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Policy PointsThe Paycheck Plus randomized controlled trial tested a fourfold increase in the Earned Income Tax Credit (EITC) for single adults without dependent children over 3 years in New York and Atlanta.In New York, the intervention improved economic, mental, and physical health outcomes. In Atlanta, it had no economic benefit or impact on physical health and may have worsened mental health.In Atlanta, tax filing and bonus receipt were lower than in the New York arm of the trial, which may explain the lack of economic benefits. Lower mental health scores in the treatment group were driven by disadvantaged men, and the study sample was in good mental health. Context: The Paycheck Plus experiment examined the effects of an enhanced Earned Income Tax Credit (EITC) for single adults on economic and health outcomes in Atlanta, GA and New York City (NYC). The NYC study was completed two years prior to the Atlanta study and found mental and physical benefits for the subgroups that responded best to the economic incentives provided. In this article, we present the findings from the Atlanta study, in which the uptake of the treatment (tax filings and EITC bonus) were lower and economic and health benefits were not observed. Methods: Paycheck Plus Atlanta was an unblinded randomized controlled trial that assigned n = 3,971 participants to either the standard federal EITC (control group) or an EITC supplement of up to $2,000 (treatment group) for three tax years (2017–2019). Administrative data on employment and earnings were obtained from the Georgia Department of Labor and survey data were used to examine validated measures of health and well‐being. Findings: In Atlanta, the treatment group had significantly higher earnings in the first project year but did not have significantly higher cumulative earnings than the control group overall (mean difference = $1,812, 95% CI = −150, 3,774, p = 0.07). The treatment group also had significantly lower scores on two measures of mental health after the intervention was complete: the Patient Health Questionnaire 8 (mean difference = 0.19, 95% CI = 0.06, 0.32, p = 0.005) and the Kessler 6 (mean difference = 0.15, 95% CI = 0.03, 0.27, p = 0.012). Secondary analyses suggested these results were driven by disadvantaged men, but the study sample was in good mental health. Conclusions: The EITC experiment in Atlanta was not associated with gains in earnings or improvements in physical or mental health. [ABSTRACT FROM AUTHOR]

Objectives. To compare health insurance coverage and access to care by sex and sexual minority status during the COVID-19 pandemic and assess whether lack of insurance hindered access to care by sexual minority status. Methods. Using Behavioral Risk Factor Surveillance System data (January 2021–February 2022), we examined differences by sex and sexual orientation among 158 722 adults aged 18 to 64 years living in 34 states. Outcomes were health insurance coverage type and 3 access to care measures. Results. Sexual minority women were significantly more likely to be uninsured than were heterosexual women, and lack of insurance widened the magnitude of disparity by sexual minority status in all measures of access. Compared with heterosexual men with health insurance, sexual minority men with health insurance were significantly more likely to report being unable to afford necessary care. Conclusions. During the pandemic, 1 in 8 sexual minority adults living in 34 study states were uninsured. Among sexual minority women, lack of insurance widened inequities in access to care. There were inequities among sexual minority men with health insurance. Public Health Implications. Sexual minority adults may be disproportionately affected by the unwinding of the COVID-19 public health emergency and may require tailored efforts to mitigate insurance coverage loss. (Am J Public Health. 2024;114(1):118–128. https://doi.org/10.2105/AJPH.2023.307446) [ABSTRACT FROM AUTHOR]

Antipoverty policies have the potential to improve mental health. We conducted a randomized trial (Paycheck Plus Health Study Randomized Controlled Trial, New York, New York) to investigate whether a 4-fold increase in the Earned Income Tax Credit for low-income Americans without dependent children would reduce psychological distress relative to the current federal credit. Between 2013 and 2014, a total of 5,968 participants were recruited; 2,997 were randomly assigned to the treatment group and 2,971 were assigned to the control group. Survey data were collected 32 months postrandomization (n  = 4,749). Eligibility for the program increased employment by 1.9 percentage points and after-bonus earnings by 6% ($635/year), on average, over the 3 years of the study. Treatment was associated with a marginally statistically significant decline in psychological distress, as measured by the 6-item Kessler Psychological Distress Scale, relative to the control group (score change = −0.30 points, 95% confidence interval (CI): −0.63, 0.03; P  = 0.072). Women in the treated group experienced a half-point reduction in psychological distress (score change = −0.55 points, 95% CI: −0.97, −0.13; P  = 0.032), and noncustodial parents had a 1.36-point reduction (95% CI: −2.24, −0.49; P  = 0.011). Expansion of a large antipoverty program to individuals without dependent children reduced psychological distress for women and noncustodial parents—the groups that benefitted the most in terms of increased after-bonus earnings. [ABSTRACT FROM AUTHOR]

As medicine has become increasingly sophisticated and technologically complex, medical education and medical care have come to rely on increased specialization (Moore & Showstack, 2003). Dividing providers into specialties, however, [...]

Background: This study examined the association between Medicaid expansions under the Affordable Care Act (ACA) and births among low-income women of reproductive age in the United States. Materials and Methods: We used data from the 2008 to 2019 American Community Survey to estimate the association between state adoption of Medicaid expansion under the ACA and the percent of low-income women of reproductive age with a birth in the past year using a difference-in-difference research design. Subgroup analysis was explored by race and ethnicity, age group, educational attainment, marital status, and number of children. Results: We found that Medicaid expansion was associated with a small reduction in births among low-income women of reproductive age by 0.45 percentage points (95% confidence interval: −0.84 to −0.05). In subgroup analyses, we found reductions in births among Hispanic women, American Indian or Alaska Native women, women 25–29 years of age, women 35–39 years of age, unmarried women, and women with more than three children. Conclusions: Reductions in births associated with Medicaid expansion could suggest that expanding Medicaid addressed previously unmet reproductive health care needs among low-income women of reproductive age. The reductions in births among low-income women that we observe were occurring among some groups with higher unintended pregnancy rates, including Hispanic women, American Indian or Alaska Native women, young women, and unmarried women. These findings underscore the importance of reproductive health care access through insurance coverage on empowering women to have control over their reproductive decision-making and timing. [ABSTRACT FROM AUTHOR]

The United States is facing a maternal health crisis with rising rates of maternal mortality and morbidity and stark disparities in maternal outcomes by race and socioeconomic status. Among the efforts to address this issue, one policy proposal is gaining particular traction: extending the period of Medicaid eligibility for pregnant women beyond 60 days after childbirth. The authors examine the legislative and regulatory pathwaysmost readily available for extending postpartumMedicaid, including their relative political, economic, and public health trade-offs. They also review the state and federal policy activity to date and discuss the impact of the COVID-19 pandemic on the prospects for policy change. [ABSTRACT FROM AUTHOR]

Objectives. To evaluate the effect of the Affordable Care Act (ACA) Medicaid expansions on national rates of home eviction and eviction initiation in the United States. Methods. Using nationally representative administrative data from The Eviction Lab at Princeton University, we estimated the effects of the ACA Medicaid expansions on county-level evictions and filings from 2000 to 2016 with a difference-in-difference regression design. Results. We found that Medicaid expansions were associated with an annual reduction in the rate of evictions by 1.15 per 1000 renter-occupied households (P <.001), a reduction of 1.59 eviction filings per 1000 renter-occupied households (P <.001), and a reduction in the average number of evictions by 46 (P <.05). We found additional evidence that increasing rates of African American residents in a county was associated with a greater rate of evictions filed, and increased rates of poverty and rent burdens relative to income were associated with more evictions both filed and completed. Conclusions. Evictions decreased after Medicaid expansion, demonstrating further evidence of the substantive financial protections afforded by this coverage. The reduction in the eviction filing rate suggests that Medicaid expansion could be reducing evictions by preventing the court proceeding entirely. [ABSTRACT FROM AUTHOR]

Evictions are increasingly recognized as a serious concern facing low-income households. This study evaluated whether expansions of Medicaid can prevent evictions from occurring. We examined data from a privately licensed database of eviction records in fourteen states (286 counties) and used a difference-in-differences research design to compare rates of eviction before and after California's early Medicaid expansion (51 counties). Early Medicaid expansion in California was associated with a reduction in the number of evictions, with 24.5 fewer evictions per month in each county from a pre-expansion average of 224.7. These results imply that for every thousand new Medicaid enrollees in California, Medicaid expansion was associated with roughly twenty-two fewer evictions per year. Additionally, we found a 2.9-percentage-point reduction in evictions per capita associated with early expansion. The effects were concentrated among counties with the highest pre-expansion rates of uninsurance. We conclude that health insurance coverage is associated with improved housing stability. [ABSTRACT FROM AUTHOR]

We conducted a literature review of best practice in peer review. Following this research, we identified five principles for better peer review: Content Integrity, Content Ethics, Fairness, Usefulness, and Timeliness. For each of these principles, we have developed a set of recommendations to improve peer review standards. In this article, we describe the role of peer review and how our five principles support that goal. This article is intended to continue the conversation about improving peer review standards and provide guidance to journal teams looking to improve their standards. It is accompanied by a detailed checklist, which could be used by journal teams to assess their current peer review standards. [ABSTRACT FROM AUTHOR]

It was previously shown by the first author that every knot in S 3 is ambient isotopic to one component of a two-component, alternating, hyperbolic link. In this paper, we define the alternating volume of a knot K to be the minimum volume of any link L in a natural class of alternating, hyperbolic links such that K is ambient isotopic to a component of L. Our main result shows that the alternating volume of a knot is coarsely equivalent to the twist number of a knot. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of Medicaid coverage on dental care outcomes, a major health concern for low-income populations.Data Sources: Primary and secondary data on health care use and outcomes for participants in Oregon's 2008 Medicaid lottery.Study Design: We used the lottery's random selection to gauge the causal effects of Medicaid on dental care needs, medication, and emergency department visits for dental care.Data Collection: Data were collected for lottery participants over 2 years, including mail surveys (N = 23,777) and in-person questionnaires (N = 12,229). Emergency department (ED) records were matched to lottery participants in Portland (N = 24,646).Principal Findings: Medicaid coverage significantly reduced the share of respondents who reported needing dental care (-9.8 percentage points, p < .001) or having unmet dental care needs (-13.5 percentage points, p < 0.001). Medicaid doubled the share visiting the ED for dental care (+2.6 percentage points, p = .003) and the use of anti-infective medications often prescribed for dental care, but it had no detectable effect on uncovered dental care or out-of-pocket spending.Conclusions: Expansion of Medicaid covering emergency dental care substantially reduced unmet need for dental care, increasing ED dental visits and medication use, while not changing patient use of uncovered dental services. [ABSTRACT FROM AUTHOR]

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for context. We examine health care access and use, personal finances, and self-reported health. While urban and rural populations have unique demographic profiles, rural populations appear to have benefited from Medicaid as much as urban. Qualitative interviews revealed the distinctive challenges still facing low-income uninsured and newly insured rural populations. [ABSTRACT FROM AUTHOR]

The article discusses evidence from an Oregon study as of 2017 which shows that expansion of uninsured Medicaid coverage increased prescription medication use, specially those on chronic conditions like diabetes and mental health. It states that Medicaid increases primary and preventive care use and emergency department and hospital presentations, and that it eliminated the use of original prescription medications. Also noted is the Medicaid expansion's potential impact on the opioid epidemic.

We examined the impact of California's early Medicaid expansion under the Affordable Care Act on the use of payday loans, a form of high-interest borrowing used by low- and middle-income Americans. Using a data set for the period 2009-13 (roughly twenty-four months before and twenty-four months after the 2011-12 Medicaid expansion) that covered the universe of payday loans from five large payday lenders with locations around the United states, we used a difference-in-differences research design to assess the effect of the expansion on payday borrowing, comparing trends in early-expansion counties in California to those in counties nationwide that did not expand early. The early Medicaid expansion was associated with an 11 percent reduction in the number of loans taken out each month. It also reduced the number of unique borrowers each month and the amount of payday loan debt. We were unable to determine precisely how and for whom the expansion reduced payday borrowing, since to our knowledge, no data exist that directly link payday lending to insurance status. Nonetheless, our results suggest that Medicaid reduced the demand for high-interest loans and improved the financial health of American families. [ABSTRACT FROM AUTHOR]

Background: Back pain is a global health problem. Recent research has shown that risk factors that are proximal to the onset of back pain might be important targets for preventive interventions. Rapid communication through social media might be useful for delivering timely interventions that target proximal risk factors. Identifying individuals who are likely to discuss back pain on Twitter could provide useful information to guide online interventions.Methods: We used a case-crossover study design for a sample of 742 028 tweets about back pain to quantify the risks associated with a new tweet about back pain.Results: The odds of tweeting about back pain just after tweeting about selected physical, psychological, and general health factors were 1.83 (95% confidence interval [CI], 1.80-1.85), 1.85 (95% CI: 1.83-1.88), and 1.29 (95% CI, 1.27-1.30), respectively.Conclusion: These findings give directions for future research that could use social media for innovative public health interventions. [ABSTRACT FROM AUTHOR]

Background: The Oregon Medicaid lottery provided a unique opportunity to assess the causal impacts of health insurance on cancer screening rates within the framework of a randomized controlled trial. Prior studies regarding the impacts of health insurance have almost always been limited to observational evidence, which cannot be used to make causal inferences.Methods: The authors prospectively followed a representative panel of 16,204 individuals from the Oregon Medicaid lottery reservation list, collecting data before and after the Medicaid lottery drawings. The study panel was divided into 2 groups: a treatment group of individuals who were selected in the Medicaid lottery (6254 individuals) and a control group who were not (9950 individuals). The authors also created an elevated risk subpanel based on family cancer histories. One year after the lottery drawings, differences in cancer screening rates, preventive behaviors, and health status were compared between the study groups.Results: Medicaid coverage resulted in significantly higher rates of several common cancer screenings, especially among women, as well as better primary care connections and self-reported health outcomes. There was little evidence found that acquiring Medicaid increased the adoption of preventive health behaviors that might reduce cancer risk.Conclusions: Medicaid coverage did not appear to directly impact lifestyle choices that might reduce cancer risk, but it did provide access to important care and screenings that could help to detect cancers earlier. These findings could have long-term population health implications for states considering or pursuing Medicaid expansion. Cancer 2016;122:791-797. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

Objective--To evaluate the long-term risk of recurrence of calcium oxalate (CaOx) cystic calculi in dogs of various breeds fed 1 of 2 therapeutic diets. Design--Retrospective cohort study. Animals--135 dogs with a history of CaOx cystic calculi. Procedures--Medical records for 4 referral hospitals were searched to identify dogs that had had CaOx cystic calculi removed. Owners were contacted and medical records evaluated to obtain information on postoperative diet, recurrence of signs of lower urinary tract disease, and recurrence of cystic calculi. Dogs were grouped on the basis of breed (highrisk breeds, low-risk breeds, and Miniature Schnauzers) and diet fed after removal of cystic calculi (diet A, diet B, and any other diet [diet C], with diets A and B being therapeutic diets formulated to prevent recurrence of CaOx calculi). Results--Breed group was a significant predictor of calculi recurrence (as determined by abdominal radiography or ultrasonography), with Miniature Schnauzers having 3 times the risk of recurrence as did dogs of other breeds. Dogs in diet group A had a lower prevalence of recurrence than did dogs in diet group C, but this difference was not significant in multivariable analysis. Conclusions and Clinical Relevance--Results indicated that Miniature Schnauzers had a higher risk of CaOx cystic calculi recurrence than did dogs of other breeds. In addition, findings suggested that diet may play a role in decreasing recurrence, but future prospective studies are needed to validate these observations. [ABSTRACT FROM AUTHOR]

The article discusses the results of the expansion of the Medicaid health insurance program in Oregon in relation to the U.S. Patient Protection and Affordable Care Act of 2010 (ACA). Topics include the use of a lottery to enroll patients in the Medicaid program Oregon Health Plan Standard in relation to experimental design; the impact of the program on access to medical care and hospital use; and lack of change related to chronic disease risk, labor force participation, and use of social service programs.

Medicaid expansions will soon cover millions of new enrollees, but insurance alone may not ensure that they receive high-quality care. This study examines health care interactions and the health perceptions of an Oregon cohort three years after they gained Medicaid coverage. During in-depth qualitative interviews, 120 enrollees reported a wide range of interactions with the health care system. Forty percent of the new enrollees sought care infrequently because they were confused about coverage, faced access barriers, had bad interactions with providers, or felt that care was unnecessary. For the 60 percent who had multiple health care interactions, continuity and ease of the provider-patient relationship were critical to improved health. Some newly insured Medicaid enrollees recounted rapid improvements in health. However, most reported that gains came after months or years of working closely and systematically with a provider. Our findings suggest that improving communication with beneficiaries and increasing the availability of coordinated care across settings could reduce the barriers that new enrollees are likely to face. [ABSTRACT FROM AUTHOR]

In 2008 Oregon allocated access to its Medicaid expansion program, Oregon Health Plan Standard, by drawing names from a waiting list by lottery. The lottery was chosen by policy makers and stakeholders as the preferred way to allocate limited resources. At the same time, it also gave rise to the Oregon Health Insurance Experiment: an unprecedented opportunity to do a randomized evaluation-the gold standard in medical and scientific research-of the impact of expanding Medicaid. In this article we provide historical context for Oregon's decision to conduct a lottery, discuss the importance of randomized controlled designs for policy evaluation, and describe some of the practical challenges in successfully capitalizing on the research opportunity presented by the Oregon lottery through public-academic partnerships.Since policy makers will always face tough choices about how to distribute scarce resources, we urge thoughtful consideration of the opportunities to incorporate randomization that can substantially improve the evidence available to inform policy decisions without compromising policy goals. [ABSTRACT FROM AUTHOR]

A barrier to dissemination of research is that it depends on the end-user searching for or ‘pulling’ relevant knowledge from the literature base. Social media instead ‘pushes’ relevant knowledge straight to the end-user, via blogs and sites such as Facebook and Twitter. That social media is very effective at improving dissemination seems well accepted, but, remarkably, there is no evidence to support this claim. We aimed to quantify the impact of social media release on views and downloads of articles in the clinical pain sciences. Sixteen PLOS ONE articles were blogged and released via Facebook, Twitter, LinkedIn and ResearchBlogging.org on one of two randomly selected dates. The other date served as a control. The primary outcomes were the rate of HTML views and PDF downloads of the article, over a seven-day period. The critical result was an increase in both outcome variables in the week after the blog post and social media release. The mean ± SD rate of HTML views in the week after the social media release was 18±18 per day, whereas the rate during the other three weeks was no more than 6±3 per day. The mean ± SD rate of PDF downloads in the week after the social media release was 4±4 per day, whereas the rate during the other three weeks was less than 1±1 per day (p<0.05 for all comparisons). However, none of the recognized measures of social media reach, engagement or virality related to either outcome variable, nor to citation count one year later (p>0.3 for all). We conclude that social media release of a research article in the clinical pain sciences increases the number of people who view or download that article, but conventional social media metrics are unrelated to the effect. [ABSTRACT FROM AUTHOR]

In 2008, a group of uninsured low-income adults in Oregon was selected by lottery to be given the chance to apply for Medicaid. This lottery provides an opportunity to gauge the effects of expanding access to public health insurance on the health care use, financial strain, and health of low-income adults using a randomized controlled design. In the year after random assignment, the treatment group selected by the lottery was about 25 percentage points more likely to have insurance than the control group that was not selected. We find that in this first year, the treatment group had substantively and statistically significantly higher health care utilization (including primary and preventive care as well as hospitalizations), lower out-of-pocket medical expenditures and medical debt (including fewer bills sent to collection), and better self-reported physical and mental health than the control group. [ABSTRACT FROM AUTHOR]

The recently enacted Patient Protection and Affordable Care Act includes a major expansion of Medicaid to low-income adults in 2014. This paper describes the Oregon Health Study, a randomized controlled trial that will be able to shed some light on the likely effects of such expansions. In 2008, Oregon randomly drew names from a waiting list for its previously closed public insurance program. Our analysis of enrollment into this program found that people who signed up for the waiting list and enrolled in the Oregon Medicaid program were likely to have worse health than those who did not. However, actual enrollment was fairly low, partly because many applicants did not meet eligibility standards. [ABSTRACT FROM AUTHOR]

The article discusses the importance for primary teachers and administrators to understand aspects of dyslexia to better identify at risk students in the classroom in the U.S. It states that failure of identifying dyslexic in the classroom will give teachers difficulty in teaching them to read proficiently. The scientific research indicates that instruction based on Orton-Gillingham principles is proven effective to teach students with dyslexia to read.

This Viewpoint discusses the financial pressures placed on US state budgets from the likely growth of Medicaid rolls during the COVID-19 pandemic, and proposes financing and policy adjustments to assist states in providing lifeline health care to low-income individuals during the crisis. [ABSTRACT FROM AUTHOR]

Two patients with florid symptoms and severely disturbed behaviours were treated with a cognitive-behavioural programme. The programme aimed to facilitate the patients' and their carers' ability to adaptively cope with the distress generated by the patients' florid symptoms. Both patients actively co-operated and responded with a marked reduction in symptoms and behavioural disturbance. [ABSTRACT FROM PUBLISHER]