Florida: 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.Florida's governor and legislative leadership declined to participate in setting up an Affordable Care Act (ACA) exchange and, indeed, refused or returned federal grants awarded to facilitate exchange planning. Instead, the state provided funding for an existing state-funded exchange for small business and individuals unrelated to the ACA that opened with limited services in spring 2014. Florida led the way in opposition to the ACA. Its then attorney general, Republican Bill McCollum, filed suit against the Obama administration aiming to have the law blocked as unconstitutional in both its individual mandate and its requirement for Medicaid expansion

The Monterey event in the Mediterranean: A record from shelf sediments of Malta

Oligo-Miocene carbonate platform and shelf sediments outcropping on the Maltese Islands provide an excellent archive of the paleoceanography of the central Mediterranean. A sequence of shallow water limestones, than shelf limestones, and marls, followed again by shallow water limestones, reflects drowning of a carbonate platform, the establishment of a shelf environment and, in the late Miocene, renewed progradation and aggradation of shallow water carbonates. The sequence recording the deepening of the Maltese platform contains several phosphorite hardgrounds and phosphorite pebble beds. These phosphorites were dated with strontium isotopes. Major episodes of phosphogenesis occurred between 25 and 16 Ma, and they are coeval with those phosphorite events reported from Florida and North Carolina. A Miocene carbon isotope and oxygen isotope stratigraphy was established on planktic and benthic foraminifera and on bulk samples. A major carbon isotope excursion with an amplitude of up to +l‰ between 18 and 12.5 Ma can be correlated with the globally recognized Monterey carbon isotope excursion. This is the first record of this event both in shallow water sediments and in the Mediterranean. The carbon isotope excursion precedes an oxygen isotope excursion which also was recognized in deep-sea records. Major episodes of phosphogenesis and platform drowning preceded the carbon isotope excursion by up to millions of years

A Heuristic Inquiry: Engaging with Spirituality as Self-Care

This heuristic inquiry explored effective self-care practices, specifically engaging with spirituality, for emerging dance/movement therapists. Guided by a pragmatic paradigm and heuristic methodology, I was the only researcher and participant and I engaged in meditation within nature as a spiritual practice. Data collection methods included completing a semi-structured self-interview after each spiritual practice, creating embodied experiences of spirituality as self-care and filming them, and recording themes from this footage in relation to Laban’s body, effort, shape, and space categories (Moore, 2014). Moustakas’ (1990) data analysis method and creative synthesis were used. Findings revealed that engaging in spiritual self-care fostered increased internal and external awareness, as well as heightened senses. It also contributed to positive physical, mental, and emotional changes, as well as promoting a spiritual relationship between myself and my higher power. Implications from these findings revealed that engaging with spirituality may promote authentic presence and increased self-awareness; facilitate positive physical, mental, and emotional changes; offer personal meaning-making; and nurture relationship with one’s higher power. 95 pages

Setting Eligibility Criteria for a Care-Coordination Benefit

To examine different clinically relevant eligibility criteria sets to determine how they differ in numbers and characteristics of individuals served. Design : Cross-sectional analysis of the 2000 wave of the Health and Retirement Study (HRS), a nationally representative longitudinal health interview survey of adults aged 50 and older. Setting : Population-based cohort of community-dwelling older adults, subset of an ongoing longitudinal health interview survey. Participants : Adults aged 65 and older who were respondents in the 2000 wave of the HRS (n=10,640, representing approximately 33.6 million Medicare beneficiaries). Measurements : Three clinical criteria sets were examined that included different combinations of medical conditions, cognitive impairment, and activity of daily living/instrumental activity of daily living (ADL/IADL) dependency. Results : A small portion of Medicare beneficiaries (1.3–5.8%) would be eligible for care coordination, depending on the criteria set chosen. A criteria set recently proposed by Congress (at least four severe complex medical conditions and one ADL or IADL dependency) would apply to 427,000 adults aged 65 and older in the United States. Criteria emphasizing cognitive impairment would serve an older population. Conclusion : Several criteria sets for a Medicare care-coordination benefit are clinically reasonable, but different definitions of eligibility would serve different numbers and population groups of older adults.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65226/1/j.1532-5415.2005.00496.x.pd

Novel sulfonate compounds

The invention relates to novel sulfonate compounds of formula (I) or (II): wherein the R1 are selected from hydrocarbon radicals having 4 to 26 C atoms and optionally at least one O or s atom; R2 to R5 are each independently selected from hydrogen and hydrocarbon radicals having from 1 to 26 carbon atoms and optionally at least one O or s atom; the R6 are each independently selected from hydrogen and hydrocarbon radicals having from 1 to 6 carbon atoms, wherein the two radicals R.6 optionally, as indicated by the dashed line, are joined together to form a five-or six-membered ring comprising the carbonyl carbon; and each X is independently selected from monovalent and polyvalent cations X.n+, wherein n ≥ 1, including H.+In formula (I), both X together optionally represent a polyvalent cation; and a process for their preparation and their use as surfactants