No equity, no triple aim: strategic proposals to advance health equity in a volatile policy environment

Health professionals, including social workers, community health workers, public health workers, and licensed health care providers, share common interests and responsibilities in promoting health equity and improving social determinants of health—the conditions in which we live, work, play, and learn. This article summarizes underlying causes of health inequity and comparatively poor health outcomes in the U.S. It describes barriers to realizing the hope embedded in the 2010 Patient Protection and Affordable Care Act that moving away from fee-for-service payments will naturally drive care upstream as providers respond to greater financial risk for the health of their patients by undertaking greater prevention efforts. The article asserts that health equity should serve as the guiding framework for achieving the Triple Aim of health care reform. It outlines practical opportunities for improving care and for promoting stronger efforts to address social determinants of health. These proposals include developing a dashboard of measures to assist providers committed to health equity and community-based prevention and to promote institutional accountability for addressing socio-economic factors that influence health

No equity, no triple aim: strategic proposals to advance health equity in a volatile policy environment

Health professionals, including social workers, community health workers, public health workers, and licensed health care providers, share common interests and responsibilities in promoting health equity and improving social determinants of health—the conditions in which we live, work, play, and learn. This article summarizes underlying causes of health inequity and comparatively poor health outcomes in the U.S. It describes barriers to realizing the hope embedded in the 2010 Patient Protection and Affordable Care Act that moving away from fee-for-service payments will naturally drive care upstream as providers respond to greater financial risk for the health of their patients by undertaking greater prevention efforts. The article asserts that health equity should serve as the guiding framework for achieving the Triple Aim of health care reform. It outlines practical opportunities for improving care and for promoting stronger efforts to address social determinants of health. These proposals include developing a dashboard of measures to assist providers committed to health equity and community-based prevention and to promote institutional accountability for addressing socio-economic factors that influence health

Evaluation of the cytotoxic and genotoxic potential of Khat (Catha edulis Forsk) extracts on human T lymphoblastoid cell line

This paper reports on an investigation of the cytotoxic and genotoxic potential of khat extract using a human T lymphoblastoid cell line (CEM). Exponentially growing CEM cells were cultured for 12 h in the presence of khat extract (0-2000 μg ml-1). Statistically significant, dose-dependent increases in; CEM cell death at dose (> 400 μg ml-1), in DNA damage at dose (>200 μg ml-1) and in micronuclei frequency, at dose (>200 μg ml-1) were observed. The genetic damage effects of khat extract on human cell line observed in this study could serve as a major contribution towards the understanding and creating of awareness of an increased risk of cancer amongst long-term khat consumers

Quasi-fission reactions as a probe of nuclear viscosity

Fission fragment mass and angular distributions were measured from the ^{64}Ni+^{197}Au reaction at 418 MeV and 383 MeV incident energy. A detailed data analysis was performed, using the one-body dissipation theory implemented in the code HICOL. The effect of the window and the wall friction on the experimental observables was investigated. Friction stronger than one-body was also considered. The mass and angular distributions were consistent with one-body dissipation. An evaporation code DIFHEAT coupled to HICOL was developed in order to predict reaction time scales required to describe available data on pre-scission neutron multiplicities. The multiplicity data were again consistent with one-body dissipation. The cross-sections for touch, capture and quasi-fission were also obtained.Comment: 25 pages REVTeX, 3 tables, 13 figures, submitted to Phys. Rev

Relations between fusion cross sections and average angular momenta

We study the relations between moments of fusion cross sections and averages of angular momentum. The role of the centrifugal barrier and the target deformation in determining the effective barrier radius are clarified. A simple method for extracting average angular momentum from fusion cross sections is demonstrated using numerical examples as well as actual data.Comment: 16 REVTeX pages plus 8 included Postscript figures (uses the epsf macro); submitted to Phys. Rev. C; also available at http://nucth.physics.wisc.edu/preprint

Peculiarities of sub-barrier fusion with quantum diffusion approach

With the quantum diffusion approach the unexpected behavior of fusion cross section, angular momentum, and astrophysical S-factor at sub-barrier energies has been revealed. Out of the region of short-range nuclear interaction and action of friction at turning point the decrease rate of the cross section under the barrier becomes smaller. The calculated results for the reactions with spherical nuclei are in a good agreement with the existing experimental data.Comment: 11 pages, 5 figure

Chemostratigraphy of Neoproterozoic carbonates: implications for 'blind dating'

The delta C-13(carb) and Sr-87/Sr-86 secular variations in Neoproteozoic seawater have been used for the purpose of 'isotope stratigraphy' but there are a number of problems that can preclude its routine use. In particular, it cannot be used with confidence for 'blind dating'. The compilation of isotopic data on carbonate rocks reveals a high level of inconsistency between various carbon isotope age curves constructed for Neoproteozoic seawater, caused by a relatively high frequency of both global and local delta C-13(carb) fluctuations combined with few reliable age determinations. Further complication is caused by the unresolved problem as to whether two or four glaciations, and associated negative delta C-13(carb) excursions, can be reliably documented. Carbon isotope stratigraphy cannot be used alone for geological correlation and 'blind dating'. Strontium isotope stratigraphy is a more reliable and precise tool for stratigraphic correlations and indirect age determinations. Combining strontium and carbon isotope stratigraphy, several discrete ages within the 590-544 Myr interval, and two age-groups at 660-610 and 740-690 Myr can be resolved

Recent experimental results in sub- and near-barrier heavy ion fusion reactions

Recent advances obtained in the field of near and sub-barrier heavy-ion fusion reactions are reviewed. Emphasis is given to the results obtained in the last decade, and focus will be mainly on the experimental work performed concerning the influence of transfer channels on fusion cross sections and the hindrance phenomenon far below the barrier. Indeed, early data of sub-barrier fusion taught us that cross sections may strongly depend on the low-energy collective modes of the colliding nuclei, and, possibly, on couplings to transfer channels. The coupled-channels (CC) model has been quite successful in the interpretation of the experimental evidences. Fusion barrier distributions often yield the fingerprint of the relevant coupled channels. Recent results obtained by using radioactive beams are reported. At deep sub-barrier energies, the slope of the excitation function in a semi-logarithmic plot keeps increasing in many cases and standard CC calculations over-predict the cross sections. This was named a hindrance phenomenon, and its physical origin is still a matter of debate. Recent theoretical developments suggest that this effect, at least partially, may be a consequence of the Pauli exclusion principle. The hindrance may have far-reaching consequences in astrophysics where fusion of light systems determines stellar evolution during the carbon and oxygen burning stages, and yields important information for exotic reactions that take place in the inner crust of accreting neutron stars.Comment: 40 pages, 63 figures, review paper accepted for EPJ

Physics of Solar Prominences: I - Spectral Diagnostics and Non-LTE Modelling

This review paper outlines background information and covers recent advances made via the analysis of spectra and images of prominence plasma and the increased sophistication of non-LTE (ie when there is a departure from Local Thermodynamic Equilibrium) radiative transfer models. We first describe the spectral inversion techniques that have been used to infer the plasma parameters important for the general properties of the prominence plasma in both its cool core and the hotter prominence-corona transition region. We also review studies devoted to the observation of bulk motions of the prominence plasma and to the determination of prominence mass. However, a simple inversion of spectroscopic data usually fails when the lines become optically thick at certain wavelengths. Therefore, complex non-LTE models become necessary. We thus present the basics of non-LTE radiative transfer theory and the associated multi-level radiative transfer problems. The main results of one- and two-dimensional models of the prominences and their fine-structures are presented. We then discuss the energy balance in various prominence models. Finally, we outline the outstanding observational and theoretical questions, and the directions for future progress in our understanding of solar prominences.Comment: 96 pages, 37 figures, Space Science Reviews. Some figures may have a better resolution in the published version. New version reflects minor changes brought after proof editin