Relative Affordability of Health Insurance Premiums under CHIP Expansion Programs and the ACA

Affordability is integral to the success of health care reforms aimed at ensuring universal access to health insurance coverage, and affordability determinations have major policy and practical consequences. This article describes factors that influenced the determination of affordability benchmarks and premium-contribution requirements for Children's Health Insurance Program (CHIP) expansions in three states that sought to universalize access to coverage for youth. It also compares subsidy levels developed in these states to the premium subsidy schedule under the Affordable Care Act (ACA) for health insurance plans purchased through an exchange. We find sizeable variability in premium-contribution requirements for children's coverage as a percentage of family income across the three states and in the progressivity and regressivity of the premium-contribution schedules developed. These findings underscore the ambiguity and subjectivity of affordability standards. Further, our analyses suggest that while the ACA increases the affordability of family coverage for families with incomes below 400 percent of the federal poverty level, the evolution of CHIP over the next five to ten years will continue to have significant implications for low-income families.     

An analytical evaluation of eight on-site oral fluid drug screening devices using laboratory confirmation results from oral fluid

A decaying cadaver emits volatile organic compounds that are used by necrophilous and necrophagous insects in order to find their brood substrate. Although volatile organic compounds (VOCs) that are released by carcasses have been identified, little is known about the specific compounds that are used by these insects while searching for a brood substrate. Therefore, we have investigated the chemical ecology involved in the attraction of the necrophagous hide beetle Dermestes maculatus, which feeds as an adult and larva upon decomposing carcasses. Our aims have been to identify the responsible compounds in the odours of the carcass that are important for the attraction of the beetles. Furthermore, we have studied sex- and age-related differences in beetle attraction and tested whether the hide beetle can distinguish between various stages of decomposition by means of the emitted odours. Headspace collection of volatiles released from piglet carcasses (bloated stage, post-bloating stage, advanced decay and dry remains), coupled gas chromatography-mass spectrometry (GC-MS), gas chromatography with electroantennographic detection (GC-EAD) and bioassays were conducted to identify the volatiles responsible for the attraction of the beetles. Freshly emerged male beetles were attracted by the odour of piglets in the post-bloating stage (9 days after death; T(mean) = 27 °C) and the EAD-active compound benzyl butyrate. Statistical analysis revealed a higher relative proportion of benzyl butyrate in the odour bouquet of the post-bloating stage in comparison with the other stages. We therefore conclude that this compound plays an important role in the attraction of hide beetles to carcass odour. This underlines the potential use of D. maculatus for the estimation of the post mortem interval. The decomposition stage at which the female beetles are attracted to the odour of a cadaver remains unknown, as does the nature of this attraction. Pheromones (sexual or aggregation pheromones) might play an essential role correlated with their attraction to carrion and consequently with their attraction to the substrate for mating and ovipositioning.     

Why Muslims like democracy yet have so little of it

This paper explains the observed combination of relatively low levels of democracy and positive attitudes towards it in the Muslim world. It argues that this democracy paradox is understandable from the perspective of the principle of diminishing marginal utility: people value highly that of which they have little. This reasoning implies, however, that surveys like the World Values Surveys (WVS) elicit circumstance-driven marginal preferences rather than culturally determined attitudinal traits. Empirical evidence showing that individuals living in undemocratic societies have much more favorable inclinations towards democracy supports our argument.     

Criminal Violence and Democratization in Central America: The Survival of the Violent State

Why does Nicaragua have less violent crime than Guatemala, El Salvador, and Honduras? All these countries underwent political transitions in the 1990s. Many explanations point to the legacies of war, socioeconomic underdevelopment, and neoliberal structural reforms. However, these arguments do not fully explain why, despite economic reforms conducted throughout the region, war‐less Honduras and wealthier Guatemala and El Salvador have much more crime than Nicaragua. This article argues that public security reforms carried out during the political transitions shaped the ability of the new regimes to control the violence produced by their own institutions and collaborators. In the analysis of the crisis of public security, it is important to bring the state back. The survival of violent entrepreneurs in the new security apparatus and their relationship with new governing elites foster the conditions for the escalation of violence in northern Central America.     

A brain penetration after Taser injury: Controversies regarding Taser gun safety

We report the case of a 27 year old man who was injured by a Taser gun device which penetrated the frontal part of the skull and damaged the underlying frontal lobe. Cerebral penetration was revealed by a brain CT scan. A neurosurgical procedure was required to remove the dart from the skull and brain and the evolution was successful allowing discharge of the patient one week later. There were no additional lesions, particularly electrifying lesion, as only one probe had penetrated the skull. We also observed the length of a Taser dart is sufficient to allow brain penetration. Fortunately, no infection or neurological complication occurred following brain injury. This case study underlines the potential risk induced by the use of Taser stun gun. Although generally regarded as a safe alternative, serious injuries have however been reported and questions regarding the safety of the device still remains unresolved.     

Severe necrosis of oesophageal and gastric mucosa in fatal methanol poisoning

Methanol is a potent neurotoxic substance that causes severe metabolic acidosis and serious neurological disorders. Most of the cases are accidental exposures to drinking beverages contaminated with methanol. There are few articles reporting pure methanol intoxication; however, it is well known that small quantities of pure methanol causes blindness and death, the minimum lethal dose being 50-100 ml.A case report is presented of a 67-year-old woman, who committed suicide by ingestion of 500 ml of absolute methanol. Despite symptomatic and supportive intensive care, the woman died 23 h after hospital admission due to metabolic acidosis and multiple organ dysfunction syndrome. A complete medico-legal autopsy was performed. Grossly, there was complete detachment of the oesophagus mucosa and brownish discolouration of the gastric mucosa. Histological findings showed diffuse haemorrhagic necrosis of the stomach mucosa and intense acute inflammatory infiltration of the lamina propria. To our knowledge, this is the first autopsy report of such severe digestive injuries. A discussion and review of the recent literature on the subject are given.     

Law’s Cultural Project and the Claim to Universality or the Equivocalities of a Familiar Debate

Do our present circumstances allow us to defend a specific connection (that specific connection) between ?legal rules?, ?moral claims? and ?democratic principles? which we may say is granted by an unproblematic presupposition of universality or by an ?acultural? experience of modernity? In order to discuss this question, this paper invokes the challenge-visée of a plausible reinvention of Law??s autonomous project (a reinvention which may be capable of critically re-thinking and re-experiencing Law??s constitutive cultural-civilizational originarium in a ?limit-situation? such as our own). The discussion is developed by recognising that the claim to universality is not only incompatible with a substantive conception of juridicalness as validity but also sustained with difficulty by a procedural representation of discourse and rationality (a representation which, against its own conclusion-claims, could also be said to be culturally and civilizationally bounded). Not forgetting some specific features of contemporary juridical pluralism??namely that which emerges from the counterpoint between semiotic groups or interpretative communities (and their differently assumed claims of intersemioticity concerning the signifier law)??this train of reflection diagnoses briefly a sequence of complementary main difficulties (as ?obstacles? to recognising Law??s demand as an unmistakable cultural project), namely those arising from the formalistic normativistic inheritance (confounding legal autonomy with isolationism), from the challenges and seductions of practical holism (justifying a continuum in which Law??s project loses its sense and autonomy), and also from the familiar debate between exclusive and inclusive versions of positivism and non-positivism (a debate which establishes-consecrates an equivocal counterpoint between Law and Morality).     

Quantification of the subpubic angle in South Africans

Due to the high crime rate in South Africa, forensic anthropologists are increasingly approached to aid in the identification of skeletonized remains, with sex and population affinity assignment being some of the most critical tasks they face. For over a century, the pelvis has been known to be one of the most sexually dimorphic bones of the human body and the subpubic angle is one of the most accurate, albeit scarcely quantified, features thereof. Hence, the aim of this study was to quantify the size of the subpubic angle and compare it between male and female South Africans of African (black) and European (white) descent. One hundred and forty five (145) pelves were selected, consisting of 68 white (43 male and 25 female) and 77 black South Africans (44 male and 33 female), from the Raymond A. Dart Collection of Human Skeletons housed at the University of the Witwatersrand, Johannesburg, South Africa. Each of the pelves were articulated and placed into a custom built stand for photographing. Measures of the subpubic angle from these digital images were subjected to numerous statistical analyses. Results indicated that significant differences exist between the sexes, as well as between the two population groups. For black individuals it was found that males generally possessed a subpubic angle of 74.9° or less, with larger values being indicative of the female sex. For white individuals, subpubic angles of 81.4° and less indicated males whilst larger values indicated females, with an average accuracy of 86% for both population groups. These results illustrate the advantages of using the subpubic angle to assist in the estimation of sex and population affinity and also reinforce the need for population specific parameters to be applied.     

Are there population differences in minutiae frequencies? A comparative study of two Argentinian population samples and one Spanish sample

In recent years, both scientific and judicial sources have highlighted the need for more knowledge about minutiae variability, in order to improve their statistical application to fingerprint identification. In line with this trend toward improving our knowledge of this subject, the aim of the present study was to calculate the frequency with which 20 types of minutiae appeared in 2780 fingerprint impressions obtained from 278 individuals from two Argentinian population samples (100 individuals from Ramal and 178 from Puna-Quebrada). The different types of minutiae were located, identified, and quantified visually in two areas on the fingerprint, the inside and outside of a circle, the radius of which cut fifteen ridges perpendicularly, starting from the center cut of the axes defining the sectors. The non-equiprobability found in both population samples for the different minutiae types studied demonstrated that the evidential weight provided by these characteristics is not the same when applied in identification processes, whether used quantitatively (numerical standard) or qualitatively (holistic method). The results obtained for both populations were compared statistically with those published previously for a Spanish population sample, which had been collected using the same methodology. This comparison has enabled us to demonstrate, for the first time, the existence of significant differences between populations in minutiae frequencies, independently from the main pattern type.     

The Grey Threat: Presence of Jihadist Terrorism and Failings in the Portuguese National Security System

This article starts by establishing a link between the nature of the threats created by jihadist terrorism and global organized crime and the investigation model used by Portuguese intelligence and police entities to detect and eliminate them. The visible manifestations of jihad terrorism and related organized crime recorded in Portugal since 2001 are also documented. The article goes on to analyze most recent theories produced on the importance of intelligence work and criminal investigation in combating these threats. On this basis, the article raises the hypothesis that Portugal's capacity to confront these threats has been dangerously weakened by the investigation powers constraints and conflicts of jurisdiction in the national security system, the lack of effective coordination in the whole system, and delays in the necessary reforms for over a decade.