Supporting State Policymakers' Implementation of Federal Health Reform

Outlines the capacities states will need to implement federal healthcare reform in the areas of information and analysis, strategic implementation and planning, topic-specific technical assistance, communications, and coordination and integration

A State Policymakers' Guide to Federal Health Reform: Part I: Anticipating How Federal Health Reform Will Affect State Roles

Examines how federal healthcare reform will affect states' tools and roles in connecting people to services, promoting coordination and integration, improving care for those with complex needs, being results-oriented, and increasing efficiencies

High Time for Conservation: Adding the Environment to the Debate on Marijuana Liberalization

The liberalization of marijuana policies, including the legalization of medical and recreational marijuana, is sweeping the United States and other countries. Marijuana cultivation can have significant negative collateral effects on the environment that are often unknown or overlooked. Focusing on the state of California, where by some estimates 60% -- 70% of the marijuana consumed in the United States is grown, we argue that (a) the environmental harm caused by marijuana cultivation merits a direct policy response, (b) current approaches to governing the environmental effects are inadequate, and (c) neglecting discussion of the environmental impacts of cultivation when shaping future marijuana use and possession policies represents a missed opportunity to reduce, regulate, and mitigate environmental harm

Developing Flexible, High Performance Polymers with Self-Healing Capabilities

Flexible, high performance polymers such as polyimides are often employed in aerospace applications. They typically find uses in areas where improved physical characteristics such as fire resistance, long term thermal stability, and solvent resistance are required. It is anticipated that such polymers could find uses in future long duration exploration missions as well. Their use would be even more advantageous if self-healing capability or mechanisms could be incorporated into these polymers. Such innovative approaches are currently being studied at the NASA Kennedy Space Center for use in high performance wiring systems or inflatable and habitation structures. Self-healing or self-sealing capability would significantly reduce maintenance requirements, and increase the safety and reliability performance of the systems into which these polymers would be incorporated. Many unique challenges need to be overcome in order to incorporate a self-healing mechanism into flexible, high performance polymers. Significant research into the incorporation of a self-healing mechanism into structural composites has been carried out over the past decade by a number of groups, notable among them being the University of I1linois [I]. Various mechanisms for the introduction of self-healing have been investigated. Examples of these are: 1) Microcapsule-based healant delivery. 2) Vascular network delivery. 3) Damage induced triggering of latent substrate properties. Successful self-healing has been demonstrated in structural epoxy systems with almost complete reestablishment of composite strength being achieved through the use of microcapsulation technology. However, the incorporation of a self-healing mechanism into a system in which the material is flexible, or a thin film, is much more challenging. In the case of using microencapsulation, healant core content must be small enough to reside in films less than 0.1 millimeters thick, and must overcome significant capillary and surface tension forces to flow, mix and react to achieve healing. Vascular networks small enough to fit into such films must also overcome these same flow limitations. Self-healing has also been demonstrated in ionomeric substrates such as Surlyn , wherein the heat generated by a projectile impact triggers the latent ability of this substrate to flow back to its original shape. Recent work using Diels-Alder reactions have shown promise in bringing about actual reforming of broken chemical bonds to achieve self-healing [2]. All self-healing mechanisms that rely on the use of inherent latent substrate properties require some degree of polymer chain flow to achieve any significant level of healing

Comparison of Cell Sediment and Surface Grown Test Plaque Using Scanning Electron Microscopy

Scanning electron microscopy was used to compare the morphology, integrity and distribution of bacterial cells in a test plaque grown on the surface of enamel with that of the cell sediment plaque routinely used in a short-term intraoral caries model. Cultures of S. mutans IB-1600 or S. sobrinus 6715-13 were grown in complex media supplemented with either 2.0% sucrose (glucan plaque) or 0.2 % glucose (non-glucan plaque). Cell sediment (CS) plaque was prepared by centrifuging the cultures after incubation, recovering the cell sediment, and spreading it on Metricel membrane filter paper. Surface grown (SG) plaque was prepared by suspending saliva-coated bovine enamel in the culture inedium, incubating, and recovering the enamel assembly with bacterial accumulations. Cell morphology and integrity, as well as the appearance of glucan-like material produced by the cells, was similar in both CS and SG test plaques. The cell distribution however, varied in the SG plaque from extremes of all cells to all glucan, whereas the cell sediment plaque was more uniform in cell distribution. A highly standardized test plaque minimizes variability in the intraoral caries model. These findings support the contention that the bacterial cells in a cell sediment plaque are similar in morphology, integrity and glucan production to surface grown plaque, and have the added advantage of uniform distribution, which makes the cell sediment plaque more appropriate for intraoral caries model studies

Who uses the internet as a source of nutrition and dietary information? An Australian population perspective

Background: The Internet contains a plethora of nutrition information. Health organizations are increasingly using the Internet to deliver population-wide health information and interventions. Effective interventions identify their target population and their needs; however, little is known about use of the Internet as a source of nutrition information. Objective: The aim was to assess the change in prevalence and demographic characteristics of Western Australian adults accessing the Internet as a source of nutrition information and identify specific information needs. Methods: Data were pooled from the Western Australian Department of Health’s 3-yearly Nutrition Monitoring Survey Series telephone survey between 1995 and 2012 of 7044 participants aged 18 to 64 years. Outcome variables were the main sources of nutrition information used in the last year and yes/no responses to 4 suggestions to what would make it easier to eat a healthy diet. Sociodemographic variables were collected. Results: The proportion of respondents using the Internet for nutrition information increased from <1% in 1995-2001 to 9.1% in 2004 and 33.7% in 2012. Compared to 2004, logistic regression showed that the odds of using the Internet for this information increased significantly in 2009 (OR 2.84, 95% CI 2.07-3.88) and 2012 (OR 5.20, 95% CI 3.86-7.02, P<.001). Respondents using the Internet as a source were more likely to be female (OR 1.30, 95% CI 1.05-1.60, P=.02), live in a metropolitan area (OR 1.26, 95% CI 1.03-1.54, P=.03), born in countries other than Australia/UK/Ireland (OR 1.41, 95% CI 1.07-1.85, P=.02), more educated (university: OR 2.46, 95% CI 1.77-3.42, P<.001), and were less likely to be older (55-64 years: OR 0.38, 95% CI 0.25-0.57, P<.001). The majority of respondents agreed the following information would assist them to make healthier choices: more ways to prepare healthy foods (72.0%, 95% CI 70.7-73.3), quicker ways to prepare healthy foods (79.0%, 95% CI 77.8-80.1), how to choose healthy foods (68.8%, 95% CI 67.5-70.1), and knowing more about cooking (54.7%, 95% CI 53.3-56.1). Those using the Internet for nutrition information were more likely than nonusers to want to know quicker ways to prepare healthy foods (83.0% vs 78.1%, P=.005) and information on choosing healthy foods (76.3% vs 67.3%, P<.001)

Adolescent Psychological Assets and Cardiometabolic Health Maintenance in Adulthood: Implications for Health Equity

Background Positive cardiometabolic health (CMH) is defined as meeting recommended levels of multiple cardiometabolic risk factors in the absence of manifest disease. Prior work finds that few individuals—particularly members of minoritized racial and ethnic groups—meet these criteria. This study investigated whether psychological assets help adolescents sustain CMH in adulthood and explored interactions by race and ethnicity. Methods and Results Participants were 3478 individuals in the National Longitudinal Study of Adolescent Health (49% female; 67% White, 15% Black, 11% Latinx, 6% other [Native American, Asian, or not specified]). In Wave 1 (1994–1995; mean age=16 years), data on 5 psychological assets (optimism, happiness, self‐esteem, belongingness, and feeling loved) were used to create a composite asset index (range=0–5). In Waves 4 (2008; mean age=28 years) and 5 (2016–2018; mean age=38 years), CMH was defined using 7 clinically assessed biomarkers. Participants with healthy levels of ≥6 biomarkers at Waves 4 and 5 were classified as maintaining CMH over time. The prevalence of CMH maintenance was 12%. Having more psychological assets was associated with better health in adulthood (odds ratio [OR]linear trend, 1.12 [95% CI, 1.01–1.25]). Subgroup analyses found substantive associations only among Black participants (OR, 1.35 [95% CI, 1.00–1.82]). Additionally, there was some evidence that racial and ethnic disparities in CMH maintenance may be less pronounced among participants with more assets. Conclusions Youth with more psychological assets were more likely to experience favorable CMH patterns 2 decades later. The strongest associations were observed among Black individuals. Fostering psychological assets in adolescence may help prevent cardiovascular disease and play an underappreciated role in shaping health inequities