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Affordable act

Paul L Weygandt, Scott M Dresden, Emilie S Powell, Joe Feinglass
Introduction: Illinois hospitals have experienced a marked decrease in the number of uninsured patients after implementation of the Affordable Care Act (ACA). However, the full impact of health insurance expansion on trauma mortality is still unknown. The objective of this study was to determine the impact of ACA insurance expansion on trauma patients hospitalized in Illinois. Methods: We performed a retrospective cohort study of 87,001 trauma inpatients from third quarter 2010 through second quarter 2015, which spans the implementation of the ACA in Illinois...
March 2018: Western Journal of Emergency Medicine
Parveen Akhter Lone, Syed Wakeel Ahmed, Vivek Prasad, Bashir Ahmed
Plants & their extracts have immense potential for the management or treatment of the wounds. The pyhto medicines for the wound healing are not only cheap & affordable but are purportedly safe as hypersensitivity reactions are rarely encountered with the use of these agents, these natural agents induce healing & regeneration of the lost tissue by multiple mechanisms Turmeric commonly is called as Haldi in Hindi. C Longa has been reported to possess anti bacterial, anti fungal & anti inflammatory activities...
January 2018: Journal of Oral Biology and Craniofacial Research
Katherine Smith, Jeffrey P Fleming, Bernard Gros
Heart failure (HF) is one of the most prevalent chronic diseases in the United States (U.S.), with an estimated prevalence of five million patients in the U.S. and an annual healthcare cost of greater than 30 billion dollars. Readmission rates for HF patients are astronomically high, with up to 25% of hospitalized patients with HF requiring readmission within 30 days of discharge. The Hospital Readmissions Reduction Program (HRRP) of the Patient Protection and Affordable Care Act aims to address these concerns by financially penalizing institutions with unacceptably high risk-adjusted 30-day readmission rates for HF patients...
January 15, 2018: Curēus
Caslin A Gilroy, Stefan Roberts, Ashutosh Chilkoti
Fibroblast growth factor 21 (FGF21) is under investigation as a type 2 diabetes protein drug, but its efficacy is impeded by rapid in vivo clearance and by costly production methods. To improve the protein's therapeutic utility, we recombinantly expressed FGF21 as a fusion with an elastin-like polypeptide (ELP), a peptide polymer that exhibits reversible thermal phase behavior. Below a critical temperature, ELPs exist as miscible unimers, while above, they associate into a coacervate. The thermal responsiveness of ELPs is retained upon fusion to proteins, which has notable consequences for the production and in vivo delivery of FGF21...
March 15, 2018: Journal of Controlled Release: Official Journal of the Controlled Release Society
Renae Furl, Shinobu Watanabe-Galloway, Elizabeth Lyden, Susan Swindells
BACKGROUND: The introduction of the Affordable Care Act (ACA) has provided unprecedented opportunities for uninsured people with HIV infection to access health insurance, and to examine the impact of this change in access. AIDS Drug Assistance Programs (ADAPs) have been directed to pursue uninsured individuals to enroll in the ACA as both a cost-saving strategy and to increase patient access to care. We evaluated the impact of ADAP-facilitated health insurance enrollment on health outcomes, and demographic and clinical factors that influenced whether or not eligible patients enrolled...
March 16, 2018: BMC Infectious Diseases
James W Hindley, Yuval Elani, Catriona M McGilvery, Simak Ali, Charlotte L Bevan, Robert V Law, Oscar Ces
Cell-sized vesicles have tremendous potential both as miniaturised pL reaction vessels and in bottom-up synthetic biology as chassis for artificial cells. In both these areas the introduction of light-responsive modules affords increased functionality, for example, to initiate enzymatic reactions in the vesicle interior with spatiotemporal control. Here we report a system composed of nested vesicles where the inner compartments act as phototransducers, responding to ultraviolet irradiation through diacetylene polymerisation-induced pore formation to initiate enzymatic reactions...
March 15, 2018: Nature Communications
Alain Bruno Tagne Nouemssi
Tuberculosis (TB) continues to represent an important public health challenge in the world and the USA, especially given its association with HIV infection and population migration. Cervical tuberculous lymphadenitis represents the most common extrapulmonary presentation of TB in the USA. Considerations for other causes of neck mass often contribute to delay in diagnosis. In this report, we describe the case of a 41-year-old man who presented with painful swelling of the neck and was diagnosed with tuberculous lymphadenitis, complicated by HIV therapy-associated immune reconstitution syndrome...
March 15, 2018: BMJ Case Reports
Ashley H Snyder, Carol S Weisman, Guodong Liu, Douglas Leslie, Cynthia H Chuang
OBJECTIVES: The Affordable Care Act (ACA) contraceptive coverage mandate issued in August 2012 requires most private health insurance plans to cover all U.S. Food and Drug Administration-approved contraceptive methods without cost sharing. We evaluate the impact of this policy on out-of-pocket costs and use of long-acting reversible contraceptives (LARCs) and other prescription methods through 2014. METHODS: Data from Truven Health MarketScan were used to examine out-of-pocket costs and contraceptive use patterns for all reversible prescription contraceptives before and after the implementation of the contraceptive mandate for privately insured women ages 13 to 45...
March 2, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Boris A Trofimov, Pavel A Volkov, Kseniya O Khrapova, Anton A Telezhkin, Nina I Ivanova, Alexander I Albanov, Nina K Gusarova, Oleg N Chupakhin
Pyridines undergo site selective cross-coupling with secondary phosphine chalcogenides (oxides, sulfides, and selenides) in the presence of acylphenylacetylenes under metal-free mild conditions (70-75 °C, MeCN) to afford 4-chalcogenophosphoryl pyridines in up to 71% yield. In this new type of SNHAr reaction acylacetylenes act as oxidants, being stereoselectively reduced to the corresponding olefins of the E-configuration.
March 15, 2018: Chemical Communications: Chem Comm
Jecca Rhea Steinberg, Janine S Bruce, Paloma Marin-Nevarez, Kimmy Phan, Sylvia Bereknyei Merrell, Lisa J Chamberlain
OBJECTIVE: School readiness by kindergarten entry is associated with increased high school graduation, decreased juvenile arrest, and better long-term health. Inadequate early childhood learning (ECL) disproportionately affects low-income children. Pediatricians have near-universal access to children younger than 5 years but remain an underused ECL resource. This study examined caregivers' perceptions of ECL, the role of the pediatrician and pediatric office, and the use of community-based ECL resources among diverse, low-income caregivers whose children were not enrolled in preschool...
March 13, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
Carl D Stevens
The sudden, dramatic collapse of the seven-year struggle in Congress to repeal and replace the Affordable Care Act holds important lessons for all would-be reformers, including those advocating fundamental changes in medical education. In this Invited Commentary, the author draws parallels between reform initiatives in health policy and those in medical education, highlighting that, in both settings, stakeholders rarely support "repeal" in the absence of a superior replacement, even when they view the status quo as deeply flawed...
March 13, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Lisa B VanWagner, Fasiha Kanwal
With the passage of the Affordable Care Act (ACA) followed by the physician payment reform, there is an urgent need to better understand the complex relationships between structure (including incentives), processes, and outcomes of health care and, based on this understanding, identify interventions that can ensure delivery of high value care to patients with liver disease. As hepatologists, how do we systematically address these issues and ensure that we provide high-value care to our patients? These factors combine in the burgeoning field of health services research...
March 14, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Atena B Solea, Tobie Wohlhauser, Parisa Abbasi, Yvan Mongbanziama, Aurelien Crochet, Katharina M Fromm, Ghenadie Novitchi, Cyrille Train, Melanie Pilkington, Olimpia Mamula
A versatile synthetic methodology to access the first family of chiral verdazyl N,N'-chelate ligands is described and exemplified by N,N'-dimethyl-, N,N'-di-isopropyl- and N,N'-diphenyl oxoverdazyls bearing two isomers of the pinene-pyridine functional group. Their physical properties were probed by X-band EPR spectroscopy, cyclic voltammetry and DFT calculations. Preliminary reactivity studies show they can act as N,N'-chelate ligands affording a chiral 1 : 1 complex (3b) with CuCl2 , which was characterized by single-crystal X-ray diffraction...
March 13, 2018: Dalton Transactions: An International Journal of Inorganic Chemistry
Erin Brantley, Jessica Greene, Brian Bruen, Erika Steinmetz, Leighton Ku
Introduction: Smoking rates for Medicaid beneficiaries have remained flat in recent years. Medicaid may support smokers in quitting by covering a broad array of tobacco cessation services without barriers such as copays. This study examines the impact of increasing generosity in Medicaid tobacco cessation coverage policies on smoking and cessation behaviors. Methods: We used 2010 and 2015 National Health Interview Survey data merged with information on state tobacco, Medicaid cessation, and Medicaid eligibility policies to estimate state fixed effects models of cessation medication use, counseling use, quit attempts, and current smoking...
March 7, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
Brandon Bowling, David Newman, Craig White, Ashley Wood, Alberto Coustasse
Decreasing health care expenditures has been one of the main objectives of the Affordable Care Act. To achieve this goal, the Centers for Medicare and Medicaid Services (CMS) has been tasked with experimenting with provider reimbursement methods in an attempt to increase quality, while decreasing costs. The purpose of this research was to study the effects of the Affordable Care Act on physician reimbursement rates from CMS to determine the most cost-effective method of delivering health care services. The CMS has experimented with payment methods in an attempt to increase cost-effectiveness...
March 9, 2018: Health Care Manager
Santanu Mondal, Sangram S Parelkar, Mitesh Nagar, Paul R Thompson
Protein Arginine deiminases (PADs) play an important role in the pathogenesis of various diseases, including rheumatoid arthritis, multiple sclerosis, lupus, ulcerative colitis and breast cancer. Therefore, the development of PAD-inhibitors has drawn significant research interest in recent years. Herein, we describe the development of the first photoswitchable PAD-inhibitors. These compounds possess an azobenzene photoswitch to optically control PAD activity. Screening of a series of inhibitors structurally similar to BB-Cl-Amidine afforded compounds 1 and 2 as the most promising candidates for the light-controlled inhibition of PAD2; the cis-isomer of 1 is 10-fold more potent than its trans-isomer, whereas the trans-isomer of 2 is 45-fold more potent than the corresponding cis-isomer...
March 8, 2018: ACS Chemical Biology
Badr Serji, Tarik Bouhout, Mohammed Chablou, Ebo Egur Ussman, Tijani El Harroudi
Skin complications are common in people who have an ostomy, and often involve the skin's function as a barrier breaking down. Many products have been developed to prevent and treat complications. However, in developing countries, they may be too expensive for patients to buy or not be available. Three case studies found the use of rhassoul, an affordable clay that is readily available in Morocco, to manage peristomal skin damage and protect the skin. Its protective properties are believed to include its ability to absorb and neutralise substances in ostomy output that damage skin and to act as a barrier...
March 8, 2018: British Journal of Nursing: BJN
Larry Charleston, Jeffrey Royce, Teshamae S Monteith, Susan W Broner, Hope L O'Brien, Salvador L Manrriquez, Matthew S Robbins
OBJECTIVE: To review the scope of the problem facing individuals with migraine who are under- or uninsured. In this first of a 2-part narrative review, we will explore migraine epidemiology and the challenges that face this vulnerable population. BACKGROUND: Implementation of the Affordable Care Act has improved access to health care for many individuals who were previously uninsured, but there are many, particularly those of certain demographics, who are at high risk for worse outcomes...
March 8, 2018: Headache
Shenghai Guo, Fang Wang, Li Tao, Xinying Zhang, Xuesen Fan
A simple and practical procedure for the selective preparation of 3H-indol-3-one and indolo[1,2-c]quinazoline derivatives through copper-catalyzed aerobic oxygenation and intramolecular cyclization reactions of 2-(2-amidoaryl)-1H-indoles in the presence of acid has been disclosed. Interestingly, the reaction outcomes are exclusively dependent on the reaction medium employed. With DMF as the solvent, the amide moiety of indole substrates could act as an auxiliary to enable the indole's oxygenation reaction with molecular oxygen from air as the oxidant to give 3H-indol-3-one derivatives in a highly selective manner...
March 7, 2018: Journal of Organic Chemistry
Lilit Karapetyan, Om Dawani, Heather S Laird-Fick
The immigrant population in the United States has grown over the past years. Undocumented immigrants account for 14.6% of the uninsured population in the United States. Decisions about end-of-life treatment are often difficult to reach in the best of situations. We present a 43-year-old undocumented Mexican female immigrant with metastatic sarcomatoid squamous cell cervical cancer and discuss the barriers that she faced during her treatment. Limited English proficiency, living below the poverty line, low level of education, and lack access to Medicare, Medicaid, or other insurance coverage under the Affordable Care Act are major causes of decreased health-care access and service utilization by the immigrant population...
January 1, 2018: Journal of Palliative Care
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