Enrollment in Medicare is associated with fewer outpatient mental healthcare visits among those with mental health symptoms.

Objective: To test whether enrolling in traditional Medicare (TM) or Medicare Advantage (MA) at age 65 reduces mental healthcare utilization among individuals with mental health symptoms and low or moderate family incomes.

Study Setting And Design: We employ a fuzzy regression discontinuity design, comparing the likelihood of having an outpatient mental health visit or a psychotropic drug fill among individuals younger than or older than the age 65 Medicare eligibility threshold.

Data Sources And Analytic Sample: We analyze 2014-2021 Medical Expenditure Panel Survey data.

Neighbourhood walkability and transportation and leisure physical activity by residency status: A cross-sectional analysis of nationally representative Canadian data.

Objective: We aimed to 1) estimate the differences in transportation (TPA) and leisure physical activity (LPA) participation and duration between Canadian-born and immigrant adults, and 2) examine whether associations between neighbourhood walkability and physical activity differ by residency status.

Methods: We linked Canadian Community Health Survey (CCHS; 2017-2018) with Canadian Active Living Environment (2016) data. Participants were urban Canadian-born or immigrant adults (recent: <10 years, established: ≥10 years).

How Specialized Are Special Needs Plans? Evidence From Provider Networks.

Enrollment in Medicare Advantage (MA) Dual-Eligible Special Needs Plans (D-SNPs) among individuals dually eligible for Medicare and Medicaid has more than tripled over the past decade. Little is known about whether D-SNP plan design differs from standard MA plan design nor whether this design reflects the needs of dual-eligible enrollees. We characterize the degree to which D-SNPs specialize in an important plan design dimension-provider networks.

Recent cohorts aging into Medicare use more counseling and psychotherapy than past cohorts.

Objectives: Despite recent policy interest in improving access to mental health care in Medicare, little is known about how demand for care will change among the Medicare population as newer cohorts age into the program. We documented the growing rate of counseling and psychotherapy use in the decade prior to turning age 65 years among subsequent cohorts aging into Medicare. We characterized how this growth varied across demographic groups, income levels, and mental and physical health status.

It is child's play: Caregiver and playworker perspectives on a community park-based unstructured play program.

Unstructured play is characterized as play that is child initiated and determined, allowing children the freedom and flexibility to engage in activities, including taking risks, without adult intervention. However, playworkers and caregivers are important mediators of children's unstructured play. Studies have investigated playworker and caregiver perspectives regarding play, yet few have done so within the context of community based unstructured play interventions.

Growing divergence between Medicare Advantage plan bids and payments to plans.

As the Medicare Advantage (MA) program grows in enrollment and costs, there has been increasing concern that federal payments to MA plans exceed necessary levels. Estimates suggest that, in 2023, MA plans were paid up to 6% more per enrollee than would have been spent had that beneficiary instead enrolled in traditional Medicare (TM). We evaluated the factors driving this overpayment, characterizing trends in MA benchmarks, bids, and total payments from pre-Affordable Care Act (pre-ACA) levels through 2023.

The relationship between neighbourhood built characteristics, physical activity, and health-related fitness in urban dwelling Canadian adults: A mediation analysis.

Objective: Physical activity supportive environments have the potential to promote health-related fitness in adults. However, the extent to which neighbourhood built characteristics promote health-related fitness via physical activity has received little research attention. Therefore, our objective was to estimate the indirect and direct effects between neighbourhood built characteristics and health-related fitness mediated by physical activity.

Trends in the level and composition of supplemental benefits in Medicare Advantage.

Medicare Advantage (MA) plans that bid below benchmarks (or bidding targets) receive a portion of that difference as rebates, which they then must return to beneficiaries through supplemental benefits or reduced premiums or cost-sharing. Using Centers for Medicare & Medicaid Services data, we evaluate the growth in rebates and concomitant changes in supplemental benefit composition among health maintenance organizations (HMOs) and local preferred provider organizations (PPOs) from 2011 through 2022. Average rebates grew considerably, particularly after 2015 and among PPOs.

Neighbourhood walkability and greenspace and their associations with health-related fitness in urban dwelling Canadian adults.

Objective: Muscular strength and body composition are important components of health-related fitness (HRF). Grip strength and body fat percent, in particular, are associated with chronic disease and affected by health behaviours. Evidence suggests relationships between the neighbourhood built environment (BE) and HRF exist, however, few studies have focused on grip strength and body fat percent.

Transcriptomic changes behind Sparus aurata hepatic response to different aquaculture challenges: An RNA-seq study and multiomics integration.

Gilthead seabream (Sparus aurata) is an important species in Mediterranean aquaculture. Rapid intensification of its production and sub-optimal husbandry practices can cause stress, impairing overall fish performance and raising issues related to sustainability, animal welfare, and food safety. The advent of next-generation sequencing technologies has greatly revolutionized the study of fish stress biology, allowing a deeper understanding of the molecular stress responses.

Fostering Flexibility: How Medicare Advantage Potentially Accelerated Telehealth Benefits.

In 2018, the US Congress enacted a policy permitting Medicare Advantage (MA) plans to cover telehealth services in a beneficiary's home and through audio-only means as part of the basic benefit package of services, where prior to the policy change such benefits were only allowed to be covered as a supplemental benefit. MA plans were afforded 2 years of lead time for strategizing, negotiating, and capital investment prior to the start date (January 1, 2020) of the new coverage option. Our data analysis found basic benefit telehealth was offered by plans comprising 71% of enrollment in 2020 and increased to 95% in 2021.

Engaging Chief Medical Officers to Improve Multidisciplinary Rounds.

Background: Multidisciplinary rounds (MDRs), a model of care in which multiple members of the care team, representing different disciplines, come together to discuss the care of a patient in real-time. MDRs are a valuable tool for clinical teams to improve patient length of stay (LOS), reduce healthcare-associated infections, and increase care coordination. HCA Healthcare's data science and performance improvement teams created a data visualization tool called Next-gen Analytics for Treatment and Efficiency (NATE) Tempo to support care teams in managing rounds and barriers.

Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users.

Background: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.

Mediation analysis of the associations between neighbourhood walkability and greenness, accelerometer-measured physical activity, and health-related fitness in urban dwelling Canadians.

Objective: To estimate sex-specific associations (total, direct, and indirect effects) between objectively measured neighbourhood walkability and greenness and objectively measured physical activity and health-related fitness including cardiorespiratory and muscular fitness in Canadian adults.

Methods: Neighbourhood walkability (Canadian Active Living Environment) and greenness (Normalized Difference Vegetation Index; NDVI) data were linked to cardiorespiratory (i.e.

A novel target-enriched multilocus assay for sponges (Porifera): Red Sea Haplosclerida (Demospongiae) as a test case.

With declining biodiversity worldwide, a better understanding of species diversity and their relationships is imperative for conservation and management efforts. Marine sponges are species-rich ecological key players on coral reefs, but their species diversity is still poorly understood. This is particularly true for the demosponge order Haplosclerida, whose systematic relationships are contentious due to the incongruencies between morphological and molecular phylogenetic hypotheses.

Exploring a Potential Avenue for Beekeeping in Ireland: Safeguarding Locally Adapted Honeybees for Breeding Varroa-Resistant Lines.

Beekeeping in Ireland has been strongly impacted by the parasitic mite , whose introduction caused alarming honeybee colony losses. If unmitigated, these losses could lead to the disappearance of the native honeybee subspecies, , with severe consequences for local biodiversity. Although beekeepers play a pivotal role in mitigating this crisis, beekeeping in Ireland is less intensive compared to other European regions, lacking significant infrastructure or support.

Physician responses to Medicare reimbursement rates.

This paper investigates how office-based physicians respond to Medicare reimbursement changes. Using variation from an Affordable Care Act policy that increased reimbursements for office-based care in four states, we use a triple difference analysis, comparing physicians with higher and lower reimbursement changes in treated states to similar physicians in untreated states. We find two mechanisms through which physicians respond.

An exploration of parent perceptions of a take-home loose parts play kit intervention during the COVID-19 pandemic.

The restrictions introduced in response to the COVID-19 pandemic affected the regular routines of Canadians, including access to play and physical activity opportunities, while limiting social connections. In response to this, a recreation centre created take-home play kits that contained loose parts with the aim of facilitating unstructured play. Between August 2021 and January 2022, ten parents participated in semi-structured interviews via telephone or videoconferencing platforms that captured their experiences of the take-home play kits.

The British Columbia Farmers' Market Nutrition Coupon Program Reduces Short-Term Household Food Insecurity Among Adults With Low Incomes: A Pragmatic Randomized Controlled Trial.

Background: The British Columbia Farmers' Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers' markets.

Objective: To examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention.

Design: Secondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention.

Urban Form Metrics for Promoting Walking: Street Layouts and Destinations.

There is evidence that higher street connectivity and availability of destinations can support walking behavior. However, the availability of data and comparability between previous studies remain a challenge. Based on a large Canadian adult sample, this study examined the associations between street layout and walking behaviors and explored whether objectively measured destinations may mediate these relationships.

Sponge-derived fatty acids inhibit biofilm formation of MRSA and MSSA by down-regulating biofilm-related genes specific to each pathogen.

Aim: A promising approach for the development of next-generation antimicrobials is to shift their target from causing bacterial death to inhibiting virulence. Marine sponges are an excellent potential source of bioactive anti-virulence molecules (AVM). We screened fractions prepared from 26 samples of Irish coastal sponges for anti-biofilm activity against clinically relevant pathogens.

An Observational Study on Play and Physical Activity Associated with a Recreational Facility-Led Park-Based "Loose Parts" Play Intervention during the COVID-19 Pandemic.

Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children's play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, Canada) during the pandemic.