Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities

https://digitalmaine.com/hhs_feddocs/1000/thumbnail.jp

SAMHSA\u27s Concept of Trauma and Guidance for a Trauma-Informed Approach

Trauma is a widespread, harmful and costly public health problem. It occurs as a result of violence, abuse, neglect, loss, disaster, war and other emotionally harmful experiences. Trauma has no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, geography or sexual orientation. It is an almost universal experience of people with mental and substance use disorders. The need to address trauma is increasingly viewed as an important component of effective behavioral health service delivery. Additionally, it has become evident that addressing trauma requires a multi-pronged, multi-agency public health approach inclusive of public education and awareness, prevention and early identification, and effective trauma-specific assessment and treatment. In order to maximize the impact of these efforts, they need to be provided in an organizational or community context that is trauma-informed, that is, based on the knowledge and understanding of trauma and its far-reaching implications

Maternity Leave Benefits in the United States: Today's Economic Climate Underlines Deficiencies

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72143/1/j.1523-536X.2009.00330.x.pd

Physicians', nurses' and community health workers' knowledge about physical activity in Brazil: A cross-sectional study

AbstractObjectivesTo measure knowledge of current recommendations of physical activity and consequences of physical inactivity among healthcare providers throughout Brazil.MethodsA phone survey of 1600 randomly selected primary healthcare units in Brazil was conducted between January and July 2011. At each unit, a physician, nurse or community healthcare worker (n=798) responded to a 40-minute survey, eliciting information about demographics, knowledge, and health behaviors pertaining to physical activity.ResultsAmong nurses and community healthcare workers, >95% reported needing more information on physical activity guidelines. Among physicians this proportion was 80%. Nearly 40% of the professionals incorrectly believed 90-min of moderate-intensity physical activity per week is the recommended amount for health benefits; nearly 30% believed that 90-min of vigorous-intensity activity per week is needed for the same purpose. More than 75% of all groups reported that type II diabetes, hypertension, depression, and coronary heart disease might result from physical inactivity, but on average only 60% from each group are aware of osteoporosis as a possible consequence of physical inactivity.ConclusionsTraining health professionals in how to convey all relevant information about physical activity to their patients is critical for health promotion within the primary care system in Brazil

Naturally Better? A Review of the Natural‐is‐Better Bias

People are frequently exposed to products and services that are labeled natural (e.g., Nature Made Vitamins or GoJo Natural Orange Hand Cleaner). The frequency with which this label is used suggests that it delivers an advantage in marketing and sales. Our review examines the preference for and perception of naturalness and reveals that people have a bias for items described as natural in many domains including foods, medicine, beauty products, cigarettes, and lighting. These preferences abound even when the natural item is identical or not objectively better than the non‐natural or synthetic item. We believe this bias may be driven by a natural‐is‐better default belief as well as the belief that natural items are safer than non‐natural items. Although a bias for natural items is apparent, this literature is in its infancy, and we suggest three areas that will help build and refine the empirical research base and theory: the measurement of behavior, the examination of individual differences, and the development of methods for reducing the bias. A better understanding of the naturalness bias relevant to these areas will lead to a more comprehensive understanding of the area, including factors that may cause and reduce it

Evaluation of the Capitainer-B microfluidic device as a new hematocrit-independent alternative for dried blood spot collection

The hematocrit-bias still remains one of the most discussed issues when it comes to dried blood spot (DBS) analysis. Therefore, many attempts to cope with this issue have been made, among which the development of novel sampling tools such as the Capitainer-B (further referred to as MF (microfluidic)-DBS) devices. These are designed to allow a straightforward absorption of a fixed volume (13.5 mu L) of blood by a preperforated paper disc, which can be analyzed afterward. The aim of this study was to evaluate the potential of these devices to nullify the hematocrit-based area bias and to investigate whether the amount of blood applied has an influence on the device performance. An LC-MS/MS method for the quantification of caffeine and paraxanthine in MF-DBS was fully validated, meeting all preset acceptance criteria. In a next step, using a set of 133 authentic, venous patient samples with a hematocrit range of 18.8-55.0, concentrations of both compounds in MF-DBS were compared to those in corresponding partial-punch pipetted DBS (PI-DBS) and liquid blood samples. When compared to blood as a reference, the concentrations obtained in MF-DBS were not affected by a bias in function of the evaluated hematocrit, in contrast to those obtained from partial-punch PI-DBS. Furthermore, analysis of samples resulting from spiking different volumes of whole blood at different hematocrit levels, revealed that the amount of blood applied at the device inlet has no influence on the performance of the devices. Therefore, it can be concluded from this study, being the first in which the impact of the hematocrit and the applied volume is evaluated by analyzing authentic, venous patient samples, that MF-DBS devices effectively assist in eliminating the hematocrit-based area bias, independently from the applied blood volume

Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports.

OBJECTIVE: To use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day). DESIGN: Systematic review and meta-analysis. DATA SOURCES: Medline 1946 to May 2015, with manual searches of references. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke. DATA EXTRACTION/SYNTHESIS: MOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR1_per_day-1) expressed as a proportion of that for smoking 20 cigarettes per day (RR20_per_day-1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder. RESULTS: The meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men. CONCLUSIONS: Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.This study was supported by a core grant from Cancer Research UK (C444/A15953)

Trends in Folic Acid Awareness and Behavior in the United States: The Gallup Organization for the March of Dimes Foundation Surveys, 1995–2005

Objective: To summarize changes in folic acid awareness, knowledge, and behavior among women of childbearing age in the United States since the U.S. Public Health Service (USPHS) 1992 folic acid recommendation and later fortification. Methods: Random-digit dialed telephone surveys were conducted of approximately 2000 women (per survey year) aged 18–45 years from 1995–2005 in the United States. Results: The percentage of women reporting having heard or read about folic acid steadily increased from 52% in 1995 to 84% in 2005. Of all women surveyed in 2005, 19% knew folic acid prevented birth defects, an increase from 4% in 1995. The proportion of women who reported learning about folic acid from health care providers increased from 13% in 1995 to 26% in 2005. The proportion of all women who reported taking a vitamin supplement containing folic acid increased slightly from 28% in 1995 to 33% in 2005. Among women who were not pregnant at the time of the survey in 2005, 31% reported taking a vitamin containing folic acid daily compared with 25% in 1995. Conclusions: The percentage of women taking folic acid daily has increased modestly since 1995. Despite this increase, the data show that the majority of women of childbearing age still do not take a vitamin containing folic acid daily. Health care providers and maternal child health professionals must continue to promote preconceptional health among all women of childbearing age, and encourage them to take a vitamin containing folic acid daily