Monetary Integration in East Asia: Issues of Economic and Policy Convergence in a Comparative Context

In recent years, Asian policymakers have considered the possibility of promoting closer financial integration and, possibly, monetary union. This paper considers the economics of the decision to form a currency union in East Asia using the European experience as a benchmark. We also compare the appropriateness of an East Asian currency union to MERCOSUR. In sum, we find that a core group of five East Asian countries appear to meet the convergence criteria set out in the Maastricht Treaty, whereas some of the others are moving toward that goal. The macroeconomic indicators tend to be strong and symmetric.Monetary integration; ASEAN; Economic Integration; East Asia

Analysis of Community-Based Accumulation of Home Medications (CACHES) Found at Death Scenes in Davidson County, Tennessee

Introduction: Stockpiling of unused medications by community-dwelling individuals results in Community-based ACcumulation of Home mEdicationS (CACHES). CACHES place the individual, health care and justice system, and ecosystem at risk for adverse outcomes including: a) diversion of prescription medications by friends and family, b) pediatric poisonings, c) adverse drug events, d) increased criminal justice system costs related to prescription drug abuse, e) increased health care costs, and f) pollution of local water supplies via improper medication disposal. This study explores the relationship among individual risk factors (gender, race, age, comorbid conditions), geographical location, health care risk factors (number of prescribers and dispensaries), and CACHES. Methods: This study involved an analysis of existing data extracted from death scene charts created by the Medical Examiners and Medicolegal Death Scene Investigators of Forensic Medical, PLC in Nashville, Tennessee from January 1 through December 31, 2011. The study examined the prevalence, size, and composition of CACHES found in decedents\u27 homes. In addition, this study included a descriptive analysis of demographic data (gender, race, age, and comorbid conditions) and presence of CACHES. Additionally, the geographic locations of CACHES were mapped. Finally, the relationship between health care risk factors (number of prescribers and dispensaries) and CACHES was explored. Results: The analyses showed no statistical differences in gender, race, or age between decedents with medications (used and unused) in the home and decedents without medications. The study sample was predominantly male, Caucasian/Non-Hispanic, and older than the Davidson County population. Fifty-six percent of decedents had CACHES. More than half had ≥ 4 bottles of unused medications with a mean of 38.9 ± 43.7 pills. Sixty percent of the unused medications came from two major classes - those affecting the central nervous system and the cardiovascular system. The CACHES group was significantly older, had a higher likelihood of having a psychiatric diagnosis, and used more prescribers and dispensaries. The analyses did not support a statistical difference between the two groups with regards to gender, race, or total number of comorbid conditions. There was insufficient data to perform an analyses on the relationship between geographical location (Zip code) and CACHES. Discussion/Conclusions: Limitations in the original data as well as differences in study design complicated a direct comparison of the prevalence, size, and composition of the CACHES to other studies. However, this exploratory study corroborates the CACHES model\u27s assertion that the stockpiling of unused medications is a pervasive problem. Furthermore, the analyses support advanced age, having a psychiatric comorbid condition, and the use of multiple prescribers and dispensaries increases the individual\u27s risk for the accumulation of unused medications in the home. Additional research is needed to further illuminate the relationship between gender, race, and the number of comorbid conditions and CACHES

Current Practices, Perceptions and Challenges of Telehealth in the Treatment of Mental Health in the U.S. Department of Veterans Affairs

Currently there are 17,964,242 million Veterans living in the U.S. Around 50% of these Veterans are over 65 years of age. Many U.S. service members – both active and retired, experience trauma and dysfunction in restructuring their lives. Mental health problems are reported in over 50% of Veterans both in active service and retired. According to the U.S. Department of Veterans Affairs (VA), ten times more suicides are reported among Veterans who did not register with the VA compared to those who do register. Longer deployments, shorter times at home between the deployments and combat exposure are the greatest contributors of physical and psychological health problems. Combat exposure has been linked with most cases of PSTD. This creates a greater need for mental health services to Veterans than any other forms of treatment. Due to the complex nature of Veterans population, characterized by an aging majority and location of many Veterans in rural areas, delivering mental health services is a huge challenge for the VA. The VA has been making efforts to ensure that all Veterans can access mental health services from where they are. Out of these efforts, integration of telehealth services to improve access to mental health care services has yielded promising results but this is not without challenges. This dissertation explores the current practices, perceptions and challenges of telehealth in the treatment of mental health in the U.S. Department of Veterans Affairs (VA)

Analysis of Platelet Activating Factor in the Gravid Reproductive Tracts of Swine

Depressed hog prices in 1998 and 1999 were due to not enough shackle space (kill capacity) and not to a glut of slaughter swine. However, many swine producers were put out of business in California. In 2000, market prices rebounded due to increased shackle space and reduced numbers of slaughter swine available as a result of the sellouts of the previous two years. The economic roller coaster ride emphasized the need for maximizing profit while streamlining operations. Increasing numbers of pigs per litter, and thereby reducing the cost per pig produced, is one aspect of streamlining. A significant step in improved litter efficiency would be to utilize platelet activating factor (PAF) in commercial swine operations. Platelet activating factor is involved in signal transduction within many of the body’s physiological systems. Of primary interest in the reproductive system is PAF’s enhancement of embryonic development, placental attachment and sperm functioning. The amount of embryo-derived PAF produced is correlated to pregnancy potential, since higher PAF levels lead to greater numbers of embryos developing to the blastocyst stage. It is produced by the embryos of various mammalian species, exerts significant effects upon the preimplantation embryo placental attachment, and perhaps maternal recognition of pregnancy and sperm functioning. Presently, only Professor John Diehl of the Animal and Veterinary Science Department at Clemson University, in collaboration with others, has published data to suggest that PAF is found in either male or female swine reproductive tracts. Most notably, PAF was found in the uterine luminal fluid (ULF), the developing filamentous embryo and the endometrium

The Role of Photon Sources in Materials Research: Past, Present, & Future

In this lecture I will trace the development of Light Sources from the early days of parasitic operation to the new billion dollar dedicated facilities. Clearly, the mode of usage has changed, but so has the type of user. How have these facilities balanced the need for beyond the state-of-the art experiments and serving the needs for routine characterization of materials? How can and should these facilities address the needs for the development of a workforce needed for the next generation of machines and science? Have they produced the science and scientists anticipated? Where do we go next, what is the role of light sources in the next couple decades? To address the last question I use the DoE report “Five Challenges for Science and the Imagination” as a guide, focusing on Chapter 7 “Enabling Grand Challenge Science: The People and the Tools required [1]. Examples will be associated with emergent phenomena in complex systems, How do complex phenomena emerge from simple ingredients [2,3] or How do remarkable properties of matter emerge from complex correlations of the atomic or electronic constituents and how to control these properties [1]? What role will light sources play? [1] Graham Flemming and Mark Ratner, “Direction Matter and Energy: “Five Challenges for Science and the Imagination,” A Report from the Basic Energy Sciences Advisory Committee (2007). [2] John Timmer reported on the National Academies of Science report titled “Condensed-Matter and Materials Physics: The Science of the World Around Us” in June 2007. The article is titled “Inability to Meet ‘Grand Challenges’ of Physics Likely to Hurt U. S. Competitiveness. The First Grand Challenge is, How Do Complex Phenomena Emerge from Simple Ingredients?”(see http://www.phys.utk.edu/ grandchallenges.html). [3] “Condensed-Matter and Materials Physics: The science of the World around Us,” National Research Council of the National Academies of Science (2007)

The effects of subcurative praziquantel treatment on life-history traits and trade-offs in drug-resistant Schistosoma mansoni

Natural selection acts on all organisms, including parasites, to maximize reproductive fitness. Drug resistance traits are often associated with life-history costs in the absence of treatment. Schistosomiasis control programmes rely on mass drug administration to reduce human morbidity and mortality. Although hotspots of reduced drug efficacy have been reported, resistance is not widespread. Using Bayesian state-space models (SSMs) fitted to data from an in vivo laboratory system, we tested the hypothesis that the spread of resistant Schistosoma mansoni may be limited by life-history costs not present in susceptible counterparts. S. mansoni parasites from a praziquantel-susceptible (S), a praziquantel-resistant (R) or a mixed line of originally resistant and susceptible parasites (RS) were exposed to a range of praziquantel doses. Parasite numbers at each life stage were quantified in their molluscan intermediate and murine definitive hosts across four generations, and SSMs were used to estimate key life-history parameters for each experimental group over time. Model outputs illustrated that parasite adult survival and fecundity in the murine host decreased across all lines, including R, with increasing drug pressure. Trade-offs between adult survival and fecundity were observed in all untreated lines, and these remained strong in S with praziquantel pressure. In contrast, trade-offs between adult survival and fecundity were lost under praziquantel pressure in R. As expected, parasite life-history traits within the molluscan host were complex, but trade-offs were demonstrated between parasite establishment and cercarial output. The observed trade-offs between generations within hosts, which were modified by praziquantel treatment in the R line, could limit the spread of R parasites under praziquantel pressure. Whilst such complex life-history costs may be difficult to detect using standard empirical methods, we demonstrate that SSMs provide robust estimates of life-history parameters, aiding our understanding of costs and trade-offs of resistant parasites within this system and beyond

Rambler Rose

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