Early Implementation of the Health Coverage Tax Credit in Maryland, Michigan, and North Carolina: A Case Study Summary

Examines the effectiveness of HCTCs and assesses their prospects as a model for broader reforms. Proposes reforms to improve HCTCs' ability to help current target populations and aid policymakers in designing future health insurance tax credits

Does Small Dam Removal Affect Local Property Values? An Empirical Analysis

This paper uses hedonic analysis to examine the impact of small dam removal on property values in South-central Wiscosin. Data on residential property sales were obtained for three categories of sites: those where a dam is intact, those where a dam was recently removed, and those where the stream has been free-flowing for at least 20 years. The primary conclusions that emerge from the data are that residential property located in the vicinity of a free-flowing stream is more valuable than identical property in the vicinity of a small impoundment, and that shoreline frontage along small impoundments confers no increase in residential property value compared to frontage along free-flowing streams.

A need for otolaryngology education among primary care providers

Objective: Otolaryngic disorders are very common in primary care, comprising 20–50% of presenting complaints to a primary care provider. There is limited otolaryngology training in undergraduate and post-graduate medical education for primary care. Presented at the American Academy of Otolaryngology – Head & Neck Surgery 2011 Annual Meeting, San Francisco, USA, on Tuesday, September 13, 2011. Continuing medical education may be the next opportunity to train our primary care providers (PCPs). The objective of this study was to assess the otolaryngology knowledge of a group of PCPs attending an otolaryngology update course. Methods: PCPs enrolled in an otolaryngology update course completed a web-based anonymous survey on demographics and a pre-course knowledge test. This test was composed of 12 multiple choice questions with five options each. At the end of the course, they were asked to evaluate the usefulness of the course for their clinical practice. Results: Thirty seven (74%) PCPs completed the survey. Mean knowledge test score out of a maximum score of 12 was 4.0±1.7 (33.3±14.0%). Sorted by area of specialty, the mean scores out of a maximum score of 12 were: family medicine 4.6±2.1 (38.3±17.3%), pediatric medicine 4.2±0.8 (35.0±7.0%), other (e.g., dentistry, emergency medicine) 4.2±2.0 (34.6±17.0%), and adult medicine 3.9±2.1 (32.3±17.5%). Ninety one percent of respondents would attend the course again. Conclusion: There is a low level of otolaryngology knowledge among PCPs attending an otolaryngology update course. There is a need for otolaryngology education among PCPs

Vitamin D Status Relative to Diet, Lifestyle, Injury, and Illness in College Athletes

Vitamin D deficiency is endemic in the general population; however, there is much to be learned about the vitamin D status of athletes. Purpose: The purposes of this study were to assess the prevalence of vitamin D insufficiency in collegiate athletes and to determine whether 25(OH)D concentrations are related to vitamin D intake, sun exposure, body composition, and risk for illness or athletic injury. Methods: 25(OH) vitamin D concentrations were measured in 41 athletes (18 men/23 women, 12 indoor/29 outdoor athletes) throughout the academic year. Dietary intake and lifestyle habits were assessed via questionnaire, bone density was measured by dual energy x-ray absorptiometry, and injury and illness were documented as part of routine care. Results: The 25(OH)D concentrations changed across time (P = 0.001) and averaged 49.0 T 16.6, 30.5 T 9.4, and 41.9 T 14.6 ngImLj1 (mean T SD) in the fall, winter, and spring, respectively, and were higher in outdoor versus indoor athletes in the fall (P G 0.05). Using 40 ngImLj1 as the cutoff for optimal status, 75.6%, 15.2%, and 36.0% of athletes had optimal status in the fall, winter, and spring, respectively. 25(OH)D concentrations were significantly (P G 0.05) correlated with multivitamin intake in the winter (r = 0.39) and tanning bed use in the spring (r = 0.48); however, status was otherwise not related to intake, lifestyle factors, or body composition. 25(OH)D concentrations in the spring (r = j0.40, P = 0.048) was correlated with frequency of illness. Conclusions: Our results suggest that collegiate athletes can maintain sufficient status during the fall and spring but would benefit from supplementation during the winter to prevent seasonal decreases in 25(OH)D concentrations. Results further suggest that insufficient vitamin D status may increase risk for frequent illness. Future research is needed to identify whether vitamin D status influences injury risk during athletic training or competition

The impact of cow size on cow-calf and postweaning progeny performance in the Nebraska Sandhills

Optimizing beef production system efficiency requires an understanding of genetic potential suitable for a given production environment. Therefore, the objective of this retrospective analysis was to determine the influence of cow body weight (BW) adjusted to a common body condition score (BCS) of 5 at weaning-influenced cow-calf performance and postweaning steer and heifer progeny performance. Data were collected at the Gudmundsen Sandhills Laboratory, Whitman, NE, on crossbred, mature cows (n = 1,607) from 2005 to 2017. Cow BCS at calving, prebreeding, and weaning were positively associated (P \u3c 0.01) with greater cow BW. Increasing cow BW was positively associated (P \u3c 0.01) with the percentage of cows that conceived during a 45-d breeding season. For every additional 100-kg increase in cow BW, calf BW increased (P \u3c 0.01) at birth by 2.70 kg and adjusted 205-d weaning BW by 14.76 kg. Calf preweaning average daily gain (ADG) increased (P \u3c 0.01) 0.06 kg/d for every additional 100-kg increase in cow BW. Heifer progeny BW increased (P \u3c 0.01) postweaning with every additional 100-kg increase in dam BW. Dam BW did not influence (P ≥ 0.11) heifer puberty status prior to breeding, overall pregnancy rates, or the percentage of heifers calving in the first 21 d of the calving season. Steer initial feedlot BW increased by 7.20 kg, reimplant BW increased by 10.47 kg, and final BW increased by 10.29 kg (P ≤ 0.01) for every additional 100-kg increase in dam BW. However, steer feedlot ADG was not influenced (P \u3e 0.67) by dam BW. Hot carcass weights of steers were increased (P = 0.01) by 6.48 kg with every additional 100-kg increase in cow BW. In a hypothetical model using the regression coefficients from this study, regardless of pricing method, cow-calf producers maximize the highest amount of profit by selecting smaller cows. Overall, larger-sized cows within this herd and production system of the current study had increased reproductive performance and offspring BW; however, total production output and economic returns would be potentially greater when utilizing smaller-sized cows

Tracheotomy care simulation training program for inpatient providers

Objectives: Tracheotomy complications can be life-threatening. Many of these complications may be avoided with proper education of health care providers. Unfortunately, access to high-quality tracheotomy care curricula is limited. We developed a program to address this gap in tracheotomy care education for inpatient providers. This study aimed to assess the efficacy of this training program in improving trainee knowledge and comfort with tracheotomy care. Methods: The curriculum includes asynchronous online modules coupled with a self-directed hands-on simulation activity using a low-cost tracheotomy care task trainer. The program was offered to inpatient providers including medical students, residents, medical assistants, nurses, and respiratory therapists. Efficacy of the training was assessed using pre-training and post-training surveys of learner comfort, knowledge, and qualitative feedback. Results: Data was collected on 41 participants. After completing the program, participants exhibited significantly improved comfort in performing tracheotomy care activities and 15% improvement in knowledge scores, with large effect sizes respectively and greater gains among those with little prior tracheotomy care experience. Conclusion: This study has demonstrated that completion of this integrated online and hands-on tracheotomy simulation curriculum training increases comfort and knowledge, especially for less-experienced learners. This training addresses an important gap in tracheotomy care education among health care professionals with low levels of tracheotomy care experience and ultimately aims to improve patient safety and quality of care. This curriculum is easily transferrable as it requires only access to the online modules and low-cost simulation materials and could be used in other hospitals, long-term care facilities, outpatient clinics, and home settings

Phylogenetic estimation of the viral fitness landscape of HIV-1 set-point viral load

Set-point viral load (SPVL), a common measure of human immunodeficiency virus (HIV)-1 virulence, is partially determined by viral genotype. Epidemiological evidence suggests that this viral property has been under stabilising selection, with a typical optimum for the virus between 10$^{4}$ and 10$^{5}$ copies of viral RNA per ml. Here we aimed to detect transmission fitness differences between viruses from individuals with different SPVLs directly from phylogenetic trees inferred from whole-genome sequences. We used the local branching index (LBI) as a proxy for transmission fitness. We found that LBI is more sensitive to differences in infectiousness than to differences in the duration of the infectious state. By analysing subtype-B samples from the Bridging the Evolution and Epidemiology of HIV in Europe project, we inferred a significant positive relationship between SPVL and LBI up to approximately 10$^{5}$ copies/ml, with some evidence for a peak around this value of SPVL. This is evidence of selection against low values of SPVL in HIV-1 subtype-B strains, likely related to lower infectiousness, and perhaps a peak in the transmission fitness in the expected range of SPVL. The less prominent signatures of selection against higher SPVL could be explained by an inherent limit of the method or the deployment of antiretroviral therapy

Theology at the University of Pretoria - 100 years: (1917-2017) Past, present and future

In this scholarly book, a century’s theology presented by the Faculty of Theology at the University of Pretoria, is celebrated. All authors are academics or research associates of the University of Pretoria. A historical and futuristic overview with perspectives from the past, present and future, are examined. The past is not only portrayed by means of societal and scientific contributions and achievements, but the authors also reflect on malfunctions, ill behaviour and disappointments of church and theology, presented at the University of Pretoria within the South African context over 100 years. The book commences with a chapter in which institutional transformation is discussed, as well as the changes that demonstrate the role of the Faculty of Theology within a secular state university. It includes an explanation of the importance of research impact, research productivity and research reputation. Among various discipline indicators, the category Theology and Religion Studies plays a significant role in the measurement of world university rankings of universities. With regard to scientific and encyclopaedic content, the book focuses on the theological disciplines presented in the academic curricula: first the biblical sciences (Old and New Testament Studies), then the historical disciplines (Systematic Theology, Church History and Church Polity), and finally the practical disciplines (Practical Theology, Science of Religion and Missiology). The role of Religion Studies in a newly established Faculty of Theology and Religion not only enhances the diversity of interreligious tolerance and an atmosphere of dialogue, but it serves as platform to interconnect with the fields of Humanities, Social and Natural Sciences and other academic disciplines. In the conclusive part of the book, contributions highlight the role of the centres in the Faculty (Centre for Contextual Ministry and Centre for Sustainable Communities), as well as the continental and international footprints of the two theological journals whose title ownership is attached to the Faculty of Theology of the University of Pretoria, namely HTS Theological Studies and Verbum et Ecclesia. The methodology comprised in all the chapters amounts to a literature and contextual study. Since the book describes the histories of formal academic departments, these texts are of a descriptive, interpretative and critical character. Reference is made in some chapters to exegetical methods, like the historical critical methods. The target audience of the book is academic scholars and theologians, who specialise in the different fields of Theology, the Humanities and other Social Sciences. The book is also accessible to scholars of other academic disciplines outside these disciplines. The book comprises original research by several authors and is not plagiarised from other scientific publications of this nature

Phylogenetic estimation of the viral fitness landscape of HIV-1 set-point viral load

Set-point viral load (SPVL), a common measure of human immunodeficiency virus (HIV)-1 virulence, is partially determined by viral genotype. Epidemiological evidence suggests that this viral property has been under stabilising selection, with a typical optimum for the virus between 104 and 105 copies of viral RNA per ml. Here we aimed to detect transmission fitness differences between viruses from individuals with different SPVLs directly from phylogenetic trees inferred from whole-genome sequences. We used the local branching index (LBI) as a proxy for transmission fitness. We found that LBI is more sensitive to differences in infectiousness than to differences in the duration of the infectious state. By analysing subtype-B samples from the Bridging the Evolution and Epidemiology of HIV in Europe project, we inferred a significant positive relationship between SPVL and LBI up to approximately 105 copies/ml, with some evidence for a peak around this value of SPVL. This is evidence of selection against low values of SPVL in HIV-1 subtype-B strains, likely related to lower infectiousness, and perhaps a peak in the transmission fitness in the expected range of SPVL. The less prominent signatures of selection against higher SPVL could be explained by an inherent limit of the method or the deployment of antiretroviral therapy.Peer Reviewe