Europe and Central Asia's great post-communist social health insurance experiment : impacts on health sector and labor market outcomes

The post-communist transition to social health insurance in many of the Central and Eastern European and Central Asian countries provides a unique opportunity to try to answer some of the unresolved issues in the debate over the relative merits of social health insurance and tax-financed health systems. This paper employs a regression-based generalization of the difference-in-differences method and instrumental variables on panel data from 28 countries for the period 1990-2004. The authors find that, controlling for any concurrent provider payment reforms, adoption of social health insurance increased national health spending and hospital activity rates, but did not lead to better health outcomes. The authors also find that adoption of social health insurance reduced employment in the economy as a whole and increased unemployment, although it did not apparently increase the size of the informal economy.Health Monitoring&Evaluation,Health Systems Development&Reform,Population Policies,Health Economics&Finance,Disease Control&Prevention

System-wide impacts of hospital payment reforms : evidence from central and eastern Europe and central Asia

Although there is broad agreement that the way that health care providers are paid affects their performance, the empirical literature on the impacts of provider payment reforms is surprisingly thin. During the 1990s and early 2000s, many European and Central Asian countries shifted from paying hospitals through historical budgets to fee-for-service or patient-based-payment methods (mostly variants of diagnosis-related groups). Using panel data on 28 countries over the period 1990-2004, the authors of this study exploit the phased shift from historical budgets to explore aggregate impacts on hospital throughput, national health spending, and mortality from causes amenable to medical care. They use a regression version of difference-in-differences and two variants that relax the difference-in-differences parallel trends assumption. The results show that fee-for-service and patient-based-payment methods both increased national health spending, including private (out-of-pocket) spending. However, they had different effects on inpatient admissions (fee-for-service increased them; patient-based-payment had no effect), and average length of stay (fee-for-service had no effect; patient-based-payment reduced it). Of the two methods, only patient-based-payment appears to have had any beneficial effect on"amenable mortality,"but there were significant impacts for only a couple of causes of death, and not in all model specifications.Health Monitoring&Evaluation,Health Systems Development&Reform,Health Economics&Finance,Health Law,Population Policies

Future potential net primary production trends of contiguous United States rangelands

Rangelands are an important ecosystem covering nearly 24% of the earth’s terrestrial vegetation. Climate change is predicted to affect many of the factors that influence the production of rangeland vegetation. Understanding future trends and patterns in net primary production (NPP) requires projected potential NPP to better understand how rangelands will be affected by a changing climate. Here, I used climate data projected from a global climate model (GCM) to drive the biogeochemical model (Biome-BGC) in an attempt to simulate future potential NPP trends in rangelands of the contiguous United States from 2001-2100 on a 100 km2 scale. In response to the simulated climate projections, I found an overall slight increase in potential NPP throughout time. However, these increases were not spatially consistent; in some areas, NPP decreased substantially. Biome-BGC found three distinct zones that have similar potential NPP trends and primary correlating climatic factors that drove these trends. The south western portion of the United States may see a decrease in NPP driven mostly by a decrease in moisture. This simulation indicates a rise in NPP in the Great Plains mostly from c4 grasses driven primarily by an increase in temperature. Furthermore, it projects little to no change in The Great Basin driven by a combination of a slight increase in precipitation and maximum temperature

Core reduction for singular Riemannian foliations in positive curvature

We show that for a smooth manifold equipped with a singular Riemannian foliation, if the foliated metric has positive sectional curvature, and there exists a pre-section, that is a proper submanifold retaining all the transverse geometric information of the foliation, then the leaf space has boundary. In particular, we see that polar foliations of positively curved manifolds have leaf spaces with nonempty boundary.Comment: 12 page

Case Report : Widespread rash in an immunocompromised 31-year-old female : Case report and literature search

A 31-year-old female presents with a widespread vesicular and papular rash involving her anterior and posterior trunk, proximal extremities, neck, and face with sparing of soles and palms. Her past medical history is significant for Philadelphia chromosome and BCR-ABL positive chronic myelogenous leukemia (CML) diagnosed in 2011 and now s/p allogenic hematopoietic stem-cell transplant (HSCT) and subsequent CNS recurrence. Five days before presenting, the rash initially began around her vagina and coccyx and spread laterally to the left and onto her medial buttock and is associated with significant pernineal swelling

The Boundary Conjecture for Leaf Spaces

We prove that the boundary of an orbit space or more generally a leaf space of a singular Riemannian foliation is an Alexandrov space in its intrinsic metric, and that its lower curvature bound is that of the leaf space. A rigidity theorem for positively curved leaf spaces with maximal boundary volume is also established and plays a key role in the proof of the boundary problem.Comment: 7 page

Maxillariella vulcanica

Maxillariella vulcanica is recognized by the ascending habit, slender cane-like stems bearing few, ellipsoid pseudobulbs. The flowers are white, diversely su used and spotted with pink, the lip bears a conspicuous callus near the middle, and the column is prominently fringed apically. It was previously known from Ecuador and Peru, and is here recoded for Colombia as well.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Jardín Botánico Lankester (JBL

Masdevallia racemosa

Masdevallia racemosa, an endemic species from the Central Cordillera in Cauca department, is recognized by its long repent habit, with a creeping or ascending rhizome, a loose inflorescence of successive and simultaneous intense red-orange flowers, deeply connate sepals forming sepaline tube, elliptical acute petals and an oblong lip. Like other Masdevallia species with large, brightly-colored flowers, M. racemosa is commonly believed to be hummingbird pollinated. Nevertheless, the morphology of petals, lip and column, as can be seen in the LCDP, is consistent with fly pollination instead.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Jardín Botánico Lankester (JBL

Masdevallia coccinea

Masdevallia coccinea is a widely distributed species in the Eastern Cordillera of Colombia, being locally abundant. It is “a most remarkable plant”, with large, bright red flowers. The lateral sepals are tail-less, and the tail of the dorsal sepal is commonly erect, sometimes directed either slightly backwards or forwards.UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Agroalimentarias::Jardín Botánico Lankester (JBL