The Climate Impact of Medical Residency Interview Travel in the United States and Canada: A Scoping Review.

The change from in-person to virtual interviews for graduate medical education (GME) provides the opportunity to compare the potential environmental effects. To explore and summarize the existing literature on the potential climate impact of medical residency interview travel through a scoping review. The search was conducted in October 2022 using 5 research databases.

Predicting access to postoperative treatment after glioblastoma resection: an analysis of neighborhood-level disadvantage using the Area Deprivation Index (ADI).

Purpose: Social determinants of health (SDoH)-socioeconomic and environmental factors-impact outcomes. The Area Deprivation Index (ADI), a composite of seventeen SDoH factors, has been correlated with poorer outcomes. We aimed to compare outcomes and treatment access for glioblastoma, a universally fatal malignant brain tumor, in patients more (ADI 34-100%) versus less disadvantaged (ADI 0-33%).

A population-level strain genotyping method to study pathogen strain dynamics in human infections.

A hallmark of chronic bacterial infections is the long-term persistence of 1 or more pathogen species at the compromised site. Repeated detection of the same bacterial species can suggest that a single strain or lineage is continually present. However, infection with multiple strains of a given species, strain acquisition and loss, and changes in strain relative abundance can occur.

Combining Ivacaftor and Intensive Antibiotics Achieves Limited Clearance of Cystic Fibrosis Infections.

Drugs called CFTR modulators improve the physiologic defect underlying cystic fibrosis (CF) and alleviate many disease manifestations. However, studies to date indicate that chronic lung infections that are responsible for most disease-related mortality generally persist. Here, we investigated whether combining the CFTR modulator ivacaftor with an intensive 3.

Inflammatory cytokines TNF-α and IL-17 enhance the efficacy of cystic fibrosis transmembrane conductance regulator modulators.

Without cystic fibrosis transmembrane conductance regulator-mediated (CFTR-mediated) HCO3- secretion, airway epithelia of newborns with cystic fibrosis (CF) produce an abnormally acidic airway surface liquid (ASL), and the decreased pH impairs respiratory host defenses. However, within a few months of birth, ASL pH increases to match that in non-CF airways. Although the physiological basis for the increase is unknown, this time course matches the development of inflammation in CF airways.

Health Care and Community-Based Organization Partnerships to Address Social Needs: Medicare Advantage Plan Representatives' Perspectives.

Payers and providers are increasingly being held accountable for the overall health of their populations and may choose to partner with community-based organizations (CBOs) to address members' social needs. This study examines the opportunities and challenges that health care entities, using Medicare Advantage (MA) plans as an example, encounter when forming these relationships. We conducted interviews with 38 representatives of 17 MA organizations, representing 65% of MA members nationally.

Pregnancy and Parenting in Medical School: Highlighting the Need for Data and Support.

More than 7% of medical students graduate from medical school with at least 1 nonspouse dependent, the majority of whom are likely children. However, there are no national studies on medical students who are parents, and very little is known about what medical schools are doing to support them. A growing literature on the experiences of residents and attending physicians who are parents has neglected to include those of medical students who are parents.

Changes in fecal microbiota with CFTR modulator therapy: A pilot study.

Studies have demonstrated that people with CF with pancreatic insufficiency (PI) have fecal dysbioses. Evidence suggests the causes of these dysbioses are multifactorial, and that important drivers include antibiotic exposure, dietary intake, and CF gastrointestinal tract dysfunction, including nutrient malabsorption. In this pilot study, we tested whether initiation of the CFTR modulator treatments ivacaftor (in a cohort of pancreatic sufficient (PS) people with CF and an R117H CFTR variant) or lumacaftor/ivacaftor (in a cohort of PI people with CF and an F508del variant) changed fecal measures of malabsorption or fecal microbiomes.

Medicare Advantage plan representatives' perspectives on Pay for Success.

Objectives: To understand how Medicare Advantage (MA) plan representatives perceive the alternative financing model Pay for Success (PFS) and its potential to address members' social risk factors.

Study Design: Semistructured qualitative interviews designed to understand plan representatives' priorities regarding addressing nonmedical needs of their members, awareness of and experiences with PFS, and thoughts about implementing PFS as a method to address members' nonmedical needs.

Methods: Interviews with 38 upper-management representatives from 17 MA plans, which represent 65% of MA beneficiaries nationally, were conducted from July to November 2018.

Perspectives of Medicare Advantage Plan Representatives on Addressing Social Determinants of Health in Response to the CHRONIC Care Act.

Importance: The passage of the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act in 2018 allows Medicare Advantage (MA) plans, which enroll more than one-third of Medicare beneficiaries, greater flexibility to address members' social determinants of health (SDOH) through supplemental benefits.

Objective: To understand MA plan representatives' perspectives on the importance of addressing members' SDOH and their responses to the passage of the CHRONIC Care Act.

Design, Setting, And Participants: This semistructured qualitative interview study conducted via telephone from July 6, 2018, to November 7, 2018, included participants from 17 MA plans that collectively enrolled more than 13 million MA members (>65% of the total MA market).

Early Adoption of New Supplemental Benefits by Medicare Advantage Plans.

Following CMS’ 2018 expansion of supplemental benefits available to HMO and PPO Medicare Advantage enrollees, this study assesses enrollee adoption by type of benefit (eg, caregiver support, in-home personal care, palliative nursing, and social work) and specific plan characteristics in the first year.

Incarcerated Individuals' Perspectives on Living with Serious Illness.

The object of this study was to elicit patient perspectives on the experience of living with serious illness while incarcerated. The study was conducted at the Rhode Island Adult Corrections Institutions (ACI) in both the men's medium security and women's (all levels) facilities in June of 2016. Semi-structured interviews were conducted with participants, who met study criteria for serious illness.

A Behavioral Health Survey of Primary Care Integration in Rhode Island.

Background: Integrating behavioral and primary care practices improves quality of care, but limited data exists regarding the extent or attributes of such integration. We conducted a baseline evaluation of the level and characteristics of integrated practices in Rhode Island.

Methods: The Rhode Island Department of Health 2015 Statewide Health Inventory Behavioral Health Survey was sent to behavioral health clinics and outpatient psychiatry and psychology practices.

Neighborhood disadvantage and chronic disease management.

Objective: To assess the relationship between a composite measure of neighborhood disadvantage, the Area Deprivation Index (ADI), and control of blood pressure, diabetes, and cholesterol in the Medicare Advantage (MA) population.

Data Sources: Secondary analysis of 2013 Medicare Healthcare Effectiveness Data and Information Set, Medicare enrollment data, and a neighborhood disadvantage indicator.

Study Design: We tested the association of neighborhood disadvantage with intermediate health outcomes.

Impact Of Risk Adjustment For Socioeconomic Status On Medicare Advantage Plan Quality Rankings.

Sociodemographically disadvantaged patients have worse outcomes on some quality measures that inform Medicare Advantage plan ratings. Performance measurement that does not adjust for sociodemographic factors may penalize plans that disproportionately serve disadvantaged populations. We assessed the impact of adjusting for socioeconomic and demographic factors (sex, race/ethnicity, dual eligibility, disability, rurality, and neighborhood disadvantage) on Medicare Advantage plan rankings for blood pressure, diabetes, and cholesterol control.

Severe Hyperkalemia: Can the Electrocardiogram Risk Stratify for Short-term Adverse Events?

Introduction: The electrocardiogram (ECG) is often used to identify which hyperkalemic patients are at risk for adverse events. However, there is a paucity of evidence to support this practice. This study analyzes the association between specific hyperkalemic ECG abnormalities and the development of short-term adverse events in patients with severe hyperkalemia.