Supporting the threads of the family tapestry : the role of child life in adoption

Explores the developmental, cultural and health related impacts of adoption along with effects of early adversity. The goal of this paper is to utilize existing research on adoption to argue the necessity for a child life specialist in the life of an adopted child and their family

Changes to Racial Disparities in Readmission Rates After Medicare’s Hospital Readmissions Reduction Program Within Safety-Net and Non-Safety-Net Hospitals

After the Medicare Hospital Readmissions Reduction Program began enforcing financial penalties, disparities in readmissions between white and black patients widened at safety-net hospitals for conditions not targeted by the program. Disparities were stable for conditions targeted by the program. At non-safety-net hospitals, disparities were unchanged for both targeted and non-targeted conditions

Diffuse Extragalactic Background Radiation

Attenuation of high--energy gamma rays by pair--production with UV, optical and IR background photons provides a link between the history of galaxy formation and high--energy astrophysics. We present results from our latest semi-analytic models (SAMs), based upon a $\Lambda$CDM hierarchical structural formation scenario and employing all ingredients thought to be important to galaxy formation and evolution, as well as reprocessing of starlight by dust to mid- and far-IR wavelengths. Our models also use results from recent hydrodynamic galaxy merger simulations. These latest SAMs are successful in reproducing a large variety of observational constraints such as number counts, luminosity and mass functions, and color bimodality. We have created 2 models that bracket the likely ranges of galaxy emissivities, and for each of these we show how the optical depth from pair--production is affected by redshift and gamma-ray energy. We conclude with a discussion of the implications of our work, and how the burgeoning science of gamma-ray astronomy will continue to help constrain cosmology.Comment: 12 pages, 8 figures, to be published in the Proceedings of the 4th Heidelberg International Symposium on High Energy Gamma-Ray Astronomy, held July 2008 in Heidelberg, German

Many Older Americans Do Not Receive the Recommended Home Health Care After Hospitalization

Only 54% of Medicare patients referred to home health care services following a hospitalization received home health care visits. Policymakers must address this discrepancy to ensure all patients receive the home health services they need

Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes

A nursing home report card that converted 12 measures of quality into a simple 5-star system significantly affected consumer demand for low- and high-scoring facilities. One-star facilities typically lost 8 percent of their market share and 5-star facilities gained more than 6 percent of their market share. These results support the use of summary measures in report cards

Modeling Gamma-Ray Attenuation in High-Redshift GeV Spectra

We present two models for the cosmological UV background light, and calculate the opacity of GeV gamma--rays out to redshift 9. The contributors to the background include 2 possible quasar emissivities, and output from star--forming galaxies as determined by recent a semi--analytic model (SAM) of structure formation. The SAM used in this work is based upon a hierarchical build-up of structure in a $\Lambda$CDM universe and is highly successful in reproducing a variety of observational parameters. Above 1 Rydberg energy, ionizing radiation is subject to reprocessing by the IGM, which we treat using our radiative transfer code, CUBA. The two models for quasar emissivity differing above z = 2.3 are chosen to match the ionization rates observed using flux decrement analysis and the higher values of the line-of-sight proximity effect. We also investigate the possibility of a flat star formation rate density at z $>5$. We conclude that observations of gamma--rays from 10 to 100 GeV by Fermi (GLAST) and the next generation of ground based experiments should confirm a strongly evolving opacity from $1<$ z $<4$. Observation of attenuation in the spectra of gamma--ray bursts at higher redshift could constrain emission of UV radiation at these early times, either from a flat or increasing star-formation density or an unobserved population of sources.Comment: 4 pages, 7 figures, To be published in the Proceedings of the 4th Heidelberg International Symposium on High Energy Gamma-Ray Astronomy, held July 2008 in Heidelberg, German

Physicians and Advanced Practitioners Specializing in Nursing Home Care, 2012-2015

The number of clinicians specializing in nursing home care increased by 33.7% from 2012 to 2015, although nursing home specialists made up only 21% of nursing home clinicians in 2015. Most of these specialists were advanced practitioners (physician assistants and nurse practitioners) delivering post-acute care. The change in number of nursing home specialists varied significantly by geographic region

The Pay-Off on Nursing Home Report Cards

For the past decade, policymakers have used public reporting of quality measures as a strategy to improve quality in nursing homes. In theory, public reporting might improve overall quality in two ways: first, if consumers choose nursing homes with better performance, and second, if public reporting encourages nursing homes to improve their performance. Has public reporting had its intended effects? Does improving quality give nursing homes a competitive advantage in the marketplace, thereby improving their bottom line? This Issue Brief summarizes a series of studies that assess the impact of public reporting on nursing home quality and on the financial performance of these facilities