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Background The treatment landscape for advanced hepatocellular carcinoma (aHCC) is rapidly expanding beyond tyrosine kinase inhibitors (TKIs) in the first-line (1L) setting, with multiple TKIs and immune-checkpoint inhibitors (ICIs) now being evaluated in combination. Real-world evidence describing current treatment patterns and reasons for 1L and 2L treatment selection in aHCC is sparse. Patients and Methods A retrospective cohort study with a cross-sectional survey element was conducted using Cardinal Health's Oncology Provider Extended Network. U.S. medical oncologists identified adult aHCC patients initiating 1L systemic therapy between January 1, 2017 and July 31, 2019 and abstracted data from patient medical records. Data included provider characteristics, patient demographics and clinical characteristics, treatment regimens, and physician rationale for treatment regimen choice. Results A total of 44 medical oncologists provided data on 284 aHCC patients. The median age at 1L initiation was 61.5 years, and the majority were male (78%) and white (66%). Nearly half (47%) initiated 1L treatment in 2019, 34% were ECOG performance status 2+, and 63% were Child-Pugh Class B/C. Among the 284 aHCC patients, TKIs were used by 94% of patients in the 1L setting, comprised predominantly of sorafenib (54%) and lenvatinib (38%). ICIs were most common among the 90 patients (66%) who received 2L treatment. Conclusion In the community-oncology practice setting, nearly all aHCC patients received sorafenib or lenvatinib in the 1L setting, while the majority of patients received an ICI in the 2L setting. With recent ICI approvals in aHCC, this marks the beginning of an increased use of ICIs in the 1L setting. [ABSTRACT FROM AUTHOR]

The article discusses U.S. regulatory developments concerning media, privacy, defamation, and advertising law from October 17 to September 2018. Topics explored include the defamation claims filed against comedian Bill Cosby, the rejection of the misappropriation claim brought by actress Lindsay Lohan by the New York Court of Appeals, and the refusal of the U.S. Court of Appeals for the Sixth Circuit to reveal the identity of the anonymous blogger in Signature Management Team, LLC v. Doe.

The article discusses the legal development related to publishing from October 1, 2015, through September 30, 2016 in the U.S. Topics discussed include on torts involving defamation and privacy, Internet law concerning anonymous speech, personal jurisdiction, application of the single publication rule, immunity to interactive computer service providers under Section 230 of the Communications Decency Act and developments in advertising law relating to social media influencers.

The article discusses legal developments in the U.S. media, privacy, defamation and advertising law from October 1, 2014-September 30, 2015. Topics discussed include torts involving defamation and privacy, changes in the Internet law under Section 230 of the U.S. Communications Decency Act, and issues associated with publication of news and federal law protecting a reporter's confidential sources. Also it mentions changes to the U.S. Telephone Consumer Protection Act.

The Health Care and Education Affordability Reconciliation Act was signed into law by the President on March 30, 2010. This legislation will have a significant impact on the U.S. health care delivery system. Specifically, the legislation will challenge the current operating models of health care organizations that have relied on fee-for-service revenue structures to prosper. This changing environment will produce tremendous opportunities for those health care institutions that are prepared to positively respond to the demands of the health care consumer. Two factors will gain additional traction going forward: 1) The focus will continue to shift toward prevention and wellness and away from health restoration. 2) The focus will move toward performance outcomes in health care delivery and away from the number and type of activities being performed. Consumer education is critical to this transition. Using concepts from disruptive innovation research, this paper explores ways to develop and deliver effective health education programs to the public, particularly in the area of chronic diseases and their complications. [ABSTRACT FROM AUTHOR]

Background Dementia is a common and growing global public health problem. It leads to a high burden of suffering for society with an annual cost of $100 billion in the US and $10 billion in the UK. New strategies for both treatment and prevention of dementia are currently being developed. Implementation of these strategies will depend on the presence of a viable community or primary care based dementia screening and diagnosis program and patient acceptance of such a program. Objective To compare the acceptance, perceived harms and perceived benefits of dementia screening among older adults receiving their care in two different primary health care systems in two countries. Design A Cross-sectional study. Setting Primary care clinics in Indianapolis, USA and Kent, UK. Participants A convenience sample of 245 older adults (Indianapolis, n = 125; Kent, n = 120). Outcomes Acceptance of dementia screening and its perceived harms and benefits as determined by a 52-item questionnaire (PRISM-PC questionnaire). Results Four of the five domains were significantly different across the two samples. The UK sample had significantly higher dementia screening acceptance scores (p < 0.05); higher perceived stigma scores (p < 0.05); higher perceived loss of independence scores (p < 0.01); and higher perceived suffering scores (p < 0.01) than the US sample. Both groups perceived dementia screening as beneficial (p = 0.218). After controlling for prior experience with dementia, acceptance and stigma were marginalized. Conclusions Older adults attending primary care clinics across the Atlantic value dementia screening but have significant concerns about dementia screening although these concerns differed between the two countries. Low acceptance rates and high rates of perceived harms might be a significant barrier for the introduction of treatment or preventive methods for dementia in the future. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article discusses the abnormal statistical patterns and sub-legal practices that led to the financial crisis in the U.S. as explained by researchers. The article says that the late Edward Gramlich, a former Federal Reserve Governor had given notice of the ill effects of subprime lending as early as 10 years before 2008. Peter Wallison, in his book "Serving Two Masters, Yet Out of Control: Fannie Mae and Freddie Mac" released in 2001 is said to have exposed the risks associated with the intercession on the two government sponsored enterprises.

Study Objective. To compare triptan therapies for migraine in terms of the cost to treat 100 migraine attacks and the cost per successfully treated patient (cost/success), by analyzing utilization and reimbursement data from state Medicaid programs. Design. Pharmacoeconomic analysis. Data Source. Clinical efficacy data were obtained from a previously published meta-analysis for 11 triptan-dose combinations: almotriptan 12.5 mg; eletriptan 20 and 40 mg; naratriptan 2.5 mg; rizatriptan 5 and 10 mg; sumatriptan 25, 50, and 100 mg; and zolmitriptan 2.5 and 5 mg. Triptan reimbursement data were obtained from the Medicaid Drug Rebate Program of seven geographically dispersed states (Florida, Georgia, Illinois, North Carolina, Ohio, Wisconsin, and West Virginia). Measurements and Main Results. Efficacy measures were derived based on data from the published meta-analysis that evaluated headache pain status at 2 and 24 hours after triptan dosing. Reimbursement data for the triptans were applied to a previously developed model of migraine treatment outcomes to calculate the cost to treat 100 migraine attacks and the cost/success. Sensitivity analysis around dosing assumptions was conducted to assess robustness of estimates. Across the seven states, the two treatments associated with the lowest cost to treat 100 migraine attacks were eletriptan 20 mg (range $1549-$1658) and eletriptan 40 mg ($1578-$1661). Naratriptan 2.5 mg (range $1734-$2018), sumatriptan 25 mg ($1853-1954), and zohmitriptan 5 mg ($1854-$1960) were associated with the highest cost to treat 100 migraine attacks. Eletriptan 40 mg was associated with the lowest cost/success (range $57.03-$60.05); naratriptan 2.5 mg ($99.39-$115.65), sumatriptan 25 mg ($107.11-$112.93), and rizatriptan 5 mg ($99.41-$111.25) were associated with the highest cost/success values. Changes in dosing assumptions did not significantly change the rank ordering of triptans across either economic end point. Conclusions. Eletriptan 20- and 40-mg doses were shown to be associated with the lowest cost to treat 100 migraine attacks and the lowest cost/success in both the baseline and sensitivity analyses. These findings are consistent with results of similar economic analyses that compared multiple triptan therapies. [ABSTRACT FROM AUTHOR]

A large number of our policy makers are focusing on the millions of Americans without health insurance as the major health care problem in this country. Their solution to the growing problem of access to the health care system is some form of national health insurance for all Americans. This paper questions whether the real problem in our health care system is an issue of access or a desire for good health. If it is an issue of a desire for good health then access alone is not the real problem. Access to health care services in itself does not guarantee good health. Good health can generally be obtained and preserved by practicing good health habits. If one is healthy, the access problem becomes less of an issue for most Americans. Lack of information concerning good health behaviors and the direction of health care resources towards this end becomes the most significant health care problem, not access. [ABSTRACT FROM AUTHOR]

There have been dramatic changes in pension funds investing in the last ten years of the 20th century including the growth of asset allocations to international equity a significant decline in fixed income and the emergence of new asset classes like private equity. Indeed, this was an extraordinary period for pension hinds, with bountiful returns and relatively few worries, until recently. A survey was conducted of the study of the 200 largest defined-benefit pension funds, which constitute one of the largest investment sectors in the U.S. economy.

Diabetes mellitus is the seventh leading cause of death (sixth leading cause of death by disease) in the US. Approximately 5.9% of the US population has diabetes and one-third of those with diabetes are unaware that they have the condition. Diabetes is the leading cause of adult blindness, end-stage renal disease, and non-traumatic lower extremity amputation. The annual per-capita incremental cost of diabetes among employees compared with individuals without diabetes has been estimated at $US4410 (1998 values). Furthermore, more than 30% of the costs associated with diabetic employees are attributable to medically related work absences and disability, and this is estimated to cause a one-third reduction in earnings due to reduced workforce participation. The incidence of diabetes and long term medical complications could be reduced through more effective diabetes education and patient self-management. Intensive management of diabetes can help workers remain productive, decrease costs associated with complications, and reduce associated costs for overtime. Policy complications from this review encourage employers and Medicare/Medicaid to invest in diabetes education and wellness programs. [ABSTRACT FROM AUTHOR]

Focuses on the implementation of HIV education programs in public schools in Pennsylvania. Superintendents' knowledge of the risks of HIV infections; Priorities on HIV instruction in school districts; Plans to evaluate and revise the HIV curriculum; Influence of the reported incidence of AIDS in the state on the emphasis placed on HIV educational programs.