Welfare Plastic: The Transformation of Public Assistance in the Electronic Age

Several states have developed electronic benefit transfer (EBT) systems to deliver cash assistance and food stamp benefits. These systems establish electronic account balances which recipients access through the use of a debit card at terminals such as bank automatic teller machines or transaction authorization machines like those that validate credit card charges. We examine the potential effects of such systems on involved stakeholders, including government agencies, benefit recipients, financial institutions, and food retailers. Overall, each stakeholder group benefits from EBT, but some subgroups do not fare as well. Several key issues are identified

Performance of Series-Design Prototype Main Quadrupoles for the LHC

After the successful construction of two first-generation prototypes of the main quadrupoles for the LHC, three series-design prototypes have been further manufactured at CEA-Saclay. Together with the sextupole-dipole corrector magnets and tuning quadrupoles, these twin-aperture main quadrupoles are assembled into the cold masses of the so-called short straight sections. Already during their fabrication, the collared coils and later the completed cold masses undergo warm magnetic measurements. Two of the main quadrupole cold masses have been mounted into their definitive machine cryostats and submitted to training and magnetic measurements. This paper presents the results of these cold tests by describing the quench behaviour, the transfer function in each of the apertures and the multipole components found at different levels of excitation. The field quality results, in cold conditions, will be compared to those measured at room temperatur

Triplicity and Physical Characteristics of Asteroid (216) Kleopatra

To take full advantage of the September 2008 opposition passage of the M-type asteroid (216) Kleopatra, we have used near-infrared adaptive optics (AO) imaging with the W.M. Keck II telescope to capture unprecedented high resolution images of this unusual asteroid. Our AO observations with the W.M. Keck II telescope, combined with Spitzer/IRS spectroscopic observations and past stellar occultations, confirm the value of its IRAS radiometric radius of 67.5 km as well as its dog-bone shape suggested by earlier radar observations. Our Keck AO observations revealed the presence of two small satellites in orbit about Kleopatra (see Marchis et al., 2008). Accurate measurements of the satellite orbits over a full month enabled us to determine the total mass of the system to be 4.64+/-0.02 10^18 Kg. This translates into a bulk density of 3.6 +/-0.4 g/cm3, which implies a macroscopic porosity for Kleopatra of ~ 30-50%, typical of a rubble-pile asteroid. From these physical characteristics we measured its specific angular momentum, very close to that of a spinning equilibrium dumbbell.Comment: 35 pages, 3 Tables, 9 Figures. In press to Icaru

Elevated Depression Symptoms, Antidepressant Medicine Use, and Risk of Developing Diabetes During the Diabetes Prevention Program

OBJECTIVE—To assess the association between elevated depression symptoms or antidepressant medicine use on entry to the Diabetes Prevention Program (DPP) and during the study and the risk of developing diabetes during the study. RESEARCH DESIGN AND METHODS—DPP participants (n = 3,187) in three treatment arms (intensive lifestyle [ILS], metformin [MET], and placebo [PLB]) completed the Beck Depression Inventory (BDI) and reported their use of antidepressant medication at randomization and throughout the study (average duration in study 3.2 years). RESULTS—When other factors associated with the risk of developing diabetes were controlled, elevated BDI scores at baseline or during the study were not associated with diabetes risk in any arm. Baseline antidepressant use was associated with diabetes risk in the PLB (hazard ratio 2.25 [95% CI 1.38–3.66]) and ILS (3.48 [1.93–6.28]) arms. Continuous antidepressant use during the study (compared with no use) was also associated with diabetes risk in the same arms (PLB 2.60 [1.37–4.94]; ILS 3.39 [1.61–7.13]), as was intermittent antidepressant use during the study in the ILS arm (2.07 [1.18–3.62]). Among MET arm participants, antidepressant use was not associated with developing diabetes. CONCLUSIONS—A strong and statistically significant association between antidepressant use and diabetes risk in the PLB and ILS arms was not accounted for by measured confounders or mediators. If future research finds that antidepressant use independently predicts diabetes risk, efforts to minimize the negative effects of antidepressant agents on glycemic control should be pursued

A Modular Design for the 56 Variants of the Short Straight Section in the Arcs of the Large Hadron Collider (LHC)

The 360 Short Straight Sections (SSS) necessary for the eight arcs of the LHC machine have to fulfil different requirements. Their main function is to house the lattice two-in-one superconducting quadrupole and various correction magnets, all operating at 1.9 K in a superfluid helium bath. The magnetic and powering schemes of the arcs and the fact that the two proton beams alternate between the inner and outer magnet channels impose 24 different combinations of magnet assemblies, all housed in an identical helium enclosure. The cryogenic architecture of the LHC machine is based on cryogenic loops spanning over one half-cell (53 m) for the 4.6-20 K circuit, over a full cell (107 m) for the 1.9 K circuits, up to the full arc (about 2.3 km) for the shield cooling line. This cryogenic layout, when superimposed to the magnetic scheme, further complicated by the cryostat insulation vacuum sectorisation every 2 cells, creates additional assembly variants, up to a total number of 56. The required flexibility in the manufacture and assembly, as well as economic considerations, have led to a modular design for the different SSS components and sub-assemblies. This modularity allows to "specialise" the SSS at the latest possible assembly step of the "just in time" production line. This paper presents the conceptual design considerations to achieve this modularity, the SSS design retained for the series manufacture, and the assembly procedures recently validated on a prototype program at CERN

Motivation: key to a healthy lifestyle in people with diabetes? Current and emerging knowledge and applications

Aim Motivation to take up and maintain a healthy lifestyle is key to diabetes prevention and management. Motivations are driven by factors on the psychological, biological and environmental levels, which have each been studied extensively in various lines of research over the past 25 years. Here, we analyse and reflect on current and emerging knowledge on motivation in relation to lifestyle behaviours, with a focus on people with diabetes or obesity. Structured according to psychological, (neuro‐)biological and broader environmental levels, we provide a scoping review of the literature and highlight frameworks used to structure motivational concepts. Results are then put in perspective of applicability in (clinical) practice. Results Over the past 25 years, research focusing on motivation has grown exponentially. Social–cognitive and self‐determination theories have driven research on the key motivational concepts ‘self‐efficacy’ and ‘self‐determination’. Neuro‐cognitive research has provided insights in the processes that are involved across various layers of a complex cortical network of motivation, reward and cognitive control. On an environmental – more upstream – level, motivations are influenced by characteristics in the built, social, economic and policy environments at various scales, which have provided entry points for environmental approaches influencing behaviour. Conclusions Current evidence shows that motivation is strongly related to a person's self‐efficacy and capability to initiate and maintain healthy choices, and to a health climate that supports autonomous choices. Some approaches targeting motivations have been shown to be promising, but more research is warranted to sustainably reduce the burden of diabetes in individuals and populations

Comparing Patch vs Pen Bolus Insulin Delivery in Type 2 Diabetes Using Continuous Glucose Monitoring Metrics and Profiles

OBJECTIVE: CeQur Simplicity™ (CeQur, Marlborough, MA) is a 3-day insulin delivery patch designed to meet mealtime insulin requirements. A recently reported 48-week, randomized, multicenter, interventional trial compared efficacy, safety and self-reported outcomes in 278 adults with type 2 diabetes (T2D) on basal insulin therapy who initiated and managed mealtime insulin therapy with a patch pump versus insulin pen. We assessed changes in key glycemic metrics among a subset of patients who wore a continuous glucose monitoring (CGM) device. METHODS: Study participants (patch, n = 49; pen, n = 48) wore a CGM device in masked setting during the baseline period and prior to week 24. Glycemic control was assessed using international consensus guidelines for percentage of Time In Range (%TIR: \u3e70% at 70-180 mg/dL), Time Below Range (%TBR: \u3c4% at \u3c70 mg/dL; \u3c1% at \u3c54 mg/dL), and Time Above Range (%TAR: \u3c25% at \u3e180 mg/dL; \u3c5% at \u3e250 mg/dL). RESULTS: Both the patch and pen groups achieved recommended targets in %TIR (74.1% ± 18.7%, 75.2 ± 16.1%, respectively) and marked reductions in %TAR \u3e180 mg/dL (21.1% ± 19.9%, 19.7% ± 17.5%, respectively) but with increased %TBR \u3c70 mg/dL (4.7% ± 5.2%, 5.1 ± 5.8, respectively), all P \u3c .0001. No significant between-group differences in glycemic improvements or adverse events were observed. CONCLUSIONS: CGM confirmed that the patch or pen can be used to safely initiate and optimize basal-bolus therapy using a simple insulin adjustment algorithm with SMBG. Preference data suggest that use of the patch vs pen may enhance treatment adherence

National Standards for Diabetes Self-Management Education

Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by key organizations and federal agencies within the diabetes education community. A Task Force was jointly convened by the American Association of Diabetes Educators and the American Diabetes Association in the summer of 2006. Additional organizations that were represented included the American Dietetic Association, the Veteran's Health Administration, the Centers for Disease Control and Prevention, the Indian Health Service, and the American Pharmaceutical Association. Members of the Task Force included a person with diabetes; several health services researchers/behaviorists, registered nurses, and registered dietitians; and a pharmacist. The Task Force was charged with reviewing the current DSME standards for their appropriateness, relevance, and scientific basis. The Standards were then reviewed and revised based on the available evidence and expert consensus. The committee convened on 31 March 2006 and 9 September 2006, and the Standards were approved 25 March 2007