The Affordable Care Act and Beyond: Opportunities for Advancing Health Equity and Social Justice

In 2010, the most monumental health care legislation in forty-five years was enacted. The Patient Protection and Affordable Care Act ( ACA ) makes changes great and small in virtually every important component of the American health care system. The new law\u27s implications will not be known fully for many years because state governments and federal agencies are in the process of interpreting key provisions, drafting rules and devising general implementation strategies. And, uncertainty exists about the scope of the ACA because of the recent Supreme Court ruling in National Federal of Independent Business v. Sebelius. The court upheld nearly all of the provisions in the ACA, but it ruled that the federal government cannot withhold Medicaid funds from states that refuse to expand their Medicaid programs to cover individuals with incomes of as much as 133 percent of the federal poverty level. This article seeks to analyze the most significant changes that affect communities of color and to examine the resulting health equity and social justice implications. Part I explains the moral and economic case for eliminating racial and ethnic health care disparities. Part II analyzes provisions in the new law designed to expand access to health insurance. Part III focuses on the special access challenges communities of color face and how the ACA provisions attempt to address these. Part IV examines key ACA provisions that are explicitly intended to reduce health disparities and improve the health of racially and ethnically diverse populations. Part V argues that achieving health equity for racial and ethnic minority groups will require policy strategies focused outside of the health care arena. This article concludes with recommendations on how to leverage federal spending to advance racial and ethnic equality

Precise time and time interval users, requirements and specifications

The functional areas of application of Precise Time and Time Interval (PTTI) were considered and expanded. A comprehensive overview of the PTTI requirements and applications would provide an opportunity for individuals working in a specific functional area. Mutual problems, requirements, applications or successes shared by those in other functional areas were studied. Based upon the results of a two year study a compendium of PTTI requirements, applications and the means of meeting the requirements among Department of Defense components, other government agencies and major commercial users was compiled and is presented. It was found that the planning process for PTTI support for new acquisitions or new programs was less than a well defined, coordinated process. The processes are described in general terms and a generic model for requirements determination and subsequent coordination which may enhance the planning process and introduce cost benefits to the program is also presented

Mortality, protoplasm decay rate, and reliability of staining techniques to recognise 'living' foraminifera: a review.

Non-vital staining, especially with rose Bengal, has been widely used in ecological studies to differentiate between the tests of dead(unstained) foraminifera from those presumed to be living at the time of collection (stained). Doubts have been expressed about staining methods because of the possibility that dead individuals may retain undecayed protoplasm for weeks or months after death; when stained, such individuals would be recorded as living. To assess the importance of such false positives, it is necessary to examine rates of mortality, and the modes of generation of empty tests, i.e., whether due to reproduction, growth stages (leaving empty tests during growth) or death. It can be argued that reproduction, ontogeny, and death through predation lead to tests devoid of protoplasm. Whereas reproduction may affect only a small proportion of the population of each species (due to high pre-reproductive mortality), predation in oxygenated environments may be responsible for the major part of that pre-reproductive mortality. In oxygenated environments, disease or adverse environmental conditions are most likely to lead to dead individuals having tests containing protoplasm. In dysaerobic/anoxic environments, predation by macrofauna may be excluded, so foraminifera die through other causes and thus more tests with dead protoplasm may be potentially available for staining. Therefore, for most other environments, the problem of staining dead individuals is almost certainly overstated. Furthermore, from comparative studies, it seems that the most commonly used technique (staining with rose Bengal) is as reliable as others. Now that new vital staining techniques, especially the use of fluorescent probes, are being introduced, it is timely for further objective comparative studies of all techniques to be made in order to evaluate data already gathered and to develop the best strategies for future ecological studies according to whether they are field-based or experimental

Department of Defense Precise Time and Time Interval program improvement plan

The United States Naval Observatory is responsible for ensuring uniformity in precise time and time interval operations including measurements, the establishment of overall DOD requirements for time and time interval, and the accomplishment of objectives requiring precise time and time interval with minimum cost. An overview of the objectives, the approach to the problem, the schedule, and a status report, including significant findings relative to organizational relationships, current directives, principal PTTI users, and future requirements as currently identified by the users are presented

Higgs-Boson Two-Loop Contributions to Electric Dipole Moments in the MSSM

The complete set of Higgs-boson two-loop contributions to electric dipole moments of the electron and neutron is calculated in the minimal supersymmetric standard model. The electric dipole moments are induced by CP-violating trilinear couplings of the `CP-odd' and charged Higgs bosons to the scalar top and bottom quarks. Numerical estimates of the individual two-loop contributions to electric dipole moments are given.Comment: 12 pages, LaTeX, two encapsulated figure

Investing in Health to Improve the Wellbeing of the Disadvantaged: Reversing the Augment of the Marmot Reports

The Marmot reports have argued that health inequalities are the result of social inequalities. They advocate reducing health inequalities by undertaking fundamental changes that make society fairer. We argue that the focus should be on improving the health and wellbeing of the disadvantaged, even if the policies that do this also raise the health of the better off, and worsen inequality. We also argue that the causality runs from health to social status, and that health interventions are needed to improve socioeconomic outcomes. While we disagree on goals and mechanisms we are in surprisingly close agreement with Marmot Reports on policies. In particular, we agree with the focus on in early childhood investments in health and physical and cognitive development that have long term socioeconomic payoffs. We also endorse making society fairer, though mainly as a goal in itself rather than an instrument to reduce health inequality.health inequality, early childhood investments, Marmot Reports

Electrical control of flame carbon

Imperial Users onl