Hybrid hollow silica particles: synthesis and comparison of properties with pristine particles.

In the past decade, interest in hollow silica particles has grown tremendously because of their applications in diverse fields such as thermal insulation, drug delivery, battery cathodes, catalysis, and functional coatings. Herein, we demonstrate a strategy to synthesize hybrid hollow silica particles having shells made of either polymer-silica or carbon-silica. Hybrid shells were characterized using electron microscopy.

The "Golden Rules" for Eliminating Disparities: Title VI, Medicare, and the Implementation of the Affordable Care Act.

Addressing health care disparities rarely focuses on how the "gold" (meaning the federal dollars flowing into the nation's health system) has, at different times, both widened and narrowed health care disparities. This paper describes (1) the early attempts to use the power of the federal purse to address disparities that led to the enactment of Title VI of the 1964 Civil Rights Act; (2) how Title VI, as applied in the implementation of Medicare, reduced disparities; and (3) the lessons that this story offers for similar opportunities in the implementation of the Affordable Care Act (ACA). Reducing disparities with the implementation of the ACA will require (1) rekindling the spirit of the grass roots movement that captured the Title VI enforcement process with the implementation of Medicare; (2) exposing adversaries through data disclosure and taking advantage of the "invisible army" that supports these goals; (3) using the power of both the economic and ethical versions of the Golden Rule; and (4) creating the political insulation and urgency necessary to reduce health care disparities.

The accumulated challenges of long-term care.

During the past century, long-term care in the United States has evolved through five cycles of development, each lasting approximately twenty years. Each, focusing on distinct concerns, produced unintended consequences. Each also added a layer to an accumulation of contradictory approaches--a patchwork system now pushed to the breaking point by increasing needs and financial pressures.

Racial disparities in access to long-term care: the illusive pursuit of equity.

While nursing homes were insulated from civil-rights enforcement at the time of the implementation of the Medicare program and lagged behind other parts of the health sector in providing comparable access to minorities, they are the only providers for which current reporting requirements make it possible to fully assess racial disparities in use and quality of care. We find that African Americans' use of nursing homes in 2000 in the United States was 14 percent higher than Caucasians' use. The largest relative African American use of nursing homes in 2000 took place in the South and West.

Separate and unequal: racial segregation and disparities in quality across U.S. nursing homes.

We describe the racial segregation in U.S. nursing homes and its relationship to racial disparities in the quality of care.

Racial disparities in care: the concealed legacy of a divided system.

Background And Objectives: New national initiatives to end racial disparities in health could benefit from the experience with Title VI enforcement in the Medicare Program.

Goals: The goals of this study were to describe events in a test case to extend Medicare Title VI conditions for hospitals to the practice patterns of its medical staff and how the outcome shaped disparities.

Method: This article distills interviews, archives, and secondary data sources.

Going backward into the future.

Racial and ethnic disparities in medical treatment persist 40 years after passage of Medicare and Medicaid legislation. Concerns about rising healthcare costs have overshadowed efforts to eliminate inequality in treatment. Eliminating disparities in treatment requires linking goals with financial incentives.

The politics of racial disparities: desegregating the hospitals in Jackson, Mississippi.

As health care policymakers and providers focus on eliminating the persistent racial disparities in treatment, it is useful to explore how resistance to hospital desegregation was overcome. Jackson, Mississippi, provides an instructive case study of how largely concealed deliberations achieved the necessary concessions in a still rigidly segregated community. The Veterans Administration hospital, the medical school hospital, and the private nonprofit facilities were successively desegregated, owing mainly to the threatened loss of federal dollars.

Racial and ethnic health disparities and the unfinished civil rights agenda.

Civil rights-era efforts to end disparities in health care in federally financed health programs faced three successively more difficult challenges: (1) ending Jim Crow practices, (2) eliminating more subtle forms of segregation, and (3) assuring nondiscriminatory treatment in integrated settings. Federal efforts peaked with the implementation of the Medicare program. Visible symbols of Jim Crow disappeared, and most crude disparities in access were eliminated.

The perils of healthcare workforce forecasting: a case study of the Philadelphia metropolitan area.

In 1996, a widely circulated and influential forecast for the Philadelphia Metropolitan Area stated that a decline in hospital and healthcare employment in the region would occur over the next five years. It also suggested that this decline would exacerbate the problem of an oversupply of nurses seeking hospital employment. The forecast reflected a regional leadership and expert consensus on the impact of the managed care transformation on workforce needs and was supported by short-term statistical trends in regional utilization and employment.