Building on MaineCare’s Success

This commentary provides a particular viewpoint on MaineCare (Maine’s Medicaid program). Lisa Pohlmann and Christine Hastedt critique reform efforts in several states and emphasize the key role of MaineCare in the state’s overall health care system

Meeting Maine’s Need for Frontline Workers in Long-term Care and Service Options

Thousands of workers across Maine and the nation provide assistance and health care for elders as well as adults and children with disabilities. The Maine Department of Labor estimates that there were about 17,600 direct care workers employed in 2005, which does not include self-employed workers in private pay arrangements. As baby boomers retire over the next 20 years, the demand for direct care and personal assistance services will continue to grow, making direct care occupations some of the highest demand jobs in the state. There is already a labor shortage in this area of work, and thus long-term consumers are often unable to get the care that they need. As this labor shortage is going to be increasingly more dramatic, this paper evaluates barriers as well as means to meet the need for these frontline workers. The current initiatives include the Maine Personal Assistance Services Association, the Maine State Employee Association, and the Maine Direct Care Worker Coalition, among others. This report puts an emphasis on coordinating state level planning efforts, providing livable wages and benefits to frontline direct care workers, investing in training, career pathway development and workplace culture changes, and marketing the profession

Overcoming Barriers, Building on Strengths: Maine Women Look at Aspirations

There is widespread belief in Maine that the aspirations of both young people and adults fall below much of the rest of the nation. Implicit in this perspective is the idea that aspirations must be raised if Maine is to prosper economically. Yet opinions differ about the definition of aspirations, whether that definition may be expected or permitted to vary by county or region of the state, what factors contribute to the problem being identified as a lack of aspirations, and whether rural parts of Maine and women are at a particular disadvantage. In an effort to further the dialogue on these issues, the Maine Center for Economic Policy convened a round-table discussion in June, moderated and edited for Maine Policy Review by Lisa Pohlmann. The four participants are women who grew up in rural Maine and retain ties and allegiances to those roots. They have attained significant leadership positions within their fields and are respected widely for their many achievements and contributions to the public good. Their conversation was informal, candid, and spanned numerous issues. Here, their comments have been organized around a number of themes that emerged from the content of those discussions

Ambivalence about Leadership in Women's Organizations: a Look at Bangladesh

Summary Women's organizations present special challenges for leadership. Feminist organizers are trying to create new organizational structures based on sharing power more equitably among members but they are still in transition and are capable of recreating hierarchical patterns of behaviour. The pressure of the male?dominated public sphere to conform to hierarchical modes of operation and attempts to undermine women's collective action also affects these change efforts. Women end up feeling ambivalent both as leaders and towards leadership and authority. Self?reflection and open communication on these issues can increase group effectiveness and solidarity. RESUME Les ambigus concernant la direction des organisations pour les femmes: une étude de cas au Bangladesh Les organisations pour les femmes présentent des problèmes particuliers au niveau de leur direction. Les organisatrices féministes tentent de créer de nouvelles structures organisationnelles fondées sur un partage plus équitable du pouvoir parmi les membres or ces nouvelles structures n'en sont qu'à un stade transitionnel et de ce fait, elles restent capables de recréer des modèles de comportement d'ordre hiérarchique. Les pressions dans un domaine public à dominance masculine pour se conformer à des normes d'opération hierarchisées, ainsi que les tentatives de saper l'action collective des femmes militent contre les efforts de changement. En fin de compte, les femmes ressentent une certaine ambivalence envers leur propre responsabilité et envers leurs responsables et l'autorité en général. L'introspection et la communication ouverte sont deux moyens qui permettent d'augmenter l'efficacité et la solidarité des groupes en ce qui concerne ces questions. RESUMEN Ambivalencia sobre liderazgo en organizaciones femeninas; el caso de Bangladesh Las organizaciones femeninas presentan desafíos especiales al liderazgo. Los organizadores feministas están tratando de crear nuevas estructuras basadas en una distribución más justa del poder entre sus miembros, pero todavía están en un período de transición y podrían llegar a recrear pautas jerárquicas de acción. La presión por parte de las esferas públicas para una aceptación de modos jerárquicos de acción y los intentos de socavar la acción colectiva de las mujeres también afectan estos esfuerzos dirigidos al cambio. Las mujeres terminan con un sentimiento de ambivalencia tanto con respecto a su posición de líderes como hacia el liderazgo y la autoridad en general. Para aumentar la efectividad del grupo y la solidaridad deben existir mas auto reflexión y mas comunicación

Cleavage of the SARS Coronavirus Spike Glycoprotein by Airway Proteases Enhances Virus Entry into Human Bronchial Epithelial Cells In Vitro

Background: Entry of enveloped viruses into host cells requires the activation of viral envelope glycoproteins through cleavage by either intracellular or extracellular proteases. In order to gain insight into the molecular basis of protease cleavage and its impact on the efficiency of viral entry, we investigated the susceptibility of a recombinant native full-length S-protein trimer (triSpike) of the severe acute respiratory syndrome coronavirus (SARS-CoV) to cleavage by various airway proteases. Methodology/Principal Findings: Purified triSpike proteins were readily cleaved in vitro by three different airway proteases: trypsin, plasmin and TMPRSS11a. High Performance Liquid Chromatography (HPLC) and amino acid sequencing analyses identified two arginine residues (R667 and R797) as potential protease cleavage site(s). The effect of protease-dependent enhancement of SARS-CoV infection was demonstrated with ACE2 expressing human bronchial epithelial cells 16HBE. Airway proteases regulate the infectivity of SARS-CoV in a fashion dependent on previous receptor binding. The role of arginine residues was further shown with mutant constructs (R667A, R797A or R797AR667A). Mutation of R667 or R797 did not affect the expression of S-protein but resulted in a differential efficacy of pseudotyping into SARS-CoVpp. The R667A SARS-CoVpp mutant exhibited a lack of virus entry enhancement following protease treatment. Conclusions/Significance: These results suggest that SARS S-protein is susceptible to airway protease cleavage and, furthermore, that protease mediated enhancement of virus entry depends on specific conformation of SARS S-protein upon ACE2 binding. These data have direct implications for the cell entry mechanism of SARS-CoV along the respiratory system and, furthermore expand the possibility of identifying potential therapeutic agents against SARS-CoV. © 2009 Kam et al.published_or_final_versio

Novel HPAIV H5N8 Reassortant (Clade 2.3.4.4b) Detected in Germany

A novel H5N8 highly pathogenic avian influenza virus (HPAIV) was detected in a greater white-fronted goose in January 2020 in Brandenburg, Germany, and, in February 2020, in domestic chickens belonging to a smallholding in Baden-Wuerttemberg, Germany. Full-genome sequencing was conducted on the MinION platform, enabling further phylogenetic analyses. The virus of clade 2.3.4.4b holds six segments from a Eurasian/Asian/African HPAIV H5N8 reassortant and two segments from low pathogenic avian influenza H3N8 subtype viruses recently detected in wild birds in Central Russia. These new entries continue to show the reassortment potential of the clade 2.3.4.4 H5Nx viruses, underlining the necessity for full-genome sequencing and continuous surveillance

SARS-CoV-2 spike D614G change enhances replication and transmission

During the evolution of SARS-CoV-2 in humans, a D614G substitution in the spike glycoprotein (S) has emerged; virus containing this substitution has become the predominant circulating variant in the COVID-19 pandemic1. However, whether the increasing prevalence of this variant reflects a fitness advantage that improves replication and/or transmission in humans or is merely due to founder effects remains unknown. Here we use isogenic SARS-CoV-2 variants to demonstrate that the variant that contains S(D614G) has enhanced binding to the human cell-surface receptor angiotensin-converting enzyme 2 (ACE2), increased replication in primary human bronchial and nasal airway epithelial cultures as well as in a human ACE2 knock-in mouse model, and markedly increased replication and transmissibility in hamster and ferret models of SARS-CoV-2 infection. Our data show that the D614G substitution in S results in subtle increases in binding and replication in vitro, and provides a real competitive advantage in vivo-particularly during the transmission bottleneck. Our data therefore provide an explanation for the global predominance of the variant that contains S(D614G) among the SARS-CoV-2 viruses that are currently circulating