Trade Enhancing Goals for Reducing Sanitary and Phytosanitary Barriers

Food Consumption/Nutrition/Food Safety, International Relations/Trade,

“Understanding the experiences of STEM mentors: Evaluating Indianapolis’ US2020 initiative”

poster abstractTechPoint Foundation for Youth is the Project Manager for Indianapolis’ US2020 Initiative, currently in its pilot year. The goal of the National US2020 Initiative is to match 1 million STEM mentors with students participating in STEM programs by the year 2020. The Indianapolis US2020 Initiative encourages STEM professionals to volunteer in the role of mentor, coach, or knowledge authority and to facilitate hands-on, experiential, STEM programs for students. These programs are specifically serving populations often underrepresented in STEM fields, such as low-income students, minorities, and girls. Ten Indianapolis schools and four Boys and Girls Club sites have been selected to participate in the program. At the beginning of the 2014 school year, pilot school and community sites were given the opportunity to select two or three STEM out-of-school time programs that cater to K-12 students. STEM professionals, recruited from our Corporate Partners, were then able to select mentoring opportunities through the Indianapolis US2020 Mentor Matching Portal, committing 10-20 hours of their time. Through evaluation procedures, US2020 and TechPoint Foundation for Youth hope to gain an understanding of: 1) student interest in STEM education and careers; 2) mentor satisfaction and engagement; 3) school facilitator/program satisfaction; and 4) corporate partner satisfaction. The evaluation will include pre-/post-surveys of students participating in US2020 programs, mentor journals given at major milestones of their mentoring experiences, post-mentor and school facilitator surveys, and interviews with corporate partners and TechPoint Foundation for Youth staff at the conclusion of the pilot year

Prospects for the tenth district energy industry

Federal Reserve District, 10th ; Power resources

Supervised Lower Extremity Strengthening Program to Improve Function in Women Over Fifty with Knee Osteoarthritis: A Time Series Design

Objective: Develop a simple, self-paced lower extremity strengthening program incorporating functional activities for women over the age of fifty to reduce limitations associated with knee OA. Study Design: This was a pilot study utilizing a time series design with 8 women aged 55-65 (M + SD = 60 + 3) meeting the American College of Rheumatology\u27s criteria for clinical diagnosis of knee OA. Background: Lower extremity weakness in women with knee osteoarthritis is associated with pain and functional limitations. Methods and Measures: Subjects began the 14-week program with 2 weeks of baseline treadmill walking. The following 12 weeks were divided into 3 phases, 4 weeks each, consisting of a 10 minute walking warm-up, 18 minute stepping protocol and a 10 minute walking cool-down. Step height progressively increased by 2 inches each phase. Outcome measures included Limits of Stability and Sensory Organization Test taken at weeks 1 and 14 on the NeuroCom Smart Equitest®; the Western Ontario and McMaster’s University Arthritis Index (WOMAC) and quadriceps strength using a hand-held dynamometer recorded at each change of phase; and pain rating using a visual analogue scale which was scored every session. Results: A repeated measures ANOVA demonstrated a significant difference between WOMAC means (F(4,28) = 6.218, p\u3c.001). Additionally, a statistically significant difference was found among the means for bilateral quadriceps strength measurements (F(4,28) = 36.338, p\u3c.0005). Pair-wise comparisons for bilateral quadriceps strength revealed a statistically significant difference among the means between all treatment times when compared to the post-treatment scores (ps\u3c.003). Conclusions: Subjects demonstrated an increase in quadriceps strength particularly in the final phase of the step program. WOMAC scores revealed significant changes between pre and week 10 treatment functional levels. The gains seen within this subject group in a limited time frame offer preliminary evidence that a strength-training program may benefit women over 50 with knee OA by improving lower extremity strength and function. These results warrant further investigation using more rigorous methodology

Year-round radiocarbon-based source apportionment of carbonaceous aerosols at two background sites in South Asia

Atmospheric Brown Clouds (ABC), regional-scale haze events, are a significant concern for both human cardiopulmonary health and regional climate impacts. In order to effectively mitigate this pollution-based phenomenon, it is imperative to understand the magnitude, scope and source of ABC in regions such as South Asia. Two sites in S. Asia were chosen for a 15-month field campaign focused on isotope-based source apportionment of carbonaceous aerosols in 2008-2009. Both the Maldives Climate Observatory in Hanimaadhoo (MCOH) and a mountaintop site in Sinhagad, India (SINH) act as regionally mixed receptor sites. Annual radiocarbon-based source apportionment for soot elemental carbon (SEC) at MCOH and SINH revealed 73 6 and 59 5 contribution from biomass combustion, respectively (remainder from fossil fuel). The contributions from biogenic/biomass combustion to total organic carbon were similar between MCOH and SINH (69 5 and 64 5, respectively). The biomass combustion contribution for SEC in the current study, especially the results from MCOH, shows good agreement with published black carbon emissions inventories for India. Geographic source assessment, including clustered back trajectory analysis and carbon contribution by source region, indicated that the highest SEC/TOC loads originated from the W. Indian coastal margin, including the coastal city of Mumbai, India. The winter dry season 14C-based source apportionment of the BC-tracing SEC fraction for 2006, 2008, 2009 were not statistically different (p = 0.7) and point to a near-constant two-thirds contribution from biomass combustion practices, including wood and other biofuels as well as burning of agricultural crop residues

Radiocarbon-based source apportionment of elemental carbon aerosols at two South Asian receptor observatories over a full annual cycle

Black carbon (BC) aerosols impact climate and air quality. Since BC from fossil versus biomass combustion have different optical properties and different abilities to penetrate the lungs, it is important to better understand their relative contributions in strongly affected regions such as South Asia. This study reports the first year-round 14C-based source apportionment of elemental carbon (EC), the mass-based correspondent to BC, using as regional receptor sites the international Maldives Climate Observatory in Hanimaadhoo (MCOH) and the mountaintop observatory of the Indian Institute of Tropical Meteorology in Sinhagad, India (SINH). For the highly-polluted winter season (December–March), the fractional contribution to EC from biomass burning (fbio) was 53 ± 5% (n = 6) at MCOH and 56 ± 3% at SINH (n = 5). The fbio for the non-winter remainder was 53 ± 11% (n = 6) at MCOH and 48 ± 8% (n = 7) at SINH. This observation-based constraint on near-equal contributions from biomass burning and fossil fuel combustion at both sites compare with predictions from eight technology-based emission inventory (EI) models for India of (fbio)EI spanning 55–88%, suggesting that most current EI for Indian BC systematically under predict the relative contribution of fossil fuel combustion. A continued iterative testing of bottom-up EI with top-down observational source constraints has the potential to lead to reduced uncertainties regarding EC sources and emissions to the benefit of both models of climate and air quality as well as guide efficient policies to mitigate emissions

Air Quality and Source Apportionment

Atmospheric particulate matter (PM) is known to have far-ranging impacts on human health through to climate forcing. The characterization of emission sources and the quantification of specific source impacts to PM concentrations significantly enhance our understanding of, and our ability to, eventually predicting the fate and transport of atmospheric PM and its associated impacts on humans and the environment. Recent advances in source apportionment applications have contributed unique combinations of chemical and numerical techniques for determining the contributions of specific sources, including diesel exhaust and biomass burning. These advances also identify and help characterize the contributions of previously uncharacterized sources. Numerical modeling has also enabled estimations of contributions of emission sources to atmospherically processed PM in urban and rural regions. Investigation into the emissions sources driving air quality is currently of concern across the globe. This Special Issue offers studies at the intersection of air quality and source apportionment for study areas in China, Germany, Iceland, Mexico, and the United States. Studies cover diverse methods for chemical characterization and modeling of the impact of different emission sources on air quality

Medicaid Expansion, Medicaid Reimbursement Methodologies, and Counselor Employment at Federally Qualified Health Centers

Advocacy for the counseling profession necessitates a thorough understanding of the factors influencing the hiring and reimbursement of licensed professional counselors. The Patient Protection and Affordable Care Act (ACA) enacted several health care reforms that may influence the utilization of mental health services and the employment of mental health professionals. These reforms included the option for states to expand their Medicaid population (effective January 1, 2014), mental health parity requirements for most insurance plans including Medicaid plans, and increased funding for Federally Qualified Health Centers (FQHCs or health centers). FQHCs, created by Congress in 1989, provide primary care services, including mental health services, to approximately 24 million Americans annually and function as a vital safety net for medically underserved communities and populations. The largest source of revenue for FQHCs is Medicaid, and FQHCs receive enhanced reimbursement for services provided to Medicaid patients, known as the Medicaid Prospective Payment System (PPS) rate. Federal law, however, explicitly approves only certain health care professions as billable PPS providers. Licensed clinical social workers (LCSWs), along with psychologists and psychiatrists, are included as billable PPS providers under federal law, but not licensed professional counselors (LPCs). Some states have expanded the list of health care professions able to generate billable PPS encounters at FQHCs to include licensed professional counselors. It is vital for the counseling profession to understand the impact of these reforms and the interplay of federal and state policies related to reimbursement upon the mental health industry. The optional Medicaid expansion provision of the ACA created an opportunity for a natural experiment to compare mental health service utilization and employment at FQHCs in Medicaid expansion states versus non-Medicaid expansion states. This quasiexperimental study first tested the causal impact of Medicaid expansion on the number of mental health visits and full-time equivalent (FTE) mental health staff at FQHCs, using state-level data gathered from FQHC reports submitted annually to the Uniform Data System. A count model difference-in-differences analysis strategy compared utilization and employment numbers in 2012-2013 (pre-Medicaid expansion) and 2014-2015 (post- Medicaid expansion) between Medicaid expansion states and non-Medicaid expansion states. Then, a two-sample test of proportions utilizing data from a research-developed employment survey examined the relationship between states approving counselors and states not approving counselors as billable FQHC mental health providers under the enhanced PPS reimbursement and the proportion of LPCs at FQHCs (of the total number of LPCs and LCSWs). In both groups of states (Medicaid expansion states and non-Medicaid expansion states), it was evident that there was a substantial increase in the number of mental health visits and FTE mental health staff at FQHCs from 2012 to 2015. Contrary to prediction, the first count model difference-in-differences analysis indicated that non-Medicaid expansion states had a significantly higher rate of change in the number of mental health visits from pre-Medicaid expansion (2012-2013) to post-Medicaid expansion (2014- 2015), as compared to Medicaid expansion states (α = .05, p = .01). Then, contrary to prediction, the second count model difference-in-differences analysis indicated that there was not a significant difference in the rate of change for the number of FTE mental health staff between Medicaid expansion states and non-Medicaid expansion states from pre- Medicaid expansion (2012-2013) to post-Medicaid expansion (2014-2015; α = .05, p = .13). As predicted, the two-sample test of proportions resulting from the survey responses of 138 FQHCs (60% response rate) indicated that there was a significantly higher proportion of LPCs employed at FQHCs in states approving LPCs as billable FQHC mental health providers under PPS as compared to states not approving LPCs ( = 4.24, p \u3c .001, Cohen’s h = .76). Thus, counselor employment at FQHCs was significantly improved in those states approving counselors as billable PPS providers. It is essential for counselors to understand the impact of federal and state health care policies, such as Medicaid expansion, increased funding of FQHCs, and various Medicaid reimbursement methodologies, to successfully advocate for the profession in the dynamic health care landscape. Counselor educators have a responsibility to convey information to students related to the potential repercussions of billable mental health provider status on their employment opportunities following graduation