Orange County: Changing Market Fuels New Models of Provider Collaboration

Since 2010, Orange County has largely recovered from the economic downturn and remains a relatively well-educated community with high rates of private insurance coverage overall. Socioeconomic variation persists in this county, with the number of low-income residents growing and a large jump in the proportion of the population that gained Medi-Cal coverage under the Affordable Care Act (ACA). Other key findings include:The region's major hospital systems are expanding ambulatory services and geographic reach.Orange County physicians are increasingly giving up independence to varying degrees and joining larger physician organizations or hospital-affiliated groups to gain shelter from mounting financial pressures and administrative burdens.Providers are collaborating on new payment arrangements, with some Orange County physician organizations and hospitals working toward assuming more risk for more patients, particularly the growing numbers in preferred-provider organizations (PPOs).The proportion of Orange County residents covered by Medi-Cal has jumped, with a greater proportional increase in Medi-Cal enrollment than other California regions studied.Safety-net provider capacity is tight; private providers are playing a significant role in serving the Medi-Cal expansion population

Global Ethics and Nanotechnology: A Comparison of the Nanoethics Environments of the EU and China

The following article offers a brief overview of current nanotechnology policy, regulation and ethics in Europe and The People’s Republic of China with the intent of noting (dis)similarities in approach, before focusing on the involvement of the public in science and technology policy (i.e. participatory Technology Assessment). The conclusions of this article are, that (a) in terms of nanosafety as expressed through policy and regulation, China PR and the EU have similar approaches towards, and concerns about, nanotoxicity—the official debate on benefits and risks is not markedly different in the two regions; (b) that there is a similar economic drive behind both regions’ approach to nanodevelopment, the difference being the degree of public concern admitted; and (c) participation in decision-making is fundamentally different in the two regions. Thus in China PR, the focus is on the responsibility of the scientist; in the EU, it is about government accountability to the public. The formulation of a Code of Conduct for scientists in both regions (China PR’s predicted for 2012) reveals both similarity and difference in approach to nanotechnology development. This may change, since individual responsibility alone cannot guide S&T development, and as public participation is increasingly seen globally as integral to governmental decision-making

Bigger, Faster, Better? Rhetorics and Practices of Large-Scale Research in Contemporary Bioscience

publication-status: Publishedtypes: ArticleEditorial for Special Issu

Towards Guidelines for Usability of e-Learning Applications

One present goal of researchers and developers is to design software tools that make learning materials available online in an educationally effective manner. We face the twofold challenge of implementing advanced e-leaming functionalities, though designing their interface so as to provide an easy interaction grasping the students' interest. A poorly designed interface makes students spend more time in learning it than in mastering the provided knowledge, so becoming a barrier to effective learning. In this context, both User-Centered Design (UCD) and Learner-Centered Design (LCD) guidelines are needed; it is also important to devise suited evaluation tools, able to help in identifying usability, and, more in general, accessibility flaws. Such tools must be designed bearing in mind the specific characteristics of e-learning applications. Traditional heuristic evaluation appears too general and subjective. In this paper, we propose a set of guidelines and criteria for e-learning platforms (containers) and for educational modules (contents), to be used within the SUE (Systematic Usability Evaluation) inspection. We point out that human factors experts can primarily evaluate "syntactic" aspects of applications. Experts of education science and domain experts are to be in

The impact of coastal grabbing on community conservation – a global reconnaissance

"Coastal grab" refers to the contested appropriation of coastal (shore and inshore) space and resources by outside interests. This paper explores the phenomenon of coastal grabbing and the effects of such appropriation on community-based conservation of local resources and environment. The approach combines social-ecological systems analysis with socio-legal property rights studies. Evidence of coastal grab is provided from four country settings (Canada, Brazil, India and South Africa), distinguishing the identity of the 'grabbers' (industry, government) and 'victims', the scale and intensity of the process, and the resultant 'booty'. The paper also considers the responses of the communities. While emphasizing the scale of coastal grab and its deleterious consequences for local communities and their conservation efforts, the paper also recognizes the strength of community responses, and the alliances/partnerships with academia and civil society, which assist in countering some of the negative effects

Reading the biomineralized book of life: expanding otolith biogeochemical research and applications for fisheries and ecosystem-based management

Chemical analysis of calcified structures continues to flourish, as analytical and technological advances enable researchers to tap into trace elements and isotopes taken up in otoliths and other archival tissues at ever greater resolution. Increasingly, these tracers are applied to refine age estimation and interpretation, and to chronicle responses to environmental stressors, linking these to ecological, physiological, and life-history processes. Here, we review emerging approaches and innovative research directions in otolith chemistry, as well as in the chemistry of other archival tissues, outlining their value for fisheries and ecosystem-based management, turning the spotlight on areas where such biomarkers can support decision making. We summarise recent milestones and the challenges that lie ahead to using otoliths and archival tissues as biomarkers, grouped into seven, rapidly expanding and application-oriented research areas that apply chemical analysis in a variety of contexts, namely: (1) supporting fish age estimation; (2) evaluating environmental stress, ecophysiology and individual performance; (3) confirming seafood provenance; (4) resolving connectivity and movement pathways; (5) characterising food webs and trophic interactions; (6) reconstructing reproductive life histories; and (7) tracing stock enhancement efforts. Emerging research directions that apply hard part chemistry to combat seafood fraud, quantify past food webs, as well as to reconcile growth, movement, thermal, metabolic, stress and reproductive life-histories provide opportunities to examine how harvesting and global change impact fish health and fisheries productivity. Ultimately, improved appreciation of the many practical benefits of archival tissue chemistry to fisheries and ecosystem-based management will support their increased implementation into routine monitoring.[GRAPHICS]

Cognitive tests aid in clinical differentiation of Alzheimer's disease versus Alzheimer's disease with Lewy body disease: Evidence from a pathological study

Introduction: Clinical differentiation between Alzheimer's disease (AD) and AD with Lewy body disease (LBD) is relatively imprecise. The current study examined pathologically confirmed group differences in neuropsychological functioning, and the classification ability of specific tests. Methods: Fifty‐one participants with postmortem diagnoses of AD (n = 34) and AD plus LBD (n = 17) were drawn from the Predictors Study. One‐way analyses of variance (ANOVAs) and χ2 analyses examined group differences in neuropsychological performance. Binary logistic regressions examined predictive utility of specific tests for pathological diagnosis. Results: Individuals with AD had better visuoconstruction (P = .006), phonemic fluency (P = .08), and processing speed than AD plus LBD (P = .013). No differences were found in memory, naming, semantic fluency, or set‐switching. Processing speed and visuoconstruction predicted pathologic group (P = .03). Discussion: Processing speed and visuoconstruction predicted postmortem diagnosis of AD versus AD plus LBD. Current results offer guidance in the selection and interpretation of neuropsychological tests to be used in the differential diagnosis of early dementia

A collaboratively-derived science-policy research agenda

The need for policy makers to understand science and for scientists to understand policy processes is widely recognised. However, the science-policy relationship is sometimes difficult and occasionally dysfunctional; it is also increasingly visible, because it must deal with contentious issues, or itself becomes a matter of public controversy, or both. We suggest that identifying key unanswered questions on the relationship between science and policy will catalyse and focus research in this field. To identify these questions, a collaborative procedure was employed with 52 participants selected to cover a wide range of experience in both science and policy, including people from government, non-governmental organisations, academia and industry. These participants consulted with colleagues and submitted 239 questions. An initial round of voting was followed by a workshop in which 40 of the most important questions were identified by further discussion and voting. The resulting list includes questions about the effectiveness of science-based decision-making structures; the nature and legitimacy of expertise; the consequences of changes such as increasing transparency; choices among different sources of evidence; the implications of new means of characterising and representing uncertainties; and ways in which policy and political processes affect what counts as authoritative evidence. We expect this exercise to identify important theoretical questions and to help improve the mutual understanding and effectiveness of those working at the interface of science and policy.William Sutherland is funded by Arcadia http://www.arcadiafund.org.uk