Behavioral Health Service Use and Expenditures in Massachusetts Medicare and Medicaid Members Aged 55 and Over, 2005

Summary: This report describes behavioral health service use and expenditures for Massachusetts Medicare and Medicaid (MassHealth) members aged 55 and over with behavioral health disorders (BHDs) in calendar year 2005. With an expected increase in the number of elders with BHDs, a better and more comprehensive understanding of behavioral health service delivery is essential in order to identify opportunities for systematic changes that can improve behavioral health services for elders. However, older adults have not been the main focus of previous studies on behavioral health services and expenditures. Furthermore, although existing studies have examined behavioral health services and expenditures in broad geographic areas and at the national level, few studies have taken into account variations among health insurance coverage, particularly Medicare and Medicaid which are important resources for elders and for people with disabilities

Twelve-Month Diagnosed Prevalence of Mental Illness, Substance Use Disorders, and Medical Comorbidity in Massachusetts Medicare and Medicaid Members Aged 55 and Over, 2005

This report describes the 12-month diagnosed prevalence of behavioral health disorders (BHDs) among Massachusetts Medicare and Medicaid (MassHealth) members 55 years of age and older during calendar year 2005. Although population-based estimates of prevalence of BHDs among the elderly are available in only a few selected studies, none of them describe Massachusetts. With an expected rise in the number of elderly people with psychiatric disorders, a better understanding of the prevalence of mental illness and addictions in this population is needed to plan for services and supports

UAS Literary & Arts Journal 2017

The 2017 edition of Tidal Echoes presents an annual showcase of writers and artists who share one thing in common: a life surrounded by the rainforests and waterways of Southeast Alaska.Remembering Dr. Teri Rofkar -- Editor's Note -- Acknowledgements -- Esther -- Untitled -- How to Love Your Body -- no mercy -- Winter Sangria -- Morning Poppies -- How Mom Hooked Dad -- Your Ripples and My Ripples -- Making the Kids Clean Up -- Conquering the Wild Skunk Cabbage -- What’s Queer Got To Do With It? -- Mile Ten for Mary Oliver -- Cache -- This Place (The Tongass) -- No More Shoulds -- Nagoon and Caterpillar -- How to age gracefully -- Yellow Legs --Feeding Her Inner Goose at the Boy Scout Camp -- On Guard -- We Are Family -- Grandma Zona -- Mere Minerals -- Life Goes On -- Evergreen Cemetery -- Untitled -- What is the heart but a -- Why I Feel Nostalgic for Hurricanes -- Stardust in Seattle: Motes of Human Activity -- Coyote -- Untitled -- An Affair with Andromeda -- Untitled -- How Night Comes in Winter -- Light Up the Sky -- Courage -- See You In Spring -- Smoking Luckies -- Agape -- Old Days in Douglas, Alaska -- Pink House -- Tableside Conversation/Overheard in a Restaurant -- The Kumquat Cure for Hypomanics -- Pleistocene -- A Taste of Punjab -- Untitled -- Feeding My Family -- Corn -- When Nothing Else Works -- Feedback Loop -- Dancing With Dante -- 451 -- Circle Room -- An Interview with Rico Lanaat’ World -- Check Out Time -- Cabbage Canner Shoes -- Chanterelle (detail) -- Visiting Hour -- That’s Alright It’s a Warm Rain -- Welcome to the Jungle: Jonestown!! -- Green Unfurling -- Four O’ Clock in the Morning -- Pathway -- An Interview with Lynn Schooler -- Glacier Study 2 and Glacier Study 7 -- Storm -- Loitering -- What I Call Home -- Beyond Heritage -- Naming the Sun -- Auke Lake Mirror -- To Be a Superhero -- Keepsies -- Alchemy -- Gleeful Refuge -- Shaatk’ásk’u -- A Smooth Snowfall -- Back Country -- A Good Morning -- Magical Sunset -- A Simple Gesture -- Columbine -- Notorious -- There Are More Dead Veteran Poets Than Live Ones -- Lupine Dreaming -- Untitled -- Peaches -- Squirrel Sampling Sapsucker Holes -- To Alight -- Mattress -- Curveball -- Crossing Chance -- Gyibaw Ukulele -- Ipswiche -- Hummingbird in Formline with Daisy -- The Pigeons of Valparaiso, Chile -- Hold On Come Along -- Man In A Malt Shop -- Untitled -- Downpours -- Untitled -- The Truth -- Swimming in Place -- Matriline -- Writer and Artist Biographies -- Motherhoo

'To live and die [for] Dixie': Irish civilians and the Confederate States of America

Around 20,000 Irishmen served in the Confederate army in the Civil War. As a result, they left behind, in various Southern towns and cities, large numbers of friends, family, and community leaders. As with native-born Confederates, Irish civilian support was crucial to Irish participation in the Confederate military effort. Also, Irish civilians served in various supporting roles: in factories and hospitals, on railroads and diplomatic missions, and as boosters for the cause. They also, however, suffered in bombardments, sieges, and the blockade. Usually poorer than their native neighbours, they could not afford to become 'refugees' and move away from the centres of conflict. This essay, based on research from manuscript collections, contemporary newspapers, British Consular records, and Federal military records, will examine the role of Irish civilians in the Confederacy, and assess the role this activity had on their integration into Southern communities. It will also look at Irish civilians in the defeat of the Confederacy, particularly when they came under Union occupation. Initial research shows that Irish civilians were not as upset as other whites in the South about Union victory. They welcomed a return to normalcy, and often 'collaborated' with Union authorities. Also, Irish desertion rates in the Confederate army were particularly high, and I will attempt to gauge whether Irish civilians played a role in this. All of the research in this paper will thus be put in the context of the Drew Gilpin Faust/Gary Gallagher debate on the influence of the Confederate homefront on military performance. By studying the Irish civilian experience one can assess how strong the Confederate national experiment was. Was it a nation without a nationalism

Educating the public health workforce: Issues and challenges

Background: In public health, as well as other health education contexts, there is increasing recognition of the transformation in public health practice and the necessity for educational providers to keep pace. Traditionally, public health education has been at the postgraduate level; however, over the past decade an upsurge in the growth of undergraduate public health degrees has taken place. Discussion: This article explores the impact of these changes on the traditional sphere of Master of Public Health programs, the range of competencies required at undergraduate and postgraduate levels, and the relevance of these changes to the public health workforce. It raises questions about the complexity of educational issues facing tertiary institutions and discusses the implications of these issues on undergraduate and postgraduate programs in public health. Conclusion: The planning and provisioning of education in public health must differentiate between the requirements of undergraduate and postgraduate students – while also addressing the changing needs of the health workforce. Within Australia, although significant research has been undertaken regarding the competencies required by postgraduate public health students, the approach is still somewhat piecemeal, and does not address undergraduate public health. This paper argues for a consistent approach to competencies that describe and differentiate entry-level and advanced practice

Plant Ontology (PO): a Controlled Vocabulary of Plant Structures and Growth Stages

The Plant Ontology Consortium (POC) (www.plantontology.org) is a collaborative effort among several plant databases and experts in plant systematics, botany and genomics. A primary goal of the POC is to develop simple yet robust and extensible controlled vocabularies that accurately reflect the biology of plant structures and developmental stages. These provide a network of vocabularies linked by relationships (ontology) to facilitate queries that cut across datasets within a database or between multiple databases. The current version of the ontology integrates diverse vocabularies used to describe Arabidopsis, maize and rice (Oryza sp.) anatomy, morphology and growth stages. Using the ontology browser, over 3500 gene annotations from three species-specific databases, The Arabidopsis Information Resource (TAIR) for Arabidopsis, Gramene for rice and MaizeGDB for maize, can now be queried and retrieved

CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children

© 2016 Bishop et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children\u27s language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi technique to see whether it was possible to achieve consensus among professionals on appropriate criteria for identifying children who might benefit from specialist services. We recruited a panel of 59 experts representing ten disciplines (including education, psychology, speech-language therapy/pathology, paediatrics and child psychiatry) from English-speaking countries (Australia, Canada, Ireland, New Zealand, United Kingdom and USA). The starting point for round 1 was a set of 46 statements based on articles and commentaries in a special issue of a journal focusing on this topic. Panel members rated each statement for both relevance and validity on a sevenpoint scale, and added free text comments. These responses were synthesised by the first two authors, who then removed, combined or modified items with a view to improving consensus. The resulting set of statements was returned to the panel for a second evaluation (round 2). Consensus (percentage reporting \u27agree\u27 or \u27strongly agree\u27) was at least 80 percent for 24 of 27 round 2 statements, though many respondents qualified their response with written comments. These were again synthesised by the first two authors. The resulting consensus statement is reported here, with additional summary of relevant evidence, and a concluding commentary on residual disagreements and gaps in the evidence base

Ruxolitinib versus best available therapy for polycythemia vera intolerant or resistant to hydroxycarbamide in a randomized trial

Purpose Polycythemia vera (PV) is characterized by JAK/STAT activation, thrombotic/hemorrhagic events, systemic symptoms, and disease transformation. In high-risk PV, ruxolitinib controls blood counts and improves symptoms. Patients and Methods MAJIC-PV is a randomized phase II trial of ruxolitinib versus best available therapy (BAT) in patients resistant/intolerant to hydroxycarbamide (HC-INT/RES). Primary outcome was complete response (CR) within 1 year. Secondary outcomes included duration of response, event-free survival (EFS), symptom, and molecular response. Results One hundred eighty patients were randomly assigned. CR was achieved in 40 (43%) patients on ruxolitinib versus 23 (26%) on BAT (odds ratio, 2.12; 90% CI, 1.25 to 3.60; P = .02). Duration of CR was superior for ruxolitinib (hazard ratio [HR], 0.38; 95% CI, 0.24 to 0.61; P < .001). Symptom responses were better with ruxolitinib and durable. EFS (major thrombosis, hemorrhage, transformation, and death) was superior for patients attaining CR within 1 year (HR, 0.41; 95% CI, 0.21 to 0.78; P = .01); and those on ruxolitinib (HR, 0.58; 95% CI, 0.35 to 0.94; P = .03). Serial analysis of JAK2V617F variant allele fraction revealed molecular response was more frequent with ruxolitinib and was associated with improved outcomes (progression-free survival [PFS] P = .001, EFS P = .001, overall survival P = .01) and clearance of JAK2V617F stem/progenitor cells. ASXL1 mutations predicted for adverse EFS (HR, 3.02; 95% CI, 1.47 to 6.17; P = .003). The safety profile of ruxolitinib was as previously reported. Conclusion The MAJIC-PV study demonstrates ruxolitinib treatment benefits HC-INT/RES PV patients with superior CR, and EFS as well as molecular response; importantly also demonstrating for the first time, to our knowledge, that molecular response is linked to EFS, PFS, and OS