The Uninsured at the Starting Line: Findings from the 2013 Kaiser Survey of Low-Income Americans and the ACA

In January 2014, the major coverage provisions of the 2010 Affordable Care Act (ACA) went into full effect. These provisions include the creation of new Health Insurance Marketplaces where low and moderate income families can receive premium tax credits to purchase coverage and, in states that opted to expand their Medicaid programs, the expansion of Medicaid eligibility to almost all adults with incomes at or below 138% of the federal poverty level (FPL). The ACA has the potential to reach many of the 47 million Americans who lack insurance coverage, as well as millions of insured people who face financial strain or coverage limits related to health insurance. Though implementation is underway and people are already enrolling in coverage, policymakers continue to need information to inform coverage expansions. Data on the population targeted for coverage expansions can help policymakers target early efforts, provide insight into some of the challenges that are arising in the first months of new coverage, and evaluate the ACA's longer-term effects. The Kaiser Family Foundation has launched a new series of comprehensive surveys of the low and moderate income population to provide data on these groups' experience with health coverage, current patterns of care, and family situation. This report, based on the baseline 2013 Kaiser Survey of Low-Income Americans and the ACA, provides a snapshot of health insurance coverage, health care use and barriers to care, and financial security among insured and uninsured adults across the income spectrum at the starting line of ACA implementation. The report also examines how findings from the baseline survey can help policymakers understand and address early challenges in implementing health reform

Security Sector Reform in the Western Balkans: An Economic Perspective

Security sector reform is a fairly new concept in the world of political development. Security sector reform often requires the development of various agencies and actors within the government, prompting high costs as these developments occur. However, in light of the recent economic crisis, there has been little economic growth in the Western Balkan countries. Despite this lack of growth, security sector reform has continued to occur. This paper seeks to answer to what extent each country’s economic development (or lack thereof) has impacted their security sector reform. Using the definition established by the OECD, this paper analyzes security sector reform in three countries: Bosnia and Herzegovina, Serbia, and Greece. The first two countries analyzed are current analyses, while the third is a historical analysis of Greece’s security sector reform including the initial security sector reform after democratization. The analysis is completed using the four sectors of security sector reform listed in the OECD’s definition – core security actors, security management and oversight bodies, justice and law enforcement institutions, and non-statutory security forces – to measure growth in the security sector. In each country analyzed, the growth in these sub-sectors of security reform will be compared to the growth or lack of growth in that country’s GDP to understand how security sector reform is financed, and if there are elements outside of a country’s GDP that impact how they fund reform of their security sectors

Infection frequently triggers thrombotic microangiopathy in patients with preexisting risk factors : a single-institution experience

Thrombotic microangiopathies are rare conditions characterized by microangiopathic hemolytic anemia, microthrombi, and multiorgan insult. The disorders, which include hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, are often acute and life threatening. We report a retrospective analysis of 65 patients presenting to our institution from 1997 to 2008 with all forms of thrombotic microangiopathy. Therapeutic plasma exchange was a requirement for analysis and 65 patients were referred to our institution; 66% of patients were female and median age at presentation was 52 years. Bacterial infection was the most commonly identified etiologic factor and in the multivariate model was the only significant variable associated with survival outcome (odds ratio 5.1, 95% confidence interval, 1.2-21.7). As infection can be considered a common trigger event for thrombotic microangiopathy, patients with hepatobiliary sepsis may benefit from elective cholecystectomy. We conclude that bacterial infection frequently triggers TTP and other thrombotic microangiopathies in patients with preexisting risk factors and propose a model for the development of these syndromes

The Impact of the Economic Crisis on English Language Teaching in Greece: a Case Study of a Language School

The ongoing financial crisis and subsequent austerity measures imposed on Greece have impacted heavily on the country. While recent studies have highlighted the effect on health and other social services, the domain of education remains under-researched, especially in the field of EFL (English as a Foreign Language) provision. Due to the long-standing deficiencies in the state education system, most EFL students attend private language schools (frontistiria); in a time of economic crisis this presents certain challenges for the students and the frontistiria themselves. A case study approach was used to explore this issue. The investigation identified certain ways in which a single language school is being affected by the crisis. Non-payment of school fees can be seen to have resulted in delayed salary payments to the staff, while student exam choice has also been influenced by the current economic situation. Insights from behavioural economics and theories of decision making under uncertainty were drawn upon to help in understanding choices made by stakeholders at the school. Bourdieusian notions of linguistic capital were also utilised and behavioural economic theory applied to these conceptualisations of capital. The study suggests that with private EFL tuition still in demand, the school and its stakeholders are adapting old ways to respond to a new situation

Social proximity and user-generated health content : an experimental test of perceived source similarity and construal level theory

The affordances of the internet, particularly as manifest in social network site platforms, allow for interpersonal mediated communication with socially proximal sources. In a 3 (expert source cues vs. low cues vs. low cue) �-2 (socially proximal vs. distal source cues) online between-subjects experiment (n = 305), this study explores how source cues indicating expertise and social proximity affect assessment of interpersonal similarity and user-generated health messages. Assessment of interpersonal similarity moderates the impact of source proximity cues on assessments of messages, which in turn influence health-related behavioral intentions. In a test of construal level theory, results also show that psychological proximity to message sources influences how readers construe the actions depicted in those messages and how they describe beliefs related to message topics. The findings from this study add to the literature on perceived similarity as a variable relevant to health communication and identify mediated interpersonal health content as a domain ripe for further study. They also extend the application of construal level theory by demonstrating how psychological distance from sources influences reactions to messages produced by those sources