Achieving Equity by Building a Bridge From Eligible to Enrolled

Calls for multilingual outreach and enrollment efforts to enable Californians of color and those with limited English proficiency to benefit from the Health Benefit Exchange. Recommends targeting high-need groups and strengthening data collection

Use of a comprehensive patient safety tool in primary care practices

Purpose To present a tool that can be used to evaluate patient safety in both nurse‐led and physician‐led practices. Data source This article describes our experience with the Physician Practice Patient Safety Assessment (PPPSA) tool in six safety net practices—three of which were primary care nurse‐managed health centers and three were physician‐led federally qualified health centers. The information provided is from the tool itself and how it might be used in clinical settings, especially primary care. Conclusions The PPPSA is a tool to measure the extent to which patient safety practices are rigorously and systematically implemented throughout a health center. The tool's methodology requires discussion and consensus, incorporating a team approach with multiple perspectives within a center. It is designed to promote changes in practices that would improve patient safety. Implications for practice The tool has enormous relevance for primary care settings, especially those preparing themselves for patient‐centered medical home status and meaningful use. But most important, it has relevance as we create healthcare environments that promote patient safety and a practice culture that is truly patient centered.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99022/1/jaan12021.pd

Two methods for estimating limits to large-scale wind power generation

Wind turbines remove kinetic energy from the atmospheric flow, which reduces wind speeds and limits generation rates of large wind farms. These interactions can be approximated using a vertical kinetic energy (VKE) flux method, which predicts that the maximum power generation potential is 26% of the instantaneous downward transport of kinetic energy using the preturbine climatology. We compare the energy flux method to the Weather Research and Forecasting (WRF) regional atmospheric model equipped with a wind turbine parameterization over a 105 km2 region in the central United States. The WRF simulations yield a maximum generation of 1.1 We⋅m−2, whereas the VKE method predicts the time series while underestimating the maximum generation rate by about 50%. Because VKE derives the generation limit from the preturbine climatology, potential changes in the vertical kinetic energy flux from the free atmosphere are not considered. Such changes are important at night when WRF estimates are about twice the VKE value because wind turbines interact with the decoupled nocturnal low-level jet in this region. Daytime estimates agree better to 20% because the wind turbines induce comparatively small changes to the downward kinetic energy flux. This combination of downward transport limits and wind speed reductions explains why large-scale wind power generation in windy regions is limited to about 1 We⋅m−2, with VKE capturing this combination in a comparatively simple way

Effectiveness of different methods for delivering tailored nutrition education to low income, ethnically diverse adults

<p>Abstract</p> <p>Background</p> <p>Computer-tailored written nutrition interventions have been shown to be more effective than non-tailored materials in changing diet, but continued research is needed. Your Healthy Life/Su Vida Saludable (YHL-SVS) was an intervention study with low income, ethnically diverse, English and Spanish-speaking participants to determine which methods of delivering tailored written nutrition materials were most effective in lowering fat and increasing fruit and vegetable (F&V) intake.</p> <p>Methods</p> <p>YHL-SVS was a randomized controlled trial with four experimental conditions: 1) Nontailored (NT) comparison group; 2) Single Tailored (ST) packet; 3) Multiple Tailored (MT) packet mailed in four installments; 4) Multiple Re-Tailored (MRT) MT packets re-tailored between mailings via brief phone surveys. A baseline telephone survey collected information for tailoring as well as evaluation. Follow-up evaluation surveys were collected 4- and 7-months later. Primary outcomes included F&V intake and fat related behaviors. Descriptive statistics, paired t-test and ANOVA were used to examine the effectiveness of different methods of delivering tailored nutrition information.</p> <p>Results</p> <p>Both the ST and MT groups reported significantly higher F&V intake at 4-months than the NT and MRT groups. At 7 months, only the MT group still had significantly higher F&V intake compared to the NT group. For changes in fat-related behaviors, both the MT and MRT groups showed more change than NT at 4 months, but at 7 months, while these differences persisted, they were no longer statistically significant. There was a significant interaction of experimental group by education for change in F&V intake (P = .0085) with the lowest educational group demonstrating the most change.</p> <p>Conclusion</p> <p>In this study, tailored interventions were more effective than non-tailored interventions in improving the short-term dietary behaviors of low income, ethnically diverse participants. Delivery of information in multiple smaller doses over time appeared to improve effectiveness. Future studies should determine which variables are mediators of dietary change and whether these differ by participant demographics. Moreover, future research should differentiate the effects of tailoring vs. cultural adaptation in ethnically diverse populations and study the dissemination of tailored interventions into community-based settings.</p> <p>Trial registration</p> <p>Current Controlled Trials # NCT00301691.</p

Foundations of plasma standards

The field of low-temperature plasmas (LTPs) excels by virtue of its broad intellectual diversity, interdisciplinarity and range of applications. This great diversity also challenges researchers in communicating the outcomes of their investigations, as common practices and expectations for reporting vary widely in the many disciplines that either fall under the LTP umbrella or interact closely with LTP topics. These challenges encompass comparing measurements made in different laboratories, exchanging and sharing computer models, enabling reproducibility in experiments and computations using traceable and transparent methods and data, establishing metrics for reliability, and in translating fundamental findings to practice. In this paper, we address these challenges from the perspective of LTP standards for measurements, diagnostics, computations, reporting and plasma sources. This discussion on standards, or recommended best practices, and in some cases suggestions for standards or best practices, has the goal of improving communication, reproducibility and transparency within the LTP field and fields allied with LTPs. This discussion also acknowledges that standards and best practices, either recommended or at some point enforced, are ultimately a matter of judgment. These standards and recommended practices should not limit innovation nor prevent research breakthroughs from having real-time impact. Ultimately, the goal of our research community is to advance the entire LTP field and the many applications it touches through a shared set of expectations

Photoelectron angular distributions from rotationally resolved autoionizing states of N2

The single-photon, photoelectron-photoion coincidence spectrum of N2 has been recorded at high (~1.5 cm–1 ) resolution in the region between the N2+ X 2Σg+, v+ = 0 and 1 ionization thresholds by using a double-imaging spectrometer and intense vacuum-ultraviolet light from the Synchrotron SOLEIL. This approach provides the relative photoionization cross section, the photoelectron energy distribution, and the photoelectron angular distribution as a function of photon energy. The region of interest contains autoionizing valence states, vibrationally autoionizing Rydberg states converging to vibrationally excited levels of the N2+ X 2Σg+ ground state, and electronically autoionizing states converging to the N2+ A 2Π and B 2Σu+ states. The wavelength resolution is sufficient to resolve rotational structure in the autoionizing states, but the electron energy resolution is insufficient to resolve rotational structure in the photoion spectrum. A simplified approach based on multichannel quantum defect theory is used to predict the photoelectron angular distribution parameters, β, and the results are in reasonably good agreement with experiment

Photoelectron angular distributions from rotationally resolved autoionizing states of N2

The single-photon, photoelectron-photoion coincidence spectrum of N2 has been recorded at high (~1.5 cm–1 ) resolution in the region between the N2+ X 2Σg+, v+ = 0 and 1 ionization thresholds by using a double-imaging spectrometer and intense vacuum-ultraviolet light from the Synchrotron SOLEIL. This approach provides the relative photoionization cross section, the photoelectron energy distribution, and the photoelectron angular distribution as a function of photon energy. The region of interest contains autoionizing valence states, vibrationally autoionizing Rydberg states converging to vibrationally excited levels of the N2+ X 2Σg+ ground state, and electronically autoionizing states converging to the N2+ A 2Π and B 2Σu+ states. The wavelength resolution is sufficient to resolve rotational structure in the autoionizing states, but the electron energy resolution is insufficient to resolve rotational structure in the photoion spectrum. A simplified approach based on multichannel quantum defect theory is used to predict the photoelectron angular distribution parameters, β, and the results are in reasonably good agreement with experiment

Visual pigments, ocular filters and the evolution of snake vision

Much of what is known about the molecular evolution of vertebrate vision comes from studies of mammals, birds and fish. Reptiles (especially snakes) have barely been sampled in previous studies despite their exceptional diversity of retinal photoreceptor complements. Here we analyse opsin gene sequences and ocular media transmission for up to 69 species to investigate snake visual evolution. Most snakes express three visual opsin genes (rh1, sws1, lws). These opsin genes (especially rh1 and sws1) have undergone much evolutionary change, including modifications of amino acid residues at sites of known importance for spectral tuning, with several tuning site combinations unknown elsewhere among vertebrates. These changes are particularly common among dipsadine and colubrine ‘higher’ snakes. All three opsin genes are inferred to be under purifying selection, though dN/dS varies with respect to some lineages, ecologies, and retinal anatomy. Positive selection was inferred at multiple sites in all three opsins, these being concentrated in transmembrane domains and thus likely to have a substantial effect on spectral tuning and other aspects of opsin function. Snake lenses vary substantially in their spectral transmission. Snakes active at night and some of those active by day have very transmissive lenses, while some primarily diurnal species cut out shorter wavelengths (including UVA). In terms of retinal anatomy, lens transmission, visual pigment spectral tuning and opsin gene evolution the visual system of snakes is exceptionally diverse compared to all other extant tetrapod orders

Comedy in Unfunny Times: News Parody and Carnival after 9/11

Comedy has a special role in helping societies manage crisis moments, and the U.S. media paid considerable attention to the proper role of comedy in public culture after the 9/11 tragedies. As has been well documented, many popular U.S. comic voices were paralyzed in trying to respond to 9/11 or disciplined by audiences when they did. Starting with these obstacles in mind, this essay analyzes early comic responses to 9/11, and particularly those of the print and online news parody The Onion, as an example of how “fake” news discourse could surmount the rhetorical chill that fell over public culture after the tragedies. By exposing the news as “mere” production and by setting an agenda for learning about Islamic culture and Middle East politics, The Onion avoided violating decorum and invited citizen participation. This kind of meta-discourse was crucial after 9/11, when shifting rules for decorum created controversy and as official voices in government and media honed frames and narratives for talking about the attacks

Demonstration of the temporal matter-wave Talbot effect for trapped matter waves

We demonstrate the temporal Talbot effect for trapped matter waves using ultracold atoms in an optical lattice. We investigate the phase evolution of an array of essentially non-interacting matter waves and observe matter-wave collapse and revival in the form of a Talbot interference pattern. By using long expansion times, we image momentum space with sub-recoil resolution, allowing us to observe fractional Talbot fringes up to 10th order.Comment: 17 pages, 7 figure