The Impact of Program Changes on Enrollment, Access, and Utilization in the Oregon Health Plan Standard Population

In February 2003, in an effort to expand Medicaid coverage within tight fiscal constraints, the Oregon Health Plan (OHP) underwent a significant redesign of benefits, cost-sharing and premium structure. The OHP2 redesign resulted in two tiers of coverage, OHP Plus and OHP Standard, and a premium subsidy program. The OHP Plus benefit package and cost sharing structure is similar to the original OHP and serves the federally-mandated Medicaid populations: children and pregnant women, low-income elderly and individuals meeting the SSI definition of disability. OHP Standard, designed for Oregon’s expansion population,1 includes a reduced benefit package, expanded co-pays and increased premiums. Premium rules were also tightened for the OHP Standard group: individuals are now disqualified from benefits for non-payment of premiums and locked-out from OHP for six months following a disqualification. In addition, monthly premiums are no longer waived for certain groups.(e.g., homeless, zero income). In order to assess the impact of recent program changes, a mail-return survey was conducted between November 2003 and February 2004 with a random sample of OHP beneficiaries who were enrolled as of February 2003, immediately before the program changes were implemented. The survey assessed issues related to enrollment, health care access, health care use, and financial and health status and covered a six-month period following the OHP changes. A total of 2,783 individuals completed surveys, 1,405 individuals in OHP Plus and 1,378 in OHP Standard. This report presents descriptive survey results for the 1,378 OHP Standard enrollees and addresses the impact of recent program changes on 3 key outcomes: enrollment, health care access, and utilization

USING OTOLITH MICROCHEMISTRY TO CLASSIFY YELLOW PERCH AS STOCKED OR NATURALLY PRODUCED

Fisheries managers routinely use stocking to supplement fish populations (Schramm and Piper 1995, Fisher 1996). Stocking eyed-eggs offers substantial cost savings compared to stocking fry and fingerlings (PFBC 2011); however, traditional stocking evaluation using oxytetracycline (OTC) marking of otoliths is ineffective for eyed-eggs of some species (e.g., yellow perch, [Perca fla- vescens]). Thus, there is a need for additional approaches to be able to classify fish as stocked or naturally produced. Fish otoliths are paired calcified structures in the inner ear that permanently deposit trace elements in proportion to water column concentrations (Campana 1999, Campana et al. 2000). Coupled with otolith growth increments (i.e., annuli), elemental accumulation permits retrospective evaluation of environmental history (e.g., natal origins, movement) if water chemistry is spatially heterogeneous and temporally constant (Elsdon et al. 2008). Otolith microchemistry can be used to evaluate stocking contributions (Pracheil et al. 2014) and in the context of eyed-egg stockings, may be useful for classifying fish as stocked or naturally produced. Yellow perch is a popular sport fish species in South Dakota (Gigliotti 2007) and is routinely stocked by fisheries managers to supplement weak year classes (Schoene- beck et al. 2010). The South Dakota Department of Game, Fish and Parks (SDGFP) propagates yellow perch for stocking (e.g., eyed-eggs, fry, fingerlings) and also stocks adult perch through trap and transfer operations (Lott 1991, Fisher 1996). However, the contributions of yellow perch stockings in South Dakota are largely unknown because it is difficult to differentiate stocked fish from resident individuals (Brown and St. Sauver 2002). Our objective was to assess the utility of otolith microchemistry to distinguish hatchery-reared yellow perch stocked at the eyed-egg stage from naturally produced individuals

Kikuchi-Fujimoto Disease in a 30-Year-Old Caucasian Female

Kikuchi-Fujimoto disease is a rare, self-limited, histiocytic, necrotizing lymphadenitis first described in Japan in 1972. Necrosis of lymph node tissue is caused by apoptosis and may be virally induced. It commonly presents with cervical lymphadenitis and fever. Despite its low incidence, Kikuchi-Fujimoto disease should be considered in patients with persistent lymphadenopathy. Originally thought to occur only in young Asian women, it is now recognized in other geographic regions. We report a 30-year-old white woman with Kikuchi-Fujimoto disease. We discuss the clinical features, differential diagnosis, radiography, pathology, and outcome

Atom chips on direct bonded copper substrates

We present the use of direct bonded copper (DBC) for the straightforward fabrication of high power atom chips. Atom chips using DBC have several benefits: excellent copper/substrate adhesion, high purity, thick (> 100 microns) copper layers, high substrate thermal conductivity, high aspect ratio wires, the potential for rapid (< 8 hr) fabrication, and three dimensional atom chip structures. Two mask options for DBC atom chip fabrication are presented, as well as two methods for etching wire patterns into the copper layer. The wire aspect ratio that optimizes the magnetic field gradient as a function of power dissipation is determined to be 0.84:1 (height:width). The optimal wire thickness as a function of magnetic trapping height is also determined. A test chip, able to support 100 A of current for 2 s without failing, is used to determine the thermal impedance of the DBC. An assembly using two DBC atom chips to provide magnetic confinement is also shown.Comment: 8 pages, 5 figure

An Assessment of the Spanish-Language Oregon Medicaid Health Risk and Health Status Survey (OMHRHSS)

The purpose of this project was to assess the validity of the Spanish-language version of the Oregon Medicaid Health Risk and Health Status Survey (OMHRHSS

Universal quantum computation using the discrete time quantum walk

A proof that continuous time quantum walks are universal for quantum computation, using unweighted graphs of low degree, has recently been presented by Childs [PRL 102 180501 (2009)]. We present a version based instead on the discrete time quantum walk. We show the discrete time quantum walk is able to implement the same universal gate set and thus both discrete and continuous time quantum walks are computational primitives. Additionally we give a set of components on which the discrete time quantum walk provides perfect state transfer.Comment: 9 pages, 10 figures. Updated after referee comments - Section V expanded and minor changes to other parts of the tex

Reducing “Treble” with Performance Focused Music Programs in Medical School: A Student Driven Needs Assessment to Clarify Participation Barriers Amongst Undergraduate Medical Students

Introduction: The beneficial impact of performing arts involvement within undergraduate medical education, such as music, has been studied, but support for the arts varies significantly by institution. Research has suggested that medical student involvement in the arts can help develop their identities as physicians and may reduce stress and burnout, an increasingly difficult problem within the medical student community. Methods: We used a mixed-method cross-sectional study design, using a questionnaire and semi-structured interview designed amongst a team of music professionals and healthcare providers with music backgrounds. Out of 511 enrolled medical students, 93 students participated in the study for a response rate of 18.2%. Questions were piloted among eight medical students, with modifications made in response to feedback. Participants were recruited to participate in an online survey via social media. Results: Within our sample, the most popular background instrument was piano (58.5%) and voice (50.0%). Of those who responded, most preferred to perform alone (85.7%) or in small groups (51.4%). 78.8% of respondents agreed that music was essential to their wellbeing. Only 62.5% of the respondents with musical backgrounds still play music or sing. Of those who no longer play music, 90.5% of respondents reported time constraint as the limiting factor, followed by lack of access to instruments (42.9%). Conclusion: This study suggests there are diverse music backgrounds and interests amongst the medical student population. Although most participants believed music was a form of stress relief, undergraduate medical training demands impose time restrictions on student engagement. Investments in music programs that enable adequate involvement and meet student demand have the potential to improve medical student engagement with the arts, alleviate stress, and may even lead to stronger/more empathetic physicians. Periodic needs assessments may be a powerful tool to better align programming to address student desires and reduce barriers

Adjustable microchip ring trap for cold atoms and molecules

We describe the design and function of a circular magnetic waveguide produced from wires on a microchip for atom interferometry using deBroglie waves. The guide is a two-dimensional magnetic minimum for trapping weak-field seeking states of atoms or molecules with a magnetic dipole moment. The design consists of seven circular wires sharing a common radius. We describe the design, the time-dependent currents of the wires and show that it is possible to form a circular waveguide with adjustable height and gradient while minimizing perturbation resulting from leads or wire crossings. This maximal area geometry is suited for rotation sensing with atom interferometry via the Sagnac effect using either cold atoms, molecules and Bose-condensed systems

Catastro de poblaciones de insectos en siembras de Capsicum chinense L. en Georgetown, San Vicente, usando trampas CC modificadas.

The insect populations in hot pepper, Capsicum chinense L. (Solanaceae), were surveyed in Georgetown, St. Vincent, during the 2004 wet and 2005 dry seasons. Modified white, blue, and yellow CC traps were used to capture insects in the plantings. Overall, 69 insect families were captured, 41 of which were captured during both the wet and dry seasons. During the wet season, the greatest numbers of individuals captured were from the Cecidomyiidae, Chironomidae, Chloropidae, Chrysomelidae, Cicadellidae, and Drosophilidae families. During the dry season, the greatest numbers of individuals captured were from Chrysomelidae and Cicadellidae families. The addition of dichlorvos as a killing agent and propylene glycol as an insect preservative to the CC traps increased the number and diversity of insects caught. Additionally, propylene glycol helped to preserve the specimens for taxonomic and genetic determinations. CC traps with yellow bases attracted more insect families than traps with white or blue bases. However, CC traps with blue bases caught more Lonchaeidae during both the wet and dry seasons, and more Tachinidae during the dry season. CC traps with white or yellow trap bases were equally attractive to insects in the families Aleyrodidae, Drosophilidae, Lauxaniidae, and Otitidae.Las poblaciones de insectos en el ají picante, Capsicum chinense L., se monitorearon en Georgetown, San Vicente, durante la época de lluvia de 2004 y la de sequía de 2005. Se usaron las trampas CC modificadas, blancas, azules y amarillas, para capturar insectos en las siembras. Se capturaron 69 familias de insectos; 41 de éstas se capturaron durante ambas épocas, la de lluvia y la de sequía. Durante la época de lluvia, el mayor número de individuos capturados pertenecía a las familias Cecidomyiidae, Chironomidae, Chloropidae, Chrysomelidae, Cicadellidae y Drosophilidae. Durante la época de sequía, el mayor número de individuos capturados pertenecía a las familias Cicadellidae y Chrysomelidae. El número y la diversidad de los insectos capturados aumentaron al añadir dichlorvos como un agente exterminador y glicol de propileno como agente preservativo a las trampas CC. Además, el glicol de propileno ayudó a preservar los especímenes para las determinaciones taxonómicas y genéticas. Las trampas CC con bases amarillas atrajeron más familias de insectos que las trampas con bases blancas o azules. Sin embargo, las trampas CC con bases azules capturaron más Lonchaeidae durante ambas épocas, de lluvia y sequía, y más Tachinidae durante la época de sequía. Las trampas CC con bases blancas o amarillas resultaron igualmente atractivas a los insectos en las familias Aleyrodidae, Drosophilidae, Lauxaniidae y Otitidae

Load Planning Processes to Enhance Cargo Compartment Utilization

Purpose: The United States Air Force often provides effective airlift for cargo distribution, but is at times inefficient. This paper aims to address the under-utilization of military airlift cargo compartments that plagues the airlift system.Design/methodology/approach: The authors examine seven techniques designed to increase cargo compartment utilization and increase airlift utilization rates. The techniques were applied through load planning software to 30 real-world movements consisting of 159 sorties. They then ran each post-technique movement through a modeled flight environment to obtain cycle movement data. The metrics gained from both the load planning software and the modeled environment were regressed to provide statistical understanding regarding how well each technique influenced cost savings.Findings: The results showed a 24 per cent elimination of aircraft required and a savings of $14.5m. Extrapolation of the authors’ findings to four years of airlift mission data revealed an estimated annual savings of$1.6bn