Dismantling the Poverty Trap: Disability Policy for the 21st Century. Policy Brief

Working-age Americans with disabilities are much more likely to live in poverty than other Americans and generally did not share in the economic prosperity of the late 1990s. At the same time, public expenditures to support them are growing at a rate that will be difficult to sustain when the baby boom generation retires and begins to draw Social Security Retirement and Medicare benefits. We argue that this discouraging situation will continue unless we can bring disability programs into line with more contemporary understanding of the capabilities of people with disabilities and successfully implement broad, systemic reforms to promote their economic self-sufficiency. This policy brief summarizes a larger paper (Stapleton, O’Day, Livermore & Imparato, 2005). It suggests principles to guide reforms and encourage debate. Future policy briefs will elaborate on some of these principles

Dismantling the Poverty Trap: Disability Policy for the Twenty-First Century

Working-age people with disabilities are much more likely than people without disabilities to live in poverty and not be employed or have shared in the economic prosperity of the late 1990s. Today’s disability policies, which remain rooted in paternalism, create a “poverty trap” that recent reforms have not resolved. This discouraging situation will continue unless broad, systemic reforms promoting economic self-sufficiency are implemented, in line with more modern thinking about disability. Indeed, the implementation of such reforms may be the only way to protect people with disabilities from the probable loss of benefits if the federal government cuts funding for entitlement programs. This article suggests some principles to guide reforms and encourage debate and asks whether such comprehensive reforms can be successfully designed and implemented

Enhanced magnetic fields within a stratified layer

Mounting evidence from both seismology and numerical experiments on core composition suggests the existence of a layer of stably stratified fluid at the top of Earth’s outer core. In such a layer, a magnetostrophic force balance and suppressed radial motion lead to stringent constraints on the magnetic field, named Malkus constraints, which are a much more restrictive extension of the well known Taylor constraints. Here, we explore the consequences of such constraints for the structure of the core’s internal magnetic field. We provide a new simple derivation of these Malkus constraints, and show solutions exist which can be matched to any external potential field with arbitrary depth of stratified layer. From considerations of these magnetostatic Malkus constraints alone, it is therefore not possible to uniquely infer the depth of the stratified layer from external geomagnetic observations. We examine two models of the geomagnetic field defined within a spherical core, which obey the Taylor constraints in an inner convective region and the Malkus constraints in an outer stratified layer. When matched to a single-epoch geomagnetic potential field model, both models show that the toroidal magnetic field within the outer layer is about 100 times stronger compared to that in the inner region, taking a maximum value of 8 mT at a depth of 70 km. The dynamic regime of such a layer, modulated by suppressed radial motion but also a locally enhanced magnetic field, may therefore be quite distinct from that of any interior dynamo

Full sphere hydrodynamic and dynamo benchmarks

Convection in planetary cores can generate fluid flow and magnetic fields, and a number of sophisticated codes exist to simulate the dynamic behaviour of such systems. We report on the first community activity to compare numerical results of computer codes designed to calculate fluid flow within a whole sphere. The flows are incompressible and rapidly rotating and the forcing of the flow is either due to thermal convection or due to moving boundaries. All problems defined have solutions that allow easy comparison, since they are either steady, slowly drifting or perfectly periodic. The first two benchmarks are defined based on uniform internal heating within the sphere under the Boussinesq approximation with boundary conditions that are uniform in temperature and stress-free for the flow. Benchmark 1 is purely hydrodynamic, and has a drifting solution. Benchmark 2 is a magnetohydrodynamic benchmark that can generate oscillatory, purely periodic, flows and magnetic fields. In contrast, Benchmark 3 is a hydrodynamic rotating bubble benchmark using no slip boundary conditions that has a stationary solution. Results from a variety of types of code are reported, including codes that are fully spectral (based on spherical harmonic expansions in angular coordinates and polynomial expansions in radius), mixed spectral and finite difference, finite volume, finite element and also a mixed Fourier–finite element code. There is good agreement between codes. It is found that in Benchmarks 1 and 2, the approximation of a whole sphere problem by a domain that is a spherical shell (a sphere possessing an inner core) does not represent an adequate approximation to the system, since the results differ from whole sphere results

Rapid and Point-of-Care Testing in Respiratory Tract Infections: An Antibiotic Guardian?

This is a narrative review on the potential of rapid and point-of-care microbiological testing in pneumonia patients, focusing particularly on hospital-acquired and ventilator-associated pneumonia, which have substantial mortality and diverse microbiology. This work is written from a United Kingdom perspective, but much of it is generalizable internationally. In a world where antimicrobial resistance is a major international threat, the use of rapid molecular diagnostics has great potential to improve both the management of pneumonia patients and the stewardship of antibiotics. Rapid tests potentially can distinguish patients with bacterial versus viral infection and can swiftly identify bacterial pathogens and their resistances. We seek to answer the question: "Can such tests be used as an antibiotic guardian?"Their availability at the bedside rather than in the laboratory should best ensure that results are swiftly used to optimize patient management but will raise new challenges, not the least with respect to maintaining quality control and microbiology/infection control input. A further challenge lies in assessing the degree of trust that treating clinicians will place in these molecular diagnostic tests, particularly when early de-escalation of antibiotic therapy is indicated

Being on the Juvenile Dermatomyositis Rollercoaster: a qualitative study

Objectives: Juvenile Dermatomyositis is a rare, potentially life-threatening condition with no known cure. There is no published literature capturinghow children and young people feel about their condition, from their perspective. This study was therefore unique in that it asked children and young people what is it like to live with Juvenile Dermatomyositis. Methods: Data wereobtained from fifteen young people with Juvenile Dermatomyositis, between eightand nineteen years of age from one Paediatric Rheumatology department using audio-recordedinterpretive phenomenology interviews. Data were analyzed phenomenologically, using a process that derives narratives from transcripts resulting in a collective composite of participants shared experiences, called a‘phenomenon’. Results:The overarching metaphor of a rollercoaster captures the phenomenon of living withJuvenile Dermatomyositisas a young person, with the ups and downs at different time points clearly described by those interviewed. The five themes plotted on the rollercoaster, began with confusion; followed by feeling different, being sick, steroidal and scared from the medications; uncertainty; and then ended with acceptance of the disease over time. Conclusion: Young people were able to talk about their experiences about having Juvenile Dermatomyositis. Our findings will aid clinicians in their practice by gaining a deeper understanding of what daily life is like and highlighting ways to enhance psychosocial functioning. Hopefully, this study and any further resulting studies,will raise understanding of Juvenile Dermatomyositis worldwide and will encourage health care professionals to better assess psychosocial needs in the future