Navigating health care: brokerage and access for undocumented Latino immigrants under the 2010 Affordable Care Act

ABSTRACT

Brokerage is a prominent mechanism that explains access for Latino immigrants to many American institutions. However, few studies examine the dual nature of brokerage in answering questions on access to health care for undocumented Latino immigrants. The growing importance of Federally Qualified Health Centers (FQHCs) and ethnic navigators connecting immigrants to health care under the 2010 Affordable Care Act calls attention to the duality of brokers and its role in access. The study draws from 44 in-depth interviews with providers, clinic directors, navigators, and immigrant patients and two years of fieldwork in FQHCs in California’s San Francisco Bay Area (2011–2013). Results show that brokers enable access through coaching and myth-busting but they also hinder it through scrutiny and bureaucratic filtering. The widespread dependence on brokerage, I argue, leads to ersatz brokerage, such as when providers navigate the health-care system for the undocumented without the appropriate linguistic resources or coordination. Furthermore, the study shows that the duality in brokerage generates misinformation, churning, and alienation. Understanding the relational processes that both include and exclude vulnerable populations from needed services enhances theories of immigrant integration and can help design more efficient policies and address inequalities related to documentation status.     

Integrating Behavioral Science with Human Factors to Address Process Safety

ABSTRACT

Applying the science of human factors to eliminate error across all aspects of process design, management, operation, and maintenance has been a focus in the process safety area for many years. Human error has been attributed as a major cause of many high profile catastrophic accidents around the world. These accidents have resulted in national and international attention, which has led to a focus on improving organizational capabilities, systems, and in many cases, governmental regulations around human factors. This article provides a review of the field of human factors highlighting various topics in the literature, and introduces governmental regulatory bodies currently engaging organizations in a scientific approach to human factors. Finally, the need for integrating behavioral science methodologies with human factors is addressed. This is done with specific focus on how Organizational Behavior Management methodologies can work in concert with human factors to optimize process safety.     

Leadership’s Role in Process Safety: An Understanding of Behavioral Science Among Managers and Executives Is Needed

ABSTRACT

A recent prevalence of high visibility catastrophic events has garnered increased attention to process safety issues. While the use of Behavior-Based Safety interventions demonstrate a reduction in workplace injuries by targeting employee behavior, we believe that process safety requires a greater focus on the behavior of leaders (e.g., creating and executing strategy). One effective method to begin targeting leader behavior for the improvement of process safety is to teach leaders about the principles of behavior, including ways by which the science may be applied within their own organizational models.     

Risk Assessment of Human Listeriosis from Semisoft Cheeses Made from Raw Sheep's Milk in Lazio and Tuscany (Italy)

Semisoft cheese made from raw sheep's milk is traditionally and economically important in southern Europe. However, raw milk cheese is also a known vehicle of human listeriosis and contamination of sheep cheese with Listeria monocytogenes has been reported. In the present study, we have developed and applied a quantitative risk assessment model, based on available evidence and challenge testing, to estimate risk of invasive listeriosis due to consumption of an artisanal sheep cheese made with raw milk collected from a single flock in central Italy. In the model, contamination of milk may originate from the farm environment or from mastitic animals, with potential growth of the pathogen in bulk milk and during cheese ripening. Based on the 48‐day challenge test of a local semisoft raw sheep's milk cheese we found limited growth only during the initial phase of ripening (24 hours) and no growth or limited decline during the following ripening period. In our simulation, in the baseline scenario, 2.2% of cheese servings are estimated to have at least 1 colony forming unit (CFU) per gram. Of these, 15.1% would be above the current E.U. limit of 100 CFU/g (5.2% would exceed 1,000 CFU/g). Risk of invasive listeriosis per random serving is estimated in the 10^?12 range (mean) for healthy adults, and in the 10^?10 range (mean) for vulnerable populations. When small flocks (10–36 animals) are combined with the presence of a sheep with undetected subclinical mastitis, risk of listeriosis increases and such flocks may represent a public health risk.     

Cloud manufacturing system for sheet metal processing

Abstract

Cloud computing is changing the way industries and enterprises run their businesses. Cloud manufacturing is emerging as an approach to transform the traditional manufacturing business model, while helping the manufacturer to align production efficiency with its business strategy, and creating intelligent factory networks that enable collaboration across the whole enterprise. Many production planning and control (PPC) problems are essentially optimisation problems, where the objective is to develop a plan that meets the demand at minimum cost or maximum profit. Because the underlying optimisation problem will vary in the different business and operation phases, it is important to think about optimisation in a dynamic mechanism and in a number of interlinked sub-problems at the same time. Cloud manufacturing has the potential to offer decision support as a service and medium of communication in PPC. To solve these problems and produce collaboration across the supply chain, this paper provides an overview of the state of the art in cloud manufacturing and presents a model of cloud-based production planning and production system for sheet metal processing.     

Optimal Dynamic Order Scheduling under Capacity Constraints Given Demand‐Forecast Evolution

We consider a manufacturer without any frozen periods in production schedules so that it can dynamically update the schedules as the demand forecast evolves over time until the realization of actual demand. The manufacturer has a fixed production capacity in each production period, which impacts the time to start production as well as the production schedules. We develop a dynamic optimization model to analyze the optimal production schedules under capacity constraint and demand‐forecast updating. To model the evolution of demand forecasts, we use both additive and multiplicative versions of the martingale model of forecast evolution. We first derive expressions for the optimal base stock levels for a single‐product model. We find that manufacturers located near their market bases can realize most of their potential profits (i.e., profit made when the capacity is unlimited) by building a very limited amount of capacity. For moderate demand uncertainty, we also show that it is almost impossible for manufacturers to compensate for the increase in supply–demand mismatches resulting from long delivery lead times by increasing capacity, making lead‐time reduction a better alternative than capacity expansion. We then extend the model to a multi‐product case and derive expressions for the optimal production quantities for each product given a shared capacity constraint. Using a two‐product model, we show that the manufacturer should utilize its capacity more in earlier periods when the demand for both products is more positively correlated.     

“国防一线”的“三线建设”——云南三线建设的历史研究

云南处于援越抗美和对越自卫反击战的国防一线,同时又是我国地缘国防战略的大后方。既是“一线”又是“三线”的特殊地缘政治环境,赋予了云南三线建设独特的面貌和经验。在1964年至1980年的云南三线建设历程中,经历了两个建设高潮。文章试图真实再现各个阶段的规划部署、实施过程,分析出现的问题,以弥补相关研究的不足。这场特殊的“备战经济”建设,为保卫边疆安全、巩固国防发挥了应有的作用,同时也为云南的经济社会发展做出了重大的贡献。     

山寨制造的正名及调控

山寨制造和山寨文化的泛化,使中国信用建设遭遇了前所未有的挑战。规制山寨,一方面是重构社会信用体系,另一方面是建立中国标准,掀起世界产业革命,提高中国在国际标准和国际规则方面的话语权和决定权。我们必须进一步厘清山寨文化的各种表现、真实本质和国际比较,做好山塞制造的规范和调控,从而实现中国信用建设的科学发展。     

社会安全阀运行与和谐社会构建

社会安全阀具有宣泄社会情感、激发制度创新与整合社会结构的重要功能。由于制度化手段的缺失,当代中国社会安全阀机制具有潜制度化特征并在运行中逐渐显现出弊端,已不能适应社会和谐发展的需要。应该引入制度化的手段,用“显社会安全阀”替代“潜社会安全阀”,在经济、法律、政治、社会生活诸领域中实现社会安全阀的制度化运行机制。     

改善我国食品安全状况的思考

研究了现行的食品安全管理体制及弊端,分析了影响食品安全的主要因素,提出了改善食品安全性的措施。