Texas: Round 1 - 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.Since the Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010, Texas has reviewed and debated the different policy directives of the legislation. In 2011, Texas decided against administering a state-run health insurance exchange and opted in to a federally run exchange. This decision occurred prior to the Supreme Court decision on the constitutionality of ACA provisions. In 2013, after the 2012 Supreme Court decision allowed states to decide whether to expand Medicaid, Texas chose not to expand Medicaid eligibility and enrollment

Does glucosamine relieve arthritis joint pain?

Glucosamine may provide some pain relief. Studies have shown varied results, ranging from glucosamine being superior or equivalent to other agents, to no difference between glucosamine and placebo. However, most of these studies have small sample sizes, short duration, and often other significant flaws. Meta-analyses of available studies suggest a trend toward benefit from glucosamine (strength of recommendation: B). Glucosamine may help osteoarthritis pain, but it is premature to recommend it universally until better studies are done. Even if glucosamine is effective, this sector of the market is currently unregulated, and products may not contain the amount or kind of glucosamine material advertised on their labels

Asparagine and glutamine: using hydrogen atom contacts in the choice of side-chain amide orientation

Small-probe contact dot surface analysis, with all explicit hydrogen atoms added and their van der Waals contacts included, was used to choose between the two possible orientations for each of 1554 asparagine (Asn) and glutamine (Gln) side-chain amide groups in a dataset of 100 unrelated, high-quality protein crystal structures at 0.9 to 1.7 AÊ resolution. For the movable-H groups, each connected, closed set of local H-bonds was optimized for both H-bonds and van der Waals overlaps. In addition to the Asn/Gln ``¯ips'', this process included rotation of OH, SH, NH 3, and methionine methyl H atoms, ¯ip and protonation state of histidine rings, interaction with bound ligands, and a simple model of water interactions. However, except for switching N and O identity for amide ¯ips (or N and C identity for His ¯ips), no non-H atoms were shifted. Even in these very high-quality structures, about 20 % of the Asn/Gln side-chains required a 180 ¯ip to optimize H-bonding and/o

Privatizing Functions of State Government

Privatization of traditional governmental functions has been extensively discussed in the United States for more than two decades, and states have chosen a wide range of programs for privatization and selected a variety of implementation and oversight strategies. In this report we examine the potential for privatization, privatization pitfalls, and ways to optimize the success of privatization effects. Privatization can be attractive for one of two different reasons. It may provide a revenue benefit when the contracting entity can provide the service at a lower cost than that experienced by the governing entity. Typically, lower costs arise from lower personnel costs or through the use of less expensive methods and technologies, including IT solutions. It may also be attractive because privatization may allow government to perform specific services more effectively or more efficiently than it could with its own employees. Typically, these situations occur when a private entity can be more flexible in the deployment of personnel and resources andwhen dealing with new technologies or processes.Includes bibliographical reference

Belief propagation algorithm for computing correlation functions in finite-temperature quantum many-body systems on loopy graphs

Belief propagation -- a powerful heuristic method to solve inference problems involving a large number of random variables -- was recently generalized to quantum theory. Like its classical counterpart, this algorithm is exact on trees when the appropriate independence conditions are met and is expected to provide reliable approximations when operated on loopy graphs. In this paper, we benchmark the performances of loopy quantum belief propagation (QBP) in the context of finite-tempereture quantum many-body physics. Our results indicate that QBP provides reliable estimates of the high-temperature correlation function when the typical loop size in the graph is large. As such, it is suitable e.g. for the study of quantum spin glasses on Bethe lattices and the decoding of sparse quantum error correction codes.Comment: 5 pages, 4 figure

Alien plant invasions in South Africa: Driving forces and the human dimension

Invasive alien plants pose a substantial threat to the rich biodiversity of South Africa, and to the sustained delivery of a wide range of ecosystem services. Biological invasions are driven by human activities and mediated by culturally shaped values and ethics. This paper explores the human dimensions of alien plant invasions in South Africa. We consider four primary forces, those which directly influence the likelihood and rate of invasion — arrival of propagules; changes in disturbance regimes; changes in the availability of limiting factors; and fragmentation of the landscape — and the roles of 22 secondary driving forces in shaping the outcomes of the four primary driving forces. Human societies and their dynamics and activities are an integral part of each of the secondary driving forces. A map of the interactions between and among the primary and secondary driving forces shows how they are interlinked and influence each other — either positively or negatively, or switching between the two. There are two key points for intervention: prevention of the introduction of propagules of potentially invasive species and developing collaborative initiatives with enterprises that rely largely on alien species (for example, horticulture, agriculture and forestry, including community forestry) to minimize the introduction and use of potentially invasive species. An example of the first type of intervention would be to implement more effective inspection systems at international border and customs posts. This type of intervention can only be effective if those who are directly affected — whether businessmen, tourists or migrants — understand the requirement for these measures, and collaborate. The need to build public awareness of the critical importance of the human dimension of invasions emerges as a key theme from this analysis and is the basis for better-informed decisions, more effective control programmes and a reduction of further invasions

Central Nervous Control of Blood Pressure in Man; Preliminary Report

Electrical activity of the brain, eye movements, arterial pressure, heart rate, and respiratory rate and depth have been recorded continuously during a night of sleep not induced by drugs in 22 healthy subjects, two hypertensive patients, and one anephric man who was awaiting renal transplantation. Sleep was associated with reduction in arterial pressure averaging 50 mm Hg systolic and 30 mm Hg diastolic. Dreams, although occasionally associated with marked elevation of blood pressure, were usually accompanied by no change or a slight fall in pressure. The dramatic paroxysmal electroencephalographic alterations termed K complexes, occurring spontaneously or after a noise in sleep of moderate depth, were followed within two or three heart beats by abrupt elevation in arterial pressure, as much as 35 mm Hg, lasting 10 to 20 seconds. Blockade with propranolol of β-adrenergic receptors, which mediate cardio-excitatory effects of sympathetic nerve discharge, did not modify the hypertension following K complexes. Cerebral activity, transmitted by sympathetic peripheral vasoconstrictor pathways, is an important regulator of blood pressure during sleep in man

Method and apparatus for testing surface characteristics of a material

A method, apparatus and system for testing characteristics of a material sample is provided. The system includes an apparatus configured to house the material test sample while defining a sealed volume against a surface of the material test sample. A source of pressurized fluid is in communication with, and configured to pressurize, the sealed volume. A load applying apparatus is configured to apply a defined load to the material sample while the sealed volume is monitored for leakage of the pressurized fluid. Thus, the inducement of surface defects such as microcracking and crazing may be detected and their effects analyzed for a given material. The material test samples may include laminar structures formed of, for example, carbon cloth phenolic, glass cloth phenolic, silica cloth phenolic materials or carbon-carbon materials. In one embodiment the system may be configured to analyze the material test sample while an across-ply loading is applied thereto

Institutional Effects of Term Limits In Missouri1

Missouri adopted term limits in 1992 but the limits did not take full effect until 2003 in the House and will take full effect in the Senate in 2005. Missouri's limit is a lifetime limit of eight years in each chamber, for a total of sixteen years. Initially the limit applied to partial terms for those elected in a special election but the amendment was revised in 2002 to exclude from the circulation service of less then one-half a term (i.e. one year in the House or two years in the Senate). The amendment can be found in article III, section 8 of the Missouri Constitution. In January 2003, no member of the House had served more than six consecutive years and in January 2005, no member of the Senate will have served more than six consecutive years. Those who have written about term limits do not agree about the probable effects and researchers have found that the effects of term limits vary significantly from state to state (see attached bibliography). This report draws on legislative data compiled by the Missouri Secretary of State, a legislative survey, and interviews to examine the impact of term limits on legislative leaders, new member learning and specialization, the role of legislative staff, and evolving lobbyingstrategies.Includes bibliographical reference