Health Care Opinion Leaders' Views on Delivery System Innovation and Improvement

Presents survey results on healthcare experts' views on strategies and models for fostering coordination and integration, such as accountable care systems, medical homes, and bundled payments; priorities among reform provisions; and market concerns

Sociality, Cognition and Social Learning in Turtles (Emydidae)

Turtles are little studied with respect to learning, cognition and social behavior in spite of being phylogenetically a central group. Populations of many species of these long-lived animals are declining due to commercial activities (pet trade and food), pollution, and habitat destruction. This integrative study of freshwater turtle (Emydidae) behavior investigated their sociality, individual learning and memory capabilities, and the ability of turtles to learn from others. First, I studied turtle underwater social behavior which involved naturalistic observations and ethogram development of the underwater social behavior of (Family Emydidae) at the Chattanooga Aquarium. Turtle social behavioral repertoire and interaction sequencing while underwater were much more complex and varied than those recorded for turtle basking interactions. Turtles also formed stable dominance hierarchies. Second, I trained and tested 9 Florida Red-bellied Cooters (Pseudemys nelsoni) in a discrimination choice task that I developed. Turtles were first trained to an instrumental response task (dislodging clear plastic bottles to obtain food pellets). These turtles not only showed rapid learning, but required minimal to no retraining after a period of 2 years. This study marks the first time that turtles have been shown to exhibit extensive long-term memory measured in years in a controlled experimental task. Olfactory and other controls were run to confirm that the turtles were responding only to visual cues. Finally, I investigated whether turtles could learn about a visual object cue to obtain food reinforcement by observing other experienced turtles that had learned the task. All five P. nelsoni turtles tested showed evidence of social facilitation and stimulus enhancement learning i.e. they learned not only to follow another turtle to a stimulus indicating food but also to approach the correct bottle that contained food reinforcement. This is the first experimental study of social learning in turtles. This integrative study of social behavior, learning, and cognition of turtles will hopefully spark interest in turtle behavior and cognition, help advance the field of comparative animal cognition, and aid in the development of their management in the wild

Education & Awareness for the URI Community for LGBTIQQ Issues January 2011

This document contains the minutes of Education & Awareness for the URI Community for LGBTIQQ Issues meeting on January 20, 2011

High Performance Accountable Care: Building on Success and Learning From Experience

Presents the rationale for creating accountable care organizations, promising models, and the Commonwealth Fund Commission on a High Performance Health System's recommendations for implementing ACOs widely to achieve improved quality and efficiency

Firearm Safety, Gun Violence and Chicago Families: Voices of Child Health in Chicago Report

Chicago has seen continuing firearm violence, with over 2,000 shooting victims so far in 2021. The epidemic of firearm violence impacts children across the state, as it remains the number one cause of death in children and youth across Illinois. In some of our previous reports, Chicago parents identified gun violence as their top social concern for kids in the city, and in recent years, they reported it was the main social problem getting worse the fastest for Chicago youth. In this month's Voices of Child Health in Chicago Report, we focus on the importance of firearm safety and parents' concerns about gun violence in the city. We asked 1,505 Chicago parents from all 77 community areas in the city about their experiences with firearm safety as well as other gun violence prevention and concern-related questions.

Exploring what teams perceive by 'culture' when implementing new models of care.

Health and social care organizations continually face change to coordinate efforts, improve care quality and better meet patient needs in the context of growing pressure on services. NHS 'vanguard' teams funded to pilot organizational change in England have argued that alongside new structures, policies and governance, a shift in 'workplace culture' is needed to implement change. Although now defined in the literature and seen as an important driver of quality care, it was not clear what teams themselves meant when discussing workplace culture.MethodsIn a qualitative study nested in a wider behavioural science programme, 34 managers and frontline NHS staff took part in interviews and focus groups on the role and meaning of 'workplace culture' in their experience of change. Participants were from organizations in four NHS England vanguards implementing new models of care. Inductive thematic analysis revealed six interlinking themes: unity, emotions, support, consistency, openness to innovation and performance.ResultsThe term 'workplace culture' was nuanced and used in various ways. It was seen as a determinant, measure and/or consequence of change and linked to workplace behaviours, emotions and cognitions. Participants agreed that imposed top-down change in new models of care was a common cause of damaged culture and had knock-on effects on care quality, despite manager accounts of the importance of staff ideas.DiscussionOur findings suggest that exploring teams' own meanings of culture and behaviour change barriers, gathering ideas and co-developing tailored support would help overcome cultural challenges in implementing new models of care

International Coercion, Emulation and Policy Diffusion: Market-Oriented Infrastructure Reforms, 1977-1999

Why do some countries adopt market-oriented reforms such as deregulation, privatization and liberalization of competition in their infrastructure industries while others do not? Why did the pace of adoption accelerate in the 1990s? Building on neo-institutional theory in sociology, we argue that the domestic adoption of market-oriented reforms is strongly influenced by international pressures of coercion and emulation. We find robust support for these arguments with an event-history analysis of the determinants of reform in the telecommunications and electricity sectors of as many as 205 countries and territories between 1977 and 1999. Our results also suggest that the coercive effect of multilateral lending from the IMF, the World Bank or Regional Development Banks is increasing over time, a finding that is consistent with anecdotal evidence that multilateral organizations have broadened the scope of the “conditionality” terms specifying market-oriented reforms imposed on borrowing countries. We discuss the possibility that, by pressuring countries into policy reform, cross-national coercion and emulation may not produce ideal outcomes.http://deepblue.lib.umich.edu/bitstream/2027.42/40099/3/wp713.pd

A Mediterranean Diet and Walking Intervention to Reduce Cognitive Decline and Dementia Risk in Independently Living Older Australians:The MedWalk Randomized Controlled Trial Experimental Protocol, Including COVID-19 Related Modifications and Baseline Characteristics.

Background:Several clinical trials have examined diet and physical activity lifestyle changes as mitigation strategies for risk factors linked to cognitive decline and dementias such as Alzheimer’s disease. However, the ability to modify these behaviors longer term, to impact cognitive health has remained elusive.Objective:The MedWalk trial’s primary aim is to investigate whether longer-term adherence to a Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT), can reduce age-associated cognitive decline and other dementia risk factors in older, independently living individuals without cognitive impairment.Methods:MedWalk, a one-year cluster-randomized controlled trial across two Australian states, recruited 60–90-year-old people from independent living retirement villages and the wider community. Participants were assigned to either the MedWalk intervention or a control group (maintaining their usual diet and physical activity). The primary outcome is 12-month change in visual memory and learning assessed from errors on the Paired Associates Learning Task of the Cambridge Neuropsychological Test Automated Battery. Secondary outcomes include cognition, mood, cardiovascular function, biomarkers related to nutrient status and cognitive decline, MI-CBT effectiveness, Mediterranean diet adherence, physical activity, quality of life, cost-effectiveness, and health economic evaluation.Progress and Discussion:Although COVID-19 impacts over two years necessitated a reduced timeline and sample size, MedWalk retains sufficient power to address its aims and hypotheses. Baseline testing has been completed with 157 participants, who will be followed over 12 months. If successful, MedWalk will inform interventions that could substantially reduce dementia incidence and ameliorate cognitive decline in the community.<br/

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy