Facilitating Access to Health Coverage and Care by Advancing Health Insurance Literacy

Although Massachusetts currently has the highest rate of health insurance coverage in the nation, reports suggest health care consumers do not fully understand how their insurance works. Thus, the insured and uninsured populations alike need ongoing support in order to develop health insurance literacy, defined as the degree to which individuals obtain, process, and understand information about health insurance in order to make informed decisions about choosing and using their coverage, which in turn can lead to positive health outcomes. Educating consumers and giving them tools and resources are strategies that advance health insurance literacy. Since 2001, the Blue Cross Blue Shield of Massachusetts Foundation (the Foundation) has awarded over $5 million to community health centers and community-based organizations throughout Massachusetts, through its Connecting Consumers with Care (CCC) grant program, to conduct outreach, provide education and help consumers enroll in health insurance and access primary care. In 2015, the Foundation focused its CCC grant activities to improve health insurance literacy and engage consumers to utilize the health care system more effectively. Grantees have collected data on common measures, using adaptable data collection tools (e.g., brief client surveys), to assess changes in clients\u27 knowledge, confidence, and/or preparedness to better navigate complex systems of coverage and care. The poster presentation will discuss: - the importance of health insurance literacy and its relevance to improving population and community health - strategies currently used to increase health insurance literacy among diverse populations, including successes and challenges - how the impact of these strategies was measured - how assessments were designed to reflect consumers\u27 voices

Double Red Blood Cell Donation Eligibility and Interest

Introduction: The process of double RBC donation by apheresis (DRBC), which facilitates the donation of two units of red blood cells (RBC) in a single donation session, was estimated to account for approximately 4% of blood donations in 2005, and is believed to be growing at a rate of 40% per year. Blood shortages in this country could be corrected by converting as few as 10% of current single unit whole blood donors to DRBC donors. Advantages of DRBC donation may include reduction in donor-related exposures in recipients, improved cost-effectiveness of the donation process, and improved convenience for donors. The safety profile of DRBC has been found to be equal to, and in some cases better than that of single unit whole blood donation, especially in young donors (/o). DRBC donors have been shown to restore 92% of RBC volume in 4 weeks without iron supplementation, and to have no significant differences in hemoglobin, serum iron, or ferritin when compared with single unit whole blood donors six months after donation. Our study seeks to quantify the number of current single unit whole blood donors who are both eligible for and interested in DRBC donation.https://scholarworks.uvm.edu/comphp_gallery/1031/thumbnail.jp

Targeting transcription regulation in cancer with a covalent CDK7 inhibitor

Tumour oncogenes include transcription factors that co-opt the general transcriptional machinery to sustain the oncogenic state, but direct pharmacological inhibition of transcription factors has so far proven difficult. However, the transcriptional machinery contains various enzymatic cofactors that can be targeted for the development of new therapeutic candidates, including cyclin-dependent kinases (CDKs). Here we present the discovery and characterization of a covalent CDK7 inhibitor, THZ1, which has the unprecedented ability to target a remote cysteine residue located outside of the canonical kinase domain, providing an unanticipated means of achieving selectivity for CDK7. Cancer cell-line profiling indicates that a subset of cancer cell lines, including human T-cell acute lymphoblastic leukaemia (T-ALL), have exceptional sensitivity to THZ1. Genome-wide analysis in Jurkat T-ALL cells shows that THZ1 disproportionally affects transcription of RUNX1 and suggests that sensitivity to THZ1 may be due to vulnerability conferred by the RUNX1 super-enhancer and the key role of RUNX1 in the core transcriptional regulatory circuitry of these tumour cells. Pharmacological modulation of CDK7 kinase activity may thus provide an approach to identify and treat tumour types that are dependent on transcription for maintenance of the oncogenic state.National Institutes of Health (U.S.) (Grant HG002668)National Institutes of Health (U.S.) (Grant CA109901

Seroprevalencia de Leptospirosis en Puente Piedra, Lima en el año 2006 Seroprevalence of Leptospirosis in Puente Piedra, Lima, in 2006

La leptospirosis es una enfermedad ampliamente prevalente en áreas tropicales, pero también se presenta en áreas urbanas. El presente estudio tiene como objetivo determinar la seroprevalencia para Leptospira en el distrito de Puente Piedra, donde se han presentado casos de leptospirosis severa en los últimos años. Se recolectaron datos relacionados a factores de riesgo asociados con leptospirosis y muestras de sangre de 250 participantes, seleccionados por un muestreo aleatorio. Se encontró una alta prevalencia de factores de riesgo en la población y, usando la prueba de aglutinación microscópica, anticuerpos circulantes contra Leptospira en solamente tres participantes (1,2%).<br>Leptospirosis is a disease widely prevalent in tropical areas, but may also be present in urban areas. The present study aims to determine the seroprevalence of Leptospira in the district of Puente Piedra, where there have been cases of severe leptospirosis in recent years. We collected data related to risk factors associated with leptospirosis and blood samples from 250 participants, selected by random sampling. We found a high prevalence of risk factors in the population and using the microscopic agglutination test, antibodies were found in only 3 participants (1.2%)

Seroprevalencia de Leptospirosis en Puente Piedra, Lima en el año 2006

La leptospirosis es una enfermedad ampliamente prevalente en áreas tropicales, pero también se presenta en áreas urbanas. El presente estudio tiene como objetivo determinar la seroprevalencia para Leptospira en el distrito de Puente Piedra, donde se han presentado casos de leptospirosis severa en los últimos años. Se recolectaron datos relacionados a factores de riesgo asociados con leptospirosis y muestras de sangre de 250 participantes, seleccionados por un mues - treo aleatorio. Se encontró una alta prevalencia de factores de riesgo en la población y, usando la prueba de aglutinación microscópica, anticuerpos circulantes contra Leptospira en solamente tres participantes (1,2%)

Prevalence of HIV preexposure prophylaxis prescribing among persons with commercial insurance and likely injection drug use.

Importance: Although HIV preexposure prophylaxis (PrEP) implementation among persons who inject drugs has been inadequate, national HIV monitoring programs do not include data on PrEP, and specific trends in PrEP use are not well understood. Objective: To estimate HIV PrEP uptake among commercially insured persons with opioid or stimulant use disorder by injection drug use (IDU) status. Design, Setting, and Participants: This cross-sectional study used deidentified data from the MarketScan Commercial Claims and Encounters Database to identify a sample of 547 709 commercially insured persons without HIV but with opioid and/or stimulant use disorder, including 110 592 with evidence of IDU between January 1, 2010, and December 31, 2019. Data were analyzed from November 1, 2020, to July 1, 2021. Persons with opioid and/or stimulant use disorder and evidence of IDU were identified through claims data. Main Outcomes and Measures: The outcome was receipt of tenofovir disoproxil fumarate and emtricitabine for PrEP as identified from filled pharmacy claims. Multivariable logistic regression was used to assess the association of demographic and clinical characteristics with receipt of PrEP. Results: The study cohort included 211 609 (28.6%) females and 336 100 (61.4%) males with a combined mean (SD) age of 34.8 (13.1) years, including 110 592 individuals with evidence of IDU. During the study period, 508 (0.09%) persons with opioid and/or stimulant use disorder, including 170 (0.15%) with evidence of IDU, received PrEP. Receipt of PrEP increased from 0.001 to 0.243 per 100 person-years from 2010 through 2019 among the entire cohort and from 0.000 to 0.295 per 100 person-years among those with IDU. In multivariable analysis, PrEP use was more likely among males (adjusted odds ratio [aOR] 8.72; 95% CI, 6.39-11.89), persons with evidence of IDU (aOR, 1.47; 95% CI, 1.21-1.79), and persons with evidence of sexual risk indications for PrEP (aOR, 23.68; 95% CI, 19.57-28.66). Conclusions and Relevance: In this cross-sectional study of commercially insured persons with opioid and/or stimulant use disorder, HIV PrEP delivery remained low, including among those with evidence of IDU. PrEP should be consistently offered alongside substance use disorder treatment and other harm reduction and HIV prevention services

Dysregulated Gene Expression During Hematopoietic Differentiation From Human Embryonic Stem Cells

The generation of hematopoietic cells from human embryonic stem cells (hESC) has raised the possibility of using hESC as an alternative donor source for transplantation. However, functional defects identified in hESC-derived cells limit their use for full lymphohematopoietic reconstitution. The purpose of the present study was to define and quantitate key functional and molecular differences between CD34+ hematopoietic progenitor subsets derived from hESC and CD34+ subsets from umbilical cord blood (UCB) representing definitive hematopoiesis. Two distinct sub-populations were generated following mesodermal differentiation from hESC, a CD34bright (hematoendothelial) and CD34dim (hematopoietic-restricted) subset. Limiting dilution analysis revealed profound defects in clonal proliferation relative to UCB particularly in B lymphoid conditions. Transcription factors normally expressed at specific commitment stages during B lymphoid development from UCB-CD34+ cells were aberrantly expressed in hESC-derived CD34+ cells. Moreover, strong negative regulators of lymphopoiesis such as the adaptor protein LNK and CCAAT/enhancer-binding protein-α (CEBPα), were exclusively expressed in hESC-CD34+ subsets. Knockdown of LNK lead to an increase in hematopoietic progenitors generated from hESCs. The aberrant molecular profile seen in hESC-CD34+ cells represents persistence of transcripts first expressed in undifferentiated hESC and/or CD326-CD56+ mesoderm progenitors, and may contribute to the block in definitive hematopoiesis from hESC