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https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#1
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339426/evolution-of-us-health-care-reform
#2
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28334954/the-science-and-politics-of-naming-reforming-anatomical-nomenclature-ca-1886-1955
#3
Tatjana Buklijas
Anatomical nomenclature is medicine's official language. Early in their medical studies, students are expected to memorize not only the bodily geography but also the names for all the structures that, by consensus, constitute the anatomical body. The making and uses of visual maps of the body have received considerable historiographical attention, yet the history of production, communication, and reception of anatomical names-a history as long as the history of anatomy itself-has been studied far less. My essay examines the reforms of anatomical naming between the first modern nomenclature, the 1895 Basel Nomina Anatomica (BNA), and the 1955 Nomina Anatomica Parisiensia (NAP, also known as PNA), which is the basis for current anatomical terminology...
February 11, 2017: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/28333869/macra-a-new-age-for-physician-payments
#4
Kent Kwasind Huston
The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 introduced a new system of physician payments in the United States. This legislation and the complex rules written to enact the law intend to force a shift away from volume-based payments and into so called value-based payments. Physicians and other clinicians will be graded via quality and cost metrics and payments will be adjusted based on performance. Robust use of certified electronic health records is required under MACRA. Physicians will follow one of two payment reform tracks known as the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) pathways...
April 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28333221/surgical-treatment-of-adhesion-related-chronic-abdominal-and-pelvic-pain-after-gynaecological-and-general-surgery-a-systematic-review-and-meta-analysis
#5
Barend A van den Beukel, Roy de Ree, Suzanne van Leuven, Erica A Bakkum, Chema Strik, Harry van Goor, Richard P G Ten Broek
BACKGROUND: Chronic pain is a frequent post-operative complication, affecting ~20-40% of patients who have undergone surgery of the female genital or alimentary tract. Chronic pain is an important risk factor for diminished quality of life after surgery. Adhesions are frequently associated with chronic post-operative pain; however, surgical treatment of adhesion-related pain is controversial. OBJECTIVE AND RATIONALE: The aim of this study was to investigate the efficacy and harms of surgical interventions for chronic post-operative pain attributable to adhesions...
March 2, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28333121/glycerol-production-and-transformation-a-critical-review-with-particular-emphasis-on-glycerol-reforming-reaction-for-producing-hydrogen-in-conventional-and-membrane-reactors
#6
REVIEW
Giuseppe Bagnato, Adolfo Iulianelli, Aimaro Sanna, Angelo Basile
Glycerol represents an emerging renewable bio-derived feedstock, which could be used as a source for producing hydrogen through steam reforming reaction. In this review, the state-of-the-art about glycerol production processes is reviewed, with particular focus on glycerol reforming reactions and on the main catalysts under development. Furthermore, the use of membrane catalytic reactors instead of conventional reactors for steam reforming is discussed. Finally, the review describes the utilization of the Pd-based membrane reactor technology, pointing out the ability of these alternative fuel processors to simultaneously extract high purity hydrogen and enhance the whole performances of the reaction system in terms of glycerol conversion and hydrogen yield...
March 23, 2017: Membranes
https://www.readbyqxmd.com/read/28332943/effects-of-different-models-of-dialysis-care-on-patient-important-outcomes-a-systematic-review-and-meta-analysis
#7
Priya Ramar, Ahmed T Ahmed, Zhen Wang, Sagar S Chawla, Maria Lourdes Gonzalez Suarez, LaTonya J Hickson, Ann Farrell, Amy W Williams, Nilay D Shah, M Hassan Murad, Bjorg Thorsteinsdottir
Ongoing payment reform in dialysis necessitates better patient outcomes and lower costs. Suggested improvements to processes of care for maintenance dialysis patients are abundant; however, their impact on patient-important outcomes is unclear. This systematic review included comparative randomized controlled trials or observational studies with no restriction on language, published from 2000 to 2014, involving at least 5 adult dialysis patients who received a minimum of 6 months of follow-up. The effect size was pooled and stratified by intervention strategy (multidisciplinary care [MDC], home dialysis, alternate dialysis settings, and electronic health record implementation)...
March 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28332223/change-management-in-an-environment-of-ongoing-primary-health-care-system-reform-a-case-study-of-australian-primary-health-care-services
#8
Sara Javanparast, Janny Maddern, Fran Baum, Toby Freeman, Angela Lawless, Ronald Labonté, David Sanders
INTRODUCTION/BACKGROUND: Globally, health reforms continue to be high on the health policy agenda to respond to the increasing health care costs and managing the emerging complex health conditions. Many countries have emphasised PHC to prevent high cost of hospital care and improve population health and equity. The existing tension in PHC philosophies and complexity of PHC setting make the implementation and management of these changes more difficult. This paper presents an Australian case study of PHC restructuring and how these changes have been managed from the viewpoint of practitioners and middle managers...
March 22, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28331120/color-functionality-used-in-visual-display-for-occupational-and-environmental-safety-and-managing-color-vision-deficiency
#9
Nobuhisa Ochiai, Hiroyuki Kondo
The effects of color perception are utilized in visual displays for the purpose of safety in the workplace and in daily life. These effects, generally known as color functionality, are divided into four classifications: visibility, legibility, conspicuity and discriminability. This article focuses on the relationship between the color functionality of color schemes used in visual displays for occupational and environmental safety and color vision deficiency (particularly congenital red-green color deficiency), a critical issue in ophthalmology, and examines the effects of color functionality on the perception of the color red in individuals with protan defects...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28330992/localized-hepatic-lobular-regeneration-by-central-vein-associated-lineage-restricted-progenitors
#10
Jonathan M Tsai, Pang Wei Koh, Ania Stefanska, Liujing Xing, Graham G Walmsley, Nicolas Poux, Irving L Weissman, Yuval Rinkevich
The regeneration of organ morphology and function following tissue loss is critical to restore normal physiology, yet few cases are documented in mammalian postnatal life. Partial hepatectomy of the adult mammalian liver activates compensatory hepatocyte hypertrophy and cell division across remaining lobes, resulting in restitution of organ mass but with permanent alteration of architecture. Here, we identify a time window in early postnatal life wherein partial amputation culminates in a localized regeneration instead of global hypertrophy and proliferation...
March 22, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28329760/low-temperature-hydrogen-production-from-water-and-methanol-using-pt-%C3%AE-moc-catalysts
#11
Lili Lin, Wu Zhou, Rui Gao, Siyu Yao, Xiao Zhang, Wenqian Xu, Shijian Zheng, Zheng Jiang, Qiaolin Yu, Yong-Wang Li, Chuan Shi, Xiao-Dong Wen, Ding Ma
Polymer electrolyte membrane fuel cells (PEMFCs) running on hydrogen are attractive alternative power supplies for a range of applications, with in situ release of the required hydrogen from a stable liquid offering one way of ensuring its safe storage and transportation before use. The use of methanol is particularly interesting in this regard, because it is inexpensive and can reform itself with water to release hydrogen with a high gravimetric density of 18.8 per cent by weight. But traditional reforming of methanol steam operates at relatively high temperatures (200-350 degrees Celsius), so the focus for vehicle and portable PEMFC applications has been on aqueous-phase reforming of methanol (APRM)...
March 22, 2017: Nature
https://www.readbyqxmd.com/read/28329466/healthcare-reform-literacy-among-academic-dermatologists-what-we-know-and-don-t-know-about-the-affordable-care-act
#12
Brian A Raphael, Suephy Chen, Benjamin Stoff
IMPORTANCE: There have been no attempts to determinethe understanding of the Affordable Care Act (ACA)among dermatologists. OBJECTIVE: Assess knowledgeof the ACA among academic dermatologists. DESIGN: A 21-item survey was administered to membersof the Association of Professors of Dermatology(APD). The items assessed knowledge and opinionsof the ACA, and demographics of the participants.Multivariate regressions were conducted todetermine associations between variables...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328283/the-mirage-of-reform-republicans-struggle-to-dismantle-obamacare
#13
Jonathan Oberlander
Republicans have vowed to repeal and replace the Affordable Care Act (ACA) ever since its enactment. But President Donald Trump and congressional Republicans are discovering what Democrats learned long ago: health care reform is politically treacherous. Can the GOP dismantle Obamacare? The bill..
March 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28328273/the-origins-of-a-two-tier-profession-a-nursing-school-at-a-poor-law-infirmary
#14
Niall McCrae, Katerina Kuzminska
Niall McCrae, Lecturer, and Katerina Kuzminska, Postgraduate Nursing Student, Florence Nightingale Faculty of Nursing and Midwifery, King's College, London, chart the influences of Nightingale's Poor Law infirmary reforms.
March 9, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28328220/shock-wave-chemistry-in-a-metal-organic-framework
#15
Zhi Su, William L Shaw, Yu-Run Miao, Sizhu You, Dana D Dlott, Kenneth S Suslick
Metal-organic frameworks (MOFs) have potential applications as energy absorbing materials for shock wave energy mitigation due to their nanoporosity. Here we have examined km/s laser-driven flyer plate impacts on a prototypical MOF, ZIF-8. We observed particle fragmentation and morphological changes in microcrystals of ZIF-8 at lower shock pressures (≈2.5 GPa), and amorphization and structural collapse at higher pressures (≈8 GPa). High-speed emission spectroscopy revealed that 50 ns after flyer plate impacts, an emission pulse was generated by ZIF-8 resulting from chemical bonds that were broken and subsequently reformed...
March 22, 2017: Journal of the American Chemical Society
https://www.readbyqxmd.com/read/28327143/the-imperative-for-systems-thinking-to-promote-access-to-medicines-efficient-delivery-and-cost-effectiveness-when-implementing-health-financing-reforms-a-qualitative-study
#16
Tom Achoki, Abaleng Lesego
BACKGROUND: Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. METHODS: We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28325241/radiation-oncology-in-the-developing-economies-of-central-and-eastern-europe
#17
REVIEW
Natia Esiashvili
Eastern Europe is represented by 22 countries of significant variability in population density and degree of economic development. They have been affected by past geopolitical isolation due to their association with the "Soviet Block." Currently, all Eastern European countries except Slovenia are low- or middle-income level and 10 of them are part of European Union. Health care systems in Central and Eastern Europe have been influenced by the legacy of centralized soviet-era governance; however, most countries, particularly in European Union zone, have gone through health care reforms directed toward modernizing infrastructure and staffing...
April 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28324191/planarian-homolog-of-puromycin-sensitive-aminopeptidase-djpsa-is-required-for-brain-regeneration
#18
Suge Wu, Bin Liu, Zuoqing Yuan, Xiufang Zhang, Hong Liu, Qiuxiang Pang, Bosheng Zhao
Puromycin-sensitive aminopeptidase (PSA) belongs to the M1 zinc metallopeptidase family. PSA is the most abundant aminopeptidase in the brain and plays a role in the metabolism of neuropeptides including those involved in neurodegeneration. A cDNA DjPsa was identified from the planarian Dugesia japonica cDNA library. It contains a 639-bp open reading frame corresponding to a deduced protein of 212 amino acids. Whole mount in situ hybridization revealed that DjPsa is expressed in the brain and ventral nerve cords of intact and regenerating animals and demonstrates a tissue and stage-specific expression pattern of DjPsa in developing embryos and larvae...
June 2017: Invertebrate Neuroscience: IN
https://www.readbyqxmd.com/read/28324144/participatory-planning-monitoring-and-evaluation-of-multi-stakeholder-platforms-in-integrated-landscape-initiatives
#19
Koen Kusters, Louise Buck, Maartje de Graaf, Peter Minang, Cora van Oosten, Roderick Zagt
Integrated landscape initiatives typically aim to strengthen landscape governance by developing and facilitating multi-stakeholder platforms. These are institutional coordination mechanisms that enable discussions, negotiations, and joint planning between stak4eholders from various sectors in a given landscape. Multi-stakeholder platforms tend to involve complex processes with diverse actors, whose objectives and focus may be subjected to periodic re-evaluation, revision or reform. In this article we propose a participatory method to aid planning, monitoring, and evaluation of such platforms, and we report on experiences from piloting the method in Ghana and Indonesia...
March 21, 2017: Environmental Management
https://www.readbyqxmd.com/read/28323603/how-medicine-may-save-the-life-of-us-immigration-policy-from-clinical-and-educational-encounters-to-ethical-public-policy
#20
Mark G Kuczewski
Medicine has a conceptual contribution to make to the immigration debate. Our nation has been unable to move forward with meaningful immigration reform because many citizens seem to assume that immigrants are in the United States to access benefits to which they are not entitled. In contrast, when medicine encounters undocumented immigrants in the health care or medical education setting, it is obvious that their contributions to our health care system are denied by exclusionary laws. When the system is amended to be inclusive, immigrants become contributors to the systems that they access...
March 1, 2017: AMA Journal of Ethics
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