Resource allocation, health mobility and adaptation to illness

The increased availability of panel data has made it possible to estimate and measure health mobility for population subgroups who may have systematically different levels of mobility. The objective of this paper is to stimulate discussion on what estimated differences across subgroups may mean for resource allocation. We use a straightforward hypothetical example to investigate the implications of different levels of health mobility on health outcomes, considering in addition the effects of adaptation to illness over time. We also discuss some of the ethical and political implications of health mobility

Heterogeneity in the Effect of Common Shocks on Health Care Expenditure Growth

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this record.Healthcare expenditure growth is affected by important unobserved common shocks such as technological innovation, changes in sociological factors, shifts in preferences, and the epidemiology of diseases. While common factors impact in principle all countries, their effect is likely to differ across countries. To allow for unobserved heterogeneity in the effects of common shocks, we estimate a panel data model of healthcare expenditure growth in 34 OECD countries over the years 1980 to 2012, where the usual fixed or random effects are replaced by a multifactor error structure. We address model uncertainty with Bayesian model averaging, to identify a small set of robust expenditure drivers from 43 potential candidates. We establish 16 significant drivers of healthcare expenditure growth, including growth in GDP per capita and in insurance premiums, changes in financing arrangements and some institutional characteristics, expenditures on pharmaceuticals, population ageing, costs of health administration, and inpatient care. Our approach allows us to provide robust evidence to policy makers on the drivers that were most strongly associated with the growth in healthcare expenditures over the past 32 years

Superconductivity of repulsive spinless fermions with sublattice potentials

We explore unconventional superconductivity of repulsive spinless fermions on square and honeycomb lattices with staggered sublattice potentials. The two lattices can exhibit staggered d-wave and f-wave pairing respectively at low doping stemming from an effective two-valley band structure. At higher doping, in particular the square lattice displays a much richer phase diagram including topological p+ip superconductivity which is induced by a qualitatively different mechanism compared to the d-wave pairing. We illuminate this from several complementary perspectives: we analytically perform sublattice projection to analyze the effective continuum low-energy description and we numerically calculate the binding energies for pair and larger bound states for few-body doping near half filling. Furthermore, for finite doping, we present phase diagrams based on extensive FRG and and DMRG calculations

Midwives\u27 knowledge, attitudes and learning needs regarding antenatal vaccination

Objective: To determine the knowledge, attitudes and learning needs of midwives regarding antenatal vaccination. Design & Setting: A cross-sectional, paper-based survey of midwives employed at the only public tertiary maternity hospital in the Australian state of XX between November 2015 and July 2016. Participants: 252 midwives providing care in antepartum, intrapartum, and/or postpartum settings. Measurements: Self-reported responses to a 41-item survey. Findings: The vast majority of midwives supported influenza and pertussis vaccination for pregnant women, with 90.0% and 71.7% reporting they would recommend pertussis and influenza vaccine, respectively, to a pregnant friend or family member, and almost all stating that midwives should administer vaccines to pregnant patients (94.8%). Seven out of ten midwives (68.1%) responded correctly to all knowledge items regarding vaccines recommended during pregnancy; 52.8% demonstrated correct knowledge regarding vaccine administration despite only 36.6% having attended an education session on antenatal vaccination in the previous two years. Nearly all midwives (97.3%) expressed a need for more education on vaccine administration. The most commonly reported barrier to administering influenza (61.3%) and pertussis (59.0%) vaccination was having staff available with the certification required to administer vaccines. Key Conclusions: Midwives view antenatal vaccination as their responsibility and are interested and receptive to education. Implications for Practice: There is an unmet need and demand among midwives for professional development that would enable them to recommend and administer vaccines to pregnant women in accordance with national immunisation guidelines and integrate vaccination into routine antenatal care

C-fiber-related EEG-oscillations induced by laser radiant heat stimulation of capsaicin-treated skin

Nociceptive input reaches the brain via two different types of nerve fibers, moderately fast A-delta and slowly conducting C-fibers, respectively. To explore their distinct roles in normal and inflammatory pain we used laser stimulation of normal and capsaicin treated skin at proximal and distal arm sites in combination with time frequency transformation of electroencephalography (EEG) data. Comparison of phase-locked (evoked) and non-phase-locked (total) EEG to laser stimuli revealed three significant pain-related oscillatory responses. First, an evoked response in the delta-theta band, mediated by A-fibers, was reduced by topical capsaicin treatment. Second, a decrease of total power in the alpha-to-gamma band reflected both an A- and C-nociceptor-mediated response with only the latter being reduced by capsaicin treatment. Finally, an enhancement of total power in the upper beta band was mediated exclusively by C-nociceptors and appeared strongly augmented by capsaicin treatment. These findings suggest that phase-locking of brain activity to stimulus onset is a critical feature of A-delta nociceptive input, allowing rapid orientation to salient and potentially threatening events. In contrast, the subsequent C-nociceptive input exhibits clearly less phase coupling to the stimulus. It may primarily signal the tissue status allowing more long-term behavioral adaptations during ongoing inflammatory events that accompany tissue damage

NASA Science4Girls and Their Families: Connecting Local Libraries with NASA Scientists and Education Programs to Engage Girls in STEM

NASA Science4Girls and Their Families (NS4G) partners NASA Science Mission Directorate (SMD) education programs with public libraries to provide hands-on science, technology, engineering, and math (STEM) activities and career information for girls and their families, along with training for librarians, in conjunction with Women's History Month (March). NS4G is a collaboration among education teams within the four NASA SMD education and public outreach (E/PO) Forums: Planetary, Earth, Astrophysics, and Heliophysics. It began in 2012 as an Astrophysics-led program (Astro4Girls) with 9 events around the country. Upon expanding among the four Forums, over 73 events were held in Spring 2013 (Fig. 1), with preparations underway for events in Spring 2014. All events are individually evaluated by both the student participants and participating librarians to assess their effectiveness in addressing audience needs

Secondary metabolite profiling of the model legume Lotus japonicus during its symbiotic interaction with Mesorhizobium loti

Plant secondary metabolites, particularly flavonoids, are key components in the early stages of nitrogen-fixing symbiosis. Despite their importance, the endogenous secondary metabolites involved in symbiosis have not yet been identified in the model legume Lotus japonicus. We therefore determined changes in the secondary metabolic profile of Lotus japonicus roots in response to its symbiont. Analysis of the root secondary metabolite profiles 1 week after inoculation with Mesorhizobium loti revealed quantitative changes in the level of 14 phenolic peaks when compared with non-inoculated control plants. These changes affected compounds from most phenolic classes, possibly resulting from interconversion between classes since the total phenolic level remained constant. In addition, the use of 2 M. loti strains differing only in their capacity to synthesise Nod factor revealed that, although Nod factor signalling induced accumulation of a specific subset of 4 phenolic peaks, most changes were induced in response to both rhizobial strains.NR was supported by a Training Network funded by the European Training Network EU-RTN-LOTUS-HPRN-CT-2000-00086. KJW was supported by core funding from the Biotechnology and Biological Science Research Council (BBSRC), UK.Peer Reviewe