What About Mom? The Forgotten Beneficiary of the Medicaid Expansions

This paper contributes to evidence regarding the effectiveness of the Medicaid expansions by focusing on a key beneficiary - the mother - who has previously been overlooked. Using the Natality Detail Files for 1989-96, we estimate the relationship between Medicaid eligibility and maternal health outcomes for several treatment groups and a control group. Potential biases caused by improved reporting are addressed by using a 'straw man' maternal complication not preventable with prenatal care. Our results suggest that increased Medicaid eligibility lead to fewer preventable maternal complications among women most likely to have benefited from the Medicaid expansions.Maternal health; Medicaid; Prenatal care

Acidified and ultrafiltered recovered coagulants from water treatment works sludge for removal of phosphorus from wastewater

This study used a range of treated water treatment works sludge options for the removal of phosphorus (P) from primary wastewater. These options included the application of ultrafiltration for recovery of the coagulant from the sludge. The treatment performance and whole life cost (WLC) of the various recovered coagulant (RC) configurations have been considered in relation to fresh ferric sulphate (FFS). Pre-treatment of the sludge with acid followed by removal of organic and particulate contaminants using a 2kD ultrafiltration membrane resulted in a reusable coagulant that closely matched the performance FFS. Unacidified RC showed 53% of the phosphorus removal efficiency of FFS, at a dose of 20 mg/L as Fe and a contact time of 90 min. A longer contact time of 8 h improved performance to 85% of FFS. P removal at the shorter contact time improved to 88% relative to FFS by pre-acidifying the sludge to pH 2, using an acid molar ratio of 5.2:1 mol H+:Fe. Analysis of the removal of P showed that rapid phosphate precipitation accounted for >65% of removal with FFS. However, for the acidified RC a slower adsorption mechanism dominated; this was accelerated at a lower pH. A cost-benefit analysis showed that relative to dosing FFS and disposing waterworks sludge to land, the 20 year WLC was halved by transporting acidified or unacidified sludge up to 80 km for reuse in wastewater treatment. A maximum inter-site distance was determined to be 240 km above the current disposal route at current prices. Further savings could be made if longer contact times were available to allow greater P removal with unacidified RC

Big Cities. Big Water. Big Challenges: Water in an Urbanizing World.

This paper applies the water footprint methodology to six megacities across Africa, Asia, and Latin America to explore the effect of urbanization on water use and demand and determine what measures need to be taken to meet this demand. Key threats to water resources in many or all of the cities studied include: water stress or scarcity, pollution and decreasing water quality, and vulnerability to extreme weather caused by climate change

Coagulant recovery and reuse for drinking water treatment

Coagulant recovery and reuse from waterworks sludge has the potential to significantly reduce waste disposal and chemicals usage for water treatment. Drinking water regulations demand purification of recovered coagulant before they can be safely reused, due to the risk of disinfection by-product precursors being recovered from waterworks sludge alongside coagulant metals. While several full-scale separation technologies have proven effective for coagulant purification, none have matched virgin coagulant treatment performance. This study examines the individual and successive separation performance of several novel and existing ferric coagulant recovery purification technologies to attain virgin coagulant purity levels. The new suggested approach of alkali extraction of dissolved organic compounds (DOC) from waterworks sludge prior to acidic solubilisation of ferric coagulants provided the same 14:1 selectivity ratio (874 mg/L Fe vs. 61 mg/L DOC) to the more established size separation using ultrafiltration (1285 mg/L Fe vs. 91 mg/L DOC). Cation exchange Donnan membranes were also examined: while highly selective (2555 mg/L Fe vs. 29 mg/L DOC, 88:1 selectivity), the low pH of the recovered ferric solution impaired subsequent treatment performance. The application of powdered activated carbon (PAC) to ultrafiltration or alkali pre-treated sludge, dosed at 80 mg/mg DOC, reduced recovered ferric DOC contamination to <1 mg/L but in practice, this option would incur significant costs. The treatment performance of the purified recovered coagulants was compared to that of virgin reagent with reference to key water quality parameters. Several PAC-polished recovered coagulants provided the same or improved DOC and turbidity removal as virgin coagulant, as well as demonstrating the potential to reduce disinfection byproducts and regulated metals to levels comparable to that attained from virgin material

Reuse of recovered coagulants in water treatment: An investigation on the effect coagulant purity has on treatment performance

Coagulant recovery offers many potential benefits to water treatment, by reducing chemical demand and waste production. The key obstacle to successful implementation is achieving the same levels of treatment quality and process economics as commercial coagulants. This study has evaluated the selectivity of pressure-filtration in the role of a low-cost coagulant recovery technology from waterworks sludge. The treatment performance of the purified recovered coagulant was directly compared to fresh and raw recovered coagulants. DOC and turbidity removal by recovered coagulants was close to that of commercial coagulants, indicating that coagulant can be successfully recovered and regenerated by acidifying waterworks sludge. However, performance was less consistent, with a much narrower optimum charge neutralisation window and 10–30% worse removal performance under optimum conditions. This inferior performance was particularly evident for recovered ferric coagulants. The impact of this was confirmed by measuring THM formation potential and residual metals concentrations, showing 30–300% higher THMFPs when recovered coagulants were used. This study confirms that pressure-filtration can be operated on an economically viable basis, in terms of mass flux and fouling. However, the selectivity currently falls short of the purity required for potable treatment, due to incomplete rejection of sludge contaminants

The natural history of unassisted smoking cessation in Australian ex-smokers

This thesis builds on work in the field of self-change from addictive behaviours. I have used a grounded theory methodology to investigate how and why Australian smokers quit smoking unassisted, that is, without professionally mediated behavioural assistance or pharmacotherapy. My research was specifically designed to provide an in-depth understanding of the complex process of smoking cessation from the ex-smokers’ perspective. As such, this thesis provides insights into: (1) prevalence of unassisted quitting in Australia; (2) reasons why Australian smokers choose to quit unassisted; (3) process of quitting; and (4) conditions that characterise a successful quit attempt. In this thesis I draw together these findings to present a typology of quitting (measured, opportunistic, naïve or unexpected) based on four key characteristics found in participants’ accounts of quitting: presence of a clearly identifiable trigger, evidence of preparation, amount of effort invested in quitting, and speed of onset of quitting. This thesis also presents a detailed account of how ex-smokers can be classified in terms of the patterns of use (or non-use) of assistance across their quitting history, concluding that two experiences were common to all participants: almost no one quit at their first attempt and almost everyone started out quitting unassisted. Finally, I report a core concept, ‘being serious’ and explain how this concept provides an alternative to the commonly used concepts – motivation, willpower, determination and commitment. ‘Being serious’ draws on all of my earlier findings. I propose ‘being serious’ typically requires the coming together of three critical elements: previous experience of quitting, an identity (or existential threat) and suitable timing and circumstances. I conclude by suggesting dichotomising assisted and unassisted quitting is unhelpful and instead argue, based on my research findings, the two processes have more commonalities than differences

How Have Descriptions of the Arab-Israeli Conflict Changed in High School U.S. History Textbooks Since the 1950s?

This study is a qualitative and quantitative analysis of textbook content regarding the Arab-Israeli conflict, among three of the top textbook publishers in the United States from the 1950s to the present. The goal of this study was to highlight whether there has been more or less emphasis on particular events over time, and identify major patterns and changes in textbook content on the Arab-Israeli conflict. This thesis also addresses some of the historic, political, social, and educational implications of those changes. The conclusions and recommendations portion of the research contains suggestions for overcoming the limitations of textbook portrayals of the Arab-Israeli conflict

Indigenous Feminists Are Too Sexy for Your Heteropatriarchal Settler Colonialism

Within the creation myths of the United States, narratives portray Native peoples as hypersexualized and sexually desiring white men and women. Native men in captivity narratives are portrayed as wanting to rape white women and Native women such as Pocahontas are constituted as desiring the love and sexual attention of white men at the expense of her Native community. In either of these accounts of settler colonialism, Native men and women’s sexualities are read as out of control and unable to conform to white heteropatriarchy. Many Native peoples respond to these images by desexualizing our communities and conforming to heteronormativity in an attempt to avoid the violence of settler-colonialism. I interrogate these images and provide sex-positive alternatives for Native nation building as an important means of decolonizing Native America