Generalist care managers for the treatment of depressed medicaid patients in North Carolina: A pilot study

BACKGROUND: In most states, mental illness costs are an increasing share of Medicaid expenditures. Specialized depression care managers (CM) have consistently demonstrated improvements in patient outcomes relative to usual primary care (UC), but are costly and may not be fully utilized in smaller practices. A generalist care manager (GCM) could manage multiple chronic conditions and be more accepted and cost-effective than the specialist depression CM. We designed a pilot program to demonstrate the feasibility of training/deploying GCMs into primary care settings. METHODS: We randomized depressed adult Medicaid patients in 2 primary care practices in Western North Carolina to a GCM intervention or to UC. GCMs, already providing services in diabetes and asthma in both study arms, were further trained to provide depression services including self-management, decision support, use of information systems, and care management. The following data were analyzed: baseline, 3- and 6-month Patient Health Questionnaire (PHQ9) scores; baseline and 6-month Short Form (SF) 12 scores; Medicaid claims data; questionnaire on patients' perceptions of treatment; GCM case notes; physician and office staff time study; and physician and office staff focus group discussions. RESULTS: Forty-five patients were enrolled, the majority with preexisting depression. Both groups improved; the GCM group did not demonstrate better clinical and functional outcomes than the UC group. Patients in the GCM group were more likely to have prescriptions of correct dosing by chart data. GCMs most often addressed comorbid conditions (36%), then social issues (27%) and appointment reminders (14%). GCMs recorded an average of 46 interactions per patient in the GCM arm. Focus group data demonstrated that physicians valued using GCMs. A time study documented that staff required no more time interacting with GCMs, whereas physicians spent an average of 4 minutes more per week. CONCLUSION: GCMs can be trained in care of depression and other chronic illnesses, are acceptable to practices and patients, and result in physicians prescribing guideline concordant care. GCMs appear to be a feasible intervention for community medical practices and to warrant a larger scale trial to test their appropriateness for Medicaid programs nationally

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

spacetelescope/wiimatch: Maintenance release

Optimal "matching" of weighted N-dimensional image intensity data using (multivariate) polynomial

spacetelescope/tweakwcs: Maintenance release: Improved compatibility with numpy 2.0. Minor bug fixes and improvements

Algorithms for matching and aligning catalogs and for tweaking the WCS so as to minimize catalog mismatch error

spacetelescope/tweakwcs: Package setup infrastructure reorganization.

<p>Package setup infrastructure reorganization. Python 3.12 compatibility improvements.</p&gt

spacetelescope/tweakwcs: Do not use failed to align images in refcat expansion. Improved 2dhist.

<p>Images that fail to align to the reference catalog when <code>expand_refcat</code> enabled will no longer be added to the reference catalog. [#195]</p> <p>Improved algorithm for initial shift estimation used in catalog matching (<code>2dhist</code>) reduces both memory usage and often processing speed. [#196]</p&gt

spacetelescope/cubeviz: 0.3.0rc1

Prerelease candidate for v0.3.0

spacetelescope/gwcs: GWCS v0.8.0

Changes: LabelMapperRange now returns LabelMapperRange._no_label when the key is not within any range. [#71] LabelMapperDict now returns LabelMapperDict._no_label when the key does not match. [#72] Replaced domain with bounding_box. [#74] Added a LabelMapper model where mapper is an instance of ~astropy.modeling.core.Model. [#78] Evaluating a WCS with bounding box was moved to astropy.modeling. [#86] RegionsSelector now handles the case when a label does not have a corresponding transform and returns RegionsSelector.undefined_transform_value. [#86] GWCS now deals with axes types which are neither celestial nor spectral as "unknown" and creates a transform equivalent to the FITS linear transform. [#92

spacetelescope/pysiaf: Update to PRDOPSSOC-063

<p>This release updates the default JWST SIAF used in this package to PRDOPSSOC-063.</p&gt