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Safety net

Michael S Businelle, Ping Ma, Darla E Kendzor, Summer G Frank, David W Wetter, Damon J Vidrine
BACKGROUND: Mobile phone‒based real-time ecological momentary assessments (EMAs) have been used to record health risk behaviors, and antecedents to those behaviors, as they occur in near real time. OBJECTIVE: The objective of this study was to determine if intensive longitudinal data, collected via mobile phone, could be used to identify imminent risk for smoking lapse among socioeconomically disadvantaged smokers seeking smoking cessation treatment. METHODS: Participants were recruited into a randomized controlled smoking cessation trial at an urban safety-net hospital tobacco cessation clinic...
October 17, 2016: Journal of Medical Internet Research
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
Ethel M Brinda, Anto P Rajkumar, Jǿrn Attermann, Ulf G Gerdtham, Ulrika Enemark, Kuruthukulangara S Jacob
OBJECTIVE: Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs...
July 25, 2016: American Journal of Geriatric Psychiatry
Kendall R Beck, Nicole Kim, Mandana Khalili
BACKGROUND: Vulnerable populations are disproportionately affected by hepatitis C virus (HCV) infection and experience high rates of health disparity. There are no data on real-world experience with highly efficacious direct-acting anti-HCV treatment in this population. AIMS: We aimed to evaluate the real-world experience with sofosbuvir-based regimens among a vulnerable HCV-infected population. METHODS: HCV treatment response was assessed among 204 patients who completed 12-24 weeks of sofosbuvir-based regimens (in combination with pegylated interferon and ribavirin, simeprevir, ledipasvir, or daclatasvir) at the San Francisco safety-net healthcare system liver specialty clinic between January 2014 and December 2015...
October 14, 2016: Digestive Diseases and Sciences
Zeinab M Alawadi, Isabel M Leal, Juan R Flores, Julie L Holihan, Blake E Henchcliffe, Thomas O Mitchell, Tien C Ko, Mike K Liang, Lillian S Kao
BACKGROUND: The purpose of this study was to identify issues important to patients in their decision-making, expectations, and satisfaction when seeking treatment for a ventral hernia. STUDY DESIGN: An exploratory qualitative study was conducted of adult patients with ventral hernias seeking care at a safety-net hospital. Two semi-structured interviews were conducted with each patient: prior to and 6 -months following surgical consultation. Interviews were audiotaped, transcribed, and coded using latent content analysis until data saturation was achieved...
October 11, 2016: Journal of the American College of Surgeons
Zobair M Younossi, Haesuk Park, Douglas Dieterich, Sammy Saab, Aijaz Ahmed, Stuart C Gordon
BACKGROUND: New direct-acting antiviral (DAA) therapy has dramatically increased cure rates for patients infected with hepatitis C virus (HCV), but has also substantially raised treatment costs. AIM: The aim of this analysis was to evaluate the therapeutic benefit and net costs (i.e. efficiency frontier) and the quality-adjusted cost of care associated with the evolution of treatment regimens for patients with HCV genotype 1 in the United States. DESIGN: A decision-analytic Markov model...
October 2016: Medicine (Baltimore)
Sandi Rowland, Jonathon P Leider, Clare Davidson, Joanne Brady, Alana Knudson
OBJECTIVES: To characterize the expansion of a community dental access program (CDP) in rural Maryland providing urgent dental care to low-income individuals, as well as the CDP's impact on dental-related visits to a regional emergency department (ED). METHODS: We used de-identified CDP and ED claims data to construct a data set of weekly counts of CDP visits and dental-related ED visits among Maryland adults. A time series model examined the association over time between visits to the CDP and ED visits for fiscal years (FYs) 2011 through 2015...
October 13, 2016: American Journal of Public Health
Linda Aldoory, Mark D Macek, Kathryn A Atchison, Hayan Chen
There has been growing national concern over the low health literacy of Americans and, coinciding with this, a growing importance placed on measuring health literacy. Health literacy is the ability to access, understand, and use information to make health decisions. Health literacy in an oral health context means access to accurate information about oral health, understanding the risks of neglecting oral care, and calculating the chances of getting periodontal disease. This exploratory study compared the 3 most popular and well-tested health literacy measures in an oral health setting...
October 11, 2016: Journal of Health Communication
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No abstract text is available yet for this article.
October 2016: Nursing for Women's Health
Mustafa Hussein, Ana V Diez Roux, Robert I Field
Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics)...
October 7, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Francesco Pelliccia, Salvatore Rosanio, Giuseppe Marazzi, Sara Poggi, Alessandra Tanzilli, Cesare Greco, Carlo Gaudio, Giuseppe Rosano
The high risk of both stroke and major bleeding in atrial fibrillation (AF) patients with chronic kidney disease (CKD) defines an important population for whom the assessment of the balance between the risk of ischemic stroke and of bleeding is essential. The use of novel oral anticoagulants (NOACs) may be a viable option in this population due to their greater net clinical benefit than warfarin, as demonstrated by the results of the clinical phase III trials. NOACs have been found to have a greater net clinical benefit than warfarin in patients at high risk of either stroke (CHADS2≥1 or CHA2DS2-VASc score≥2) or bleeding (HAS-BLED≥3)...
October 1, 2016: International Journal of Cardiology
Stephanie Potochnick
The safety net that immigrants face today differs significantly from the immediate post-Welfare Reform era in terms of eligibility and economic context. To inform debates on immigrant access to the safety net, this paper examines implications of the 2002 Farm Security and Rural Investment Act, which restored food stamp eligibility to nearly two-thirds of immigrants who lost eligibility under Welfare Reform. Using data from the 1995-2013 Current Population Survey and a difference-in-difference design, I examine how restoration efforts have influenced food stamp participation and food insecurity rates among low-income Mexican immigrant households with children...
November 2016: Social Science Research
Manuel C D F Maia, Delmar Muniz Lourenço, Rachel Riechelmann
BACKGROUND: Approximately 10% of pancreatic neuroendocrine tumors (NET) are associated with familial syndromes, with the most common type being multiple endocrine neoplasia type 1 (MEN-1). However, the available evidence on how to treat NET comes from studies in sporadic NET. CASE REPORT: Here we report the case of a 51-year-old male patient with a metastatic MEN-1-associated pancreatic NET and hypercalcemia related to primary hyperparathyroidism and tumor-secreted parathyroid-related protein...
2016: Oncology Research and Treatment
Yang Lu, Lilian Serpas, Pauline Genter, Betty Anderson, David Campa, Eli Ipp
INTRODUCTION: Despite availability of screening for diabetic retinopathy, testing is underused by many low-income and racial/ethnic minority patients with diabetes. We examined perceived barriers to diabetic retinopathy screening among low-income patients and their health care providers and provider staffers. METHODS: We collected survey data from 101 patients with diabetes and 44 providers and staffers at a safety-net clinic where annual diabetic retinopathy screening rates were low...
October 6, 2016: Preventing Chronic Disease
Lucinda B Leung, James E Simmons, Julius Ho, Emma Anselin, Rian Yalamanchili, Joseph S Rabatin
BACKGROUND AND OBJECTIVE: Medical students are often unprepared for social challenges in caring for safety net patients. We aim to evaluate and chronicle the evolution of a pre-clinical elective alongside medical disparities curriculum. DESIGN AND METHODS: Medical students designed the course to supplement clinical training on care of vulnerable patients. From 2011-2015, there have been 80 first-year medical student participants, five cohorts of second-year course leaders, and two supporting faculty advisors for this 10-12 session evening elective...
October 4, 2016: Rhode Island Medical Journal
Malcolm Boyce, Andrew R Moore, Liv Sagatun, Bryony N Parsons, Andrea Varro, Fiona Campbell, Reidar Fossmark, Helge L Waldum, David M Pritchard
AIMS: Netazepide, a gastrin/CCK2 receptor antagonist, once daily for 12 weeks reduced the number of tumours and size of the largest one in 16 patients with autoimmune chronic atrophic gastritis (CAG), achlorhydria, hypergastrinaemia and multiple gastric neuroendocrine tumours (type 1 gastric NETs), and normalised circulating chromogranin A (CgA) produced by enterochromaffin-like cells, the source of the tumours. The aim was to assess whether longer-term netazepide treatment can eradicate type 1 gastric NETs...
October 4, 2016: British Journal of Clinical Pharmacology
Shawnita Sealy-Jefferson, Carmen Giurgescu, Jaime Slaughter-Acey, Cleopatra Caldwell, Dawn Misra
Preterm delivery (PTD), or birth before 37 completed weeks of gestation, is a serious public health issue, and racial disparities persist. In a recently published study, perceptions of the residential environment (or neighborhood context) were associated with PTD rates among urban African American women with low educational attainment (≤12 years); however, the mechanisms of these associations are unknown. Given this gap in the literature, we used data from the Life Influences on Fetal Environments Study of postpartum African American women from Metropolitan Detroit, Michigan (2009-2011; n = 399), to examine whether psychosocial factors (depressive symptomology, psychological distress, and perceived stress) mediate associations between perceptions of the neighborhood context and PTD...
October 4, 2016: Journal of Urban Health: Bulletin of the New York Academy of Medicine
Kjell E Oberg, Steven Wj Lamberts
Acromegaly is a hormonal disorder that arises when the pituitary gland secretes excess growth hormone (GH), which in turn stimulates a concomitant increase in serum insulin-like growth factor 1 (IGF-1) levels. Gastroenteropancreatic neuroendocrine tumours (GEP-NET) constitute a heterogeneous group of tumours that can secrete serotonin and a variety of peptide hormones that may cause characteristic symptoms known as carcinoid syndrome, or other symptoms and hormonal hypersecretion syndromes depending on the tumour's site of origin...
October 3, 2016: Endocrine-related Cancer
Matt L Harlow, Nichole Maloney, Joseph Roland, María José Guillén-Navarro, Matthew K Easton, Susan M Kitchen-Goosen, Elissa A Boguslawski, Zachary B Madaj, Ben K Johnson, Megan J Bowman, Maurizio D'Incalci, Mary E Winn, Lisa Turner, Galen Hostetter, Carlos M Galmarini, Pablo M Aviles, Patrick J Grohar
There is a great need to develop novel approaches to target oncogenic transcription factors with small molecules. Ewing sarcoma is emblematic of this need, as it depends on the continued activity of the EWS-FLI1 transcription factor to maintain the malignant phenotype. We have previously shown that the small molecule trabectedin interferes with EWS-FLI1. Here we report important mechanistic advances and a second-generation inhibitor to provide insight into the therapeutic targeting of EWS-FLI1. We discovered that trabectedin functionally inactivated EWS-FLI1 by redistributing the protein within the nucleus to the nucleolus...
October 3, 2016: Cancer Research
Kevin Junus, Maria Aguilar, Priya Patel, David Irwin, Stephen Yee, Benny Liu, Taft Bhuket, Robert J Wong
BACKGROUND: Individuals with chronic hepatitis B virus infection (HBV) or previously resolved HBV are at increased risk of HBV exacerbation or reactivation when they receive treatment with anti-CD20 monoclonal antibodies (against B-lymphocyte antigen cluster of differentiation 20 [CD20], an activated-glycosylated phosphoprotein) like rituximab (RTX). The objective of the current study was to evaluate the rates of appropriate HBV screening before patients started receiving RTX, at the initiation of HBV treatment, and during HBV flares among an underserved safety-net population...
October 3, 2016: Cancer
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