Endeavors Update, Iowa Medicaid Enterprise, Vol. 1, Issue 10 May 26, 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, Vol. 1, Issue 11 June 23, 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, September 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, October 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, November 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, December 2011

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, January 2012

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Changes in the risk of death after HIV seroconversion compared with mortality in the general population.

CONTEXT: Mortality among human immunodeficiency virus (HIV)-infected individuals has decreased dramatically in countries with good access to treatment and may now be close to mortality in the general uninfected population. OBJECTIVE: To evaluate changes in the mortality gap between HIV-infected individuals and the general uninfected population. DESIGN, SETTING, AND POPULATION: Mortality following HIV seroconversion in a large multinational collaboration of HIV seroconverter cohorts (CASCADE) was compared with expected mortality, calculated by applying general population death rates matched on demographic factors. A Poisson-based model adjusted for duration of infection was constructed to assess changes over calendar time in the excess mortality among HIV-infected individuals. Data pooled in September 2007 were analyzed in March 2008, covering years at risk 1981-2006. MAIN OUTCOME MEASURE: Excess mortality among HIV-infected individuals compared with that of the general uninfected population. RESULTS: Of 16,534 individuals with median duration of follow-up of 6.3 years (range, 1 day to 23.8 years), 2571 died, compared with 235 deaths expected in an equivalent general population cohort. The excess mortality rate (per 1000 person-years) decreased from 40.8 (95% confidence interval [CI], 38.5-43.0; 1275.9 excess deaths in 31,302 person-years) before the introduction of highly active antiretroviral therapy (pre-1996) to 6.1 (95% CI, 4.8-7.4; 89.6 excess deaths in 14,703 person-years) in 2004-2006 (adjusted excess hazard ratio, 0.05 [95% CI, 0.03-0.09] for 2004-2006 vs pre-1996). By 2004-2006, no excess mortality was observed in the first 5 years following HIV seroconversion among those infected sexually, though a cumulative excess probability of death remained over the longer term (4.8% [95% CI, 2.5%-8.6%] in the first 10 years among those aged 15-24 years). CONCLUSIONS: Mortality rates for HIV-infected persons have become much closer to general mortality rates since the introduction of highly active antiretroviral therapy. In industrialized countries, persons infected sexually with HIV now appear to experience mortality rates similar to those of the general population in the first 5 years following infection, though a mortality excess remains as duration of HIV infection lengthens.

Endeavors Update, Iowa Medicaid Enterprise, February 2012

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, April 2012

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, May 2012

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

Endeavors Update, Iowa Medicaid Enterprise, July 2012

The Iowa Medicaid Enterprise (IME) is an endeavor, started in 2005, to unite State staff with “best of breed” contractors into a performance-based model for administration of the Medicaid program.

The evolution of judgement bias in indirect reciprocity.

Indirect reciprocity is a form of reciprocity where help is given to individuals based on their reputation. In indirect reciprocity, bad acts (such as not helping) reduce an individual's reputation while good acts (such as helping) increase an individual's reputation. Studies of indirect reciprocity assume that good acts and bad acts are weighted equally when assessing the reputation of an individual. As different information can be processed in different ways, this is not likely to be the case, and it is possible that an individual could bias an actor's reputation by putting more weight to acts of defection (not helping) than acts of co-operation (helping) or vice versa. We term this difference 'judgement bias', and build an individual-based model of image scoring to investigate the conditions under which it may evolve. We find that, if the benefits of co-operation are small, judgement bias is weighted towards acts perceived to be bad; if the benefits are high, the reverse is true. Our result is consistent under both scoring and standing strategies, and we find that allowing judgement bias to evolve increases the level of co-operation in the population.

Social inequalities of functioning and perceived health in Switzerland: a representative cross-sectional analysis.

Many people worldwide live with a disability, i.e. limitations in functioning. The prevalence is expected to increase due to demographic change and the growing importance of non-communicable disease and injury. To date, many epidemiological studies have used simple dichotomous measures of disability, even though the WHO's International Classification of Functioning, Disability, and Health (ICF) provides a multi-dimensional framework of functioning. We aimed to examine associations of socio-economic status (SES) and social integration in 3 core domains of functioning (impairment, pain, limitations in activity and participation) and perceived health. We conducted a secondary analysis of representative cross-sectional data of the Swiss Health Survey 2007 including 10,336 female and 8,424 male Swiss residents aged 15 or more. Guided by a theoretical ICF-based model, 4 mixed effects Poisson regressions were fitted in order to explain functioning and perceived health by indicators of SES and social integration. Analyses were stratified by age groups (15-30, 31-54, ≥55 years). In all age groups, SES and social integration were significantly associated with functional and perceived health. Among the functional domains, impairment and pain were closely related, and both were associated with limitations in activity and participation. SES, social integration and functioning were related to perceived health. We found pronounced social inequalities in functioning and perceived health, supporting our theoretical model. Social factors play a significant role in the experience of health, even in a wealthy country such as Switzerland. These findings await confirmation in other, particularly lower resourced settings.

Normalisation et dimension culturelle des délocalisations de services : les cas du Maroc et de l'Inde

Cette thèse explore le rôle de la normalisation technique dans les délocalisations de services en Inde et au Maroc. La recherche appréhende le phénomène en opposant explicitement ou implicitement deux modèles. Un modèle serviciel dans lequel les activités de services sont difficilement délocalisables parce que non-mesurables ; un modèle industriel qui articule des activités de services mesurables par les normes techniques et susceptibles d'être délocalisés dans les pays du Sud à bas salaires. Notre thèse s'interroge sur la manière dont les relations Nord-Sud peuvent s'appréhender au sein de cette dichotomie et propose une réflexion épistémologique sur les représentations culturelles induites au sein de ce cadrage. A partir d'une perspective qui combine les apports de l'économie politique culturelle, la sociologie économique et les études postcoloniales au sein de l'économie politique internationale, elle mobilise trois catégories (la normalisation technique, l'imaginaire économique, la qualité). Ces catégories nous permettent de suggérer la centralité des enjeux de pouvoirs dans la définition de ce que sont les activités de services. L'analyse empirique suggère que les délocalisations de services au Maroc et en Inde expriment des réalités plus poreuses et plus dynamiques que la dichotomie entre modèle serviciel et modèle industriel laisse entendre. Elle met en évidence la capacité d'agir des acteurs des pays du Sud et suggère que les normes techniques ont une fonction politique à travers leurs fonctions de mesure. Abstract This thesis explores the role of technical standards in offshore outsourcing in India and Morocco. Current research captures the phenomenon while opposing explicitly or implicitly two models of production. A service-based model in which service activities are difficult to relocate because they are non-measurable; an industrial model that articulates service activities measured with technical standards and that may be outsourced to developing countries with low wages. Our thesis questions how North-South relations can be grasped within this dichotomy and offers an epistemologica! reflection on cultural representations induced within this framework. From a perspective that combines the contributions of cultural political economy, economic sociology and postcolonial studies in international political economy, it mobilizes three categories (technical standardization, the economic imaginary and quality). These categories allow us to suggest the centrality of power issues in the definition of service activities. The empirical analysis suggests that offshoring of services in Morocco and India express more porous and dynamic realities than the dichotomy suggested between a service model and an industrial model. It highlights the ability of the actors to act in the South and suggests that technical standards have a political function through their measurement functions.