Mortality Differences Between Traditional Medicare and Medicare Advantage: A Risk-Adjusted Assessment Using Claims Data.

Medicare Advantage (MA) has grown rapidly since the Affordable Care Act; nearly one-third of Medicare beneficiaries now choose MA. An assessment of the comparative value of the 2 options is confounded by an apparent selection bias favoring MA, as reflected in mortality differences. Previous assessments have been hampered by lack of access to claims diagnosis data for the MA population. An indirect comparison of mortality as an outcome variable was conducted by modeling mortality on a traditional fee-for-service (FFS) Medicare data set, applying the model to an MA data set, and then evaluating the ratio of actual-to-predicted mortality in the MA data set. The mortality model adjusted for clinical conditions and demographic factors. Model development considered the effect of potentially greater coding intensity in the MA population. Further analysis calculated ratios for subpopulations. Predicted, risk-adjusted mortality was lower in the MA population than in FFS Medicare. However, the ratio of actual-to-predicted mortality (0.80) suggested that the individuals in the MA data set were less likely to die than would be predicted had those individuals been enrolled in FFS Medicare. Differences between actual and predicted mortality were particularly pronounced in low income (dual eligibility), nonwhite race, high morbidity, and Health Maintenance Organization (HMO) subgroups. After controlling for baseline clinical risk as represented by claims diagnosis data, mortality differences favoring MA over FFS Medicare persisted, particularly in vulnerable subgroups and HMO plans. These findings suggest that differences in morbidity do not fully explain differences in mortality between the 2 programs

Reducing Compassion Fatigue and Burnout Among Nurses

Abstract: A literature review was done between the months of August 2022 and November 2022 to determine if nurses, who utilize hospital sponsored counseling resources or compassion fatigue reduction programs, experience less burnout than nurses who do not. Ten articles were reviewed focusing on services provided to nurses with the intent of reducing burnout and compassion fatigue and improving compassion satisfaction. The purpose was to provide Spencer Hospital, in Spencer Iowa, with viable programs and interventions that combat burnout and compassion fatigue. Results showed, when provided with the opportunity, nurses chose to learn self-care techniques or participate in compassion fatigue and burnout reduction programs. It was found that nurses equipped with self-care tools and services had a higher level of compassion satisfaction which served to mitigate their burnout and compassion fatigue

“Convoluted Journeys”: Integrating Nonprofit Organizations and University Science

University scientists are frequently challenged to embrace stakeholder engagement in a way that departs from traditional contract-oriented relationships; this is occurring within water management across the American West. However, few studies specifically address how university scientists engage nonprofit organizations as stakeholders in collaborative water management research. This manuscript reports on an examination of a key set of stakeholders—nonprofit environmental organizations—with a goal to better understand how such organizations conceptualized, created, and implemented scientific data in water management decision making. The study provides insights into why interactions between university scientists and nonprofits are infrequent and underdeveloped. The project identifies how nonprofit organizations strategically use scientific information across a variety of contexts and for diverse purposes. These practices may sometimes be at odds with how university scientists conceive of or practice science, making stakeholder engagement challenging. The study also provides suggestions for how universities might address some of these challenges

Community Engagement, Advocacy, and the Application of Science in the Boise River Basin

This poster was presented at the 2016 Idaho EPSCoR Annual Meeting, October 19-21, in Couer d\u27Alene Idaho

Maplewood Marine Restoration Project - Panel Session

The Vancouver Fraser Port Authority’s Habitat Enhancement Program (HEP) administers the largest habitat bank in Canada, through an agreement with Fisheries and Oceans Canada. This initiative is intended to provide a balance between a healthy environment and future development projects that maybe required for port operations. The program is aligned with the port authority’s vision to be the world’s most sustainable port and is focused on creating, restoring and enhancing fish and wildlife habitat. Building on the success of past projects within Burrard Inlet, in 2019, the port authority and Tsleil-Waututh Nation (TWN) entered into a ten-year agreement to formalize how collaboration would proceed on habitat bank projects within Burrard Inlet, acknowledging that there is a mutual benefit to work together in a collaborative way. The recently completed Maplewood Marine Restoration Project is an example of a positive project outcome of this agreement and is aligned with the conference theme of “Honoring Our Ancestors: Visions for Future Generations and the Salish Sea”. The project is located in North Vancouver on the north shore of Burrard Inlet, in a marine site that was identified as a restoration priority by TWN. The mudflats hold a cultural significance and continue to be used for traditional practices such as harvesting for a variety of marine species. TWN’s Burrard Inlet Action Plan set out the priority to restore critical nearshore habitat, among other priorities to improve the health of the inlet. The project restored approximately 4.5 hectares of degraded habitat at the site by creating a tidal flat, an eelgrass bed and a rock reef in an area that was previously impacted by industrial activities. The project included a skilled, multi-disciplinary team that included significant collaboration and input from TWN’s Treaty, Lands and Resource Department and involvement from Musqueam Indian Band and Squamish Nation

Senior Exhibitions Booklet

Booklet containing photos and names of all undergraduate student presenting Senior Exhibitions. April 29 - May 10, 2002.https://digitalcommons.udallas.edu/senior_01-02/1000/thumbnail.jp

Expression of Wnt gene family and frizzled receptors in head and neck squamous cell carcinomas

[Abstract] Genes of the Wnt and Frizzled class, expressed in HNSCC tissue and cell lines, have an established role in cell morphogenesis and differentiation, and also they have oncogenic properties. We studied Wnt and Fz genes as potential tumor-associated markers in HNSCC by qPCR. Expression levels of Wnt and Fz genes in 22 unique frozen samples from HNSCC were measured. We also assessed possible correlation between the expression levels obtained in cancer samples in relation to clinicopathologic outcome. Wnt-1 was not expressed in the majority of the HNSCC studied, whereas Wnt-5A was the most strongly expressed by the malignant tumors. Wnt-10B expression levels were related with higher grade of undifferentiation. Related to Fz genes, Fz-5 showed more expression levels in no-affectation of regional lymph nodes. Kaplan–Meier survival analyses suggest a reduced time of survival for low and high expression of Wnt-7A and Fz-5 mRNA, respectively. qPCR demonstrated that HNSCC express Wnt and Fz members, and suggested that Wnt and Fz signaling is activated in HNSCC cells

Public clonotype usage identifies protective Gag-specific CD8+ T cell responses in SIV infection

Despite the pressing need for an AIDS vaccine, the determinants of protective immunity to HIV remain concealed within the complexity of adaptive immune responses. We dissected immunodominant virus-specific CD8+ T cell populations in Mamu-A*01+ rhesus macaques with primary SIV infection to elucidate the hallmarks of effective immunity at the level of individual constituent clonotypes, which were identified according to the expression of distinct T cell receptors (TCRs). The number of public clonotypes, defined as those that expressed identical TCR β-chain amino acid sequences and recurred in multiple individuals, contained within the acute phase CD8+ T cell population specific for the biologically constrained Gag CM9 (CTPYDINQM; residues 181–189) epitope correlated negatively with the virus load set point. This independent molecular signature of protection was confirmed in a prospective vaccine trial, in which clonotype engagement was governed by the nature of the antigen rather than the context of exposure and public clonotype usage was associated with enhanced recognition of epitope variants. Thus, the pattern of antigen-specific clonotype recruitment within a protective CD8+ T cell population is a prognostic indicator of vaccine efficacy and biological outcome in an AIDS virus infection

Protecting 30% of the planet for nature: costs, benefits and economic implications

A. Waldron, K. Nakamura, J. Sze, T. Vilela, A. Escobedo, P. Negret Torres, R. Button, K. Swinnerton, A. Toledo, P. Madgwick, N. Mukherjee were supported by National Geographic and the Resources Legacy Fund. V. Christensen was supported by NSERC Discovery Grant RGPIN-2019-04901. M. Coll and J. Steenbeek were supported by EU Horizon 2020 research and innovation programme under grant agreement No 817578 (TRIATLAS). D. Leclere was supported by TradeHub UKRI CGRF project. R. Heneghan was supported by Spanish Ministry of Science, Innovation and Universities, Acciones de Programacion Conjunta Internacional (PCIN-2017-115). M. di Marco was supported by MIUR Rita Levi Montalcini programme. A. Fernandez-Llamazares was supported by Academy of Finland (grant nr. 31176). S. Fujimori and T. Hawegawa were supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan and the Sumitomo Foundation. V. Heikinheimo was supported by Kone Foundation, Social Media for Conservation project. K. Scherrer was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 682602. U. Rashid Sumaila acknowledges the OceanCanada Partnership, which funded by the Social Sciences and Humanities Research Council of Canada (SSHRC). T. Toivonen was supported by Osk. Huttunen Foundation & Clare Hall college, Cambridge. W. Wu was supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan. Z. Yuchen was supported by a Ministry of Education of Singapore Research Scholarship Block (RSB) Research Fellowship

Working paper analysing the economic implications of the proposed 30% target for areal protection in the draft post-2020 Global Biodiversity Framewor

58 pages, 5 figures, 3 tables- The World Economic Forum now ranks biodiversity loss as a top-five risk to the global economy, and the draft post-2020 Global Biodiversity Framework proposes an expansion of conservation areas to 30% of the earth’s surface by 2030 (hereafter the “30% target”), using protected areas (PAs) and other effective area-based conservation measures (OECMs). - Two immediate concerns are how much a 30% target might cost and whether it will cause economic losses to the agriculture, forestry and fisheries sectors. - Conservation areas also generate economic benefits (e.g. revenue from nature tourism and ecosystem services), making PAs/Nature an economic sector in their own right. - If some economic sectors benefit but others experience a loss, high-level policy makers need to know the net impact on the wider economy, as well as on individual sectors. [...]A. Waldron, K. Nakamura, J. Sze, T. Vilela, A. Escobedo, P. Negret Torres, R. Button, K. Swinnerton, A. Toledo, P. Madgwick, N. Mukherjee were supported by National Geographic and the Resources Legacy Fund. V. Christensen was supported by NSERC Discovery Grant RGPIN-2019-04901. M. Coll and J. Steenbeek were supported by EU Horizon 2020 research and innovation programme under grant agreement No 817578 (TRIATLAS). D. Leclere was supported by TradeHub UKRI CGRF project. R. Heneghan was supported by Spanish Ministry of Science, Innovation and Universities, Acciones de Programacion Conjunta Internacional (PCIN-2017-115). M. di Marco was supported by MIUR Rita Levi Montalcini programme. A. Fernandez-Llamazares was supported by Academy of Finland (grant nr. 311176). S. Fujimori and T. Hawegawa were supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan and the Sumitomo Foundation. V. Heikinheimo was supported by Kone Foundation, Social Media for Conservation project. K. Scherrer was supported by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme under grant agreement No 682602. U. Rashid Sumaila acknowledges the OceanCanada Partnership, which funded by the Social Sciences and Humanities Research Council of Canada (SSHRC). T. Toivonen was supported by Osk. Huttunen Foundation & Clare Hall college, Cambridge. W. Wu was supported by The Environment Research and Technology Development Fund (2-2002) of the Environmental Restoration and Conservation Agency of Japan. Z. Yuchen was supported by a Ministry of Education of Singapore Research Scholarship Block (RSB) Research FellowshipPeer reviewe