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Although zinc (Zn) is one of the elements with the greatest potential for biodegradable uses, pure Zn does not have the ideal mechanical or degrading properties for orthopaedic applications. The current research aims at studying the microstructure and corrosion behaviour of pure Zn (used as a reference material) and Zn alloyed with 1.89 wt.% magnesium (Mg), both in their extruded states as well as after being coated with polymethyl methacrylate (PMMA). The grafting-from approach was used to create a PMMA covering. The "grafting-from" method entails three steps: the alkali activation of the alloys, their functionalization with an initiator of polymerization through a phosphonate-attaching group, and the surface-initiated atom transfer radical polymerisation (SI-ATRP) to grow PMMA chains. Electrochemical and immersion corrosion tests were carried out in a simulated body fluid (SBF), and both confirmed the enhanced corrosion behaviour obtained after coating. The electrochemical test revealed a decrease in the degradation rate of the alloy from 0.37 ± 0.14 mm/y to 0.22 ± 0.01 mm/y. The immersion test showed the ability of complete protection for 240 h. After 720 h of immersion, the coated alloy displays minute crevice corrosion with very trivial pitting compared to the severe localized (galvanic and pitting) corrosion type that was detected in the bare alloy.

States' role in payment as well as coverage will be subject to debate as the administration and the Congress decide how to address the Affordable Care Act (ACA) and otherwise reshape the nation's health policies. Acting as stewards of health care for the entire state population and stimulated by concern about rising costs and federal support under the ACA, the elected and administrative leaders of some states have been using their political influence and authority to improve their state's overall systems of care regardless of who pays the bill. In early 2015 we conducted on-site interviews with key stakeholders in five states to explore their strategies for payment and delivery reform. We found that despite these states' similar goals, differences in their statutory authority and purchasing power, along with their leaders' willingness to use them, significantly influence a state's ability to achieve reform objectives. We caution federal and state policy makers to recognize the reality that state leaders' political desire to exercise stewardship may not be enough to achieve it., (Copyright © 2017 by Duke University Press.)

Purpose: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health. This study examines state approaches to opioid health homes (OHH) and uses a retrospective analysis to identify facilitators and barriers to the program's implementation from the perspectives of multiple stakeholders., Methods: We conducted 28 semi-structured discussions with 70 discussants across the three states, including representatives from state agencies, OHH providers (OTPs and OBOTs), Medicaid health plans, and provider associations. Discussions were recorded, transcribed, and analyzed using NVivo. In addition, we reviewed state health home applications, policies, regulatory guidance, reporting, and other available OHH materials. We adapted the Exploration, Preparation, Implementation, and Sustainment (EPIS) model as a guiding framework to examine the collected data, helping us to identify key factors affecting each stage of the OHH implementation., Results: Overall, discussants reported that the OHH model was implemented successfully and was responsible for substantial improvements in patient care. Contextual factors at both the state level (e.g., legislation, funding, state leadership, program design) and provider level (OHH provider characteristics, leadership, adaptability) affected each stage of implementation of the OHH model. States took a variety of approaches in designing and implementing the model, with facilitators related to gathering stakeholder input, receiving guidance and technical assistance, and tailoring program design to build on the state's existing care coordination initiatives and provider infrastructure. The OHH model constituted a substantial change for almost all OHH providers in the study, who reported that facilitators to implementation included having goals and workplace culture that were compatible with the OHH model, and having technical support from the state or non-governmental organizations. Some of the main barriers to implementation reported by OHH providers include shortages of primary care providers, dentists, and other providers willing to accept referrals of patients with opioid use disorder; limited community resources to address social determinants of health; challenges related to state-specific program design, such as staffing requirements and reimbursement methodology; care coordination limitations due to confidentiality restrictions and technological barriers; and internal capacity of providers to adopt the new model of care., Conclusions: The OHH model appears to have the potential to effectively address the complex needs of individuals with opioid use disorder by providing whole-person care that integrates medical care, behavioral health, and social services and supports. The experiences of Maryland, Rhode Island, and Vermont can guide development and implementation of similar OHH initiatives in other states., (Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.)

The authors examined preadolescents' ability to recognize faces of unfamiliar peers according to their attractiveness. They hypothesized that highly attractive faces would be less accurately recognized than moderately attractive faces because the former are more typical. In Experiment 1, 106 participants (M age = 10 years) were asked to recognize faces of unknown peers who varied in gender and attractiveness (high- vs. medium-attractiveness). Results showed that attractiveness enhanced the accuracy of recognition for boys' faces and impaired recognition of girls' faces. The same interaction was found in Experiment 2, in which 92 participants (M age = 12 years) were tested for their recognition of another set of faces of unfamiliar peers. The authors conducted Experiment 3 to examine whether the reason for that interaction is that high- and medium-attractive girls' faces differ more in typicality than do boys' faces. The effect size of attractiveness on typicality was similar for boys' and girls' faces. The overall results are discussed with reference to the development of face encoding and biological gender differences with respect to the typicality of faces during preadolescence.