Forging a New Path: Opportunities to Lead on Small Business Health Insurance

Professional paper for the fulfillment of the Master degree.The Office of the Mayor of Saint Paul engaged four students at the Humphrey School of Public Affairs at the University of Minnesota to research the viability of a small business health insurance pool. It was believed that creation of a citywide insurance pool for small businesses could reduce costs. Based on our research, our findings suggest that it is not viable for the City of Saint Paul to pursue the creation of a small business health insurance pool due to current legal, political, and economic conditions and realities. However, we understand that the larger goal of this research was not just to evaluate the viability of insurance pools but to examine the landscape for opportunities to lessen the burden of health care costs for small businesses while maintaining consumer protections and quality of the plans offered. We have identified two opportunities for the Mayor and his office to provide leadership to address the problem. We found in our interviews with small business owners that there is a need for more clarity and quality in the information available to business owners when they choose their plans. The creation of an Information Hub, or supporting the establishment of one by a third party, is a way that the City can directly address this specific issue. Additionally, there is an opportunity to create positive change by leading a coalition of cities and business association leaders in an effort to change laws at the state level to provide more flexibility for small businesses to access cheaper, high‐quality health insurance plans

Gluino Contribution to the 3-loop QCD beta function in the Minimal Supersymmetric Standard Model

We deduce the gluino contribution to the three-loop QCD \beta function within the minimal supersymmetric Standard Model (MSSM) from its standard QCD expression. The result is a first step in the computation of the full MSSM three-loop \beta function. In addition, in the case of a light gluino it provides the strong three-loop SUSY correction to the extrapolation of the strong coupling constant from the low energy regime to the Z region and up to the squark threshold.Comment: 11 pages, RevTex, 4 Postscript figur

Standardizing kilonovae and their use as standard candles to measure the Hubble constant

The detection of GW170817 is revolutionizing many areas of astrophysics with the joint observation of gravitational waves and electromagnetic emissions. These multimessenger events provide a new approach to determine the Hubble constant, thus, they are a promising candidate for mitigating the tension between measurements of type-Ia supernovae via the local distance ladder and the cosmic microwave background. In addition to the "standard siren"provided by the gravitational-wave measurement, the kilonova itself has characteristics that allow one to improve existing measurements or to perform yet another, independent measurement of the Hubble constant without gravitational-wave information. Here, we employ standardization techniques borrowed from the type-Ia community and apply them to kilonovae, not using any information from the gravitational-wave signal. We use two versions of this technique, one derived from direct observables measured from the light curve, and the other based on inferred ejecta parameters, e.g., mass, velocity, and composition, for two different models. These lead to Hubble constant measurements of H0=109-35+49 km s-1 Mpc-1 for the measured analysis, and H0=85-17+22 km s-1 Mpc-1 and H0=79-15+23 km s-1 Mpc-1 for the inferred analyses. This measurement has error bars within ∼2 to the gravitational-wave measurements (H0=74-8+16 km s-1 Mpc-1), showing its promise as an independent constraint on H0

Measuring the Hubble constant with a sample of kilonovae

Kilonovae produced by the coalescence of compact binaries with at least one neutron star are promising standard sirens for an independent measurement of the Hubble constant (H0). Through their detection via follow-up of gravitational-wave (GW), short gamma-ray bursts (sGRBs) or optical surveys, a large sample of kilonovae (even without GW data) can be used for H0 contraints. Here, we show measurement of H0 using light curves associated with four sGRBs, assuming these are attributable to kilonovae, combined with GW170817. Including a systematic uncertainty on the models that is as large as the statistical ones, we find H0 ¼ 73:8þ6:3 5:8 km s1 Mpc1 and H0 ¼ 71:2þ3:2 3:1 km s1 Mpc1 for two different kilonova models that are consistent with the local and inverse-distance ladder measurements. For a given model, this measurement is about a factor of 2-3 more precise than the standard-siren measurement for GW170817 using only GWs

When to start antiretroviral therapy in resource-limited settings: a human rights analysis

<p>Abstract</p> <p>Background</p> <p>Recent evidence from developed and developing countries shows clear clinical and public health benefit to starting antiretroviral therapy (ART) earlier. While discussions about when to start ART have often focused on the clinical risks and benefits, the main issue is one of fair limit-setting. We applied a human rights framework to assess a policy of early treatment initiation according to the following criteria: public-health purpose; likely effectiveness; specificity; human rights burdens and benefits; potential for less restrictive approaches; and fair administration.</p> <p>Discussion</p> <p>According to our analysis, a policy of earlier ART initiation would better serve both public health and human rights objectives. We highlight a number of policy approaches that could be taken to help meet this aim, including increased international financial support, alternative models of care, and policies to secure the most affordable sources of appropriate antiretroviral drugs.</p> <p>Summary</p> <p>Widespread implementation of earlier ART initiation is challenging in resource-limited settings. Nevertheless, rationing of essential medicines is a restriction of human rights, and the principle of least restriction serves to focus attention on alternative measures such as adapting health service models to increase capacity, decreasing costs, and seeking additional international funding. Progressive realisation using well-defined steps will be necessary to allow for a phased implementation as part of a framework of short-term targets towards nationwide policy adoption, and will require international technical and financial support.</p

Astronomical Distance Determination in the Space Age: Secondary Distance Indicators

The formal division of the distance indicators into primary and secondary leads to difficulties in description of methods which can actually be used in two ways: with, and without the support of the other methods for scaling. Thus instead of concentrating on the scaling requirement we concentrate on all methods of distance determination to extragalactic sources which are designated, at least formally, to use for individual sources. Among those, the Supernovae Ia is clearly the leader due to its enormous success in determination of the expansion rate of the Universe. However, new methods are rapidly developing, and there is also a progress in more traditional methods. We give a general overview of the methods but we mostly concentrate on the most recent developments in each field, and future expectations. © 2018, The Author(s)

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700