Impact of Compliance to Oral Hypoglycemic Agents on Short-Term Disability Costs in an Employer Population

This study evaluated the relationships between compliance with oral hypoglycemic agents and health care/short-term disability costs in a large manufacturing company. The retrospective analysis used an observational cohort drawn from active employees of Ford Motor Company. The study population consisted of 4978 individuals who were continuously eligible for 3 years (between 2001?2007) and who received a prescription for an oral hypoglycemic agent during that time. Medical, pharmacy, and short-term disability claims data were obtained from the University of Michigan Health Management Research Center data warehouse. Pharmacy claims/refill data were used to calculate the proportion of days covered (PDC); an individual was classified as compliant if his/her PDC was ≥80%. Model covariates included age, sex, work type, and Charlson comorbidity scores. The impact of compliance on disability and health care costs was measured by comparing the costs of the compliant with those of the noncompliant during a 1-year follow-up. Among these employees, compliant patients had lower medical, higher pharmacy, and lower short-term disability costs than did the noncompliant. After adjusting for demographics and comorbidity, noncompliance was associated with statistically higher short-term disability costs ($1840 vs.$1161, P<0.0001), longer short-term disability duration, and an increase in short-term disability incidence (21.5% of the noncompliant had a claim compared to 16.0% of the compliant, P<0.0001). These results suggest that medication compliance may be important in curtailing the rise of health care/disability costs in the workplace. Employers concerned with the total costs associated with diabetes should not overlook the impact of compliance on short-term disability. (Population Health Management 2014;17:35-41)Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140180/1/pop.2013.0009.pd

Accessibility, sustainability, excellence: How to expand access to research publications. Executive summary

This article is a summary, by the authors, of a 140-page report prepared in 2012 by the UK Working Group on Expanding Access to Published Research Findings, chaired by British sociologist and academic administrator Janet Finch, DBE. The Working Group was charged with recommending how to develop a model that would be effective and sustainable over time, for expanding access to the published fi ndings of research. The whole report, which can be accessed at http://www.researchinfonet.org/wp-content/uploads/2012/06/Finch-Group-report-FINAL-VERSION.pdf [http://tinyurl.com/d2lxqks], has been published under a Creative Commons License Attribution 3.0 Unported. This is the fi rst of a series of Perspectives articles devoted to the Open Access Initiative that will be published in INTERNATIONAL MICROBIOLOGY. Our journal already published an Editorial on the topic in 2004 (Guerrero R &amp; Piqueras M, Int Microbiol 7:157-161), and strongly supports open access. [Int Microbiol 2013; 16(2):125-132

Accessibility, sustainability, excellence: how to expand access to research publications. Executive summary

This article is a summary, by the authors, of a 140-page report prepared in 2012 by the UK Working Group on Expanding Access to Published Research Findings, chaired by British sociologist and academic administrator Janet Finch, DBE. The Working Group was charged with recommending how to develop a model that would be effective and sustainable over time, for expanding access to the published fi ndings of research. The whole report, which can be accessed at http://www.researchinfonet.org/wp-content/uploads/2012/06/Finch-Group-report-FINAL-VERSION.pdf [http://tinyurl.com/d2lxqks], has been published under a Creative Commons License Attribution 3.0 Unported. This is the fi rst of a series of Perspectives articles devoted to the Open Access Initiative that will be published in INTERNATIONAL MICROBIOLOGY. Our journal already published an Editorial on the topic in 2004 (Guerrero R &amp; Piqueras M, Int Microbiol 7:157-161), and strongly supports open access. [Int Microbiol 2013; 16(2):125-132

Childhood exposure to external ionising radiation and solid cancer risk

The increasing use of ionising radiation for diagnostic purposes has raised concern about potential iatrogenic damage, especially in children. In this review, we discuss some aspects of radiation-induced cancer in relation to age at exposure and measures that should be taken for limiting exposure in this sensitive population

1,25(OH)2D3 Alters Growth Plate Maturation and Bone Architecture in Young Rats with Normal Renal Function

Whereas detrimental effects of vitamin D deficiency are known over century, the effects of vitamin D receptor activation by 1,25(OH)2D3, the principal hormonal form of vitamin D, on the growing bone and its growth plate are less clear. Currently, 1,25(OH)2D3 is used in pediatric patients with chronic kidney disease and mineral and bone disorder (CKD-MBD) and is strongly associated with growth retardation. Here, we investigate the effect of 1,25(OH)2D3 treatment on bone development in normal young rats, unrelated to renal insufficiency. Young rats received daily i.p. injections of 1 µg/kg 1,25(OH)2D3 for one week, or intermittent 3 µg/kg 1,25(OH)2D3 for one month. Histological analysis revealed narrower tibial growth plates, predominantly in the hypertrophic zone of 1,25(OH)2D3-treated animals in both experimental protocols. This phenotype was supported by narrower distribution of aggrecan, collagens II and X mRNA, shown by in situ hybridization. Concomitant with altered chondrocyte maturation, 1,25(OH)2D3 increased chondrocyte proliferation and apoptosis in terminal hypertrophic cells. In vitro treatment of the chondrocytic cell line ATDC5 with 1,25(OH)2D3 lowered differentiation and increased proliferation dose and time-dependently. Micro-CT analysis of femurs from 1-week 1,25(OH)2D3-treated group revealed reduced cortical thickness, elevated cortical porosity, and higher trabecular number and thickness. 1-month administration resulted in a similar cortical phenotype but without effect on trabecular bone. Evaluation of fluorochrome binding with confocal microscopy revealed inhibiting effects of 1,25(OH)2D3 on intracortical bone formation. This study shows negative effects of 1,25(OH)2D3 on growth plate and bone which may contribute to the exacerbation of MBD in the CKD pediatric patients

Phylogenetic ctDNA analysis depicts early-stage lung cancer evolution.

The early detection of relapse following primary surgery for non-small-cell lung cancer and the characterization of emerging subclones, which seed metastatic sites, might offer new therapeutic approaches for limiting tumour recurrence. The ability to track the evolutionary dynamics of early-stage lung cancer non-invasively in circulating tumour DNA (ctDNA) has not yet been demonstrated. Here we use a tumour-specific phylogenetic approach to profile the ctDNA of the first 100 TRACERx (Tracking Non-Small-Cell Lung Cancer Evolution Through Therapy (Rx)) study participants, including one patient who was also recruited to the PEACE (Posthumous Evaluation of Advanced Cancer Environment) post-mortem study. We identify independent predictors of ctDNA release and analyse the tumour-volume detection limit. Through blinded profiling of postoperative plasma, we observe evidence of adjuvant chemotherapy resistance and identify patients who are very likely to experience recurrence of their lung cancer. Finally, we show that phylogenetic ctDNA profiling tracks the subclonal nature of lung cancer relapse and metastasis, providing a new approach for ctDNA-driven therapeutic studies

High stress experienced in the foster and kin carer role: Understanding the complexities of the carer and child in context

With the rising numbers of children in need of out-of-home care, child protection services look to foster and kin carers to play a leading role in the lives of children unable to live with their birth families. The current study examined placement, carer, and child characteristics related to perceived foster parent stress in a sample of 158 foster and kin carers in Queensland, Australia. Carers completed a self-report online survey that assessed parenting stress, and carer perceptions of the child in their care and the child protection system. Overall, foster carers reported high stress, with 20% in the clinical range on the Parenting Stress Index (PSI-4-SF). This stress was significantly higher for those providing care for children with carer-reported high emotional and behavioural problems. Both foster carer stress and the child's emotional and behavioural challenges were significantly related to placement factors, such as, the length of time the child had been in their current placement, and the child protection court order under which the child had been placed. The findings of the study highlight the challenges to caregivers in out-of-home care and the need for individualised services, resources and supports for caregivers under stress

Understanding the parental stress scale with a foster carer cohort

Objective: Using a cohort of foster and kin carers, the research examined the underlying factor structure of the Parental Stress Scale (PSS; Berry &amp; Jones, 1995). A hypothesized underlying two-dimensional theoretical model was explored. Background: With the growing demands on the foster care system, including poor retention and recruitment of foster carers, there is an urgent need to explore the positive and negative factors that may influence carers continued engagement in the role. Method: The factor structure of the PSS was examined in a sample of foster and kin carers in Australia (N = 324). The PSS consists of 10 statements addressing stressful aspects of parenting and eight statements addressing satisfying aspects of parenting. Exploratory factor analysis (EFA) explored the underlying theoretical structure of the scale as determined by the developers. Confirmatory factor analysis (CFA) was used to confirm whether four factors would sustain reduction to a two-dimensional (satisfaction–stress) model. Results: EFA and CFA supported a two-dimensional moderately correlated model measuring parent stress and parent satisfaction. The Parent Stress Index IV Short Form provided concurrent validity for the PSS stress subscale and previous analyses have also identified the strength of these dimensions over time, cohorts, and contexts. Conclusion: The current study supports using the subscale scores in research with foster carers and potentially other populations to better capture both stress and rewards and satisfaction related to their parenting role. Implications: Application of the PSS subscales can assess interactions or moderating effects of parenting in specific cohorts, making the PSS a valuable instrument to examine the balance between stress and reward for parents, foster parents and others who are “parenting” children.</p