Use of Telehealth for Follow-up Care After Children's Mental Health Hospitalizations.

Objectives: This study measured the extent to which the COVID-19 pandemic disrupted follow-up care for children and adolescents with acute mental health hospitalizations and the use of telehealth to offset barriers to in-person follow-up care.

Methods: The study used statewide claims data from Alabama's Children's Health Insurance Program, ALL Kids, from 2017 to 2022. Logit regressions measured associations between receipt of follow-up care within 30 days of acute mental health hospitalization and patient characteristics, timing of the COVID-19 pandemic, and receipt of care via telehealth.

Zero-Dollar Copayment Impact on Adherence Scores for Centers for Medicare and Medicaid Services Star Ratings Generic Medications.

Introduction: The Centers for Medicare & Medicaid Services (CMS) Star Ratings system pushes Medicare Advantage health plans to achieve ever greater attainments in key metrics, including adherence to hydroxymethylglutaryl-CoA reductase inhibitor (statins), renin-angiotensin system (RAS) antagonist, and noninsulin antihyperglycemic (DM) medications. The purpose of this observational study was to evaluate the impact of expanding a $0 copayment (copay) benefit from mail order-only to mail order plus retail pharmacies on adherence to statin, RAS, and DM medications.

Methods: Medicare beneficiaries with and without a $0 copay expansion who received ≥ 1 dispensing of a generic, CMS Star Ratings RAS, statin, and/or DM medication during both 2021 and 2022 were included.

Disorders of the Pancreas.

The pancreas is a vital intra-abdominal organ with dual exocrine and endocrine function. This article provides an overview of several common pancreatic pathologies including pancreatitis, pancreatic cysts, and pancreatic cancer with a focus on clinical presentation as well as initial diagnosis and management.

Telehealth use among pediatric Alabama Medicaid enrollees, March-December 2020: Variations by race/ethnicity & place of residence.

During the early days and months of the COVID-19 pandemic, healthcare facilities experienced a slump in non-COVID-related visits, and there was an increasing interest in telehealth to deliver healthcare services for adult and pediatric patients. The study investigated telehealth use variation by race/ethnicity and place of residence for the pediatric enrollees of the Alabama Medicaid program. This retrospective observational study examined Alabama Medicaid claims data from March to December 2020 for enrollees less than 19 years.

Social determinants of health and emergency department utilization in Alabama Children's Health Insurance Program.

Objectives: Injuries are the leading cause of death among children and youth in the United States, representing a major concern to society and to the public and private health plans covering pediatric patients. Data from ALL Kids, Alabama's Children's Health Insurance Program, were used to evaluate the relationship between community-level social determinants of health (SDOH) and pediatric emergency department (ED) use and differences in these associations by age and race.

Study Design: This was a retrospective, pooled cross-sectional analysis.

Development of an Individualized Responsive Feeding Intervention-Learning Early Infant Feeding Cues: Protocol for a Nonrandomized Study.

Background: Responsive infant feeding occurs when a parent recognizes the infant's cues of hunger or satiety and responds promptly to these cues. It is known to promote healthy dietary patterns and infant weight gain and is recommended as part of the Dietary Guidelines for Americans. However, the use of responsive infant feeding can be challenging for many parents.

Community-Level Social Determinants of Health and Well-Child Visits Among Alabama Medicaid Enrollees.

Well-child visits focus on health promotion and disease detection and are critical to the appropriate provision of care. Evidence has shown that participation in well-child visits is associated with various patient-level factors; however, there has been an increasing focus on the influence of community-level social determinants of health (SDoH). This study explored associations between well-child visits and community-level SDoH at the census tract level among children enrolled in Alabama Medicaid.

Disparities in Telehealth Utilization in a Population of Publicly Insured Children During the COVID-19 Pandemic.

Telehealth became a crucial vehicle for health care delivery in the United States during the COVID-19 pandemic. However, little research exists on inequities in telehealth utilization among the pediatric population. This study examines disparities in telehealth utilization in a population of publicly insured children.

Cognitive Behavioral Therapy for Treatment of Insomnia in Primary Care for Resident Physicians.

Introduction: Insomnia is a common complaint among primary care patients that can have significant consequences for physiological and mental health. Although psychopharmacological interventions have traditionally been taught as first-line treatment in medical education, cognitive behavioral therapy (CBT) for insomnia has emerged as the recommended treatment to address the multimodal precipitants and reinforcing factors of insomnia symptoms.

Methods: We developed a 90-minute workshop that included a didactic component to deliver content, role-playing to practice skills, and discussion to reflect and solidify learning.

Cognitive Behavioral Therapy and Pharmacotherapy for the Treatment of Tobacco Use Disorder in Primary Care for Resident Physicians.

Introduction: Though the prevalence of smoking has decreased, it remains the second leading risk for early death and disability worldwide. At the primary care level, the combined use of behavioral interventions and pharmacotherapy has been shown to be more effective in reduction of smoking. Among behavioral interventions, cognitive behavioral therapy (CBT) provides a useful framework for helping patients quit smoking.

Use of a mechanical thrombectomy device to treat early hepatic artery thrombosis after orthotopic liver transplant.

Hepatic artery thrombosis (HAT) is a major cause of morbidity and mortality after orthotopic liver transplantation, occurring in 5% of cases (Piardi et al, 2016). HAT is the second main cause of graft loss after primary nonfunction, the leading cause of graft failure in the immediate postoperative period (<1 month), and is associated with a mortality rate of up to 60% without intervention (Piardi et al, 2016; Pareja et al., 2010; Crossin et al.

Shape-Up and Eat Right Families Pilot Program: Feasibility of a Weight Management Shared Medical Appointment Model in African-Americans With Obesity at an Urban Academic Medical Center.

Objectives: Disparities in obesity care exist among African-American children and adults. We sought to test the feasibility of a pilot program, a 1-year family-based intervention for African-American families with obesity [shape up and eat right (SUPER)], adopting the shared medical appointment model (SMA) at an urban safety net hospital.

Outcomes: Primary outcomes: (1) family attendance rate and (2) program satisfaction.

Controlling HIV epidemics among injection drug users: eight years of Cross-Border HIV prevention interventions in Vietnam and China.

Introduction: HIV in Vietnam and Southern China is driven by injection drug use. We have implemented HIV prevention interventions for IDUs since 2002-2003 in Lang Son and Ha Giang Provinces, Vietnam and Ning Ming County (Guangxi), China.

Methods: Interventions provide peer education and needle/syringe distribution.

Web-based smoking cessation intervention that transitions from inpatient to outpatient: study protocol for a randomized controlled trial.

Background: E-health tools are a new mechanism to expand patient care, allowing supplemental resources to usual care, including enhanced patient-provider communication. These applications to smoking cessation have yet to be tested in a hospitalized patient sample. This project aims to evaluate the effectiveness and cost-effectiveness of a tailored web-based and e-message smoking cessation program for current smokers that, upon hospital discharge, transitions the patient to continue a quit attempt when home (Decide2Quit).

Evaluation of an alternative HIV diagnostic algorithm using specimens from seroconversion panels and persons with established HIV infections.

Background: The current algorithm for HIV diagnosis in the US involves screening with an immunoassay (IA) and supplemental testing with Western blot (WB) or immunofluorescence assay. Because of existence of more sensitive and specific FDA-approved assays that would also reduce the cost and turn-around time of testing compared to WB, several alternative algorithms have been evaluated. Recently, an alternative algorithm using a sensitive 3rd or 4th generation IA followed by an HIV-1 and HIV-2 discriminatory supplemental test on the initial IA-positive specimens was proposed.

The effects of perchlorate on thyroidal gene expression are different from the effects of iodide deficiency.

Perchlorate (ClO₄⁻), which is a ubiquitous and persistent ion, competitively interferes with iodide (I) accumulation in the thyroid, producing I deficiency (ID), which may result in reduced thyroid hormone synthesis and secretion. Human studies suggest that ClO₄⁻ presents little risk in healthy individuals; however, the precautionary principle demands that the sensitive populations of ID adults and mothers require extra consideration. In an attempt to determine whether the effects on gene expression were similar, the thyroidal effects of ClO₄⁻ (10 mg/kg) treatment for 14 d in drinking water were compared with those produced by 8 wk of ID in rats.

Assessment of BED HIV-1 incidence assay in seroconverter cohorts: effect of individuals with long-term infection and importance of stable incidence.

Background: Performance of the BED assay in estimating HIV-1 incidence has previously been evaluated by using longitudinal specimens from persons with incident HIV infections, but questions remain about its accuracy. We sought to assess its performance in three longitudinal cohorts from Thailand where HIV-1 CRF01_AE and subtype B' dominate the epidemic.

Design: BED testing was conducted in two longitudinal cohorts with only incident infections (a military conscript cohort and an injection drug user cohort) and in one longitudinal cohort (an HIV-1 vaccine efficacy trial cohort) that also included long-term infections.

Determination of mean recency period for estimation of HIV type 1 Incidence with the BED-capture EIA in persons infected with diverse subtypes.

The IgG capture BED enzyme immunoassay (BED-CEIA) was developed to detect recent HIV-1 infection for the estimation of HIV-1 incidence from cross-sectional specimens. The mean time interval between seroconversion and reaching a specified assay cutoff value [referred to here as the mean recency period (ω)], an important parameter for incidence estimation, is determined for some HIV-1 subtypes, but testing in more cohorts and new statistical methods suggest the need for a revised estimation of ω in different subtypes. A total of 2927 longitudinal specimens from 756 persons with incident HIV infections who had been enrolled in 17 cohort studies was tested by the BED-CEIA.

Evaluating the BED capture enzyme immunoassay to estimate HIV incidence among adults in three countries in sub-Saharan Africa.

Serological assays for estimating HIV-1 incidence are prone to misclassification, limiting the accuracy of the incidence estimate. Adjustment factors have been developed and recommended for estimating assay-based HIV-1 incidence in cross-sectional settings. We evaluated the performance of the recommended adjustment factors for estimating incidence in national HIV surveys in three countries in sub-Saharan Africa.

ChILD Family Education.

The Children's Interstitial Lung Disease (chILD) Foundation and chILD Research Cooperative identified a need for accurate and understandable chILD-related information for families. As a result, collaboration with the University of Alabama at Birmingham (UAB) Pediatric Pulmonary Center (PPC) produced "Get Up And Go With chILD!," a comprehensive, chILD-specific family education resource. Families and clinicians from multiple backgrounds and perspectives submitted content suggestions and copies of currently used family education and health management materials.

A review of transcriptomics in cutaneous chemical exposure.

Monitoring gene expression profiles in the skin using microarrays has become a useful approach to enhance the understanding of dermal function, toxicologic mechanisms, and risk assessment. With respect to cutaneous chemical exposure, there are few transcriptomic studies in the published literature, and these often differ in experimental design and availability of raw data. An assessment of multiple microarray data sets could be advantageous for identifying potential redundant biological mechanisms or genes associated with dermal responses to chemical exposure.

Transcriptional changes in porcine skin at 7 days following sulfur mustard and thermal burn injury.

Severe cutaneous injuries continue to result from exposure to sulfur mustard [bis(2-chloroethyl)sulfide; HD] and thermal burns. Microarray analysis was utilized in this study to evaluate transcriptional changes in porcine skin assessing the underlying repair mechanisms of HD and thermal injury involved in wound healing. Four ventral abdominal sites on each of 4 weanling swine were exposed to 400 microL undiluted HD or a heated brass rod (70 degrees C) for 8 minutes and 45-60 seconds, respectively.

Transcriptional responses associated with sulfur mustard and thermal burns in porcine skin.

In military and civilian environments, serious cutaneous damage can result from thermal burns or exposure to the blistering agent sulfur mustard [bis (2-chloroethyl) sulfide; HD]. Similar therapies have historically been used to treat cutaneous thermal and HD injuries; however, the underlying molecular mechanisms of tissue damage and wound healing may differ between the types of burns. Using microarray analysis, this study assessed the transcriptional responses to cutaneous HD and thermal injury at 48 hours post-exposure to identify molecular networks and genes associated with each type of skin injury.