The Emerging Role of Group Medicare Private Fee-for-Service Plans

Examines the legislative and regulatory changes contributing to the rapid growth of enrollment in group Medicare Advantage plans in private fee-for-service plans. Considers projected trends and implications for retirees, employers, and policy makers

Rates of sustainable forest harvest depend on rotation length and weathering of soil minerals

Abstract Removals of forest biomass in the northeastern US may intensify over the coming decades due to increased demand for renewable energy. For forests to regenerate successfully following intensified harvests, the nutrients removed from the ecosystem in the harvested biomass (including N, P, Ca, Mg, and K) must be replenished through a combination of plant-available nutrients in the soil rooting zone, atmospheric inputs, weathering of primary minerals, biological N fixation, and fertilizer additions. Few previous studies (especially in North America) have measured soil nutrient pools beyond exchangeable cations, but over the long rotations common in this region, other pools which turn over more slowly are important. We constructed nutrient budgets at the rotation time scale for three harvest intensities and compared these with detailed soil data of exchangeable, organic, and primary mineral stocks of in soils sampled in 15 northern hardwood stands developed on granitic till soils in the White Mountain region of New Hampshire, USA. This comparison can be used to estimate how many times each stand might be harvested without diminishing productivity or requiring fertilization. Under 1990s rates of N deposition, N inputs exceeded removals except in the most intensive management scenario considered. Net losses of Ca, K, Mg, and P per rotation were potentially quite severe, depending on the assumptions used.Biologically accelerated soil weathering may explain the lack of observed deficiencies in regenerating forests of the region. Sites differed widely in the long-term nutrient capital available to support additional removals before encountering limitations (e.g., a fourfold difference in available Ca, and a tenfold difference in weatherable Ca). Intensive short-rotation biomass removal could rapidly deplete soil nutrient capital, but traditional long rotations, even under intensive harvesting, are unlikely to induce nutrient depletion in the 21st century. Weatherable P may ultimately limit biomass production on granitic bedrock (in as few as 6 rotations). Understanding whether and how soil weathering rates respond to nutrient demand will be critical to determining long-term sustainability of repeated intensive harvesting over centuries

La Poésie israélienne aujourd’hui - État des lieux

L’origine des tendances de la poésie israélienne contemporaine.Cet article se concentre sur la polyphonie des voix dans la poésie israélienne contemporaine. Elle transmet son dynamisme à travers trois courants principaux: la poésie féministe, la poésie religieuse et la poésie des Orientaux (Mizrahim). L'essai identifie le poète Avot Yeshuron comme l'un des pères littéraires de la plupart des tendances poétiques contemporaines.The essay focuses on the polyphony of voices in contemporary Israeli poetry. It conveys its dynamism through three main currents: feminist poetry, religious poetry and poetry of those born in the Middle East (Mizrahim). The essay assesses the poet Avot Yeshuron as one of the literary fathers to many of the contemporary poetic trends.המאמר מתמקד בקולותיה המגוונים של השירה הישראלית בת זמננו. הוא עומד על שלושה מזרמיה המרכזיים, שירת נשים, שירה דתית ושירת המזרחים. בין היתר הוא מציג את המורר אבות ישורון כאביה הרוחני של שירה זו

Computer based learning units for science and math for secondary schools

This paper describes a development, over approximately five years, of a highly interactive graphic set of computer based learning materials, primarily focusing on middle school and high school, and concerned with science topics, with a few mathematics issues included. The material was developed in two separate projects, one supported by the National Science Foundation, and one supported by the Fund for the Improvement of Postsecondary Education. The materials, although probably most, useful in secondary schools, are usable with a wide range of users. Thus we believe that most of these modules will be usable in adult education situations too. ..

Opportunities for lattice QCD in quark and lepton flavor physics

This document is one of a series of whitepapers from the USQCD collaboration. Here, we discuss opportunities for lattice QCD in quark and lepton flavor physics. New data generated at Belle II, LHCb, BES III, NA62, KOTO, and Fermilab E989, combined with precise calculations of the relevant hadronic physics, may reveal what lies beyond the Standard Model. We outline a path toward improvements of the precision of existing lattice-QCD calculations and discuss groundbreaking new methods that allow lattice QCD to access new observables.Comment: USQCD whitepape

Effect of sedation level on the prevalence of delirium when assessed with CAM-ICU and ICDSC

Purpose: We hypothesized that reduced arousability (Richmond Agitation Sedation Scale, RASS, scores −2 to −3) for any reason during delirium assessment increases the apparent prevalence of delirium in intensive care patients. To test this hypothesis, we assessed delirium using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) in intensive care patients during sedation stops, and related the findings to the level of sedation, as assessed with RASS score. Methods: We assessed delirium in 80 patients with ICU stay longer than 48h using CAM-ICU and ICDSC during daily sedation stops. Sedation was assessed using RASS. The effect of including patients with a RASS of −2 and −3 during sedation stop ("light to moderate sedation”, eye contact less than 10s or not at all, respectively) on prevalence of delirium was analyzed. Results: A total of 467 patient days were assessed. The proportion of CAM-ICU-positive evaluations decreased from 53 to 31% (p<0.001) if assessments from patients at RASS −2/−3 (22% of all assessments) were excluded. Similarly, the number of positive ICDSC results decreased from 51 to 29% (p<0.001). Conclusions: Sedation per se can result in positive items of both CAM-ICU and ICDSC, and therefore in a diagnosis of delirium. Consequently, apparent prevalence of delirium is dependent on how a depressed level of consciousness after sedation stop is interpreted (delirium vs persisting sedation). We suggest that any reports on delirium using these assessment tools should be stratified for a sedation score during the assessmen

Investing in Equity: Creating Equitable Funding for Women Peacebuilders

Although women are vital to the success and sustainability of peace efforts, and despite progress made by the Women, Peace and Security (WPS) agenda over the past two decades, women peacebuilders remain severely underfunded — and the funding that is available to them is often unresponsive to their needs and characterized by a power disparity between funder and funded. In order to advance women’s inclusion in peace and justice processes, this report examines what equitable funding partnerships are, why they are essential to peacebuilding, and how they can best be cultivated, providing evidence from the field to support its findings, conclusions and recommendations.https://digital.sandiego.edu/ipj-research/1002/thumbnail.jp

Biotic Control of Calcium Cycling in Northern Hardwood Forests: Acid Rain and Aging Forests

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42435/1/30060399.pd