28 research outputs found
Health insurance coverage among farmworkers in California before and after the introduction of the Affordable Care Act (ACA): A mixed methods study
No full textAbstract
Background: Previous studies have found that although health insurance coverage expanded for farmworkers after the introduction of the Patient Protection and Affordable Care Act (ACA), coverage levels were lower than the general population. California recently introduced policies to expand coverage for previously excluded undocumented workers. This study examines the impact of the ACA on insurance coverage for farmworkers and identifies barriers to further expansion.Methods: A mixed methods approach was utilized. Weighted statistical analyses were conducted on the National Agriculture Worker Survey (NAWS) data for 2011-12, 2015-16 and 2017-18 to study health insurance coverage before and after the introduction of the ACA. Qualitative interviews were conducted with growers, healthcare providers and community-based organizations to examine ACA related changes in health insurance for farmworkers.Results: The ACA led to doubling of health insurance coverage for farmworkers in California (32.0%: 2011-12 to 64.8%: 2017-18), with higher rates for documented (43.0%: 2011-12: to 77.7%: 2017-18) than undocumented workers (2011-12: 26.0% to 2017-18: 46.8%), which were lower than rates for non-agricultural workers (73%). Barriers to obtaining coverage include the high cost of insurance for growers, high deductibles and copays for farmworkers and distrust of government agencies.Conclusions: While the ACA led to significant improvements in health insurance coverage for farmworkers in CA, significant barriers remain for farmworkers seeking to obtain insurance and for growers seeking to provide coverage.Policy Implications: States should consider funding a farmworker specific Medicaid program to provide health insurance coverage and care coordination across counties and states
A Decentralised Model of School Management
No full textThe Panchayat Elementary Education Officer (PEEO) structure in Rajasthan offers a model for decentralising school management to the level of each Gram Panchayat. This model was initiated in 2015-16 across the state and evolved into its current form by 2017-18.
In the PEEO structure, the idea of block-level functionaries and cluster-level functionaries providing administrative and academic support, respectively, to schools was transformed into a decentralised structure at the level of each Gram Panchayat. The principal of the higher secondary school in the Gram Panchayat was appointed as the PEEO with the responsibility of administering all the schools in the same Gram Panchayat and improving the quality of education.
The Editorial Committee of Learning Curve has put this article together based on conversations with stakeholders closest to the reform, with support from members of the Azim Premji Foundation working with Government Schools in Rajasthan
Clustering In Data Mining
No full textAbstract--Clustering is the most commonly used technique of data mining under which patterns are discovered in the underlying data. This paper presents that how clustering is carried out and the applications of clustering. It also provides us with a framework for the mixed attributes clustering problem and also shows us that how the customer data can be clustered identifying the high-profit, high-value and low-risk customers
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An Examination of the Existing Patterns of Healthcare Utilization, Barriers to Health System Integration, and the Role of Digital Health Interventions in creating an integrated healthcare system for Agricultural Workers in California
No full textIntroduction: Previous studies on healthcare utilization among California agricultural workers California report low usage despite high vulnerability. Many studies are outdated with limited scope, and do not reflect the impact of recent policy changes. This study examines the effects of distance, socioeconomic, structural, and cultural factors on healthcare access with the actual and intended healthcare utilization patterns under the current policy framework. Digital health interventions rapidly expanded during the COVID-19 pandemic and can help overcome many obstacles. This study further examines digital access and utilization patterns among workers, the perspectives of providers and advocates on their usage, and proposes delivery models that might enhance care integration.Methods: UCM FWHS was used to examine the patterns and predictors of delay in seeking services, actual and intended healthcare utilization through Chi-square tests, linear and logistic regressions. Additionally, NAWS 2018 digital access supplement and CHIS 2021-22 surveys were used to study digital access and utilization. Thirty-eight semi-structured interviews were also conducted with healthcare providers, employers, and advocates to understand their perspectives on the barriers to access and utilization. Subsequently, 20 semi-structured interviews were conducted with providers and advocates to seek their views on digital health utilization and recommendations for health integration for state agricultural workers.
Results: Cost, transportation, distrust, inconvenience, and lack of culturally competent care had a more significant impact on healthcare utilization than distance. Workers without health insurance and lower health literacy were less likely to use healthcare services. They had high digital inclusion, but lower health-related utilization, compared with the general population of California. Models for digital health integration include a hybrid model engaging Promotoras through home visits or telehealth access points, creating a separate healthcare system, or binational plans with digitally integrated services.
Conclusions: A multimodal approach is needed to address healthcare needs among agricultural workers in California that incorporates the provision of affordable, convenient, high-quality, culturally competent services.
Policy implications: Expanding health insurance coverage, using culturally competent health education programs, including digital outreach, and implementing pilot projects using hybrid models of digital health integration incorporating financial incentives for providers and trained Promotoras can improve healthcare utilization among workers
π-conjugated Polymers with Complex Architectures
No full textControlled polymerization has enabled the precise synthesis of functionalized poly(3-hexylthiophene) (P3HT) and poly(3-hexylselenophene) (P3HS) “building blocks” capable of being used to construct polymers with complex architectures. In particular, the study of comb and bottlebrush polymers presents a unique and exciting opportunity to further the development of a potential class of functional materials for optoelectronics. First, the evaluation of a synthetic graft-to methodology using copper-catalyzed click chemistry to construct P3HT-graft-poly(3-alkylselenophene) comb copolymers is presented (Chapter 2). After examining a variety of synthetic conditions, it was found that the graft-to ligation strategy is appropriate for the synthesis of low- to mid-grafting density comb copolymers. The synthesis and self-assembly of densely-grafted P3HT homopolymer bottlebrushes synthesized using a graft-through methodology is also examined (Chapter 3). When thermally annealed in thin films the bottlebrush polymers linearly assemble end-on-end to form ultralong fibers. This interesting morphology is driven by π-π stacking and attractive n-hexyl interdigitation interactions at bottlebrush polymer termini, and has not previously been observed. Continuing studies on bottlebrush copolymers are also described (Chapter 4). Block copolymer bottlebrushes containing low volume fractions of P3HT are successfully synthesized in a reproducible manner, demonstrating the first graft-through strategy to result in controlled polymerization of P3HT block copolymer bottlebrushes. The copolymer bottlebrushes are extensively characterized in thin films and in solution, where their optical properties and morphologies are driven by P3HT chain interactions. Finally, preliminary results on the synthesis of all-π-conjugated bottlebrush copolymers containing P3HT and P3HS are presented (Chapter 5). Ultimately, this thesis outlines new synthetic strategies and self-assembly behaviors of π-conjugated materials with complex architectures.Ph.D
Characterization of Receptor Kinases and Downstream Signalling Components Involved in Fusarium Head Blight Resistance
No full textFusarium Head Blight (FHB) is a devastating disease that affects wheat, barley and other small grain crops. Despite huge economic losses, current measures have not yielded desirable resistance to FHB. Resistance to F. graminearum is quantitative and thus identification of putative transmembrane receptors and signalling components involved in plant immunity will help combat this disease. A reverse genetic screen using 249 T-DNA Arabidopsis mutant plants identified two putative leucine-rich transmembrane localized receptors, RLK7 and APEX and a downstream signalling component RbohF as contributors to FHB resistance. The expression analysis suggested that RLK7 and APEX activated distinct hormone signalling pathways, ethylene and salicylic acid, to mediate the resistance. Our analyses indicated that as an intracellular signalling component, RbohF integrates signals from these hormone signalling pathways to regulate stomatal pore closures, a potential entry point for the pathogen. Overall, our findings identified key genes involved in mediating quantitative resistance to F. graminearum
