Coupling Single Photons from Discrete Quantum Emitters in WSe2 to Lithographically Defined Plasmonic Slot Waveguides.

We report the observation of the generation and routing of single plasmons generated by localized excitons in a WSe2 monolayer flake exfoliated onto lithographically defined Au-plasmonic waveguides. Statistical analysis of the position of different quantum emitters shows that they are (3.3 ± 0.7) times more likely to form close to the edges of the plasmonic waveguides. By characterizing individual emitters, we confirm their single-photon character via the observation of antibunching in the signal ( g(2)(0) = 0.42) and demonstrate that specific emitters couple to modes of the proximal plasmonic waveguide. Time-resolved measurements performed on emitters close to and far away from the plasmonic nanostructures indicate that Purcell factors up to 15 ± 3 occur, depending on the precise location of the quantum emitter relative to the tightly confined plasmonic mode. Measurement of the point spread function of five quantum emitters relative to the waveguide with <50 nm precision is compared with numerical simulations to demonstrate the potential for greater increases in the coupling efficiency for ideally positioned emitters. The integration of such strain-induced quantum emitters with deterministic plasmonic routing is a step toward deep-subwavelength on-chip single quantum light sources.

["I would not even think of applying!" - Barriers to Claiming Benefits for Rehabilitation Services for Children and Adolescents from Families' Perspectives]. / "Das würde ich gar nicht erst beantragen!" ­ Barrieren der Inanspruchnahme einer Kinder- und Jugend-Rehabilitations-Maßnahme aus Sicht der Familien.

Background Medical rehabilitation is recognized as an effective health care service to promote and protect health and social participation of children and adolescents. Although the number of children and adolescents with chronic conditions is growing, applications for rehabilitation have declined substantially since 2008. The aim of the study is to identify barriers that prevent families from claiming benefits for rehabilitation services and to give recommendations for actions. Methods In this explorative study, guided qualitative interviews with families with children and adolescents eligible for benefits were conducted. The analysis of the transcribed interviews followed the iterative process of content analysis (deductive and inductive development of main and sub-categories). Results 14 families (with 16 index-children) participated in the study. The results showed high levels of psychosocial burden of families and yet barriers to access services on a structural, disease-specific, and individual level. We identified three main topics in which families recommended modifications: (a) information policy, (b) family centeredness perspectives and flexibility, and (c) cross-sectoral collaboration/health care management. Conclusions Results indicate that families perceive the current pediatric rehabilitation services to lack fitting and flexibility. In general, a new approach of information and counselling, a more family centered perspective and integration of rehabilitation services in a comprehensive and coordinated health care structure are needed.

[Supported own initiative of rehabilitation patients ("new credo") - longterm effects of the nonrandomized trial]. / Begleitete Eigeninitiative nach der Reha ("Neues Credo") - Langzeitergebnisse der quasiexperimentellen Interventionsstudie.

OBJECTIVE: Our project is closely related to the previous study "Rehabilitation aftercare - a new credo for rehabilitation clinics"; the intensified aftercare-strategy was developed by an interdisciplinary group of health professionals and scientists for patients with chronic back pain. Main objective is the resumption and maintenance of regular physical activity in everyday life of pa-tients undergoing rehabilitation. The aim of our present study was to evaluate the long-term (24-month-follow-up) efficacy of the "New Credo" (inpatient medical rehabilitation+intensified aftercare=IG) as compared with usual care (inpatient medical rehabilitation=CG). METHODOLOGY: We conducted a prospective controlled multicentre trial (IG: 3 clinics vs. CG: 3 clinics) with 4 points of measurement (T0: before and T1: after rehabilitation as well as T3: 12 and T4: 24 month after discharge). We enrolled rehabilitants with a primary diagnosis of chronic back pain (ICD-10: M51-54) who had given their consent. Exclusion criteria were mental and/or psychological impairments as well as surgery in the past 6 months. Primary Outcomes included restriction of social participation (IMET) and functional capacity (FFbH-R). Treatment effects were evaluated using analyses of variance and adjusting for differences between baseline -values; furthermore we calculated effect sizes (SMDInter, SMDIntra, ORs). RESULTS: Complete data were available for 123 IG-rehabilitants and 299 CG-participants (Completer-Analysis, response: 52%). Regarding restriction in functional capacity in everyday life (FFbH-R) multivariate analysis confirmed a treatment*time interaction, the appropriate effect-sizes showed no significant effects (SMDInter and SMDIntra). With respect to long-term effects 24 months after discharge no significant effects were found for social participation, however. With respect to secondary outcomes there are no significant differences between the groups (SMDInter, ORs); in fact rehabilitants of both groups showed similar effects (SMDIntra) in most cases. CONCLUSION: In summary our results doesn't confirm that the intensified aftercare-programme is able to improve longer-term effectiveness of inpatient orthopaedic rehabilitation up to 24 month.

Psychosexual development in children with disorder of sex development (DSD)--results from the German Clinical Evaluation Study.

Psychosexual development is influenced by biological and psychosocial factors. Human beings show a great variability in psychosexual development both between and within gender-groups. However, there are relatively stable gender-related behaviors and self-perceptions, in which males and females differ distinctly. There is strong evidence that high concentrations of androgens lead to more male-typical behavior and that this also influences gender identity. Disorders of sex development (DSD) provide the opportunity to analyze the role of different factors on psychosexual development. We examined 166 children age 4 to 12 with DSD using instruments concerning gender role behavior, gender identity, and friendship. Results underline the hypothesis, that androgens play a decisive role in the masculinization of gender role behavior in children. There are also some relations between the experience of gender change and psychosexual outcomes which have to be discussed. Nevertheless, results indicated a high congruence between the children's gender identity and gender of rearing.

Reversal of fortune: commercial HMOs in the Medicaid market.

Between 1992 and 1996 the number of health maintenance organizations (HMOs) entering the Medicaid market grew at an average annual rate of approximately 22 percent. Participation among all ownership segments grew, resulting in a broad distribution of beneficiaries across the HMO industry. However, recent declines in financial performance within the industry appear to be more dramatic for plans with many Medicaid members. In addition, growing concerns about rate adequacy and volatility as well as expanding administrative demands raise questions about the long-term commitment of commercial HMOs to Medicaid participation. This paper analyzes operating characteristics and financial performance of licensed commercial HMOs from 1992 through 1996, drawing on indepth interviews with health plan executives and managed care stock analysts.

Factors associated with changes in satisfaction with care.

OBJECTIVE: Satisfaction with care is an important outcome for evaluating the effectiveness of medical care. Many factors can influence satisfaction, including disease state, healthcare utilization, and health-status changes. However, few studies have investigated the association between these factors and changes in satisfaction. DESIGN: This study examined the influence of personal characteristics, type of health plan, disease states, and healthcare utilization on changes in satisfaction with care in a prospective cohort over a 12-month period through two surveys, baseline and follow-up. PARTICIPANTS: Enrollees in one of three different commercial health plans: point-of-service product, an unrestricted fee-for-service product, and a preferred-provider organization product. MEASUREMENTS AND MAIN RESULTS: Two multivariate logistic regression models were constructed. The first model evaluated factors that predicted increased satisfaction with care between the two surveys. Compared with respondents who reported no change in health status, both those with improved health status (odds ratio [OR], 1.29, 95% confidence interval [CI95], 1.03-1.61) and those with declines in health (OR, 1.29, CI95, 1.03-1.61) were significantly more likely to report an increase in satisfaction with care. Those with a history of hospitalization were also more likely to report an increase in satisfaction with care (OR, 1.27, CI95, 1.01-1.59). The second multivariate logit model evaluated factors that predicted decreases in satisfaction with care from the baseline survey. Those with reported declines in health status were more likely to report decreases in satisfaction with medical care (OR, 1.43, CI95, 1.13-1.79). Neither age, gender, race, type of health plan, disease state, nor doctor's office visits were related to observed changes in satisfaction with medical care. CONCLUSION: Changes in satisfaction with care appear to be related to changes in health status. However, the relation between these two attributes is not intuitively apparent.