How Will the Patient Protection and Affordable Care Act Affect Seniors?

Summarizes how healthcare reform provisions including changes to Medicare premiums and drug benefits, preventive services, Medicare Advantage plans; reduced provider payment rates; and efforts to improve quality and system performance will affect seniors

Nested governance for effective REDD+: Institutional and political arguments

Abstract: Reducing Emissions from Deforestation and Forest Degradation and Forest Enhancement (REDD+) has become a central focus of global climate change mitigation efforts. Even though the international demand for forest-based carbon sequestration is the key driver of REDD+, forest protection strategies must be implemented on the ground. This cross-scale nature of REDD+ explains why scholars and policy makers increasingly favor nested governance arrangements over either fully centralized or fully decentralized REDD+ governance. The focus of the literature on nested REDD+ governance has mostly been on monitoring, reporting, and verification of carbon emission reductions across sub-national, national, and international levels. We build on Ostrom’s principle of ‘nested enterprises ’ to argue that REDD+ must be designed to systematically and formally link national policy reforms with the organization and execution of sub-national (regional and local) forest conservation efforts led by forest users. We also contribute new insights on the political dimensions of nestedness in REDD+, with important roles for inter-community forestry associations and forest rights movements

How We Can Pay for Health Care Reform

Describes savings and revenue sources and policies to reduce healthcare spending that could finance comprehensive reform with a public option, such as reducing physician and hospital payments, investing in prevention programs, and capping tax exclusions

Trust in Private and Common Property Experiments

We report the results from a series of experiments designed to investigate behavior in two settings that are frequently posited in the policy literature as generating different outcomes: private property and common property. The experimental settings closely parallel earlier experimental studies of the investment or trust game. The primary research question relates to the effect of the initial allocation of property rights on the level of trust that subjects will extend to others with whom they are linked. We find that assigning the initial endowments as common property of each of N pairs of a first mover and second mover leads to marginally greater cooperation or trust than when the initial endowments are fully owned by the two individual movers as their, respective, private property. Subjectsâ?? decisions are also shown to be correlated with attitudes toward trust and fairness that are measured in post-experiment questionnaires.

Trust in Private and Common Property Experiments

We report the results from a series of experiments designed to investigate behavior in two settings that are frequently posited in the policy literature as generating different outcomes: private property and common property. The experimental settings closely parallel earlier experimental studies of the investment or trust game. The primary research question relates to the effect of the initial allocation of property rights on the level of trust that subjects will extend to others with whom they are linked. We find that assigning the initial endowments as common property of each of N pairs of a first mover and second mover leads to marginally greater cooperation or trust than when the initial endowments are fully owned by the two individual movers as their, respective, private property. Subjects’ decisions are also shown to be correlated with attitudes toward trust and fairness that are measured in post-experiment questionnaires

In search of good water governance

Inleiding Voor u ligt het eindrapport van een verkenning van vormen van watergovernance buiten Nederland. RWS Waterdienst is de opdrachtgever voor het onderzoek. Op verzoek van DG Water van het Ministerie van Verkeer en Waterstaat gaf de Waterdienst de volgende doelstelling aan de onderzoekers mee: zoek naar inspirerende voorbeelden in het buitenland van de wijze waarop de bestuurlijke organisatie van het waterbeheer en beleid functioneert. De verkenning is vooral een zoektocht naar opvallende vraagstellingen en aanpakken in het buitenland, en biedt het kader om op een aantal zaken meer systematische, in de governance theorie verankerderde vergelijkende studies aan te vatten. De verkenning is uitgevoerd door onderzoekers van DHV, Grontmij en Indiana University. Om de verkenning te verbinden met de bestaande wetenschappelijke inzichten over watergovernance heeft een wetenschappelijke commissie onder leiding van hoogleraar Bestuurskunde, prof. Geert Teisman het onderzoek begeleid

Primary care provider perceptions and use of a novel medication reconciliation technology

Background Although medication reconciliation (MR) can reduce medication discrepancies, it is challenging to operationalise. Consequently, we developed a health information technology (HIT) to collect a patient medication history and make it available to the primary care (PC) provider. We deployed a self-service kiosk in a PC clinic that permits patients to indicate a medication adherence history. Patient responses are immediately viewable in the legacy electronic health record. This paper describes a survey developed to assess PC provider perceptions of our HIT and HIT implementation effectiveness. Methods We developed and administered a survey to all PC providers to assess technology implementation effectiveness. The survey included scales measuring (1) user attitudes towards MR, (2) perceptions of our HIT and (3) the local organisational climate for implementation. We also assessed the consistency and quality of tool use. Results Nearly 90% of PC providers responded to the survey and 58% indicated that they were familiar with the technology and had seen the tool output. Most providers believed that MR represented an important safety intervention, although 43% did not believe that they had the necessary resources to manage discrepancies. Composite scale scores for the 58% of respondents familiar with the HIT indicate that the majority favoured our tool over usual care. However, composite scale scores suggest that the climate for implementation at our facility was suboptimal. Overall, the quality and consistency of tool use among providers was very heterogeneous. Conclusions A patient self-service kiosk offers an efficientmechanismto collect amedication adherence history; provider survey responses indicate that they appreciated and used the MR kiosk output. Nonetheless, opportunities exist to improve data displays and embed decision support to facilitate discrepancy management

Discovery of [11C]MK-6884: a positron emission tomography (PET) imaging agent for the study of M4 muscarinic receptor positive allosteric modulators (PAMs) in neurodegenerative diseases

The measurement of receptor occupancy (RO) using positron emission tomography (PET) has been instrumental in guiding discovery and development of CNS directed therapeutics. We and others have investigated muscarinic acetylcholine receptor 4 (M4) positive allosteric modulators (PAMs) for the treatment of symptoms associated with neuropsychiatric disorders. In this article, we describe the synthesis, in vitro, and in vivo characterization of a series of central pyridine-related M4 PAMs that can be conveniently radiolabeled with carbon-11 as PET tracers for the in vivo imaging of an allosteric binding site of the M4 receptor. We first demonstrated its feasibility by mapping the receptor distribution in mouse brain and confirming that a lead molecule 1 binds selectively to the receptor only in the presence of the orthosteric agonist carbachol. Through a competitive binding affinity assay and a number of physiochemical properties filters, several related compounds were identified as candidates for in vivo evaluation. These candidates were then radiolabeled with 11C and studied in vivo in rhesus monkeys. This research eventually led to the discovery of the clinical radiotracer candidate [11C]MK-6884

Mammal collections of the Western Hemisphere: A survey and directory of collections

As a periodic assessment of the mammal collection resource, the Systematic Collections Committee (SCC) of the American Society of Mammalogists undertakes decadal surveys of the collections held in the Western Hemisphere. The SCC surveyed 429 collections and compiled a directory of 395 active collections containing 5,275,155 catalogued specimens. Over the past decade, 43 collections have been lost or transferred and 38 new or unsurveyed collections were added. Growth in number of total specimens, expansion of genomic resource collections, and substantial gains in digitization and web accessibility were documented, as well as slight shifts in proportional representation of taxonomic groups owing to increasingly balanced geographic representation of collections relative to previous surveys. While we find the overall health of Western Hemisphere collections to be adequate in some areas, gaps in spatial and temporal coverage and clear threats to long-term growth and vitality of these resources have also been identified. Major expansion of the collective mammal collection resource along with a recommitment to appropriate levels of funding will be required to meet the challenges ahead for mammalogists and other users, and to ensure samples are broad and varied enough that unanticipated future needs can be powerfully addressed. © 2018 The Author(s)