Publications by authors named "Mona Kilany"

17 Publications

  • Page 1 of 1

Phytostimulatory Influence of and Silver Nanoparticles on L. under Salinity Stress.

Plants (Basel) 2021 Apr 16;10(4). Epub 2021 Apr 16.

Department of Plant Production, College of Food and Agriculture Sciences, King Saud University, Riyadh 11461, Saudi Arabia.

They were shifting in land use increases salinity stress, significant abiotic stress affecting plant growth, limiting crop productivity. This work aimed to improve L. (linseed) growth under salinity using and silver nanoparticles (AgNPs). AgNPs were fabricated exploiting and monitored by U.V./Vis spectrophotometry scanning electron microscopy (SEM) and Fourier transforms infrared spectroscopy (FTIR). Photosynthetic pigments, enzymatic and nonenzymatic antioxidants of linseed were investigated under salt stress in treated and untreated plants with alongside AgNPs. Our findings recorded the formation of AgNPs at 457 nm, which were globular and with a diameter of 75 nm. Notably, chlorophyll-a, b, and total chlorophyll reduction while enhanced carotenoids and anthocyanin contents were attained under salinity stress. Total dissoluble sugars, proline, and dissoluble proteins, HO, malondialdehyde, enzymatic and nonenzymatic antioxidants were significantly elevated in NaCl well. Combined AgNPs and elevated photosynthetic pigments. Also, they led to the mounting of soluble sugars, proline, and soluble proteins. HO and malondialdehyde decreased while enzymatic and nonenzymatic antioxidants increased in response to AgNPs, and their combination. Thus, AgNPs and might bio-fertilizers to improve linseed crop productivity under salinity stress.
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http://dx.doi.org/10.3390/plants10040790DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073072PMC
April 2021

Development of in-house ELISAs for the detection of anti-SARS‑CoV‑2 RBD and N IgG and IgM antibodies in biological samples.

J King Saud Univ Sci 2021 Jun 15;33(4):101439. Epub 2021 Apr 15.

Research Center for Advanced Materials Science (RCAMS), King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia.

By the end of year 2019, the new virus SARS-CoV-2 appeared, causing the Coronavirus Disease 2019 (COVID-19), and spread very fast globally. A continuing need for diagnostic tools is a must to contain its spread. Till now, the gold standard method, the reverse transcription polymerase chain reaction (RT-PCR), is the precise procedure to detect the virus. However, SARS-CoV-2 may escape RT-PCR detection for several reasons. The development of well-designed, specific and sensitive serological test like enzyme immunoassay (EIA) is needed. This EIA can stand alone or work side by side with RT-PCR. In this study, we developed several EIAs including plates that are coated with either specially designed SARS-CoV-2 nucleocapsid or surface recombinant proteins. Each protein type can separately detect anti-SARS-CoV-2 IgM or IgG antibodies. For each EIAs, the cut-off value, specificity and sensitivity were determined utilizing RT-PCR confirmed Covid-19 and pre-pandemic healthy and other viruses-infected sera. Also, the receiver operator characteristic (ROC) analysis was performed to define the specificities and sensitivities of the optimized assay. The in-house EIAs were validated by comparing against commercial EIA kits. All in-house EIAs showed high specificity (98-99%) and sensitivity (97.8-98.9%) for the detection of IgG/IgM against RBD and N proteins of SARS-CoV-2. From these results, the developed Anti-RBD and anti-N IgG and IgM antibodies EIAs can be used as a specific and sensitive tool to detect SARS-CoV-2 infection, calculate the burden of disease and case fatality rates.
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http://dx.doi.org/10.1016/j.jksus.2021.101439DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049187PMC
June 2021

One-spot fabrication and in-vivo toxicity evaluation of core-shell magnetic nanoparticles.

Mater Sci Eng C Mater Biol Appl 2021 Mar 23;122:111898. Epub 2021 Jan 23.

NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Art and Mathematics, Florida Polytechnic University, Lakeland, FL 33805, USA. Electronic address:

This research, for the first time, report the synthesis of core-shell magnetic nanoparticles (NPs) consisting poly acrylic acid (PAA) coated cobalt ferrite (CF) using a simple co-precipitation route. Nanocrystalline PAA@CF-NPs, particle size of 9.2 nm, exhibited saturation magnetization as 28.9 emu/g, remnant magnetization as 8.37 emu/g, and coercivity as 543 Oe. Keeping biomedical applications into consideration, PAA@CF-NPs were further analysed to evaluate antimicrobial performance against Gram positive (Staphylococcus aureus and Bacillus subtilis) and Gram negative (Pseudomonas aeruginosa and Escherichia coli) bacteria, and biocompatibility with reference to activated splenic cells. The PAA@CF-NPs were viable to the normal splenic cells (up to 1000 μg/ml) and do not affect the ability of fast dividing ability of the cells (activated splenic cells). An optimized dose of PAA@CF-NPs was intramuscularly administrated (100 μg/ml) into Albino mice to evaluate acute toxicity. The results of these studies suggest that injected PAA@CF-NPs do not affect vital organs mainly including liver and kidneys that confirmed the heptic/renal biocompatibility. The outcomes of this research project such developed nano-system for biomedical applications, mainly for magnetically guided drug delivery and image guided therapies development. However, to support the proposed claims, extended in-vivo studies are required to explore bio-distribution, chronic toxicity, and homeostatic conditions.
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http://dx.doi.org/10.1016/j.msec.2021.111898DOI Listing
March 2021

Are Certain Health Centers Better Patient-Centered Medical Homes for People with Severe Mental Illness?

Psychiatr Q 2021 Mar;92(1):107-122

Department of Health Policy & Management and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 1105B McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, 27599-7411, USA.

Patient-centered medical homes based at federally-qualified health centers (FQHCs) can benefit patients with complex health needs, such as severe mental illness (SMI). However, little is known about FQHC characteristics associated with changes in health care expenditures and utilization for individuals with SMI. Using North Carolina Medicaid claims and FQHC data from the Uniform Data System, multivariate regression identified FQHC characteristics associated with total expenditures, medication adherence and emergency department utilization among adults with SMI, controlling for time-invariant differences by health center. Few of the FQHC-level factors affected the outcomes-not even offering on-site behavioral health services. Although the FQHCs in the analysis sample exhibited considerable variation in the provision of specialty behavioral services and in staffing configurations, it may be the case that the examination of average effects across a heterogeneous group of adults with SMI mask benefits of FQHCs to certain subgroups. These findings support the conclusion that there is no "one-size-fits-all" model that works best for this diverse patient population. Study results are relevant for practices embarking on expanded medical home services for people with SMI.
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http://dx.doi.org/10.1007/s11126-020-09754-1DOI Listing
March 2021

Are There Performance Advantages Favoring Federally Qualified Health Centers in Medical Home Care for Persons with Severe Mental Illness?

Adm Policy Ment Health 2021 01;48(1):121-130

Department of Health Policy and Management, The Gillings School of Global Public Health, Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 1105B McGavran-Greenberg Hall, CB#7411, 135 Dauer Dr., Chapel Hill, NC, 27599-7411, USA.

To identify whether medical homes in FQHCs have advantages over other group and individual medical practices in caring for people with severe mental illness. Models estimated the effect of the type of medical home on monthly service utilization, medication adherence, and total Medicaid spending over a 4-year period for adults aged 18 or older with a major depressive disorder (N = 65,755), bipolar disorder (N = 19,925), or schizophrenia (N = 8501) enrolled in North Carolina's Medicaid program. Inverse probability of treatment weights (IPTW) were used to adjust for nonrandom assignment of patients to practices. Generalized estimating equations for repeated measures were used with gamma distributions and log links for the continuous measures of medication adherence and spending, and binomial distributions with logit links for binary measures of any outpatient or any emergency department visits. Adults with major depression or bipolar disorders in FQHC medical homes had a lower probability of outpatient service use than their counterparts in individual and group practices. The probability of emergency department use, medication adherence, and total Medicaid spending were relatively similar across the three settings. This study suggests that no one type of medical practice setting-whether FQHC, other group, or individual-consistently outperforms the others in providing medical home services to people with severe mental illness.
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http://dx.doi.org/10.1007/s10488-020-01050-1DOI Listing
January 2021

The Protective Role of Toll-Like Receptor Agonist Monophosphoryl Lipid A Against Vaccinated Murine Schistosomiasis.

Acta Parasitol 2020 Sep 2;65(3):652-660. Epub 2020 Apr 2.

Biology Department, Faculty of Science, King Khalid University, PO Box 9004, Abha, 61413, Saudi Arabia.

Purpose: Schistosomiasis is a disease that afflicts over 220 million people worldwide. To date, there is no vaccine against schistosomiasis and chemotherapy relies basically on a single drug, praziquantel. The current study was undertaken to investigate the therapeutic effects of monophosphoryl lipid A (MPLA) as an adjuvant in soluble egg antigen (SEA)-vaccinated and Schistosoma mansoni-infected mice.

Methods: Mice were divided into two groups of uninfected and Schistosoma mansoni infected. The two groups were treated differently with MPLA, SEA and praziquantel. Study parameters included parasitological, immunological and biochemical parameters.

Results: Parasitological parameters revealed that intraperitoneal injection of MPLA into SEA-vaccinated and S. mansoni-infected mice was effective in reducing the worm and egg burden, granuloma count and diameter as well as the total area of infection in their livers versus SEA-untreated but infected ones. In addition, MPLA showed ameliorative action on the elevated liver oxidative stress marker, including malondialdehyde (MDA) and a decrease in the level of the antioxidant enzymes, reduced glutathione (GSH) and catalase (CAT) which may have a role in the liver damage and fibrosis due to S. mansoni infection.

Conclusion: Treatment with MPLA has multi-functions in attenuating the deleterious impacts of S. mansoni infection in mice livers. Its effects are mediated through a reduction of ova count, worm burden, granuloma diameter and amelioration of antioxidant defense systems, and liver function biomarkers.
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http://dx.doi.org/10.2478/s11686-020-00204-3DOI Listing
September 2020

Study of anticancer, antimicrobial, immunomodulatory, and silver nanoparticles production by Sidr honey from three different sources.

Food Sci Nutr 2020 Jan 9;8(1):445-455. Epub 2019 Dec 9.

Research Center for Advanced Materials Science (RCAMS) King Khalid University Abha Saudi Arabia.

Sidr honey is used as food and medicine in many countries. Study of immunomodulatory and anticancer activity of Sidr honey did not tested before. The aim of this work was to study the anticancer activity and immunomodulatory as well as antimicrobial potential of Sidr honey and its synthesized silver nanoparticles (AgNPs). Sidr honey from three sources (two from Kingdom of Saudi Arabia (KSA) and one from Pakistan) was diluted to 20% and tested for its biological activities and to synthesize AgNPs. The results demonstrated that honeys could produce AgNPs (spherical shape), modulated the growth of normal splenic cells, and have antimicrobial activities. Sidr honey has anticancer activity against HepG2 but not Hela cells. Sidr honey can be used as antimicrobial agent, but can be used as anticancer agent with care as it stimulated cell growth of some lines (e.g., Hala) and inhibited another (e.g., HepG2).
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http://dx.doi.org/10.1002/fsn3.1328DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977415PMC
January 2020

TH1/TH2 chemokines/cytokines profile in rats treated with tetanus toxoid and .

Saudi J Biol Sci 2019 Nov 18;26(7):1716-1723. Epub 2018 Aug 18.

Biology Department, Faculty of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia.

Natural products, including their purified materials, play a remarkable role in drug development. The Euphorbiaceae family, mainly , is used in some traditional medicine, and has evidence that its latex comprises immunomodulatory properties and cytokine production. This study aimed to measure the production of chemokines (IL-1α, IL-1β, IL-12, and RANTES), T1 cytokines (IFN-γ, TNF-α, GM-CSF, and IL-2) and T2 cytokines (IL-4, IL-6, IL-10, and IL-13) in rats after treatments with ethanol latex extract of . Vaccine treated and untreated rats were divided into seven groups to assess antimicrobial activities of the extracted components. After completion of the treatment schedule, blood was withdrawn and sera were collected. The results showed that the main component of the extract was a euphol compound. The extract showed antimicrobial activity and had the ability to modulate innate and adaptive immunity. Animals treated with extract for only 7 days before vaccination showed higher levels of antibody production. The extract showed antibacterial and antifungal activities. The extract could stimulate both adaptive and innate immunity. Pre-treatment with the extract increased immune responses in vaccinated animals, indicating the usefulness of the extract before immunization.
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http://dx.doi.org/10.1016/j.sjbs.2018.08.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864399PMC
November 2019

Cellular proliferation/cytotoxicity and antimicrobial potentials of green synthesized silver nanoparticles (AgNPs) using .

Saudi J Biol Sci 2019 Nov 17;26(7):1689-1694. Epub 2018 Aug 17.

College of Plant Protection, Fujian Agriculture and Forestry University, Fuzhou 350002, China.

spp. are used as medicinal plants in many countries like Bosnia, Lebanon, and Turkey. In folk medicines, these plants have been used for treating skin and respiratory tract diseases, urinary problems, rheumatism and gall bladder stones. The objectives of this work were to synthesize silver nanoparticles (AgNPs) using a coniferous tree, leaf extract and testing the synthesized AgNPs for its antimicrobial potentials, hemolytic activity, toxicity and the proliferative effects against normal and activated rat splenic cells. Leaf extract was prepared using acetone and ethanol as solvents. AgNPs were prepared using the acetone extract. AgNPs were validated using UV-Vis spectroscopy and scanning electron microscopy (SEM). Functional groups in the extract were identified using Fourier Transform Infrared (FT-IR) spectroscopy. SEM images of AgNPs showed spherical and cubic shapes with a uniform size distribution with an average size of 30-90 nm. FT-IR spectroscopy showed the presence of many functional groups in the plant extract. AgNPs showed promising antimicrobial activity against tested bacteria and fungus. AgNPs also expressed a stimulating activity towards the rat splenic cells in a dose dependent manner. Acetone as solvent was safer on cells than ethanol. Green synthesized AgNPs using might be used as a broad-spectrum therapeutic agent against microorganisms and as an immunostimulant agent.
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http://dx.doi.org/10.1016/j.sjbs.2018.08.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864202PMC
November 2019

Development of Rift Valley fever (RVF) vaccine by genetic joining of the RVF-glycoprotein Gn with the strong adjuvant subunit B of cholera toxin (CTB) and expression in bacterial system.

Saudi J Biol Sci 2019 Nov 22;26(7):1676-1681. Epub 2018 Aug 22.

Biology Department, Faculty of Sciences and Arts, King Khalid University, Dhahran Al Janoub, Saudi Arabia.

One of the mosquito-borne zoonotic diseases is the Rift Valley fever virus (RVFV). Currently, there is no completely licensed vaccine that can be used to vaccinate animals or humans outside endemic areas. The aim of this work was to use the RVFV glycoprotein (Gn) and the subunit B of cholera toxin (CTB) at gene level and build up fused recombinant vaccine. The gene of CTB was joined to the gene Gn to work as an adjuvant in the resulting fusion protein. The designed merged genes () was tested for restriction sites, open reading frames, expected fusion protein tertiary structure and antigenicity using computer software. The insert sequence was submitted to the BioProject (GenBank). The insert was subcloned into the pQE-31 expression plasmid. The target recombinant protein (rCTB-Gn) was expressed in M15 bacteria, purified and identified by protein gel electrophoresis. The insert got the accession No: PRJNA386723. Analysis of the designed rCTB-Gn protein revealed that it had the right 3D structure, immunogenic and at the correct molecular weight. The presence of the CTB in the proposed vaccine will augment its immunogenicity. Doses and protection levels of the vaccine need to be manipulated.
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http://dx.doi.org/10.1016/j.sjbs.2018.08.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864185PMC
November 2019

DNA vaccination using recombinant Schistosoma mansoni fatty acid binding protein (smFABP) gene.

Exp Parasitol 2018 Nov 25;194:53-59. Epub 2018 Sep 25.

Biology Department, Faculty of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia; Blood Products Quality Control and Research Department, National Organization for Research and Control of Biologicals, Cairo, Egypt. Electronic address:

Schistosomiasis is a fatal disease that has a negative impact on health and economics. Praziquantel (PZQ) is the drug of choice for schistosomiasis treatment, but it has no prophylactic effect; therefore, vaccination is an essential requirement in schistosomiasis control. This work was carried out to investigate the possible effect of DNA vaccination against Schistosoma mansoni infection using recombinant S. mansoni fatty acid binding protein (rsmFABP). The smFABP gene was cloned into the eukaryotic expression vector pcDNAI/Amp in order to obtain an smFABP-pcDNAI recombinant plasmid (DNA vaccine) and was used for the intramuscular DNA vaccination of out-bread Swiss albino mice prior to infection with S. mansoni cercariae. Infected groups, either DNA vaccinated or unvaccinated, were treated with PZQ at week 6 post-infection. After 8 weeks post-infection, all mouse groups were sacrificed and parasitological, immunological and histopathological parameters were studied. DNA vaccinated mice showed a high titer of anti-smFABP-IgG antibodies and acquired significant protection (74.2%, p < 0.01) against S. mansoni infection, with a reduction in ova and granuloma counts. DNA vaccinated and PZQ treated animals had higher titers of anti-smFABP-IgG antibodies and decreased (87%, P < 0.001) parenchymal granulomas compared to the DNA vaccinated PZQ untreated group. Infected mice, either non DNA vaccinated or vaccinated, had very high collagen content and fibrous granulomas (74%) compared to the PZQ treated group (10.3% fibrous granuloma) and PZQ treated + DNA vaccinated group (0% fibrous granuloma). In conclusion, DNA vaccination had protective and anti-pathological effects in naive mice and greatly improved the pathological status in PZQ-treated animals, suggesting an immunological and pathological modulating effect of PZQ treatment.
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http://dx.doi.org/10.1016/j.exppara.2018.09.018DOI Listing
November 2018

Utilization and Adherence in Medical Homes: An Assessment of Rural-Urban Differences for People With Severe Mental Illness.

Med Care 2018 10;56(10):870-876

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.

Background: The complex nature of managing care for people with severe mental illness (SMI), including major depression, bipolar disorder, and schizophrenia, is a challenge for primary care practices, especially in rural areas. The team-based emphasis of medical homes may act as an important facilitator to help reduce observed rural-urban differences in care.

Objective: The objective of this study was to examine whether enrollment in medical homes improved care in rural versus urban settings for people with SMI.

Research Design: Secondary data analysis of North Carolina Medicaid claims from 2004-2007, using propensity score weights and generalized estimating equations to assess differences between urban, nonmetropolitan urban and rural areas.

Subjects: Medicaid-enrolled adults with diagnoses of major depressive disorder, bipolar disorder or schizophrenia. Medicare/Medicaid dual eligibles were excluded.

Measures: We examined utilization measures of primary care use, specialty mental health use, inpatient hospitalizations, and emergency department use and medication adherence.

Results: Rural medical home enrollees generally had higher primary care use and medication adherence than rural nonmedical home enrollees. Rural medical home enrollees had fewer primary care visits than urban medical home enrollees, but both groups were similar on the other outcome measures. These findings varied somewhat by SMI diagnosis.

Conclusions: Findings indicate that enrollment in medical homes among rural Medicaid beneficiaries holds the promise of reducing rural-urban differences in care. Both urban and rural medical homes may benefit from targeted resources to help close the remaining gaps and to improve the success of the medical home model in addressing the health care needs of people with SMI.
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http://dx.doi.org/10.1097/MLR.0000000000000973DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298219PMC
October 2018

Facile microwave-assisted synthesis of Te-doped hydroxyapatite nanorods and nanosheets and their characterizations for bone cement applications.

Mater Sci Eng C Mater Biol Appl 2017 Mar 23;72:472-480. Epub 2016 Nov 23.

Department of Biology, Faculty of Science, King Khalid University, P.O. Box 9004, Abha 61413, Saudi Arabia; Department of Microbiology, National Organization for Drug Control and Research (NODCAR), Cairo, Egypt.

In this work, the authors have fabricated the nanorods and nanosheets of pure and Te-doped HAp with different Te concentrations (0.04, 0.08, 0.16, 0.24wt%) by microwave-assisted technique at low temperature. The crystallite size, degree of crystallinity and lattice parameters are calculated. FE-SEM study confirms that the fabricated nanostructures are nanorods of diameter about 10nm in undoped and at low concentration of Te doping. However, at and higher concentration, it becomes nanosheets of about 5nm thickness. X-ray diffraction, FT-IR and FT-Raman studies shows that the prepared products are of HAp and Te has been successfully incorporated. From EDX the Ca/P molar ratio of the pure HAp is about 1.740, while this ratio for 0.04, 0.08, 0.16, 0.24 wt% Te doped is about 1.53, 1.678, 1.724, 1.792, respectively. Crystallite size was found to be increased with Te doping from 15nm to 62nm. The value of dielectric constant is found to be enhanced at higher concentrations of Te. The values of linear absorption coefficient were also determined and show that the prepared material with Te doping is more absorbable than pure and will be highly applicable in radiation detection applications. Furthermore, the antimicrobial potential of pure and Te doped HAp was examined against some Gram- negative and positive bacteria and fungi by agar disk diffusion method. The results demonstrated that the antimicrobial activity of Te doped HAp is stronger than that of pure HAp where it exhibited the highest activity against Bacillus subtilis>Candida albicans>Shigella dysenteriae.
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http://dx.doi.org/10.1016/j.msec.2016.11.074DOI Listing
March 2017

Through the Looking Glass: Estimating Effects of Medical Homes for People with Severe Mental Illness.

Health Serv Res 2017 10 21;52(5):1858-1880. Epub 2016 Oct 21.

Department of Health Policy and Management, Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC.

Objective: To examine whether medical homes have heterogeneous effects in different subpopulations, leveraging the interpretations from a variety of statistical techniques.

Data Sources/study Setting: Secondary claims data from the NC Medicaid program for 2004-2007. The sample included all adults with diagnoses of schizophrenia, bipolar disorder, or major depression who were not dually enrolled in Medicare or in a nursing facility.

Study Design: We modeled a number of monthly service use, adherence, and expenditure outcomes using fixed effects, generalized estimating equation with and without inverse probability of treatment weights, and instrumental variables analyses.

Data Collection: Data were received from the Carolina Cost and Quality Initiative.

Principal Findings: The four estimation techniques consistently revealed generally positive associations between medical homes and access to primary care, specialty mental health care, greater medication adherence, slightly lower emergency room use, and greater expenditures. These findings were consistent across all three major severe mental illness diagnostic groups. Some heterogeneity in effects were noted, especially in preventive screening.

Conclusions: Expanding access to primary care-based medical homes for people with severe mental illness may not save money for insurance providers, due to greater access for important outpatient services with little cost offset. Health services research examining more of the treatment heterogeneity may contribute to more realistic projections about medical homes outcomes.
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http://dx.doi.org/10.1111/1475-6773.12585DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583299PMC
October 2017

State Medicaid spending and financial burden of families raising children with autism.

Intellect Dev Disabil 2012 Dec;50(6):441-51

Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, USA.

We examined the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. Child and family data were from the 2005-2006 National Survey of Children with Special Health Care Needs (n  =  2,011 insured children with autism). State characteristics were from public sources. The 4 outcomes included any out-of-pocket health care expenditures during the past year, expenditure amount, expenditures as a proportion of family income, and whether additional income was needed to care for a child. We modeled the association between state per capita Medicaid spending for children with disabilities and families' financial burden, controlling for child, family, and state characteristics. Overall, 78% of families raising children with autism had health care expenditures for their child for the prior 12 months; 42% reported expenditures over $500, with 34% spending over 3% of their income. Families living in states with higher per capita Medicaid spending for children with disabilities were significantly less likely to report financial burden. There is a robust relationship between state Medicaid spending for children with disabilities and the financial burdens incurred by families raising children with autism.
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http://dx.doi.org/10.1352/1934-9556-50.06.441DOI Listing
December 2012

State insurance parity legislation for autism services and family financial burden.

Intellect Dev Disabil 2012 Jun;50(3):190-8

Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, USA.

We examined the association between states' legislative mandates that private insurance cover autism services and the health care-related financial burden reported by families of children with autism. Child and family data were drawn from the National Survey of Children with Special Health Care Needs (N  =  2,082 children with autism). State policy characteristics were taken from public sources. The 3 outcomes were whether a family had any out-of-pocket health care expenditures during the past year for their child with autism, the expenditure amount, and expenditures as a proportion of family income. We modeled the association between states' autism service mandates and families' financial burden, adjusting for child-, family-, and state-level characteristics. Overall, 78% of families with a child with autism reported having any health care expenditures for their child for the prior 12 months. Among these families, 54% reported expenditures of more than $500, with 34% spending more than 3% of their income. Families living in states that enacted legislation mandating coverage of autism services were 28% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. Families living in states that enacted parity legislation mandating coverage of autism services were 29% less likely to report spending more than $500 for their children's health care costs, net of child and family characteristics. This study offers preliminary evidence in support of advocates' arguments that requiring private insurers to cover autism services will reduce families' financial burdens associated with their children's health care expenses.
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http://dx.doi.org/10.1352/1934-9556-50.3.190DOI Listing
June 2012

Access to care for children with autism in the context of state Medicaid reimbursement.

Matern Child Health J 2012 Nov;16(8):1636-44

University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

This paper examines the role of state residence and Medicaid reimbursement rates in explaining the relationship between having autism and access to care for children. Three questions are addressed: (1) Is there variation across states in the relationship between having autism and access to care? (2) Does taking account of state residence explain a significant amount of the variation in this relationship? (3) Does accounting for Medicaid reimbursement rates enhance our understanding of this relationship? Data from the 2005 National Survey of Children with Special Health Care Needs were combined with state characteristics to estimate a hierarchical generalized linear model of the association between state residence, Medicaid reimbursement rate and problems accessing care for children with special health care needs with and without autism. Findings indicate there is significant variation between states in the relationship between having autism and problems accessing care, and accounting for state residence explains a significant amount of variation in the model. Medicaid reimbursement rates have an independent effect on access to care for children with autism: when families raising children with autism live in states with higher reimbursement rates, they have lower odds of experiencing problems accessing care. The state context in which families live impacts access to care for children with autism. Moreover, when families live in states with higher Medicaid reimbursement rates, they are less likely to experience problems getting care. The value of this analysis is that it helps identify where to look for strategies to improve access.
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http://dx.doi.org/10.1007/s10995-011-0862-1DOI Listing
November 2012