Not so silent spectators: How spectator vessels at international sailing regattas alter marine soundscapes.

International sailing regattas are major sporting events often held within coastal marine environments which overlap with the habitats of marine species. Although races are confined to courses, the popularity of these events can attract large spectator flotillas, sometimes composed of hundreds of motorized vessels. Underwater noise from these flotillas can potentially alter soundscapes experienced by marine species.

Hospital Characteristics Associated With Clinically Integrated Network Participation.

Background: Increased integration of physician organizations and hospitals into health systems has not necessarily improved clinical integration or patient outcomes. However, federal regulators have issued favorable opinions for clinically integrated networks (CINs) as a way to pursue coordination between hospitals and physicians. Hospital organizational affiliations, including independent practice associations (IPA), physician-hospital organizations (PHOs), and accountable care organizations (ACOs), may support CIN participation.

Impact of a selective narrow network with comprehensive patient navigation on access, utilization, expenditures, and enrollee experiences.

Objective: To examine the effect of enrollee switching from a broad-network accountable care organization (ACO) health maintenance organization (HMO) to a "high performance" ACO-HMO with a selective narrow network and comprehensive patient navigation system on access, utilization, expenditures, and enrollee experiences.

Data Sources: Secondary administrative data were obtained for 2016-2020, and primary interview and survey data in 2021.

Study Design: Fixed-effects instrumental variable analyses of administrative data and regression analyses of survey data.