Non-Emergency Medical Transportation Needs of Middle-Aged and Older Adults: A Rural-Urban Comparison in Delaware, USA.

Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30.9%) areas. Multivariable logistic analyses compared trip characteristics by rurality designation. Results: Rural (37.2%) and urban (41.2%) participants used services more frequently for dialysis than for any other medical concern. Older age and personal accompaniment were more common and wheel chair use was less common for rural trips. The mean cost per trip was greater for rural users (difference of $2910 per trip), which was attributed to the greater distance per trip in rural areas. Conclusions: Among a sample who were eligible for subsidized NEMT and who utilized this service, rural trips tended to be longer and, therefore, higher in cost. Over 50% of trips were made for dialysis highlighting the need to address prevention and, potentially, health service improvements for rural dialysis patients

Variation of Muscle Quality Parameters within the Longissimus Muscle

Results of this study indicate that significant variation exists for muscle quality traits within the longissimus muscle. It is important to follow a rigidly standardized protocol when obtaining samples for use in pork quality research. The decision on which section to use as an estimate of the composite is not as important as is procedure. Relationships among sections with composite values are high for most quality traits

Performance and Body Composition of Gilts from Differing Genetic Lines as Affected by Nutritional Program

Gilts restricted fed a high-protein ration were slower growing (P\u3c.05) than gilts ad libitum fed a high- and moderate-protein diet. Gilts ad libitum fed a moderateprotein diet with added fat had significantly (P\u3c.05) more fat accretion than gilts ad libitum fed and restricted fed a high-protein diet. A genetic line by diet interaction (P\u3c.05) was observed for average daily gain. Also, gilts with the presence of a terminal breed in their ancestry were leaner and heavier muscled (P\u3c.05) than gilts with no presence of a terminal breed in their ancestry

Efficacy of Using Real-time Ultrasound to Predict Intramuscular Fat in the Longissimus Muscle of Live Swine

Results of this study indicate that real-time ultrasound can be useful in predicting intramuscular fat (IMF) in the longissimuss muscle of live swine. The addition of tenth rib backfat measurements and sex as independent variables to IMF prediction equations increases prediction accuracy. Improvements in data collection and image analysis should further enhance prediction accurac

Science with the Keck Interferometer ASTRA Program

The ASTrometric and phase-Referenced Astronomy (ASTRA) project will provide phase referencing and astrometric observations at the Keck Interferometer, leading to enhanced sensitivity and the ability to monitor orbits at an accuracy level of 30-100 microarcseconds. Here we discuss recent scientific results from ASTRA, and describe new scientific programs that will begin in 2010-2011. We begin with results from the "self phase referencing" (SPR) mode of ASTRA, which uses continuum light to correct atmospheric phase variations and produce a phase-stabilized channel for spectroscopy. We have observed a number of protoplanetary disks using SPR and a grism providing a spectral dispersion of ~2000. In our data we spatially resolve emission from dust as well as gas. Hydrogen line emission is spectrally resolved, allowing differential phase measurements across the emission line that constrain the relative centroids of different velocity components at the 10 microarcsecond level. In the upcoming year, we will begin dual-field phase referencing (DFPR) measurements of the Galactic Center and a number of exoplanet systems. These observations will, in part, serve as precursors to astrometric monitoring of stellar orbits in the Galactic Center and stellar wobbles of exoplanet host stars. We describe the design of several scientific investigations capitalizing on the upcoming phase-referencing and astrometric capabilities of ASTRA.Comment: Published in the proceedings of the SPIE 2010 conference on "Optical and Infrared Interferometry II

Food Insecurity Among Homeless and Marginally Housed Individuals Living with HIV/AIDS in San Francisco

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of health insurance, and worse physical and mental health. Food insecurity is highly prevalent among HIV-infected marginally housed individuals in San Francisco, and is associated with poor physical and mental health and poor social functioning. Screening for and addressing food insecurity should be a critical component of HIV prevention and treatment programs

First Faint Dual-field Off-axis Observations in Optical Long Baseline Interferometry

Ground-based long baseline interferometers have long been limited in sensitivity in part by the short integration periods imposed by atmospheric turbulence. The first observation fainter than this limit was performed on 2011 January 22 when the Keck Interferometer observed a K = 11.5 target, about 1 mag fainter than its K = 10.3 atmospherically imposed limit; the currently demonstrated limit is K = 12.5. These observations were made possible by the Dual-Field Phase-Referencing (DFPR) instrument, part of the NSF-funded ASTrometry and phase-Referenced Astronomy project; integration times longer than the turbulence time scale are made possible by its ability to simultaneously measure the real-time effects of the atmosphere on a nearby bright guide star and correct for it on the faint target. We present the implementation of DFPR on the Keck Interferometer. Then, we detail its on-sky performance focusing on the accuracy of the turbulence correction and the resulting fringe contrast stability

Confronting Standard Models of Proto--Planetary Disks With New Mid--Infrared Sizes from the Keck Interferometer

We present near and mid-infrared interferometric observations made with the Keck Interferometer Nuller and near-contemporaneous spectro-photometry from the IRTF of 11 well known young stellar objects, several observed for the first time in these spectral and spatial resolution regimes. With AU-level spatial resolution, we first establish characteristic sizes of the infrared emission using a simple geometrical model consisting of a hot inner rim and mid-infrared disk emission. We find a high degree of correlation between the stellar luminosity and the mid-infrared disk sizes after using near-infrared data to remove the contribution from the inner rim. We then use a semi-analytical physical model to also find that the very widely used "star + inner dust rim + flared disk" class of models strongly fails to reproduce the SED and spatially-resolved mid-infrared data simultaneously; specifically a more compact source of mid-infrared emission is required than results from the standard flared disk model. We explore the viability of a modification to the model whereby a second dust rim containing smaller dust grains is added, and find that the two-rim model leads to significantly improved fits in most cases. This complexity is largely missed when carrying out SED modelling alone, although detailed silicate feature fitting by McClure et al. 2013 recently came to a similar conclusion. As has been suggested recently by Menu et al. 2015, the difficulty in predicting mid-infrared sizes from the SED alone might hint at "transition disk"-like gaps in the inner AU; however, the relatively high correlation found in our mid-infrared disk size vs. stellar luminosity relation favors layered disk morphologies and points to missing disk model ingredients instead

Keck Interferometer Nuller Data Reduction and On-Sky Performance

We describe the Keck Interferometer nuller theory of operation, data reduction, and on-sky performance, particularly as it applies to the nuller exozodiacal dust key science program that was carried out between 2008 February and 2009 January. We review the nuller implementation, including the detailed phasor processing involved in implementing the null-peak mode used for science data and the sequencing used for science observing. We then describe the Level 1 reduction to convert the instrument telemetry streams to raw null leakages, and the Level 2 reduction to provide calibrated null leakages. The Level 1 reduction uses conservative, primarily linear processing, implemented consistently for science and calibrator stars. The Level 2 processing is more flexible, and uses diameters for the calibrator stars measured contemporaneously with the interferometer’s K-band cophasing system in order to provide the requisite accuracy. Using the key science data set of 462 total scans, we assess the instrument performance for sensitivity and systematic error. At 2.0 Jy we achieve a photometrically-limited null leakage uncertainty of 0.25% rms per 10 minutes of integration time in our broadband channel. From analysis of the Level 2 reductions, we estimate a systematic noise floor for bright stars of ~0.2% rms null leakage uncertainty per observing cluster in the broadband channel. A similar analysis is performed for the narrowband channels. We also provide additional information needed for science reduction, including details on the instrument beam pattern and the basic astrophysical response of the system, and references to the data reduction and modeling tools

ASTRA: ASTrometry and phase-Referencing Astronomy on the Keck interferometer

ASTRA (ASTrometric and phase-Referencing Astronomy) is an upgrade to the existing Keck Interferometer which aims at providing new self-phase referencing (high spectral resolution observation of YSOs), dual-field phase referencing (sensitive AGN observations), and astrometric (known exoplanetary systems characterization and galactic center general relativity in strong field regime) capabilities. With the first high spectral resolution mode now offered to the community, this contribution focuses on the progress of the dual field and astrometric modes.Comment: 10 pages, 6 figures, 2 tables, SPIE 201