Public Health Workforce Shortages Imperil Nation's Health

Examines from a community-based perspective the scope of the shortages in the public health workforce; contributing factors such as inadequate funding, salaries, and benefits; and strategies for training, recruiting, and retaining public health workers

General Hospitals, Specialty Hospitals and Financially Vulnerable Patients

Examines whether specialty hospitals draw well-insured patients away from general and safety-net hospitals, reducing their ability to cross-subsidize less profitable services and uncompensated care, in three cities. Notes challenges and implications

Luminosity Function of Faint Globular Clusters in M87

We present the luminosity function to very faint magnitudes for the globular clusters in M87, based on a 30 orbit \textit{Hubble Space Telescope (HST)} WFPC2 imaging program. The very deep images and corresponding improved false source rejection allow us to probe the mass function further beyond the turnover than has been done before. We compare our luminosity function to those that have been observed in the past, and confirm the similarity of the turnover luminosity between M87 and the Milky Way. We also find with high statistical significance that the M87 luminosity function is broader than that of the Milky Way. We discuss how determining the mass function of the cluster system to low masses can constrain theoretical models of the dynamical evolution of globular cluster systems. Our mass function is consistent with the dependence of mass loss on the initial cluster mass given by classical evaporation, and somewhat inconsistent with newer proposals that have a shallower mass dependence. In addition, the rate of mass loss is consistent with standard evaporation models, and not with the much higher rates proposed by some recent studies of very young cluster systems. We also find that the mass-size relation has very little slope, indicating that there is almost no increase in the size of a cluster with increasing mass.Comment: 22 pages, 5 figures, Accepted for publication in Ap

Massachusetts Health Reform: High Costs and Expanding Expectations May Weaken Employer Support

Examines how, as a result of the state's health reform, improved access to the individual insurance market and increased employer responsibility may reduce employers' motivation and ability to provide coverage. Considers implications

The Black Hole Mass in Brightest Cluster Galaxy NGC 6086

We present the first direct measurement of the central black hole mass, M_BH, in NGC 6086, the Brightest Cluster Galaxy (BCG) in Abell 2162. Our investigation demonstrates for the first time that stellar dynamical measurements of M_BH in BCGs are possible beyond the nearest few galaxy clusters. We observed NGC 6086 with laser guide star adaptive optics and the integral-field spectrograph (IFS) OSIRIS at the W.M. Keck Observatory, and with the seeing-limited IFS GMOS-N at Gemini Observatory North. We combined the two IFS data sets with existing major-axis kinematics, and used axisymmetric stellar orbit models to determine M_BH and the R-band stellar mass-to-light ratio, M*/L_R. We find M_BH = 3.6(+1.7)(-1.1) x 10^9 M_Sun and M*/L_R = 4.6(+0.3)(-0.7) M_Sun/L_Sun (68% confidence), from models using the most massive dark matter halo allowed within the gravitational potential of the host cluster. Models fitting only IFS data confirm M_BH ~ 3 x 10^9 M_Sun and M*/L_R ~ 4 M_Sun/L_Sun, with weak dependence on the dark matter halo structure. When data out to 19 kpc are included, the unrealistic omission of dark matter causes the best-fit black hole mass to decrease dramatically, to 0.6 x 10^9 M_Sun, and the best-fit stellar mass-to-light ratio to increase to 6.7 M_Sun/L_Sun. The latter value is at further odds with stellar population studies favoring M*/L ~ 2 M_Sun/L_Sun,R. Biases from dark matter omission could extend to dynamical models of other galaxies with central stellar cores, and new measurements of M_BH from models with dark matter could steepen the empirical scaling relationships between black holes and their host galaxies.Comment: 22 pages, 19 figures; accepted for publication in Ap

M32+/-1

WFPC-2 images are used to study the central structure of M31, M32, and M33. The dimmer peak, P2, of the M31 double nucleus is centered on the bulge to 0.1", implying that it is the dynamical center of M31. P2 contains a compact source discovered by King et al. (1995) at 1700 A. This source is resolved, with r_{1/2} approx0.2 pc. It dominates the nucleus at 3000 A, and is consistent with late B-early A stars. This probable cluster may consist of young stars and be an older version of the cluster of hot stars at the center of the Milky Way, or it may consist of heavier stars built up from collisions in a possible cold disk of stars orbiting P2. In M32, the central cusp rises into the HST limit with gamma approx0.5, and the central density rho_0>10^7M_sol pc^-3. The V-I and U-V color profiles are flat, and there is no sign of an inner disk, dust, or any other structure. This total lack of features seems at variance with a nominal stellar collision time of 2 X 10^10 yr, which implies that a significant fraction of the light in the central pixel should come from blue stragglers. InM33, the nucleus has an extremely steep gamma=1.49 power-law profile for 0.05"<r<0.2" that becomes shallower as the HST resolution limit is approached. The profile for r<0.04" has either a gamma approx 0.8 cusp or a small core with r_c ~<0.13 pc. The central density is rho_0 > 2 10^6M_sol pc^-3, and the implied relaxation time is only ~3 X 10^6 yr, indicating that the nucleus is highly relaxed. The accompanying short collision time of 7 X 10^9 yr predicts a central blue straggler component quantitatively consistent with the strong V-I and B-R color gradients seen with HST and from the ground.Comment: 44 pages, 22 figures (7 as separate JPEG images), submitted to The Astronomical Journal. Full postscript image available at http://www.noao.edu/noao/staff/lauer/lauer_paper

Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence.

BACKGROUND: Tuberculosis (TB) remains a major cause of mortality in developing countries, and in these countries diabetes prevalence is increasing rapidly. Diabetes increases the risk of TB. Our aim was to assess the potential impact of diabetes as a risk factor for incident pulmonary tuberculosis, using India as an example. METHODS: We constructed an epidemiological model using data on tuberculosis incidence, diabetes prevalence, population structure, and relative risk of tuberculosis associated with diabetes. We evaluated the contribution made by diabetes to both tuberculosis incidence, and to the difference between tuberculosis incidence in urban and rural areas. RESULTS: In India in 2000 there were an estimated 20.7 million adults with diabetes, and 900,000 incident adult cases of pulmonary tuberculosis. Our calculations suggest that diabetes accounts for 14.8% (uncertainty range 7.1% to 23.8%) of pulmonary tuberculosis and 20.2% (8.3% to 41.9%) of smear-positive (i.e. infectious) tuberculosis. We estimate that the increased diabetes prevalence in urban areas is associated with a 15.2% greater smear-positive tuberculosis incidence in urban than rural areas - over a fifth of the estimated total difference. CONCLUSION: Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control and the achievement of the United Nations Millennium Development Goals

Brightest Cluster Galaxies at the Present Epoch

We have observed 433 z<=0.08 brightest cluster galaxies (BCGs) in a full-sky survey of Abell clusters. The BCG Hubble diagram is consistent to within 2% of a Omega_m=0.3, Lambda=0.7 Hubble relation. The L_m-alpha relation for BCGs, which uses alpha, the log-slope of the BCG photometric curve of growth, to predict metric luminosity, L_m, has 0.27 mag residuals. We measure central stellar velocity dispersions, sigma, of the BCGs, finding the Faber-Jackson relation to flatten as the metric aperture grows to include an increasing fraction of the total BCG luminosity. A 3-parameter "metric plane" relation using alpha and sigma together gives the best prediction of L_m, with 0.21 mag residuals. The projected spatial offset, r_x, of BCGs from the X-ray-defined cluster center is a gamma=-2.33 power-law over 1<r_x<10^3 kpc. The median offset is ~10 kpc, but ~15% of the BCGs have r_x>100 kpc. The absolute cluster-dispersion normalized BCG peculiar velocity |Delta V_1|/sigma_c follows an exponential distribution with scale length 0.39+/-0.03. Both L_m and alpha increase with sigma_c. The alpha parameter is further moderated by both the spatial and velocity offset from the cluster center, with larger alpha correlated with the proximity of the BCG to the cluster mean velocity or potential center. At the same time, position in the cluster has little effect on L_m. The luminosity difference between the BCG and second-ranked galaxy, M2, increases as the peculiar velocity of the BCG within the cluster decreases. Further, when M2 is a close luminosity "rival" of the BCG, the galaxy that is closest to either the velocity or X-ray center of the cluster is most likely to have the larger alpha. We conclude that the inner portions of the BCGs are formed outside the cluster, but interactions in the heart of the galaxy cluster grow and extend the envelopes of the BCGs.Comment: Accepted for publication in the Astrophysical Journa

GEM-based TPC with CCD Imaging for Directional Dark Matter Detection

The world's leading directional dark matter experiments currently all utilize low-pressure gas Time Projection Chamber (TPC) technologies. We discuss some of the challenges for this technology, for which balancing the goal of achieving the best sensitivity with that of cost effective scale-up requires optimization over a large parameter space. Critical for this are the precision measurements of the fundamental properties of both electron and nuclear recoil tracks down to the lowest detectable energies. Such measurements are necessary to provide a benchmark for background discrimination and directional sensitivity that could be used for future optimization studies for directional dark matter experiments. In this paper we describe a small, high resolution, high signal- to-noise GEM-based TPC with a 2D CCD readout designed for this goal. The performance of the detector was characterized using alpha particles, X-rays, gamma-rays, and neutrons, enabling detailed measurements of electron and nuclear recoil tracks. Stable effective gas gains of greater than $1 \times 10^5$ were obtained in 100 Torr of pure CF$_4$ by a cascade of three standard CERN GEMs each with a 140 $\mu$m pitch. The high signal-to-noise and sub-millimeter spatial resolution of the GEM amplification and CCD readout, together with low diffusion, allow for excellent background discrimination between electron and nuclear recoils down below $\sim$10 keVee ($\sim$23 keVr fluorine recoil). Even lower thresholds, necessary for the detection of low mass WIMPs for example, might be achieved by lowering the pressure and utilizing full 3D track reconstruction. These and other paths for improvements are discussed, as are possible fundamental limitations imposed by the physics of energy loss