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Health Insurance Coverage before and after the Affordable Care Act in the USA
The Affordable Care Act (ACA) is at the crossroads. It is important to evaluate the effectiveness of the ACA in order to make rational decisions about the ongoing healthcare reform, but existing research into its effect on health insurance status in the United States is insufficient and descriptive. Using data from the National Health Interview Surveys from 2009 to 2015, this study examines changes in health insurance status and its determinants before the ACA in 2009, during its partial implementation in 2010–2013, and after its full implementation in 2014 and 2015. The results of trend analysis indicate a significant increase in national health insurance rate from 82.2% in 2009 to 89.4% in 2015. Logistic regression analyses confirm the similar impact of age, gender, race, marital status, nativity, citizenship, education, and poverty on health insurance status before and after the ACA. Despite similar effects across years, controlling for other variables, youth aged 26 or below, the foreign-born, Asians, and other races had a greater probability of gaining health insurance after the ACA than before the ACA; however, the odds of obtaining health insurance for Hispanics and the impoverished rose slightly during the partial implementation of the ACA, but somewhat declined after the full implementation of the ACA starting in 2014. These findings should be taken into account by the U.S. Government in deciding the fate of the ACA.
Journal Article
Keith's story
Details Keith's adventures from his days as a pilot at Galaxy Garrison to how he became a Paladin of Voltron andthe truth behind his past.
Book
Clinical Presentation and Management of a Dinutuximab Beta Extravasation in a Patient with Neuroblastoma
Extravasation can present serious accidental complication of intravenous drug application. While monoclonal antibodies do not show the necrotic potential of cytotoxic chemotherapy drugs, considerable inflammatory toxicity can occur, necessitating standardized operating procedures for the management of their extravasation. Here, we report the clinical course and management of dinutuximab beta extravasation in a 3-year-old child. Dinutuximab beta is a chimeric monoclonal antibody targeting the GD2 disialoganglioside on the surface of neuroblastoma cells that has in recent years gained significant importance in the treatment of high-risk neuroblastoma, now contributing to both first- and second-line therapy protocols. The dinutuximab beta extravasation reported here occurred when the patient received the antibody cycle as a continuous infusion over a 10-day period after haploidentical stem cell transplantation for relapsed high-risk neuroblastoma. The extravasated dinutuximab beta caused local pain, swelling, and hyperemia accompanied by fever and an overall deterioration in the general condition. Laboratory diagnostics demonstrated an increase in C-reactive protein level and total white blood cell count. Clinical complication management consisted of intravenous fluid therapy, local dabbing with dimethyl sulfoxide (DMSO), analgesia with dipyrone, as well as application of intravenous antibiotics to prevent bacterial superinfection in the severely immunocompromised host. The patient considerably improved after six days with this treatment regimen and fully recovered by day 20.
Journal Article
When mutants attack!
When the meanest mutants in New York City join together, the Teenage Mutant Ninja Turtles must use everything in their arsenal to stop them.
Book
Seedless Extractors
Randomness is a powerful tool, exploited almost everywhere in computer science – from cryptography, to distributed computing, to algorithm design and more. Unfortunately, most of these applications require access to perfectly uniform bits, while randomness harvested from nature (e.g., atmospheric noise, radioactive decay, other quantum phenomena) rarely looks so pure. This motivates the study of randomness extractors, which are deterministic algorithms that convert weak sources of randomness into uniformly random bits.The study of extractors dates back over 70 years, and has blossomed into a beautiful theory with deep connections to cryptography, complexity theory, and combinatorics. As it is impossible to construct a single extractor that works for all weak sources of randomness, research on extractors has split into two complementary settings: (1) the seeded setting, where the extractor is equipped with a short uniform seed to help extract bits from the weak source; and (2) the seedless setting, where the extractor is given no seed, but the weak source is equipped with some additional structure. While a rich body of work has culminated in near-optimal seeded extractors, we are still far from constructing optimal seedless extractors.In this thesis, we explicitly construct new seedless extractors that significantly improve the previous state-of-the-art. To build our extractors, we exploit new reductions within pseudorandomness, and unearth new connections to extremal combinatorics, communication complexity, and coding theory. Along the way, we unlock exciting new applications in cryptography, complexity theory, and beyond.
Dissertation
Lethal force
\"In the final volume of Dixon's Nightwing run, Dick Grayson is emotionally and physically pushed to his breaking point. Dick Grayson searches within for what it is to be a hero in the aftermath of the Joker's latest reign of terror. Just before he can catch his breath, another shocking development threatens everything he has ever known, as Bruce Wayne is charged with murder! This volume also features appearances from the Flash, Blue Beetle and the rest of the Bat-Family.\"-- Provided by publisher.
Book
The Relationship of the Opportunity Myth and Quality of Education for Socioeconomically Disadvantaged High School Students
Providing students with access to a quality education equips students with the skills necessary to compete in a competitive economy (Roser, Nagdy, & Ortiz-Ospina, 2015). One of the major dilemmas faced by high school graduates is that they are entering a work force without the necessary skills to perform well on the job (TNTP, 2018). The current gaps can be further addressed through the assurance of instructional practices that are properly aligned with the assessments or measurements of student learning (Abrams, Varier, & Jackson, 2016). Students also need to be in an environment where they are supported by their teachers and are able to achieve long-lasting academic growth (Hwang et al., 2014).
Dissertation
Health Insurance Coverage Before and After The Affordable Care Act
Inadequate research has examined the effect of the Affordable Care Act (ACA) on health insurance status in the United States after its full implementation as data were released only recently. This study analyzes changes in health insurance status and its determinants before the ACA, after its partial implementation in 2010-2013, and after its full implementation in 2014 and 2015. Data from the 2009-2015 National Health Interview Surveys are used to address the research problem and test the hypotheses for this study. The trend analysis shows that the national health insurance rate increased significantly from 82.2 percent in 2009 to 89.4 percent in 2015. The results of logistic regression analysis reveal that age, gender, race, marital status, nativity, U.S. citizenship status, education, and poverty level influenced health insurance status consistently before and after the Affordable Care Act. While the effects of several predictors were either identical or similar across years, holding other variables constant those aged 26 or younger, the foreign-born, Asians, and other races had greater odds of getting health insurance after the ACA than they did before the ACA; however, the likelihood of gaining health insurance for Hispanics and people living under poverty increased slightly during the partial implementation of the ACA but somewhat decreased after the full implementation of the ACA starting in 2014. The findings help assess the effectiveness of the ACA and have significant implications for the pending healthcare reform.
Dissertation
A Palaeolimnological Determination of a Regional Industrial Signal in the Sediments of Mpumalanga Highveld Pans
Fresh water endorheic wetlands are a scarce resource in South Africa and are threatened by human activities such as mining, abstraction, farming and other industry. The Mpumalanga Lake District (MLD) is a unique region comprising of over 300 endorheic pans differing in type. This provided the ideal regional setting for a pilot palaeolimnological study. The overall aim was to identify a regional industrial signal for anthropogenic influence by understanding the uniqueness of these pans through a palaeolimnological approach using historical lake sediments. A historical sediment record was established in order to identify any temporal changes in physiochemical characteristics over the last approximately 130 years. Four sites were selected so as to analyse a spatial aspect of contamination and to compare physical characteristics of pans in the MLD. Sediment samples were collected in the form of four lake sediment cores which were sub-sampled at 0.5 cm in order to understand down core trends. A bathymetric approach was adopted in which GPS, depth and water quality data were obtained in order to understand the physiochemical characteristics and morphology of these pans. Analyses performed included radio-isotopic dating through210Pb, organic carbon content analysis through Loss on Ignition methods, sediment grain size analysis using laser diffraction and the analysis of the composition of major elements in these lake sediments using x-ray fluorescence (XRF) spectrometry. Bathymetry data was used to produce maps representing the physical morphological characteristics of these pans. Sediment data including major elements, organic carbon content and grain size data was analysed statistically and represented graphically in order to understand down core trends.Identified was the uniqueness of these pans and the MLD region as a whole. The pans differed in size, depth and in terms of the sediment properties of organic carbon, carbonate and sediment grain size distribution. Results showed a distinct difference between sites TPE compared to the other three sites in terms of bathymetry and limnology. It was determined that there are multiple fluctuations throughout the sediment record which represents a seasonal variation in climatic conditions. An attempt to observe trends of environmental and climatic change was made with varied success. An identification of a possible regional industrial signal was made with respect to major element compositional changes however the distinction between natural and anthropogenic sources was difficult to determine
Dissertation