Pennsylvania: Base Line Report - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Although the ACA will no doubt have real financial consequences for insurers, hospitals, and health care providers, at this early stage in implementation, it is difficult to calculate precise gains and losses. For example, the Hospital Association of Pennsylvania supported the ACA, believing, in part, that reform was necessary to reduce current levels of uncompensated care and to reduce reliance on emergency care for patients who put off treatment for as long as possible to avoid out-of-pocket costs. The association agreed to significant cuts in Medicare and Medicaid to support the bill's passage. However, because cost savings from universal coverage have not yet been realized, hospitals reported cutting staff in April 2014 to offset the loss of Medicaid and Medicare funding. Safety net hospitals, which are required to serve all populations, seem especially affected, as many of their patients who fall into the Medicaid coverage gap are still showing up in emergency rooms without insurance

Mexican drug cartels and their Australian connections: tracking and disrupting dark networks

For Australia, the emergence of Mexican drug cartels presents significant policymaking, intelligence and strategic challenges. The size of these operations, their resource base and the fluid nature of dark network structures makes these enterprise syndicates a highly versatile and resilient opponent. This paper will provide an analysis of the organisational levels of dark networks in dealing with Mexican drug cartels and explores how these profit-seeking transnational actors form and operate including their motivations and modus operandi. It will also address the problematic nature of dark networks and the importance of robust intelligence collection and analysis capabilities to better prioritise border protection responses as well as to increase the ability of the security sector to target dispersed ‘webs’ of illicit affiliations, with a focus on the Asia-Pacific region

Submission in response to the Australian Government’s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse

A submission in response to the Australian Government\u27s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse. Introduction We are a team of academics and researchers, from the disciplines of historical studies, social work and archival science, who have substantive years of experience working on projects exploring the legacy of Australia\u27s institutional \u27care\u27 of children. Our work in this space, particularly since the release of the Forgotten Australians report in 2004, has involved ongoing engagement with a broad range of stakeholders, including care leavers, support and advocacy groups, past and current providers of out-of-home care, state and federal government departments, and cultural institutions. We welcome the opportunity to make a submission in response to the Australian Government\u27s Consultation Paper on the Establishment of the Royal Commission into Institutional Responses to Child Sexual Abuse. Our submission discusses the vital importance that records will play in this Royal Commission, with particular reference to records in the custody of past providers in religious, charitable and government sectors. We submit that records are a key issue for this Royal Commission

Quality of life of patients treated surgically for head and neck cancer

The quality of survival of 48 patients treated surgically for head and neck cancer was assessed using a problem-orientated self-administered questionnaire. The questionnaire was based on the European Organization for Research into the Treatment of Cancer (EORTC) core questionnaire to which a specific head and neck module was added. The following domains were studied: pain, fatigue, physical symptoms (gastrointestinal and 'other'), functional activity, psychological symptoms, overall physical condition and overall quality of life. For the analysis, five groups of patients were considered: laryngectomy (n = 15), pharyngolaryngoesophagectomy (n = 5), craniofacial procedure (n = 11), 'other operations' (n = 9) and patients with disease recurrence (n = 8). Each group identified different problem areas. Laryngectomees and 'other operation' patients reported relatively few problems, whereas patients with disease recurrence described difficulties in all of the domains examined. Symptoms of fatigue were common. Information collected in this way may facilitate improved rehabilitation and thus better quality of survival

Flux calculations in an inhomogeneous Universe: weighting a flux-limited galaxy sample

Many astrophysical problems arising within the context of ultra-high energy cosmic rays, very-high energy gamma rays or neutrinos, require calculation of the flux produced by sources tracing the distribution of galaxies in the Universe. We discuss a simple weighting scheme, an application of the method introduced by Lynden-Bell in 1971, that allows the calculation of the flux sky map directly from a flux-limited galaxy catalog without cutting a volume-limited subsample. Using this scheme, the galaxy distribution can be modeled up to large scales while representing the distribution in the nearby Universe with maximum accuracy. We consider fluctuations in the flux map arising from the finiteness of the galaxy sample. We show how these fluctuations are reduced by the weighting scheme and discuss how the remaining fluctuations limit the applicability of the method.Comment: 8 pages, 10 figures, accepted for publication in MNRA

Cognitive and affective components of challenge and threat states

We explored the cognitive and affective components of the Theory of Challenge and Threat States in Athletes (TCTSA) using a cross-sectional design. One hundred and seventy-seven collegiate athletes indicated how they typically approached an important competition on measures of self-efficacy, perceived control, achievement goals, emotional states and interpretation of emotional states. Participants also indicated to what extent they typically perceived the important competition as a challenge and/or a threat. The results suggest that a perception of challenge was not predicted by any of the cognitive components. A perception of threat was positively predicted by avoidance goals and negatively predicted by self-efficacy and approach goals. Both challenge and threat had a positive relationship with anxiety. Practical implications of this study are that an avoidance orientation appeared to be related to potentially negative constructs such as anxiety, threat and dejection. The findings may suggest that practitioners and researchers should focus on reducing an avoidance orientation, however the results should be treated with caution in applied settings, as this study did not examine how the combination of constructs exactly influences sport performance. The results provided partial support for the TCTSA with stronger support for proposed relationships with threat rather than challenge states

What is psychosis? A meta-synthesis of inductive qualitative studies exploring the experience of psychosis

Qualitative studies have played an important role in elucidating the lived experience of psychosis and there has recently been an increase in the number of such studies. There is now an urgent need to draw together the findings of these studies. This paper performed a meta-synthesis of inductive qualitative peer-reviewed research into psychosis. Ninety-eight articles were identified for systematic appraisal. Four themes, ‘Losing’, ‘Identifying a need for, and seeking, help’, ‘Rebuilding and reforging’, and ‘Better than new: gifts from psychosis’, were identified. The important implications these themes for clinicians and future research are examined upon. These findings also highlight that the experience of psychosis is much more than simply just hallucinations and/or delusions

Cities, The Sharing Economy and What's Next

This report seeks to provide an analysis of what is currently happening in American cities so that city leaders may better understand, encourage and regulate the growing sharing economy. Interviews were conducted with city officials on the impact of the sharing economy and related topics, and the report centers around five key themes: innovation, economic development, equity, safety and implementation.The sharing economy is also commonly referred to as collaborative consumption, the collaborative economy, or the peer-to-peer economy. This term refers to business models that enable providers and consumers to share resources and services, from housing to vehicles and more. These business models typically take the form of an online and/or application-based platform for business transactions

Family and peer modeling of alcohol use in African American college students [abstract]

Abstract only availableFamily influences on alcohol consumption have received considerable research attention. However relatively little research has examined this aspect of the alcoholism risk process for African Americans. This study tested whether familial influences on participant drinking differed as a function of socioeconomic status. The study sample consisted of 141 African American college students (mean age = 21.89, SD = 1.24; 41% male). The association between participant report of family drinking (father, mother, sibling), peer drinking and personal drinking levels were tested. Next, tests were ran to determine whether these associations differed by socioeconomic status. Results indicated that mother, sibling, and peer drinking were associated with participant drinking, but father drinking and socioeconomic status were not. There was evidence for moderation, with socioeconomic status having a greater impact on participant drinking for those reporting high maternal drinking. These results highlight the need for more complex models to test the effect of contextual factors, such as family drinking and socioeconomic status on alcohol use