Learning in Game Jams: A Case Study of the GLASS Summer School

Game jams provide exciting opportunities for education and research. In this session we describe the GLASS Summer School, sharing videos where students talk about their experiences, and sharing results from our learning survey. We discuss questions such as what are optimal conditions for game jams? How can we measure learning

Onset of runaway fragmentation of salt marshes

Salt marshes are valuable but vulnerable coastal ecosystems that adapt to relative sea level rise (RSLR) by accumulating organic matter and inorganic sediment. The natural limit of these processes defines a threshold rate of RSLR beyond which marshes drown, resulting in ponding and conversion to open waters. We develop a simplified formulation for sediment transport across marshes to show that pond formation leads to runaway marsh fragmentation, a process characterized by a self-similar hierarchy of pond sizes with power-law distributions. We find the threshold for marsh fragmentation scales primarily with tidal range and that sediment supply is only relevant where tides are sufficient to transport sediment to the marsh interior. Thus the RSLR threshold is controlled by organic accretion in microtidal marshes regardless of the suspended sediment concentration at the marsh edge. This explains the observed fragmentation of microtidal marshes and suggests a tipping point for widespread marsh loss

Barriers and Facilitators to Implementation of Value-Based Care Models in New Medicaid Accountable Care Organizations in Massachusetts: A Study Protocol

Introduction: Massachusetts established 17 new Medicaid accountable care organizations (ACOs) and 24 affiliated Community Partners (CPs) in 2018 as part of a large-scale healthcare reform effort to improve care value. The new ACOs will receive $1.8 billion dollars in state and federal funding over 5 years through the Delivery System Reform Incentive Program (DSRIP). The multi-faceted study described in this protocol aims to address gaps in knowledge about Medicaid ACOs\u27 impact on healthcare value by identifying barriers and facilitators to implementation and sustainment of the DSRIP-funded programs. Methods and analysis: The study\u27s four components are: (1) Document Review to characterize the ACOs and CPs; (2) Semi-structured Key Informant Interviews (KII) with ACO and CP leadership, state-level Medicaid administrators, and patients; (3) Site visits with selected ACOs and CPs; and (4) Surveys of ACO clinical teams and CP staff. The Consolidated Framework for Implementation Research\u27s (CFIR) serves as the study\u27s conceptual framework; its versatile menu of constructs, arranged across five domains (Intervention Characteristics, Inner Setting, Outer Setting, Characteristics of Individuals, and Processes) guides identification of barriers and facilitators across multiple organizational contexts. For example, KII interview guides focus on understanding how Inner and Outer Setting factors may impact implementation. Document Review analysis includes extraction and synthesis of ACO-specific DSRIP-funded programs (i.e., Intervention Characteristics); KIIs and site visit data will be qualitatively analyzed using thematic analytic techniques; surveys will be analyzed using descriptive statistics (e.g., counts, frequencies, means, and standard deviations). Discussion: Understanding barriers and facilitators to implementing and sustaining Medicaid ACOs with varied organizational structures will provide critical context for understanding the overall impact of the Medicaid ACO experiment in Massachusetts. It will also provide important insights for other states considering the ACO model for their Medicaid programs. Ethics and dissemination: IRB determinations were that the overall study did not constitute human subjects research and that each phase of primary data collection should be submitted for IRB review and approval. Study results will be disseminated through traditional channels such as peer reviewed journals, through publicly available reports on the mass.gov website; and directly to key stakeholders in ACO and CP leadership

10 simple rules to create a serious game, illustrated with examples from structural biology

Serious scientific games are games whose purpose is not only fun. In the field of science, the serious goals include crucial activities for scientists: outreach, teaching and research. The number of serious games is increasing rapidly, in particular citizen science games, games that allow people to produce and/or analyze scientific data. Interestingly, it is possible to build a set of rules providing a guideline to create or improve serious games. We present arguments gathered from our own experience ( Phylo , DocMolecules , HiRE-RNA contest and Pangu) as well as examples from the growing literature on scientific serious games

Multiple Dimensions of the Moral Majority Platform: Shifting Interest Group Coalitions

The issues raised by the New Political Right and the Moral Majority have overlapped in recent political history. Researchers have assumed that a single additive scale across conservative issues can identify the base of support for the Moral Majority as an organization. We examine general support for the Moral Majority separately from support for six specific issues: teaching creationism, voluntary public school prayer, military defense spending, gun control, pornography and abortion. Data are from a 1982 random sample of adult respondents from Nebraska (N = 1907). Overall, support for the Moral Majority organization is low. Discriminant analysis identifies fundamentalist and evangelical religious affiliation and Biblical literalism as independent predictors of support for the Moral Majority per se. Education increases knowledge of the organization, but does not influence support for it. Respondents with high income levels are more likely to support the Moral Majority organization. These findings contradict theories of both status politics and cultural fundamentalism. Support for the six specific platform items also varies considerably and is affected by religious conservatism and, independently, by other attitudinal and demographic indicators including age, sex, income, rural residence, education and perception of declining economic conditions. These patterns do not entirely fit the predictions of status politics or cultural fundamentalism theories. Rather, they provide evidence that distinct coalitions form on specific issues. Our conclusion is that a simple additive index of support for the Moral Majority masks these differences and oversimplifies complex patterns of coalitions in the religio-political arena

A cost-of-illness analysis of β-Thalassaemia major in children in Sri Lanka - experience from a tertiary level teaching hospital

Background Sri Lanka has a high prevalence of β-thalassaemia major. Clinical management is complex and long-term and includes regular blood transfusion and iron chelation therapy. The economic burden of β-thalassaemia for the Sri Lankan healthcare system and households is currently unknown. Methods A prevalence-based, cost-of-illness study was conducted on the Thalassaemia Unit, Department of Paediatrics, Kandy Teaching Hospital, Sri Lanka. Data were collected from clinical records, consultations with the head of the blood bank and a consultant paediatrician directly involved with the care of patients, alongside structured interviews with families to gather data on the personal costs incurred such as those for travel. Results Thirty-four children aged 2–17 years with transfusion dependent thalassaemia major and their parent/guardian were included in the study. The total average cost per patient year to the hospital was $US 2601 of which$US 2092 were direct costs and $US 509 were overhead costs. Mean household expenditure was$US 206 per year with food and transport per transfusion ($US 7.57 and$US 4.26 respectively) being the highest cost items. Nine (26.5%) families experienced catastrophic levels of healthcare expenditure (> 10% of income) in the care of their affected child. The poorest households were the most likely to experience such levels of expenditure. Conclusions β-thalassaemia major poses a significant economic burden on health services and the families of affected children in Sri Lanka. Greater support is needed for the high proportion of families that suffer catastrophic out-of-pocket costs

''With Great Power Comes Great Responsibility'': Democracy, the Secretary of State for Health and Blame Shifting Within the English National Health Service

The English National Health Service (NHS) has suffered from a democratic deficit since its inception. Democratic accountability was to be through ministers to Parliament, but ministerial control over and responsibility for the NHS were regarded as myths. Reorganizations and management and market reforms, in the neoliberal era, have centralized power within the NHS. However, successive governments have sought to reduce their responsibility for health care through institutional depoliticization, to shift blame, facilitated through legal changes. New Labour’s creation of the National Institute for Clinical Excellence (NICE) and Monitor were somewhat successful in reducing ministerial culpability regarding health technology regulation and foundation trusts, respectively. The Conservative-Liberal Democrat coalition created NHS England to reduce ministerial culpability for health care more generally. This is pertinent as the NHS is currently being undermined by inadequate funding and privatization. However, the public has not shifted from blaming the government to blaming NHS England. This indicates limits to the capacity of law to legitimize changes to social relations. While market reforms were justified on the basis of empowering patients, I argue that addressing the democratic deficit is a preferable means of achieving this goal