Achieving Better Quality of Care for Low-Income Populations: The Roles of Health Insurance and the Medical Home in Reducing Health Inequities

Outlines the importance of having both insurance and a medical home in reducing health and healthcare disparities for low-income adults, including access to care, preventive screenings, and satisfaction with quality of care. Makes policy recommendations

Coming Out of Crisis: Patient Experiences in Primary Care in New Orleans, Four Years Post-Katrina

Examines the network of neighborhood clinics funded with federal, state, and local money that emerged after Hurricane Katrina as a model for serving vulnerable populations. Looks at access, communication, chronic illnesses management, and preventive care

Enhancing the Capacity of Community Health Centers to Achieve High Performance

Based on a survey of community health centers, assesses access to care, care coordination, quality improvement efforts, health information technology adoption, and ability to serve as patient-centered medical homes. Suggests policy to strengthen clinics

Academically Resilient English Language Learners: A Focus Group Study Exploring Risk Factors and Protective Factors

In this study, the researcher explored high school English language learners’ perceptions of risk factors and protective factors present in their academic and social lives. The researcher also explored how these students negotiated risk factors and used protective factors to be academically resilient. Therefore, the study was designed to examine academic resilience from the students’ perspectives, allowing them to share their story about their success in high school. The following research questions guided this study: (1) What risk factors are present in high school English language learners’ academic and social lives? and (2) Which protective factors do high school English language learners use to be academically resilient? The researcher collected and analyzed qualitative data using key characteristics of focus group analysis. Nine students voluntarily participated in three different semi-structured focus group meetings. The findings revealed that risk factors such as lack of English language ability, low expectations of teachers, inability to form new relationships, stress, and inattentiveness prevented students from being successful. In addition, the students discussed how several protective factors like learning English, establishing and maintaining positive relationships, establishing and implementing good study habits, and possessing certain inner qualities helped them be academically resilient. Two themes that emerged were students (1) choosing to be academically resilient and (2) actively seeking sources of help. Based on this study, suggestions for educators are as follows: (1) consider providing more language support for newcomers; (2) include and build upon parent-school and teacher-student relationships; (3) encourage and provide ways for students to form relationships with others through school-based programs; (4) foster and continue to support the growth of the students’ academic skills; (5) find ways for students to become more involved with community-based services and programs; and (6) stress the importance of holding all students to high standards, regardless of students’ English language proficiency levels

The Adoption and Use of Health Information Technology by Community Health Centers, 2009-2013

With help from targeted federal investments, U.S. physician offices and hospitals have accelerated their adoption and use of patient electronic health records (EHRs) and other health information technology (HIT) in recent years. Comparison of results from. The Commonwealth Fund's two national surveys of federally qualified health centers (FQHCs) in 2009 and 2013 show that HIT adoption has also grown substantially for these important providers of care in poor and underserved communities. Nearly all surveyed FQHCs (93%) now have an EHR system, a 133 percent increase from 2009, the year federal "meaningful use" incentives for HIT were first authorized. Three-quarters of health centers (76%) reported meeting the criteria to qualify for incentive payments. Remaining challenges for health centers include achieving greater interoperability of EHR systems and ensuring patient access to their records. Mobile technology, such as text messaging, may help FQHCs further expand patient outreach and access to care

Perturbations in neuroinflammatory pathways are associated with paclitaxel-induced peripheral neuropathy in breast cancer survivors.

Paclitaxel is a common chemotherapy drug associated with the development of chronic paclitaxel-induced peripheral neuropathy (PIPN). PIPN is associated with neuroinflammatory mechanisms in pre-clinical studies. Here, we evaluated for differential gene expression (DGE) in peripheral blood between breast cancer survivors with and without PIPN and for neuroinflammatory (NI) related signaling pathways and whole-transcriptome profiles from other experiments. Pathway impact analysis identified 8 perturbed NI related pathways. Expression profile analysis found 15 experiments having similar whole-transcriptome profiles of DGE related to neuroinflammation and PIPN. These findings suggest that perturbations in pathways associated with neuroinflammation are found in cancer survivors with PIPN

Ready or Not? How Community Health Centers View Their Preparedness to Care for Newly Insured Patients

By expanding access to affordable insurance coverage for millions of Americans, the Affordable Care Act will likely increase demand for the services provided by federally qualified health centers (FQHCs), an important source of care in low-income communities. A Commonwealth Fund survey asked health center leaders in 2013 about current and anticipated workforce challenges, as well as efforts under way to prepare for the increase in patients. The majority of FQHCs reported shortages of primary care doctors (56%), especially bilingual physicians (60%). Health centers are engaged in activities to meet the needs of new patients, with 53 percent pursuing integration of behavioral health and 31 percent hiring additional clinical staff. To help them provide quality care to more patients, FQHCs will require assistance to recruit additional personnel, particularly bilingual staff and mental health professionals, and to expand access to care through telehealth and other strategies

Primary Care Providers' Views of Recent Trends in Health Care Delivery and Payment:Findings from the Commonwealth Fund/Kaiser Family Foundation 2015 National Survey of Primary Care Providers

A new survey from The Commonwealth Fund and The Kaiser Family Foundation asked primary care providers—physicians, nurse practitioners, and physician assistants—about their experiences with and reactions to recent changes in health care delivery and payment. Providers' views are generally positive regarding the impact of health information technology on quality of care, but they are more divided on the increased use of medical homes and accountable care organizations. Overall, providers are more negative about the increased reliance on quality metrics to assess their performance and about financial penalties. Many physicians expressed frustration with the speed and administrative burden of Medicaid and Medicare payments. An earlier brief focused on providers' experiences under the ACA's coverage expansions and their opinions about the law

Francisella tularensis strain typing using multiple-locus, variable-number tandem repeat analysis

Francisella tularensis, the etiological agent of tularemia, is found throughout the Northern hemisphere. After analyzing the F. tularensis genomic sequence for potential variable-number tandem repeats (VNTRs), we developed a multilocus VNTR analysis (MLVA) typing system for this pathogen. Variation was detected at six VNTR loci in a set of 56 isolates from California, Oklahoma, Arizona, and Oregon and the F. tularensis live vaccine strain. PCR assays revealed diversity at these loci with total allele numbers ranging from 2 to 20, and Nei's diversity index values ranging from 0.36 to 0.93. Cluster analysis identified two genetically distinct groups consistent with the current biovar classification system ofF. tularensis. These findings suggest that these VNTR markers are useful for identifying F. tularensisisolates at this taxonomic level. In this study, biovar B isolates were less diverse than those in biovar A, possibly reflecting the history of tularemia in North America. Seven isolates from a recent epizootic in Maricopa County, Ariz., were identical at all VNTR marker loci. Their identity, even at a hypervariable VNTR locus, indicates a common source of infection. This demonstrates the applicability of MLVA for rapid characterization and identification of outbreak isolates. Future construction of reference databases will allow faster outbreak tracking as well as providing a foundation for deciphering global genetic relationships