pioneer

The unknown planktonic foraminiferal pioneer Henry A. Buckley and his collection at The Natural History Museum, London

The Henry Buckley Collection of Planktonic Foraminifera at the Natural History Museum in London (NHMUK) consists of 1665 single-taxon slides housing 23 897 individuals from 203 sites in all the major ocean basins, as well as a vast research library of Scanning Electron Microscope (SEM) photomicrographs. Buckley picked the material from the NHMUK Ocean-Bottom Deposit Collection and also from fresh tow samples. However, his collection remains largely unused as he was discouraged by his managers in the Mineralogy Department from working on or publicizing the collection. Nevertheless, Buckley published pioneering papers on isotopic interpretation of oceanographic and climatic change and was one of the first workers to investigate foraminiferal wall structure using the SEM technique. Details of the collection and images of each slide are available via the NHMUK Data Portal (http://dx.doi.org/10.5519/0035055). The Buckley Collection and its associated Ocean-Bottom Deposit Collection have great potential for taxon-specific studies as well as geochemical work, and both collections are available on request.




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Rock 'n' roll pioneer Little Richard dies at age 87: Rolling Stone

Little Richard, the self-proclaimed "architect of rock 'n' roll" who built his ground-breaking sound with a boiling blend of boogie-woogie, rhythm and blues and gospel, died on Saturday at the age of 87, Rolling Stone magazine reported.




pioneer

The Pioneering Health Officer Who Saved Portland From the Plague

Tasked with curbing a 1907 outbreak, Esther Pohl emphasized the importance of clean, vermin-free environments




pioneer

Florian Schneider, Kraftwerk founder and electronic music pioneer, dies at 73

Florian Schneider, co-founder of pioneering German electronic band Kraftwerk, which influenced generations of pop and dance musicians with mesmerising tracks such as "Autobahn", has died of cancer aged 73, longtime bandmate Ralf Huetter said.




pioneer

Rock 'n' roll pioneer Little Richard dies at age 87: Rolling Stone

Little Richard, the self-proclaimed "architect of rock 'n' roll" who built his ground-breaking sound with a boiling blend of boogie-woogie, rhythm and blues and gospel, died on Saturday at the age of 87, Rolling Stone magazine reported.




pioneer

Phyllis Lyon death: Civil rights pioneer and face of gay marriage dies aged 95

Gay rights pioneer Phyllis Lyon has died aged 95.




pioneer

Pioneering surgeon and brave nurse fall victim to coronavirus

A pioneering heart surgeon and a dedicated nurse who volunteered to treat Covid-19 patients are among the latest Londoners to die with the virus.




pioneer

England's first NHS coronavirus recovery hospital named after pioneering nurse opens in Surrey

A hospital set up to care for people recovering from Covid-19 will be named after the pioneering nurse Mary Seacole to pay tribute to nurses on the frontline of the coronavirus pandemic.




pioneer

Robert May, former UK chief scientist and chaos theory pioneer, dies aged 84

Friends and colleagues pay tribute to gifted polymath whose achievements spanned biology, physics and public policy

Pioneering Australian scientist Robert May, whose work in biology led to the development of chaos theory, has died at age 84.

Known as one of Australia’s most accomplished scientists, he served as the chief scientific adviser to the United Kingdom, was president of the Royal Society, and was made a lord in 2001.

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Little Richard, Flamboyant Rock and Roll Pioneer, Dies at 87

Flamboyant singer-instrumentalist Little Richard, whose high-voltage, keyboard-shattering R&B singles supplied lift-off for the ’50s rock ‘n’ roll revolution, has died. The musician, whose birth name was Richard Penniman, was 87, although some sources say he was older. His death was confirmed by his son, Danny Jones Penniman, who told the New York Times the cause […]




pioneer

The A Word review: The pioneering if understated drama returns at just the right time

This series' great beauty is that it's about relationships in all their unpredictability – perfect for locked-down viewers who are seeking out human interaction vicariously




pioneer

Pioneering Afrobeat drummer Tony Allen dies aged 79

Pioneering Afrobeat drummer Tony Allen has died at the age of 79.




pioneer

John McDermott: Tottenham's loss will be the country's gain as coaching pioneer joins FA

According to those who know him best, Tottenham's head of coaching and development, John McDermott, is one of English football's more recent pioneers.




pioneer

Little Richard Dies: Rock ‘N Roll Pioneer And Seminal Hitmaker Was 87

Little Richard, the wild singer/pianist/songwriter who was one of rock ‘n roll’s pioneers, has died at age 87. His death was confirmed by his son, but the cause was not given. Little Richard’s catalog of hits is still performed by many bar bands to this day, and the songs were recorded by such acts as […]





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A pioneering study into the description of the architecture of a new standard for telecommunications

The International Telecommunication Union (ITU) is a United Nations Organization agency commissioned to regulate international telecommunications between different operating administrations and businesses. Pursuant to specific recommendations by this organization, on 1 July, standard Y.3172, an architecture for machine learning in future networks (5G and beyond), was approved for telecommunications networks.




pioneer

Little Richard, flamboyant and legendary rock ‘n’ roll pioneer, dead at 87


Born Richard Penniman, Little Richard was one of rock ‘n’ roll’s founding fathers who helped shatter the colour line on the music charts, joining Chuck Berry and Fats Domino in bringing what was once called “race music” into the mainstream.




pioneer

Florian Schneider, co-founder of electronic pioneers Kraftwerk, dies at 73

Florian Schneider, the co-founder of Kraftwerk, the German electronic group that changed the sound of pop music, has died of cancer.




pioneer

Rock and roll pioneer Little Richard has died aged 87

The music legend was credited with changing the face of music




pioneer

'Pioneering' study reveals collagen peptide changes during digestion

Rousselot, the collagen-based ingredients producer, has revealed a new study which it says provides important answers surrounding the bioavailability of collagen peptides and the modifications they undergo during digestion.




pioneer

Salsa music pioneer Ismael Quintana died

He became a pioneer of salsa music and was renowned for hits such as Puerto Rico, Adoracion, No se compara and Maestro rumbero.




pioneer

China Pioneers a National Digital Currency. Can the U.S. Catch Up?

While much of the world is consumed by the COVID-19 crisis, the Chinese government is quietly unleashing a financial innovation that will reshape its economy and improve its strategic standing for decades to come. In April, China’s central bank introduced the “digital yuan” in a pilot program across four cities, becoming the world’s first major economy to issue a national digital currency.




pioneer

China Pioneers a National Digital Currency. Can the U.S. Catch Up?

While much of the world is consumed by the COVID-19 crisis, the Chinese government is quietly unleashing a financial innovation that will reshape its economy and improve its strategic standing for decades to come. In April, China’s central bank introduced the “digital yuan” in a pilot program across four cities, becoming the world’s first major economy to issue a national digital currency.




pioneer

China Pioneers a National Digital Currency. Can the U.S. Catch Up?

While much of the world is consumed by the COVID-19 crisis, the Chinese government is quietly unleashing a financial innovation that will reshape its economy and improve its strategic standing for decades to come. In April, China’s central bank introduced the “digital yuan” in a pilot program across four cities, becoming the world’s first major economy to issue a national digital currency.




pioneer

China Pioneers a National Digital Currency. Can the U.S. Catch Up?

While much of the world is consumed by the COVID-19 crisis, the Chinese government is quietly unleashing a financial innovation that will reshape its economy and improve its strategic standing for decades to come. In April, China’s central bank introduced the “digital yuan” in a pilot program across four cities, becoming the world’s first major economy to issue a national digital currency.




pioneer

A More Complete Picture of Pioneer ACO Results


The Centers for Medicare and Medicaid Services (CMS) recently released more detailed ACO-level data for participants in first two years of the Pioneer ACO Model. The program, which is designed for health systems with more experience assuming financial risk for patient populations, has generated savings and improvements in quality measures, but has also struggled to retain participants. The program began with 32 provider organizations; following a series of recent announcements there are now 19 total participants.

Last month, CMS announced that the Pioneer Program was able to yield total program savings of $96 million in its second year and resulted in ACOs sharing in savings of $68 million. CMS also reported that the Pioneers were able to improve mean quality scores by 19 percent and increased performance on 28 of 33 measures between performance year one and performance year two.

Financial Results

The latest financial results provide more participant-level data and allow for a new level of analysis of performance across all these ACOs. In year one of the program, financial performance for individual Pioneers ranged from a gross loss of $9.31 million to a gross savings of $23.34 million. Thirteen Pioneers reduced costs enough to qualify for shared savings, with an average of $5.85 million returned to the ACOs, ranging from $1.00 million to $14.00 million. One ACO owed shared losses of $2.55 million. The remaining eighteen ACOs were within the minimum savings or loss rate and did not earn shared savings or owe money to Medicare due to losses.

Following year one, nine Pioneer ACOs either left the Medicare ACO program entirely, or moved to the lower risk Medicare Shared Savings Program (MSSP). Eight of the nine Pioneers that left the program failed to reduce spending in their first year. Out of the remaining 23 participants in the second performance year, three of these ACOs opted to defer reconciliation until the end of Performance Year 3. The 20 Pioneers with final Performance Year 2 data had financial performance ranging from a gross savings of $24.59 million to gross losses of $6.26 million. Fourteen ACOs reduced spending in Performance Year 2, eleven of which reduced enough to qualify for shared savings. The average shared savings for these ACOs was $6.55 million, ranging from $1.22 million to $13.41 million. Three Pioneers shared losses, averaging $2.33 million back to the Medicare program.

The table below shows the breakdown of ACOs according to whether they reduced spending, increased spending, shared in savings, or owed money back to Medicare due to losses. More than half of the Pioneers were able to reduce spending in year one (18/32) and year two (14/23), with more than one-third of total ACOs earning shared savings in each year as well.

The data also suggest that those ACOs that were most successful in reducing spending in the first year were also more likely to reduce spending in their second year. As the chart below shows, three ACOs that earned shared savings in year one owed money back to Medicare due to losses in year two, while no ACO that had shared losses in year one was able to attain shared savings in year two.  

Quality Results

CMS also released ACO-level performance on all 33 measures for Pioneer participants in year one and year two. The 23 ACOs that remain in the Pioneer Program showed overall improvement in average quality scores from the first to second performance year. The ACOs also improved overall on 28 of 33 measures, as the chart below shows.

The quality domain with the greatest improvement in year two was Domain 4 (At Risk-Populations) which saw an overall improvement from 67.5% to 83%. The marked improvement in this domain suggests that ACOs are making progress at better coordinating and delivery care for high-risk patients, many of whom have multiple chronic conditions. Chronic care management for conditions such as diabetes, coronary artery disease, and hypertension is critical for the continued success of accountable care efforts. All other domains saw average quality improvement as well, summarized below.

Likewise, almost all of the individual Pioneer ACOs improved their performance on quality measures from year one to year two. Of the ACOs that remained in the program for year two, all but one ACO was able to improve its overall quality score in its second year.

Additionally, the percentage of Pioneer ACOs performing in the 80th or 90th percentile in quality scores also increased from year one to year two, as shown in the chart below.

Putting Together Financial and Quality Results

In year one of the Pioneer Program there appeared to be no direct correlation between average quality scores and gross savings or losses for individual ACOs. This may not be unexpected, especially since Pioneer ACOs in their first year are eligible for shared savings simply by reporting their quality. In subsequent years, however, the ACO’s quality score impacts the level of shared savings that the Pioneers are eligible to receive, so we might expect a bit more alignment between quality and financial performance. Average quality scores and level of savings or losses for each of the 32 first year Pioneer ACOs is below.

After year two, there still does not appear to be a direct relationship between higher quality scores and level of savings or losses in the Pioneer Program. Further examination of results begs additional questions about why certain ACOs clustered in different parts of the grid relative to others.

Of those ACOs in the red circle above— higher total savings and relatively average quality scores—two of the ACOs are from the Boston area and the remaining ones from other large metropolitan areas (New York City; Orange County, CA; Phoenix, AZ; and Detroit, MI). The average per capita Medicare spending for the counties corresponding to these ACOs is $11,544, compared to an average of $10,384 for counties corresponding to all 23 of the Pioneer participants.

Meanwhile those ACOs within the yellow circle had the highest quality scores, but also experience financial losses or slight savings. Many of these ACOs are from less densely populated areas, such as Maine, Wisconsin, and Illinois. There are a number of factors that could be contributing to their quality success, but little financial savings—healthier patient populations, a smaller or more engaged patient population, financial baselines impacted by lower per capita spending in these areas, or other factors driven by their region. Further analysis of these ACOs and the other public and private ACO programs, including both their characteristics and regional market characteristics, will provide needed further insights on the factors most likely to drive success.

Next Steps

These ACO-level data reflect the range of experiences across Pioneer participants. Some ACOs have sustained positive performance to date, while others have seen diminishing rates of return. Those organizations more committed to clinical transformation, patient outreach, and organizational change may be more likely to do better, but further analysis of differences in performance could enable the Pioneer Program and ACOs to achieve bigger impacts over time.

It is hard to know what the third performance year of the Pioneer program will show, but as noted earlier, the Pioneer Program has already lost over a third of its original 32 participants. Despite the decline in participation and mixed results so far, CMS remains optimistic and committed to the program, and the overall number of Medicare, Medicaid, and privately-insured individuals in ACO arrangements continues to rise. We can anticipate a proposed rule impacting the MSSP, likely later this Fall, which will impact elements of the Pioneer ACO program. Regulatory changes that may help increase the ability of the Medicare ACO programs to support better care while ensuring sustainability include: adjustments to attribution methods, benchmark calculations, collection and sharing of data with ACOs, updating performance measures, linking to other ongoing payment and delivery reforms, and creating more financial sustainability for program participants. The current Pioneer program can be a key step toward effective payment reform, but further steps are needed to assure long-term success.

Authors

       




pioneer

The John Hope Gateway is a pioneer in modern wood construction

What a joy to stumble upon this 2009 gem by Cullinan Studio.




pioneer

Pioneering green roofed building by Ted Cullinan saved from demolition

It was designed to stay cool without air conditioning, and the green roof was part of the strategy.




pioneer

UK commits £58m to pioneering electric flight

Greener aviation is about to get a boost.






pioneer

Baroda Pioneer Hybrid Equity Fund - Plan A - Bonus Option

Category Hybrid Scheme - Aggressive Hybrid Fund
NAV 43.50
Repurchase Price 43.07
Sale Price 43.50
Date 27-Dec-2016




pioneer

Baroda Pioneer Treasury Advantage Fund- Regular Plan - Quarterly Dividend Option

Category Debt Scheme - Low Duration Fund
NAV 1204.9392
Repurchase Price 1204.9392
Sale Price 1204.9392
Date 29-Sep-2016




pioneer

Baroda Pioneer Treasury Advantage Fund - Plan B (Direct) - Bonus Option

Category Debt Scheme - Low Duration Fund
NAV 1947.0463
Repurchase Price 1947.0463
Sale Price 1947.0463
Date 30-May-2017




pioneer

Baroda Pioneer Banking And Financial Services Fund - Plan B (Direct) - Bonus Option

Category Equity Scheme - Sectoral/ Thematic
NAV 14.75
Repurchase Price 14.60
Sale Price 14.75
Date 01-Sep-2015




pioneer

Kotak Pioneer Fund-Direct Plan- Dividend Reinvestment Option

Category Equity Scheme - Sectoral/ Thematic
NAV 8.546
Repurchase Price
Sale Price
Date 08-May-2020




pioneer

Kotak Pioneer Fund- Regular Plan- Growth Option

Category Equity Scheme - Sectoral/ Thematic
NAV 8.465
Repurchase Price
Sale Price
Date 08-May-2020




pioneer

Kotak Pioneer Fund- Regular Plan- Dividend Reinvestment Option

Category Equity Scheme - Sectoral/ Thematic
NAV 8.465
Repurchase Price
Sale Price
Date 08-May-2020




pioneer

Kotak Pioneer Fund- Direct Plan- Growth Option

Category Equity Scheme - Sectoral/ Thematic
NAV 8.545
Repurchase Price
Sale Price
Date 08-May-2020




pioneer

Cookbook Contemplation by The Pioneer Woman

Have I ever told you that I really like/enjoy/have fun writing cookbooks? I do. Sure, they are all-encompassing and take over my life while they are being written/cooked/photographed/edited, but in the end, I’m always happy that I spent the time making it (hopefully!) what I wanted it to be. My number one goal when I […]




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Food Network and Cookbook Update! by The Pioneer Woman

I’ve been handling Paige’s departure to college pretty well! After the initial weeping, wailing, and gnashing of teeth, I basically just set up camp in my kitchen and have hardly left. It’s my safe zone. My haven. My happy place. Unless the sink is full of dishes, then I want to sell the house. Oh, […]




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Instant Pot Pot Roast by The Pioneer Woman

(First, can we just reflect on the phrase “Pot Pot” in the title of this post? There’s just no way to avoid it! I tried. Pot Pot!) Instant Pots are everywhere! They’re a cooking appliance known as a “Multi Cooker” which means it has several different functions, its most notable (and useful, in my experience) […]




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Cooking Away by The Pioneer Woman

I mentioned on Confessions that I’ve been cooking away on recipes for my next cookbook.     It won’t be out until NEXT October.     It feels great to start ahead of time! This is a new concept for me.     I’m a little afraid it will be like the few time I […]




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Mini Turtle Cheesecakes by The Pioneer Woman

I love cheesecake, but sometimes I can’t be bothered to make a big, honking full-sized one. I don’t know what the mental block is, but if I have the idea “Hey! I think I’ll make a cheesecake!” I immediately get really tired and want to get back in bed. I think it’s partly to do […]




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Creamy Roasted Red Pepper Soup by The Pioneer Woman

Roasted red peppers are my favorite pantry item; well, they’re up there alongside jars of good marinara sauce. You can turn a jar or two of roasted red peppers into so many different recipes, from soups to sauces to panini to dips. The flavor is mild and slightly sweet, and I’m always amazed at how […]




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Pork Rind Chicken Strips! by The Pioneer Woman

I’ve been excited to share these delightful chicken strips on my blog ever since I first made them earlier this year. They’re in my new cookbook, and if you can get past the initial weirdness of the recipe title, you will become absolutely smitten with how tasty they are.     First: About pork rinds! […]




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Chicken & Veggie Fall Skillet by The Pioneer Woman

I tried and tried to think of something bad to say about this recipe…but I haven’t come up with anything yet! Everything—from the seasoned roasted chicken to the tender autumnal veggies, to the luscious balsamic glaze to the crispy toast it’s served with—is just lovely. Winner, winner, chicken dinner and all that jazz. Here’s how […]




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Tomato Soup 2.0 by The Pioneer Woman

As I have covered on Confessions, the Drummond kids and I have been making the most of our time at home by filming episodes of my Food Network show in the Lodge kitchen. Episode 2 of this “Staying Home” series airs tomorrow morning (April 25) and I wanted to share one of the recipes from […]




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Saturday’s Recipes! by The Pioneer Woman

As I have been documenting on Confessions, I have a new “Staying Home” episode airing on Food Network tomorrow, and I think you’re going to love the recipes! These will be featured on the show Saturday morning, and the recipes will be available on Food Network’s website! These were a lot of fun to make […]




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Legendary drummer and Afrobeat pioneer Tony Allen dies in Paris

Legendary Nigerian drummer Tony Allen, who created afrobeat along with his old bandmate Fela Kuti, died suddenly at the age of 79 in Paris on Thursday, his manager told AFP.