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Healthcare governance during humanitarian responses: a survey of current practice among international humanitarian actors.

Confl Health 2021 Apr 10;15(1):25. Epub 2021 Apr 10.

Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.

Background: Large international humanitarian actors support and directly deliver health services for millions of people in crises annually, and wield considerable power to decide which health services to provide, how and to whom, across a vast spectrum of health areas. Despite decades of reform aiming to improve accountability in the sector, public health practice among humanitarian actors is not heavily scrutinized in either the countries where they are headquartered or those where they provide healthcare. We surveyed current healthcare governance practice among large international humanitarian actors to better understand what organisations are doing to ensure oversight and accountability for health services in humanitarian responses. Read More

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Service Availability in Assisted Living and Other Community-Based Residential Settings at the End of Life.

J Palliat Med 2021 Apr 7. Epub 2021 Apr 7.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Community-based residential settings (e.g., assisted living facilities and retirement communities), are increasing, where vulnerable older adults are living as they age and die. Read More

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Feasibility of a Software agent providing a brief Intervention for Self-help to Uplift psychological wellbeing ("SISU"). A single-group pretest-posttest trial investigating the potential of SISU to act as therapeutic agent.

Internet Interv 2021 Apr 24;24:100377. Epub 2021 Feb 24.

Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise Meitner Straße 16, 89081 Ulm, Germany.

Background: Software agents are computer-programs that conduct conversations with a human. The present study evaluates the feasibility of the software agent "SISU" aiming to uplift psychological wellbeing. Methods: Within a one-group pretest-posttest trial,  = 30 German-speaking participants were recruited. Read More

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Influenza vaccination rates and location for receiving the influenza vaccination among older adult Medicare beneficiaries.

J Am Pharm Assoc (2003) 2021 Feb 27. Epub 2021 Feb 27.

Objectives: The objectives of this study were to (1) assess the trends in older adult influenza vaccination rates and (2) locations at which U.S. older adults received influenza vaccinations for the 2008-2009 to 2017-2018 influenza seasons, and (3) compare the estimates of influenza vaccination rates and locations with the estimates from other sources reported previously. Read More

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February 2021

The application of social innovation in healthcare: a scoping review.

Infect Dis Poverty 2021 Mar 8;10(1):26. Epub 2021 Mar 8.

London School of Hygiene and Tropical Medicine, London, UK.

Background: Social innovation has been applied increasingly to achieve social goals, including improved healthcare delivery, despite a lack of conceptual clarity and consensus on its definition. Beyond its tangible artefacts to address societal and structural needs, social innovation can best be understood as innovation in social relations, in power dynamics and in governance transformations, and may include institutional and systems transformations.

Methods: A scoping review was conducted of empirical studies published in the past 10 years, to identify how social innovation in healthcare has been applied, the enablers and barriers affecting its operation, and gaps in the current literature. Read More

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Hearing Loss and Home Health: An Unmet Need and an Opportunity for Action.

Home Healthc Now 2021 Mar-Apr 01;39(2):72-80

The purpose of this study was to identify unmet hearing care needs among older adults receiving home healthcare as a potential method to reach a population unserved by clinic-based care. Cross-sectional analyses were used to identify hearing loss and hearing aid use among beneficiaries enrolled in home care, using data from the nationally representative 2017 Medicare Current Beneficiary Survey (MCBS). Survey participants who reported enrollment in home healthcare services in 2017 (n = 3,183,693) were included for the purposes of analyses. Read More

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Special Report from the CDC Antidepressant subclass use and fall risk in community-dwelling older Americans.

J Safety Res 2021 02 13;76:332-340. Epub 2020 Dec 13.

Larner College of Medicine, University of Vermont, Burlington, VT, USA.

Introduction: Falls among older adults are a significant health concern affecting more than a quarter of older adults (age 65+). Certain fall risk factors, such as medication use, increase fall risk among older adults (age 65+).

Aim: The aim of this study is to examine the association between antidepressant-medication subclass use and self-reported falls in community-dwelling older adults. Read More

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February 2021

Rural Enrollees In Medicare Advantage Have Substantial Rates Of Switching To Traditional Medicare.

Health Aff (Millwood) 2021 Mar;40(3):469-477

Brent A. Langellier is an assistant professor in the Department of Health Management and Policy at the Drexel Dornsife School of Public Health.

Medicare beneficiaries in rural areas may face challenges to gaining access to care, particularly if enrolled in Medicare Advantage (MA) plans with limited benefits and restrictive provider networks. These barriers to care may, in turn, increase switching to traditional fee-for-service Medicare among rural MA enrollees. Using 2010-16 Medicare Current Beneficiary Survey data, we found that switching from traditional Medicare to Medicare Advantage was uncommon among enrollees, both rural (1. Read More

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Innovative strategies for providing menstruation-supportive water, sanitation and hygiene (WASH) facilities: learning from refugee camps in Cox's bazar, Bangladesh.

Confl Health 2021 Feb 26;15(1):10. Epub 2021 Feb 26.

Columbia University, Mailman School of Public Health, 722 W. 168th Street, New York, NY, 10032, USA.

Background: There is growing attention to addressing the menstrual hygiene management (MHM) needs of the over 21 million displaced adolescent girls and women globally. Current approaches to MHM-related humanitarian programming often prioritize the provision of menstrual materials and information. However, a critical component of an MHM response includes the construction and maintenance of water, sanitation and hygiene (WASH) facilities, including more female-friendly toilets. Read More

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February 2021

Societal Cost of Opioid Use in Symptomatic Knee Osteoarthritis Patients in the United States.

Arthritis Care Res (Hoboken) 2021 Feb 24. Epub 2021 Feb 24.

Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.

Background: Symptomatic knee osteoarthritis (SKOA) is a chronic, disabling condition, requiring long-term pain management; over 800,000 SKOA patients in the USA use opioids chronically. We aim to characterize the societal economic burden of opioid use in this population.

Methods: We used the Osteoarthritis Policy Model, a validated computer simulation of SKOA, to estimate the opioid-related lifetime and annual cost generated by the USA SKOA population. Read More

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February 2021

Exploring the rapid expansion of office-based laboratories and peripheral vascular interventions across the United States.

J Vasc Surg 2021 Feb 19. Epub 2021 Feb 19.

Section of Vascular Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.

Objective: To characterize the relationship between office-based laboratory (OBL) use and Medicare payments for peripheral vascular interventions (PVI).

Methods: Using the Centers for Medicare and Medicaid Services Provider Utilization and Payment Data Public Use Files from 2014 to 2017, we identified providers who performed percutaneous transluminal angioplasty, stent placement, and atherectomy. Procedures were aggregated at the provider and hospital referral region (HRR) level. Read More

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February 2021

Differences in patient perceptions of integrated care among black, hispanic, and white Medicare beneficiaries.

Health Serv Res 2021 Feb 11. Epub 2021 Feb 11.

Stanford University School of Medicine, Stanford, California, USA.

Objective: This study sought to identify potential disparities among racial/ethnic groups in patient perceptions of integrated care (PPIC) and to explore how methodological differences may influence measured disparities.

Data Source: Data from Medicare beneficiaries who completed the 2015 Medicare Current Beneficiary Survey (MCBS) and were enrolled in Part A benefits for an entire year.

Study Design: We used 4-point measures of eight dimensions of PPIC and assessed differences in dimensions among racial/ethnic groups. Read More

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February 2021

The Immunobiogram, a Novel Assay to Evaluate Treatment Resistance in Patients Receiving Immunosuppressive Therapy.

Front Immunol 2020 25;11:618202. Epub 2021 Jan 25.

R+D Department, BIOHOPE Scientific SL, Madrid, Spain.

Immunosuppressive drugs are widely used to treat several autoimmune disorders and prevent rejection after organ transplantation. However, intra-individual variations in the pharmacological response to immunosuppressive therapy critically influence its efficacy, often resulting in poor treatment responses and serious side effects. Effective diagnostic tools that help clinicians to tailor immunosuppressive therapy to the needs and immunological profile of the individual patient thus constitute a major unmet clinical need. Read More

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January 2021

Association of self-reported hearing loss severity and healthcare utilization outcomes among Medicare beneficiaries.

Am J Otolaryngol 2021 Feb 2;42(4):102943. Epub 2021 Feb 2.

Department of Otolaryngology- Head and Neck Surgery, Stanford University School of Medicine, United States of America. Electronic address:

Purpose: Understanding health utilization trends in the elderly population is pivotal for Medicare and policymakers. This study evaluates the association between hearing status and health utilization outcomes in a representative sample of elderly Medicare beneficiaries.

Materials And Methods: We employed the 2017 Medicare Current Beneficiary Survey (MCBS), which includes self-reported hearing loss data and weighted health utilization information. Read More

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February 2021

Attenuation of FGF21 signalling might aggravate the impairment of glucose homeostasis during the high sucrose diet induced transition from prediabetes to diabetes in WNIN/GR-Ob rats.

Biomed Pharmacother 2021 May 30;137:111252. Epub 2021 Jan 30.

Molecular Genetics, National Institute of Nutrition, Hyderabad, 500007, India. Electronic address:

Fibroblast growth factor 21 (FGF21) has emerged as a pleiotropic hormone and is known for its beneficiary roles in the management of diabetes and hyperglycaemia. However, the role of FGF21 during the transition from prediabetes to diabetes still remains unclear. Hence, the present study is aimed to understand the regulation of glucose homeostasis by FGF21 during the transition from prediabetes to diabetes in WNIN/GR-Ob rats. Read More

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Electronic Communication with Public Administration in the Time of COVID-19-Poland's Experience.

Aleksandra Klich

Int J Environ Res Public Health 2021 01 14;18(2). Epub 2021 Jan 14.

Faculty of Law and Administration, University of Szczecin, 70-240 Szczecin, Poland.

The situation associated with the growing number of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections forced ongoing monitoring of the epidemic situation, which entailed an introduction of a number of restrictions and solutions intended to isolate the infected persons on the one hand, and to minimize the risk of development of an epidemic in Poland on the other. Activity of the Polish legislator is also essential, which tried to introduce solutions that would correspond with current expectations and needs. Given the multiplicity of the introduced regulations, interpretation of provisions of statutes has not always been easy. Read More

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January 2021

Testing the efficacy and safety of BIO101, for the prevention of respiratory deterioration, in patients with COVID-19 pneumonia (COVA study): a structured summary of a study protocol for a randomised controlled trial.

Trials 2021 Jan 11;22(1):42. Epub 2021 Jan 11.

Biophytis, Inc, 210 Broadway, Suite #201, Cambridge, MA, 02139, USA.

Objectives: As of December, 1, 2020, coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, resulted in more than 1 472 917 deaths worldwide and death toll is still increasing exponentially. Many COVID-19 infected people are asymptomatic or experience moderate symptoms and recover without medical intervention. However, older people and those with comorbid hypertension, diabetes, obesity, or heart disease are at higher risk of mortality. Read More

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January 2021

Asthma-chronic obstructive pulmonary disease overlap and cost-related medication non-adherence among older adults in the United States.

J Asthma 2021 Jan 19:1-15. Epub 2021 Jan 19.

School of Pharmacy, West Virginia University, Morgantown, WV, USA.

Background: Cost-related medication non-adherence (CRN) can negatively impact health outcomes in older adults with asthma and chronic obstructive pulmonary disease (COPD) overlap (ACO) by reducing access and adherence to essential medications. The objective of this study is to examine the association of ACO to any CRN and specific forms of CRN among a nationally representative sample of older (age ≥ 65 years) adults.

Methods: We adopted a cross-sectional study design using data from pooled cross-sectional Medicare Current Beneficiary Surveys (MCBS) (2006-2013) and linked fee-for-service Medicare claims. Read More

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January 2021

Full-Coverage Chiropractic in Medicare: A Proposal to Eliminate Inequities, Improve Outcomes, and Reduce Health Disparities Without Increasing Overall Program Costs.

Robert A Leach

J Chiropr Humanit 2020 Dec 7;27:29-36. Epub 2020 Dec 7.

Food Science, Nutrition and Health Promotion, Mississippi State University, Starkville, Mississippi.

Objective: The purpose of this article is to discuss evidence that supports the resolution of inequities for Medicare beneficiaries who receive chiropractic care.

Discussion: Medicare covers necessary examinations, imaging, exercise instruction, and treatments for beneficiaries with back pain when provided by medical doctors, osteopaths, and their associated support staff such as nurse practitioners, physician assistants, clinical nurse specialists, and physical therapists. However, if the same patient with back pain presents to a chiropractor, then the only service that is covered by Medicare is manipulation of the spine. Read More

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December 2020

Productive Activities But Not Paid Work Relate to Well-Being in Older Adults.

Res Gerontol Nurs 2021 Jan 14;14(1):24-32. Epub 2020 Dec 14.

Productive activity engagement may positively contribute to the subjective well-being (SWB) of older adults during retirement. The current study explored the relationships between paid work and productive activities and SWB in Medicare beneficiary older adults predominantly living in the community. The 2015-2016 data (N = 2,916) from the National Health and Aging Trends Study were used. Read More

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January 2021

Cost-related Medication Nonadherence and Its Risk Factors Among Medicare Beneficiaries.

Med Care 2021 01;59(1):13-21

School of Pharmacy, Northeastern University.

Background: Unaffordability of medications is a barrier to effective treatment. Cost-related nonadherence (CRN) is a crucial, widely used measure of medications access.

Objectives: Our study examines the current national prevalence of and risk factors for CRN (eg, not filling, skipping or reducing doses) and companion measures in the US Medicare population. Read More

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January 2021

Patient Experiences of Integrated Care in Medicare Accountable Care Organizations and Medicare Advantage Versus Traditional Fee-for-Service.

Med Care 2021 Mar;59(3):195-201

Stanford University School of Medicine, Stanford, CA.

Background: Health insurance design can influence the extent to which clinical care is well-coordinated. Through alternative payment models, Medicare Advantage (MA) and Accountable Care Organizations (ACOs) have the potential to improve integration relative to traditional fee-for-service (FFS) Medicare.

Objective: To characterize patient experiences of integrated care within Medicare and identify whether MA or ACO beneficiaries perceive greater integration than FFS beneficiaries. Read More

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The cost of waiting: Association of ED boarding with hospitalization costs.

Am J Emerg Med 2021 02 13;40:169-172. Epub 2020 Nov 13.

Department of Emergency Medicine, Yale University School of Medicine, 464 Congress Ave., Suite 260, New Haven, CT 06519, USA; Center for Outcomes Research and Evaluation, Yale University School of Medicine, 1 Church Street, Suite 200, New Haven, CT 06510, USA.

Background: Emergency Department (ED) boarding, the practice of holding patients in the ED after they have been admitted to the hospital due to unavailability of inpatient beds, is common and contributes to the public health crisis of ED crowding. Prior work has documented the harms of ED boarding on access and quality of care. Limited studies examine the relationship between ED boarding and an equally important domain of quality-the cost of care. Read More

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February 2021

Contact by Collection Agencies for Medical Debt: Rural-Urban Differences Among Older and Younger Medicare Beneficiaries.

J Appl Gerontol 2020 Dec 2:733464820975902. Epub 2020 Dec 2.

University of Minnesota School of Public Health, Minneapolis, USA.

Geographic disparities in health and health care are increasingly well-documented, as are financial barriers to accessing care. Still, less is known about whether Medicare beneficiaries differ in their ability to pay for care by rurality. Using data from the 2016 Medicare Current Beneficiary Survey ( = 12,688 U. Read More

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December 2020

Current challenges in military trauma readiness: Insufficient relevant surgical case volumes in military treatment facilities.

J Trauma Acute Care Surg 2020 12;89(6):1054-1060

From the Department of Surgery, 96 Medical Group, Eglin AFB, Florida (A.B.H., H.M.); Department of Surgery, William Beaumont Army Medical Center (E.D., A.W.), El Paso, Texas; Department of Surgery, Naval Hospital Camp Pendleton (M.V.), Camp Pendleton, California; Department of Surgery, Keesler Medical Center (J.U.), Biloxi, Mississippi; Department of Surgery, Naval Medical Center San Diego (M.D.T.), San Diego, California; Department of Surgery, Naval Medical Research Unit San Antonio (I.Q., J. Glaser), San Antonio, Texas; and Department of Surgery, Joint Trauma System and the US Army Institute of Surgical Research (J. Gurney), Defense Center of Excellence, San Antonio, Texas.

Background: The management of battlefield trauma requires a specific skill set, which is optimized by regular trauma experience. As military casualties from the prolonged conflicts in the Middle East decrease, challenges exist to maintain battlefield trauma readiness. Military surgeons must therefore depend on the Military Health System. Read More

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December 2020

Screening Mammography Utilization Among Female Medicare Beneficiaries and Breast Cancer Survivors in 2002-2016.

J Womens Health (Larchmt) 2020 Nov 18. Epub 2020 Nov 18.

Department of Health Outcomes Research and Policy, Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA.

The use of screening mammography varies by patient characteristics. This study examined the annual mammography utilization trends among female Medicare beneficiaries and breast cancer survivors, overall and by beneficiary characteristics. This retrospective, serial cross-sectional study used the 2002-2016 Medicare Current Beneficiary Survey (MCBS), including fee-for-service female Medicare beneficiaries who resided in community settings and who completed the survey ( = 53,788, weighted  = 206,259,890). Read More

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November 2020

Assessment of Sensory Impairment and Health Care Satisfaction Among Medicare Beneficiaries.

JAMA Netw Open 2020 11 2;3(11):e2025522. Epub 2020 Nov 2.

Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Importance: Satisfaction with care is associated with improved quality of care and health outcomes. Sensory impairment can be a barrier to effective communication and access to care, and this may result in reduced satisfaction with care.

Objective: This study examined the association between sensory impairment and health care satisfaction among Medicare beneficiaries. Read More

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November 2020

A robust multiplex immunoaffinity mass spectrometry assay (PromarkerD) for clinical prediction of diabetic kidney disease.

Clin Proteomics 2020 20;17:37. Epub 2020 Oct 20.

Proteomics International, Perth, Australia.

Background: PromarkerD is a novel proteomics derived blood test for predicting diabetic kidney disease (DKD). The test is based on an algorithm that combines the measurement of three plasma protein biomarkers (CD5L, APOA4, and IBP3) with three clinical variables (age, HDL-cholesterol, and eGFR). The initial format of the assay used immunodepletion of plasma samples followed by targeted mass spectrometry (MRM-LCMS). Read More

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October 2020

Discrepancies between Perceived and Physiological Fall Risks and Repeated Falls among Community-Dwelling Medicare Beneficiaries Aged 65 Years and Older.

Clin Gerontol 2020 Oct 22:1-13. Epub 2020 Oct 22.

College of Sciences, Department of Sociology, University of Central Florida , Orlando, Florida, USA.

Objectives: This study examined the associations of discrepancies between perceived and physiological fall risks with repeated falls.

Methods: We analyzed the 2016 Medicare Current Beneficiary Survey of 2,487 Medicare beneficiaries aged ≥ 65 years with ≥ 1 fall. The outcome variable was repeated falls (≥ 2 falls), the key independent variable was a categorical variable of discrepancies between perceived (fear of falling) and physiological fall risks (physiological limitations), assessed using multivariate logistic regression. Read More

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October 2020