The Mental Health Workforce: A Primer

[Excerpt] Congress has held hearings and some Members have introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy

Study of high speed complex number algorithms

A method of evaluating the radiation integral on the curved surface of a reflecting antenna is presented. A three dimensional Fourier transform approach is used to generate a two dimensional radiation cross-section along a planer cut at any angle phi through the far field pattern. Salient to the method is an algorithm for evaluating a subset of the total three dimensional discrete Fourier transform results. The subset elements are selectively evaluated to yield data along a geometric plane of constant. The algorithm is extremely efficient so that computation of the induced surface currents via the physical optics approximation dominates the computer time required to compute a radiation pattern. Application to paraboloid reflectors with off-focus feeds in presented, but the method is easily extended to offset antenna systems and reflectors of arbitrary shapes. Numerical results were computed for both gain and phase and are compared with other published work

The National Health Service Corps

The National Health Service Corps (NHSC) provides scholarships and loan repayments to health care providers in exchange for a period of service in a health professional shortage area (HPSA). The program places clinicians at facilities—generally not-for-profit or government-operated— that might otherwise have difficulties recruiting and retaining providers. The NHSC is administered by the Health Resources and Services Administration (HRSA), within the Department of Health and Human Services (HHS). Congress created the NHSC in the Emergency Health Personnel Act of 1970 (P.L. 91-623), and its programs have been reauthorized and amended several times since then. The Patient Protection and Affordable Care Act of 2010 (ACA; P.L. 111-148) permanently reauthorized the NHSC. Prior to the ACA, the NHSC had been funded with discretionary appropriations. The ACA created a new mandatory funding source for the NHSC—the Community Health Center Fund (CHCF), which was intended to supplement the program’s annual appropriation. However, since FY2012, the CHCF has entirely replaced the NHSC’s discretionary appropriation. The CHCF is time-limited. Initially an appropriation from FY2011 through FY2015, the CHCF was subsequently extended in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10) for two years (FY2016 and FY2017). As of the date of this report, no funding has been approved for the NHSC in FY2018. The program does not currently receive discretionary appropriations; consequently, funding for this program was not included in the continuing resolution for FY2018 (P.L. 115-56). From FY2011 through FY2016, the most recent year of final data available, the NHSC offered more than 33,500 loan repayment agreements and scholarship awards to individuals who have agreed to serve for a minimum of two years in a HPSA. In FY2016, the NHSC made 6,129 awards. The number of awards the NHSC makes is only one component of program size, because not all awardees are currently serving as NHSC providers; some are still completing their training (e.g., scholarship award recipients). As such, the NHSC also measures its field strength: the number of NHSC providers who are fulfilling a service obligation in a HPSA in a given year. In FY2016, total NHSC field strength was 10,493. NHSC providers are currently serving in a variety of settings throughout the entire United States and its territories. The majority of NHSC providers serve in outpatient settings, most commonly at federally qualified health centers

An Artist as Soldier: Seeking Refuge in Love and Art

At the center of this book are the World War II letters (Feldpostbriefe) of a German artist and art teacher to his wife. While Bernhard Epple’s letters to his wife, Gudrun, address many of the topics usually found in war letters (food, lodging conditions, the weather, problems with the mail service, requests for favors from home), they are unusual in two respects. Each letter is lovingly decorated with a drawing and the letters make few references to the war itself. In addition to many personal communications and expressions of love for his wife and children, Epple writes about landscapes he saw as well as churches, museums and bookstores he visited. Epple’s letters give testimony to how a particular German soldier who was drafted and survived the war did his best to remain a civilian in uniform; distancing himself from a reality that was not of his choosing, seeking comfort and refuge in his love for art and his ability to share this love with his wife, herself an artist. While Epple’s letters are deeply personal, this book is about the human experience of war and the separation from civilian life and from family and friends. The introduction provides a short discussion of the importance and uses of war letters as historical documents, followed by a biography of the letter writer. The letters make up the two central chapters. The drawings form an integral part of the letters; each is reproduced and accompanied by an English translation of the letter. In addition to the drawings, the text includes several photographs of the letter writer and his family.https://cupola.gettysburg.edu/books/1126/thumbnail.jp

The Mental Health Workforce: A Primer

[Excerpt] Congress has held hearings and introduced legislation addressing the interrelated topics of the quality of mental health care, access to mental health care, and the cost of mental health care. The mental health workforce is a key component of each of these topics. The quality of mental health care depends partially on the skills of the people providing the care. Access to mental health care relies on, among other things, the number of appropriately skilled providers available to provide care. The cost of mental health care depends in part on the wages of the people providing care. Thus an understanding of the mental health workforce may be helpful in crafting policy and conducting oversight. This report aims to provide such an understanding as a foundation for further discussion of mental health policy

Equilibrium Fee Schedules in a Monopolist Call Market

Liquidity plays a crucial role in financial exchange markets. Markets typically create liquidity through spatial consolidation with specialist/market makers matching orders arriving at different times. However, continuous trading systems have an inherent weakness in the potential for insufficient liquidity. This risk was highlighted during the 1987 market crash. Subsequent proposals suggested time consolidation in the form of call markets integrated into the continuous trading environment. This paper explores the optimal fee schedule for a monopolist call market auctioneer competing with a continuous auction market. Liquidity is an externality in that traders are not fully compensated for the liquidity they bring to the market. Thus, in the absence of differential transaction costs, traders have an incentive to delay order entry resulting in significant uncertainty in the number of traders participating at the call. A well-designed call market mechanism has to mitigate this uncertainty. The trading mechanism examined utilizes two elements: commitments to trade and discounts in fees for early commitment; thus, optimal transaction fees are time-dependent. Traders who commit early are rewarded for the enhanced liquidity that their commitment provides to the market. As participants commit earlier they pay strictly lower fees and are strictly better off by participating in the call market rather than in the continuous market. A comparison to the social welfare maximizing fee schedule shows that the monopolist does not internalize the externality completely, with the social welfare maximizing schedule offering lower fees to all traders.

The Veterans Health Administration and Medical Education: In Brief

Training health care professionals including physicians1 is part of the VA’s statutory mission. It does so to provide an adequate supply of health professionals overall and for the VA’s health system. This mission began in 1946, when the VA began entering into affiliations with medical schools as one strategy to increase capacity. Some trainees in particular, those in the later years of training may provide direct care to patients, thereby increasing provider capacity and patient access. In the long term, training physicians at the VA creates a pipeline for recruiting physicians as VA employees. In 2014, the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113 46, as amended) initiated an expansion of the VA’s medical training by requiring the VA to increase the number of graduate medical education positions at VA medical facilities by 1,500 positions over a five year period beginning July 1, 2015, through 2019.5 P.L. 114 315 extended this time period to 10 years (i.e., through FY2024)

A descriptive study of undergraduate contraceptive attitudes among students at the University of New Hampshire

PURPOSE: The purpose of this study was to examine and to understand undergraduate students’ contraceptive attitudes and its effects on contraceptive use to further enhance the education regarding unwanted pregnancies and sexually transmitted diseases (STDs). DESIGN AND METHODS: A descriptive study to understand contraceptive attitudes while exploring demographics and sexual behaviors as well as the incorporation of the Contraceptive Attitude Scale (CAS). The researchers utilized an online survey system to distribute surveys electronically. RESULTS: Most students had a positive attitude regarding contraception. IMPLICATIONS: Nurses at college health facilities can focus on educating the college population since their age group is likely to engage in risky behavior

The Changing Demographic Profile of the United States

[Excerpt] The United States, the third most populous country globally, accounts for about 4.5% of the world’s population. The U.S. population—currently estimated at 308.7 million persons—has more than doubled since its 1950 level of 152.3 million. More than just being double in size, the population has become qualitatively different from what it was in 1950. As noted by the Population Reference Bureau, “The U.S. is getting bigger, older, and more diverse.” The objective of this report is to highlight some of the demographic changes that have already occurred since 1950 and to illustrate how these and future trends will reshape the nation in the decades to come (through 2050). The United States Is Getting Bigger. U.S. population growth is due to the trends over time in the interplay of increased births, decreased deaths, and increased net immigration. The United States Is Getting Older. Aside from the total size, one of the most important demographic characteristics of a population for public policy is its age and sex structure. This report illustrates how the United States has been in the midst of a profound demographic change: the rapid aging of its population, as reflected by an increasing proportion of persons aged 65 and older, and an increasing median age in the population. The United States Is Becoming More Racially and Ethnically Diverse, reflecting the major influence that immigration has had on both the size and the age structure of the U.S. population. This section considers the changing profile of the five major racial groups in the United States. In addition, trends in the changing ethnic composition of the Hispanic or Latino Origin population are discussed. Although this report will not specifically discuss policy options to address the changing demographic profile, it is important to recognize that the inexorable demographic momentum will have important implications for the economic and social forces that will shape future societal well-being. There is ample reason to believe that the United States will be able to cope with the current and projected demographic changes if policymakers accelerate efforts to address and adapt to the changing population profile as it relates to a number of essential domains, such as work, retirement, and pensions; private wealth and income security; the federal budget and intergenerational equity; health, healthcare, and health spending; and the health and well-being of the aging population. These topics, among others, are discussed briefly in the final section of this report. This report will be updated as needed