Reflections on Bipartisan Solutions to Addressing Poverty.

This reflection on the Medicalization of Poverty asks how healthcare itself plays a role in the development of poverty. Drawing on Governor Thompson's extensive work reforming the welfare system, the reflection first stresses the importance of involving the very people impacted by any reform - a conscious process Governor Thompson used when pioneering the W-2 program in Wisconsin and then extended to the overhaul of Medicare's prescription drug benefit. Second, it stresses the advantage of developing bipartisan solutions to solve hard problems such as how best to provide affordable healthcare and reduce poverty in the lives of Americans.

ReHabgame: A non-immersive virtual reality rehabilitation system with applications in neuroscience.

This paper proposes the use of a non-immersive virtual reality rehabilitation system "ReHabgame" developed using Microsoft Kinect™ and the Thalmic™ Labs Myo gesture control armband. The ReHabgame was developed based on two third-person video games that provide a feasible possibility of assessing postural control and functional reach tests. It accurately quantifies specific postural control mechanisms including timed standing balance, functional reach tests using real-time anatomical landmark orientation, joint velocity, and acceleration while end trajectories were calculated using an inverse kinematics algorithm. The game was designed to help patients with neurological impairment to be subjected to physiotherapy activity and practice postures of daily activities. The subjective experience of the ReHabgame was studied through the development of an Engagement Questionnaire (EQ) for qualitative, quantitative and Rasch model. The Monte-Carlo Tree Search (MCTS) and Random object (ROG) generator algorithms were used to adapt the physical and gameplay intensity in the ReHabgame based on the Motor Assessment Scale (MAS) and Hierarchical Scoring System (HSS). Rasch analysis was conducted to assess the psychometric characteristics of the ReHabgame and to identify if these are any misfitting items in the game. Rasch rating scale model (RSM) was used to assess the engagement of players in the ReHabgame and evaluate the effectiveness and attractiveness of the game. The results showed that the scales assessing the rehabilitation process met Rasch expectations of reliability, and unidimensionality. Infit and outfit mean squares values are in the range of (0.68-1.52) for all considered 16 items. The Root Mean Square Residual (RMSR) and the person separation reliability were acceptable. The item/person map showed that the persons and items were clustered symmetrically.

Invited commentary - the role of government in spurring innovative health care technology - biomed 2009.

I am optimistic about the enormous potential technology holds for improving America's health care system. Thanks to the hard work being done by the nation's talented corps of biomedical researchers and engineers, we are making unprecedented progress in expanding the frontiers of medicine and finding new and better ways to deliver care. In addition to recognizing that our nation is home to the world's greatest medical and scientific research minds we must also acknowledge that America's free market economy is the engine driving our nation's ability to develop modern and innovative technology. Without the incentives offered by a competitive marketplace, inventors and investors would have little reason to risk resources on finding the next breakthroughs. While I believe that America's ability to continue to innovate will require a strong and vibrant open marketplace, I also believe that the federal government can and must play a critical role in helping to spur further advances in the development and adoption of health care technology.

Biochemical composition and immunological comparison of select pecan [Carya illinoinensis (Wangenh.) K. Koch] cultivars.

On an edible portion basis, pecan moisture, protein, lipid, total soluble sugars, and ash contents ranged from 2.1% to 6.4%, 6.0% to 11.3%, 65.9% to 78.0%, 3.3% to 5.3%, and 1.2% to 1.8%, respectively. With the exception of a high tannin (2.7%) Texas seedling, pecan tannin content was in a narrow range (0.6-1.85%). Unsaturated fatty acids (>90%) dominated pecan lipid composition with oleic (52.52-74.09%) and linoleic (17.69-37.52%) acids as the predominant unsaturated fatty acids. Location significantly influenced pecan biochemical composition. Pecan lipid content was negatively correlated with protein (r = -0.663) and total sugar (r = -0.625). Among the samples tested using SDS-PAGE a common pattern, with minor differences, in subunit polypeptide profiles was revealed. Rabbit polyclonal antibody-based immunoblotting experiments (Western blot) also illustrated the similarity in polypeptide profiles with respect to immunoreactivity. All tested cultivars registered similar immunoreactivity when their protein extracts (each at 1 mg/mL) were assessed using inhibition ELISAs (mean +/- standard deviation = 0.89 +/- 0.20; n = 27) with the USDA "Desirable" cultivar as the reference standard (immunoreactivity designated as 1.0).

A call to action.

OBJECTIVE: To summarize the challenges facing the U.S. health care system between now and 2013. SUMMARY: Between now and 2013, the American health care system will need to make major changes to successfully address Medicare's funding challenges. Making the patient a partner in care, developing systems that promote and reward prevention efforts, and ensuring that health care purchasers understand and pursue value will be key. The growing prevalence of diabetes and cardiometabolic conditions is one area in which concerted efforts are needed.

Yielding the bully pulpit: a conversation with Tommy Thompson. Interview by John K Iglehart.

In January 2005 Tommy Thompson relinquished the post of secretary of the U.S. Department of Human Services (HHS). Known as being an outspoken defender of his principles throughout his tenure at HHS, Thompson continues that tone in an interview conducted shortly after he left Washington. Topics covered include ways to curb Medicare spending; devote greater attention to preventive health and proper incentives for technology; improve the vaccine infrastructure of the United States and the world; and continue to infuse U.S. foreign policy with what Thompson has termed "medical diplomacy," in an effort to counter the messages of America's enemies.

Inadequacy of standard screen resolution for localization of seizures recorded from intracranial electrodes.

Seizures recorded during long-term monitoring with implanted intracranial electrodes are typically interpreted by visual inspection alone by using digital display systems. When high-frequency activity is digitized and displayed on a typical monitor, it is altered in ways that are not always appreciated and that may have an impact on the intracranial EEG (ICEEG) interpretation. We describe a case of a neocortical-onset seizure in which false localization occurred with a 12-s per screen display. Because frequencies in excess of 100 Hz are not uncommon in neocortical seizures, at most 4 to 5 s of EEG, depending on the screen resolution, data-sampling rate, and other factors, should be displayed at one time during visual interpretation to localize the seizure onset. Alternatively, spectral analysis should be performed on recordings of neocortical seizures to detect high-frequency activity that may be missed on visual inspection.

Advocating for medical diplomacy: a conversation with Tommy G. Thompson.

Health Affairs founding editor John Iglehart interviews HHS Secretary Tommy Thompson, who calls for closer integration of health policy and foreign policy, with the aim of improving the lives of vulnerable populations and serving the best interests of the United States. Thompson also discusses the indelible impressions of his travels to Afghanistan, Africa, and Iraq; the Medicare drug discount card program; and more.

From vision to action: hospitals for a healthy future.

As great as the American health care system is, it can be even better. America has a vision for health care that builds on its strength: competition in a free economy. In the American vision, physicians can focus on the quality of their care, not the quantity of their paperwork. The individual who chooses to work in health care, does so because he/she desires to keep people healthy. It is believed that the more information and choices people have, the healthier they are, therefore the vision is to give people more and better information and more choices so they can preserve and improve their health. The responsibility to keep Americans strong, healthy, and independent, should and does not stop at the water's edge as life and liberty are the fundamental birthright, not just of Americans, but of all mankind. Improving people's health, and in fact enlisting people in improving their own health and their families' health, is one of the greatest projects the international healthcare community can undertake. And the more choices and information people are given, the healthier they will be.