Sweet and sour: A quantitative analysis of methane emissions in contrasting Alberta, Canada, heavy oil developments.

Cold heavy oil production with or without sand (CHOPS, or CHOP) are prevalent methods of oil extraction in western Canada. CHOP(S) sites account for over 40% of all reported vented methane (CH) from oil production in Alberta, and high rates of CH emissions have been confirmed in independent measurement studies. In this study, we used truck-based surveys coupled with qualitative optical gas imaging (OGI) to quantify and characterize methane emission rates and sources at nearly 1350 and 940 well sites in two major CHOP(S) developments respectively in 2016 and 2018.

Methane emissions from upstream oil and gas production in Canada are underestimated.

Methane emissions were measured at 6650 sites across six major oil and gas producing regions in Canada to examine regional emission trends, and to derive an inventory estimate for Canada's upstream oil and gas sector. Emissions varied by fluid type and geographic region, with the heavy oil region of Lloydminster ranking highest on both absolute and intensity-based scales. Emission intensities varied widely for natural gas production, where older, low-producing developments such as Medicine Hat, Alberta showed high emission intensities, and newer developments in Montney, British Columbia showed emission intensities that are amongst the lowest in North America.

Raw milk consumption and other early-life farm exposures and adult pulmonary function in the Agricultural Lung Health Study.

Literature suggests that early exposure to the farming environment protects against atopy and asthma; few studies have examined pulmonary function. We evaluated associations between early-life farming exposures and pulmonary function in 3061 adults (mean age=63) from a US farming population using linear regression. Childhood raw milk consumption was associated with higher FEV (β=49.

House Dust Endotoxin Levels Are Associated with Adult Asthma in a U.S. Farming Population.

Rationale: Endotoxin initiates a proinflammatory response from the innate immune system. Studies in children suggest that endotoxin exposure from house dust may be an important risk factor for asthma, but few studies have been conducted in adult populations.

Objectives: To investigate the association of house dust endotoxin levels with asthma and related phenotypes (wheeze, atopy, and pulmonary function) in a large U.

Access to New Medications for Hepatitis C for Medicaid Members: A Retrospective Cohort Study.

Background: Sofosbuvir (SOF)- or simeprevir (SIM)-containing regimens are highly effective for treating chronic hepatitis C virus (HCV) infection. These regimens, however, are expensive. Most payers have implemented prior authorization (PA) requirements to ensure that patients who can benefit most have priority for these medications.

Frequent Emergency Department Visits and Hospitalizations Among Homeless People With Medicaid: Implications for Medicaid Expansion.

Objectives: We examined factors associated with frequent hospitalizations and emergency department (ED) visits among Medicaid members who were homeless.

Methods: We included 6494 Massachusetts Medicaid members who received services from a health care for the homeless program in 2010. We used negative binomial regression to examine variables associated with frequent utilization.

Which Part of a Short, Global Risk Assessment, the Risk Instrument for Screening in the Community, Predicts Adverse Healthcare Outcomes?

The Risk Instrument for Screening in the Community (RISC) is a short, global risk assessment to identify community-dwelling older adults' one-year risk of institutionalisation, hospitalisation, and death. We investigated the contribution that the three components of the RISC (concern, its severity, and the ability of the caregiver network to manage concern) make to the accuracy of the instrument, across its three domains (mental state, activities of daily living (ADL), and medical state), by comparing their accuracy to other assessment instruments in the prospective Community Assessment of Risk and Treatment Strategies study. RISC scores were available for 782 patients.

The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults.

Background: Predicting risk of adverse healthcare outcomes, among community dwelling older adults, is difficult. The Risk Instrument for Screening in the Community (RISC) is a short (2-5 min), global subjective assessment of risk created to identify patients' 1-year risk of three outcomes:institutionalisation, hospitalisation and death.

Methods: We compared the accuracy and predictive ability of the RISC, scored by Public Health Nurses (PHN), to the Clinical Frailty Scale (CFS) in a prospective cohort study of community dwelling older adults (n = 803), in two Irish PHN sectors.

Risk Factors for Relapse and Higher Costs Among Medicaid Members with Opioid Dependence or Abuse: Opioid Agonists, Comorbidities, and Treatment History.

Clinical trials show that opioid agonist therapy (OAT) with methadone or buprenorphine is more effective than behavioral treatments, but state policymakers remain ambivalent about covering OAT for long periods. We used Medicaid claims for 52,278 Massachusetts Medicaid beneficiaries with a diagnosis of opioid abuse or dependence between 2004 and 2010 to study associations between use of methadone, buprenorphine or other behavioral health treatment without OAT, and time to relapse and total healthcare expenditures. Cox Proportional Hazards ratios for patients treated with either methadone or buprenorphine showed approximately 50% lower risk of relapse than behavioral treatment without OAT.

Adherence to Buprenorphine Treatment Guidelines in a Medicaid Program.

Background: Buprenorphine is the most frequently prescribed medication for treating substance use disorders in the United States, but few studies have evaluated the structure of treatment delivered in real-world settings. The purpose of this study is to investigate adherence to current buprenorphine treatment guidelines using administrative data for Massachusetts Medicaid.

Methods: We identified buprenorphine treatment episodes beginning in 2009 through pharmacy claims.

Screening for markers of frailty and perceived risk of adverse outcomes using the Risk Instrument for Screening in the Community (RISC).

Background: Functional decline and frailty are common in community dwelling older adults, increasing the risk of adverse outcomes. Given this, we investigated the prevalence of frailty-associated risk factors and their distribution according to the severity of perceived risk in a cohort of community dwelling older adults, using the Risk Instrument for Screening in the Community (RISC).

Methods: A cohort of 803 community dwelling older adults were scored for frailty by their public health nurse (PHN) using the Clinical Frailty Scale (CFS) and for risk of three adverse outcomes: i) institutionalisation, ii) hospitalisation and iii) death, within the next year, from one (lowest) to five (highest) using the RISC.

The impact of prior authorization on buprenorphine dose, relapse rates, and cost for Massachusetts Medicaid beneficiaries with opioid dependence.

Objective: To assess the impact of a 2008 dose-based prior authorization policy for Massachusetts Medicaid beneficiaries using buprenorphine + naloxone for opioid addiction treatment. Doses higher than 16 mg required progressively more frequent authorizations.

Data Sources: Mediciaid claims for 2007 and 2008 linked with Department of Public Health (DPH) service records.

The Irish national stroke awareness campaign: a stroke of success?

Introduction: Mass media campaigns are widely used to expose large populations to health-risk behaviour messages through routine uses of media. The Act F.A.

Co-occurring risk factors for arrest among persons with opioid abuse and dependence: implications for developing interventions to limit criminal justice involvement.

Persons who abuse or are dependent on opioids are at elevated risk for arrest. Co-occurring behavioral health problems may exacerbate that risk, although the extent of any such increase has not been described. This study examines such risk factors among 40,238 individuals with a diagnosis of opioid abuse or dependence who were enrolled in the Massachusetts Medicaid program in 2010.

Health care utilization patterns of homeless individuals in Boston: preparing for Medicaid expansion under the Affordable Care Act.

Objectives: We studied 6494 Boston Health Care for the Homeless Program (BHCHP) patients to understand the disease burden and health care utilization patterns for a group of insured homeless individuals.

Methods: We studied merged BHCHP data and MassHealth eligibility, claims, and encounter data from 2010. MassHealth claims and encounter data provided a comprehensive history of health care utilization and expenditures, as well as associated diagnoses, in both general medical and behavioral health services sectors and across a broad range of health care settings.

The effect of a telephone-based health coaching disease management program on Medicaid members with chronic conditions.

Background: Despite the growing popularity of disease management programs for chronic conditions, evidence regarding the effect of these programs has been mixed. In addition, few peer-reviewed studies have examined the effect of these programs on publicly insured populations.

Objectives: To examine the effect of a telephone-based health coaching disease management program on healthcare utilization and expenditures in Medicaid members with chronic conditions.

Recruitment and retention of primary care physicians at community health centers: a survey of Massachusetts physicians.

As the backbone of the safety-net system, community health centers (CHCs) provide access to essential services, yet contend with high provider turnover. Using an online survey, primary care physicians (PCPs) at 62 Massachusetts League of Community Health Centers member sites were queried about recruitment and retention factors. Nearly 300 (n=294) PCPs representing 46 CHCs completed the survey.

An evaluation of nurse prescribing. Part 2: a literature review.

Aim: This is the second of a 2-part literature review, which aims to provide a summary of the research conducted into nurse prescribing and patients' perspectives, the prescribing practice and benefits of prescribing.

Background: Prescriptive authority for nurses was first introduced by America in 1969, followed later by the UK, Canada, New Zealand, Australia and Sweden. A review of research conducted internationally was performed to inform the development of prescribing policies and practice and to guide future research.

An evaluation of nurse prescribing. Part 1: a literature review.

Background: Prescriptive authority for nurses was first introduced by America in 1969, followed later by the UK, Canada, New Zealand, Australia and Sweden. A review of research conducted internationally was performed to inform the development of prescribing policies and practice and to guide future research.

Aims: This article, the first of a 2-part literature review, aims to provide a summary of the research conducted in relation to nurse prescribing and confidence in prescribing, the impact of prescribing on relationships, and education for prescribing.