a sensor which has a receiver and transmitter coil. The placement of the two coils on concrete structures measures the potential difference which later is used to analyse the level of corrosion

Patients’, Caregivers’, and Providers’ Perceived Strategies for Diabetes Care

Objectives: To explore strategies to improve type 2 diabetes mellitus (T2DM) self-management among low-income and minority groups. Methods: Focus groups centered on T2DM self-care behaviors were conducted using convenient sample of patients with T2DM (N = 17), caregivers (N = 5) and healthcare providers (N = 15). Results: Patients and caregivers perceived strategies included improving patient-provider communication, providers’ accessibility and compassion, and flexible clinic hours. Strategies identified by providers were realistic patient’s expectations, family support, and community resources. Conclusions: To our knowledge, this study is the first to elicit strategies to improve T2DM self-management through a joint meeting of patients, caregivers, and healthcare providers. Study findings could help inform future efforts to assist patients better manage their T2DM