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Anne C Grunseit, Samantha Rowbotham, Melanie Pescud, Devon Indig, Sonia Wutzke
Issue addressed: The Australian National Partnership Agreement on Preventive Health (NPAPH) charged states and territories with the development and implementation of the Healthy Workers Initiative (HWI) to improve workplace health promotion. Most evaluation efforts focus on the setting (micro) level. In the present study the HWI at the meso-level (state program development) was examined to understand how jurisdictions navigated theoretical, practical, and political priorities to develop their programs, and the programmatic choices that support or hinder perceived success...
October 13, 2016: Health Promotion Journal of Australia
Diana V Rodríguez-Rivera, Yerania Rodríguez-Navedo, Mariely Nieves-Plaza, Luis M Vilá
OBJECTIVE: To determine patient-reported outcomes measures in indigent patients with systemic lupus erythematosus receiving their healthcare through the Puerto Rico government managed care system and compare these measures with non-indigent patients treated in a private fee-for-service setting. METHODS: A cross-sectional study was conducted in a cohort of 98 Puerto Ricans with systemic lupus erythematosus. Patients from the public group (n = 40) were treated in a university-based specialized systemic lupus erythematosus clinic and the private group (n = 58) in a community-based rheumatology practice...
2016: SAGE Open Medicine
C Ken Shannon, Shelia S Price, Jodie Jackson
Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients...
October 2016: Journal of Dental Education
Sujit S Kulkarni, Mayo Hotta, Linda Sher, Robert R Selby, Dilipkumar Parekh, James Buxbaum, Maria Stapfer
BACKGROUND: Mirizzi syndrome (MS) is characterized by an obstruction of the proximal bile duct due to extrinsic compression by either an impacted stone in the gallbladder neck or local inflammatory changes. Although this is a rare syndrome in developed countries (0.7-1.4 %), preoperative diagnosis and careful surgical management are essential to avoid bilio-vascular injuries and misdiagnosed malignancy. METHODS: The purpose of this study was to review our experience in the diagnosis and management of MS, assess the role of laparoscopy and the risk of concomitant gallbladder carcinoma...
September 1, 2016: Surgical Endoscopy
Limin Gao, Jivin Joseph, Marcelle Santoro-Levy, Alan S Multz, Vladimir K Gotlieb
BACKGROUND: With the advances in cancer treatments, mortality rates in the United States have been consistently falling but they are accompanied by substantial increases in the cost of cancer care. Patient and prescription assistance programs (PPAPs) are offered by pharmaceutical manufacturers to provide free medications to medically indigent patients. To assist the Cancer Care Center (CCC) at Nassau University Medical Center (NUMC) with drug costs for chemotherapies, the pharmacy department uses a patient assistance program (PAP) to obtain medications from the drug companies at no cost...
July 2016: Hospital Pharmacy
Barbara Pieper, Thomas N Templin
PURPOSE: The purposes of this study were to (a) compare sleep quality of persons with and without injection-related venous ulcers (VU) and (b) examine associations between global sleep quality with age, sex, comorbidities, pain, nutrition, physical health rating, fatigue, emotional problems, health-related quality of life, attitude toward physical activity, and number of ulcers. DESIGN: This study used a cross-sectional design. SUBJECTS AND SETTING: The participants included 31 patients with VU and 30 without VU (men [n = 35] and women; mean age = 54 years) who were attending an indigent clinic for wound care or general health...
September 2016: Journal of Wound, Ostomy, and Continence Nursing
S Witter, C Boukhalfa, J A Cresswell, Z Daou, V Filippi, R Ganaba, S Goufodji, I L Lange, B Marchal, F Richard
BACKGROUND: Across the Africa region and beyond, the last decade has seen many countries introducing policies aimed at reducing financial barriers to obstetric care. This article provides evidence of the cost and effects of national policies focussed on improving financial access to caesarean and facility deliveries in Benin, Burkina Faso, Mali and Morocco. METHODS: The study uses a comparative case study design with mixed methods, including realist evaluation components...
2016: International Journal for Equity in Health
Jeff Bouffard, Elizabeth Berger, Gaylene S Armstrong
BACKGROUND: In recent years, jurisdictions have recognized the strain placed on limited existing resources by criminal offenders with mental illness who frequently cycle through local jail facilities. In response, many locales have developed and implemented specialized programs to more effectively and efficiently manage these offenders, particularly the process of assigning defense attorneys to these often indigent defendants. METHODS: The current study examined the impact of an Indigent Defense Counsel (IDC) program designed to provide specially trained defense attorneys, and enhanced case management services to 257 indigent jail inmates with a qualifying, major mental health diagnosis (e...
2016: Health & Justice
Victor G DeMarco, Barton S Richards, Larry Volkmar, Lauren C Gorski
A performance improvement project helped Bronx-Lebanon Hospital Center in New York, which serves a highly indigent population, to increase efficiencies and cost savings as it moved toward value-based health care. Specific initiatives included in-depth analyses of provider and employee productivity, performed by focus teams led by executive sponsors and the department directors or managers. Through two broad phases, focusing on nonlabor and labor areas, the organization was able to realize savings amounting to more than $20 million...
June 2016: Healthcare Financial Management: Journal of the Healthcare Financial Management Association
Erez Eitan, Ronald S Petralia, Ya-Xian Wang, Fred E Indig, Mark P Mattson, Pamela J Yao
The bioactivity of Sonic hedgehog (Shh) depends on specific lipid modifications; a palmitate at its N-terminus and a cholesterol at its C-terminus. This dual-lipid modification makes Shh molecules lipophilic, which prevents them from diffusing freely in extracellular space. Multiple lines of evidence indicate that Shh proteins are carried by various forms of extracellular vesicles (EVs). It also has been shown, for instance, that in some tissues Shh proteins are transported to neighboring cells directly via filopodia...
2016: Biology Open
Jane E Hamilton, Pratikkumar V Desai, Nathan R Hoot, Robin E Gearing, Shin Jeong, Thomas D Meyer, Jair C Soares, Charles E Begley
STUDY OBJECTIVES: Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources and a longer length of stay due in part to patients being admitted to the hospital but waiting for an inpatient bed. The present study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States...
July 7, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Peng-Yi Hu, Peng-Fei Yue, Qin Zheng, Ming Yang, Guo-Song Zhang, Bin Wu, Dan Liu
ETHNOPHARMACOLOGICAL RELEVANCE: Da Chuan Xiong Decoction Compound preparation (DCXDCP) is a classic TCM formula of an aqueous extract made from Chuanxiong Rhizoma (Ligusticum chuanxiong Hort., umbelliferae) and Tianma Rhizoma (Gastrodia elata Bl., Orchidaceae). Gastrodin (GAS), a bioactive component of tianma, its pharmacokinetic (PK) behavior significantly changed after oral administration of DCXDCP compared with the extract of tianma. However, little is known about how the ingredients of chuanxiong influenced on the PK of GAS...
September 15, 2016: Journal of Ethnopharmacology
Howard S Kim, Kennon J Heard, Susan Heard, Jason A Hoppe
PURPOSE: Opioid prescription fill rates and the time to fill after emergency department (ED) discharge were studied. METHODS: Data were evaluated for all patients discharged from the ED between September 1, 2011, who were February 1, 2012, who were diagnosed with one of the following: dental pain, jaw pain, flank pain, abdominal pain, pelvic pain, back pain, neck pain, knee pain, headache, fracture, or sprain. Clinical information was abstracted via computer algorithm, and prescription filling within 100 days of prescription writing was determined by cross-referencing patient demographics with the state prescription drug monitoring program...
June 15, 2016: American Journal of Health-system Pharmacy: AJHP
Amanda Hu
Many young people look forward to volunteering abroad and overlook the ample volunteer opportunities at home. There are several advantages to volunteering at home: you help people in your own community; you can make a long-term commitment; and you have continuity of care for your patients. There are >1200 free clinics in the United States whose main goal is to provide care to the indigent population. These free clinics are always looking for volunteers with specialized medical training. This article reviews the medically related and unrelated volunteer opportunities available in the United States...
August 2016: Otolaryngology—Head and Neck Surgery
Ji Heon Noh, Kyoung Mi Kim, Kotb Abdelmohsen, Je-Hyun Yoon, Amaresh C Panda, Rachel Munk, Jiyoung Kim, Jessica Curtis, Christopher A Moad, Christina M Wohler, Fred E Indig, Wilson de Paula, Dawood B Dudekula, Supriyo De, Yulan Piao, Xiaoling Yang, Jennifer L Martindale, Rafael de Cabo, Myriam Gorospe
Some mitochondrial long noncoding RNAs (lncRNAs) are encoded by nuclear DNA, but the mechanisms that mediate their transport to mitochondria are poorly characterized. Using affinity RNA pull-down followed by mass spectrometry analysis, we found two RNA-binding proteins (RBPs), HuR (human antigen R) and GRSF1 (G-rich RNA sequence-binding factor 1), that associated with the nuclear DNA-encoded lncRNA RMRP and mobilized it to mitochondria. In cultured human cells, HuR bound RMRP in the nucleus and mediated its CRM1 (chromosome region maintenance 1)-dependent export to the cytosol...
May 15, 2016: Genes & Development
Bryan B Brimhall, Sam C Hankins, Vineel Kankanala, Gregory L Austin
BACKGROUND/AIMS: Colonoscopy is performed on patients across a broad spectrum of demographic characteristics. These characteristics may aggregate by patient insurance provider and influence bowel preparation quality and the prevalence of adenomas. The purpose of this study was to evaluate the association of insurance status and suboptimal bowel preparation, recommendation for an early repeat colonoscopy due to suboptimal bowel preparation, adenoma detection rate (ADR), and advanced ADR (AADR)...
2016: PloS One
Charles Scott Hultman
INTRODUCTION: Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. METHODS: We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption...
June 2016: Annals of Plastic Surgery
Charles Scott Hultman
PURPOSE: Portfolio planning in health care represents the strategic prioritization of services that permits an organization to better achieve its goals of margin and mission. Because of recent volatility in the economy, declining reimbursement, and rising costs of providing care, such strategic planning has become increasingly important if physicians want to remain leaders in health care. This project assesses the financial impact of procedural portfolio planning on an academic plastic surgery practice from the physician's perspective...
June 2016: Annals of Plastic Surgery
Ama P Fenny, Felix A Asante, Daniel K Arhinful, Anthony Kusi, Divya Parmar, Gemma Williams
BACKGROUND: The National Health Insurance Scheme (NHIS) was launched in Ghana in 2003 with the main objective of increasing utilisation to healthcare by making healthcare more affordable. Previous studies on the NHIS have repeatedly highlighted that cost of premiums is one of the major barriers for enrollment. However, despite introducing premium exemptions for pregnant women, older people, children and indigents, many Ghanaians are still not active members of the NHIS. In this paper we investigate why there is limited success of the NHIS in improving access to healthcare in Ghana and whether social exclusion could be one of the limiting barriers...
2016: BMC Health Services Research
Mary Wassel Zavala, Arthur Yule, Lorna Kwan, Sylvia Lambrechts, Sally L Maliski, Mark S Litwin
OBJECTIVES: To examine accuracy of patient-reported prostate-specific antigen (PSA) levels among indigent, uninsured men in a state-funded prostate cancer treatment program that provides case management, care coordination, and health education. DESIGN AND SAMPLE: Program evaluation. About 114 men with matched self- and lab-reported PSA levels at program enrollment and another time point within 18 months. MEASURES: Abstraction of self- and lab-reported PSA levels to determine self-report as "accurate" or "inaccurate," and evaluate accuracy change over time, before and after nursing interventions...
May 8, 2016: Public Health Nursing
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