Medicaid-the need for reform: commentary

Health care reform ; Medicaid

Medicaid Policy and Long-Term Care Spending: An Interactive View

Examines state variations in Medicaid spending on long-term care and links between coverage policies and spending. Outlines potential factors, limitations of conventional methods of measurement, and an approach that includes interactions between policies

Dynamics of Transformation from Segregation to Mixed Wealth Cities

We model the dynamics of the Schelling model for agents described simply by a continuously distributed variable - wealth. Agents move to neighborhoods where their wealth is not lesser than that of some proportion of their neighbors, the threshold level. As in the case of the classic Schelling model where segregation obtains between two races, we find here that wealth-based segregation occurs and persists. However, introducing uncertainty into the decision to move - that is, with some probability, if agents are allowed to move even though the threshold level condition is contravened - we find that even for small proportions of such disallowed moves, the dynamics no longer yield segregation but instead sharply transition into a persistent mixed wealth distribution. We investigate the nature of this sharp transformation between segregated and mixed states, and find that it is because of a non-linear relationship between allowed moves and disallowed moves. For small increases in disallowed moves, there is a rapid corresponding increase in allowed moves, but this tapers off as the fraction of disallowed moves increase further and finally settles at a stable value, remaining invariant to any further increase in disallowed moves. It is the overall effect of the dynamics in the initial region (with small numbers of disallowed moves) that shifts the system away from a state of segregation rapidly to a mixed wealth state. The contravention of the tolerance condition could be interpreted as public policy interventions like minimal levels of social housing or housing benefit transfers to poorer households. Our finding therefore suggests that it might require only very limited levels of such public intervention - just sufficient to enable a small fraction of disallowed moves, because the dynamics generated by such moves could spur the transformation from a segregated to mixed equilibrium.Comment: 12 pages, 7 figure

Test-retest reliability of the auditory Computerized Revised Token Test (CRTT) and three experimental reading CRTT-R versions in normal elderly individuals and persons with aphasia

The purpose of this study was to assess the test-retest reliability of the Computerized Revised Token Test (CRTT) and three CRTT-R reading versions in normal elderly individuals (NEI) and in persons with aphasia (PWA). Results revealed high correlation coefficients between test and retest performance for all CRTT versions in the PWA and moderate to high correlations in the NEI. There were no significant differences among test-retest conditions for overall and subtest scores except for the reading word-fade condition (both groups) and auditory condition for the PWA. Overall, high test-retest reliability of the CRTT and the three CRTT-R versions was demonstrated

Concurrent Validation of the Computerized Revised Token Test (CRTT) and Three Experimental Reading Versions (CRTT-R) in Normal Elderly Individuals and Persons With Aphasia

This study evaluated one listening and three reading tasks with stimuli, scoring, and task requirements coherent for auditory and visual administrations of the Computerized Revised Token Test (CRTT), thus allowing for direct comparisons across modalities and language functions. Thirty Persons with Aphasia (PWA) and 30 Normal Elderly Individuals (NEI) received the four versions of the CRTT in random order. The Porch Index of Communicative Ability (PICA) and the Reading Comprehension Battery for Aphasia (RCBA) also were administered. In PWA the four versions were strongly related and highly correlated with the PICA and the RCBA. The NEI differed from this pattern

New Methods for Measuring and Analyzing Segregation

demographic techniques; quantitative research methods; segregation; bias; distributio

Relationships between Working Memory Capacity and Listening and Reading Sentence Comprehension in Normal Elderly Individuals and Persons with Aphasia

The purposes of the study are to investigate whether working memory (WM) capacity significantly predicts performance on auditory and reading comprehension tasks for aphasic individuals, and to examine whether WM-group differences between low and high WM groups emerge in demanding comprehension tasks. The results revealed that WM capacity significantly predicted performance on an auditory comprehension task and on a reading comprehension task presented with a self-paced moving window method. WM group effects emerged especially under the subtests with more linguistic elements and these findings are consistent with the WM capacity model (Just & Carpenter, 1992)

Spectra of Mutations Induced by Tritium Beta Radiation or 2-Chloroethyl Methanesulfonate in Drosophila Melanogaster Germ Cells.

Tritium beta radiation (tritium) was used to induce mutations at the alcohol dehydrogenase (Adh) locus in male Drosophila melanogaster post-meiotic germ cells. All 23 mutations recovered were deletions greater than one kilobase in size (multikilobase deletions) as determined by genetic complementation analysis. A statistical difference was observed between the frequency of multikilobase deletions (23/23 or 1.0) induced by tritium and the frequency of multikilobase deletions (19/27 or 0.7) induced by 100-kVp X-radiation (X-rays). The relative frequency of multikilobase deletions induced by tritium with respect to that induced by X-rays was 1.4. This value was compared to the relative biological effectiveness (RBE = 1.4) of these 2 radiation sources, determined from the ratio of the regression coefficients of the respective sex-linked recessive lethal (SLRL) dose-response data. A relationship may exist between the relative frequency of multikilobase deletions induced at the Adh locus and the RBE determined from the SLRL dose-response data. In addition, a genetic map of the multikilobase deletion break-points induced by tritium and by three monofunctional alkylating agents, 1-ethyl-1-nitrosourea, 1-methyl-1-nitrosourea and ethyl methanesulfonate, is presented. Previous in vitro research suggests that 2-chloroethyl methanesulfonate (Cl-EMS) will produce the same DNA adduct as 1,2-dichloroethane or 1,2-dibromoethane. D. melanogaster gonial cells were treated with Cl-EMS, and the sex-linked recessive lethal (SLRL) and alcohol dehydrogenase (Adh) induced mutation frequencies were determined. The results of these studies were the following: First, mutation frequencies 200 times the spontaneous mutation frequency were induced with Cl-EMS. Second, lethal mutations on the X-chromosome were selected against in the hemizygous male. Third, the induced Adh mutation frequency was higher in the male than in the female. Fourth, all of the 83 Adh null mutations recovered were intragenic mutations as determined by complementation analysis. Fifth, treatment of gonial cells resulted in mutations of common origin, verified by DNA sequence analysis. Sixth, all 36 mutations of independent origin were GC to AT transitions. This study was supported by NIEHS PO1-EEO3447 and DE-FG05-86ER60393

Territorial Developments Based on Graffiti: a Statistical Mechanics Approach

We study the well-known sociological phenomenon of gang aggregation and territory formation through an interacting agent system defined on a lattice. We introduce a two-gang Hamiltonian model where agents have red or blue affiliation but are otherwise indistinguishable. In this model, all interactions are indirect and occur only via graffiti markings, on-site as well as on nearest neighbor locations. We also allow for gang proliferation and graffiti suppression. Within the context of this model, we show that gang clustering and territory formation may arise under specific parameter choices and that a phase transition may occur between well-mixed, possibly dilute configurations and well separated, clustered ones. Using methods from statistical mechanics, we study the phase transition between these two qualitatively different scenarios. In the mean-field rendition of this model, we identify parameter regimes where the transition is first or second order. In all cases, we have found that the transitions are a consequence solely of the gang to graffiti couplings, implying that direct gang to gang interactions are not strictly necessary for gang territory formation; in particular, graffiti may be the sole driving force behind gang clustering. We further discuss possible sociological -- as well as ecological -- ramifications of our results