Biomedical subjects

Jennifer Ryan

Publications and source records attributed to Jennifer Ryan.

8 recordsLinked to original sources

PubMed2006

Premium assistance in Medicaid and SCHIP: ace in the hole or house of cards?

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children's Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes that could facilitate the use of premium assistance as a mechanism for health coverage expansion.

Child↗

PubMed2006

Medicaid in 2006: a trip down the yellow brick road.

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act of 2005 (DRA) and examines the implications of these provisions for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery. The role of section 1115 waivers in the context of the DRA and as a mechanism for continued state innovation is also discussed.

Budgets↗

PubMed2006

Executive control in a modified antisaccade task: Effects of aging and bilingualism.

Two studies are reported that assess differences associated with aging and bilingualism in an executive control task. Previous work has suggested that bilinguals have an advantage over monolinguals in nonlinguistic tasks involving executive control; the major purpose of the present article is to ascertain which aspects of control are sensitive to the bilingual experience. Study 1 used an antisaccade task and found no effects of aging or bilingualism. Study 2 used the identical visual display but coupled to keypress responses. The results showed that bilinguals resolved various types of response conflict faster than monolinguals and that this bilingual advantage generally increased with age. A speculative interpretation of this pattern of results is offered in conclusion.

Adult↗

PubMed2005

Local coverage initiatives: solution or band-aid for the uninsured?

This issue brief surveys health coverage expansion initiatives that are operating on the county or local level, often without the benefit of federal funding. The paper explores the circumstances that have made these initiatives possible and considers the ongoing barriers that local policymakers face in sustaining the programs. Descriptions of four initiatives illustrate the range and variety of programs in operation today and offer both best practices and lessons learned for other communities. The paper also includes a brief analysis of the key elements that make up a successful coverage initiative. Finally, this issue brief considers the role of local and county-based initiatives in the context of overall health care delivery in the national policy framework, highlighting the prospects for sustainability and replication on a broader scale.

California↗

PubMed2004

A prospective study of nurse initiated panadeine forte: expanding pain management in the ED.

INTRODUCTION: This study describes an innovative pain management strategy that aimed to improve the efficiency and effectiveness of timely analgesia for those patients in moderate pain and who experienced significant delay prior to medical assessment. METHOD: A 12-week prospective exploratory study was conducted to evaluate the introduction of a triage nurse initiated schedule 4 drug. A panadeine forte policy was developed and a data tool formulated to evaluate the effectiveness and frequency of nurse initiated panadeine forte. RESULTS: The average pre-pain score reported by patients was 68 mm and the median was 70 mm. The average post-pain score was 37 mm and the median was 35 mm. The average post-pain score reduced by 31 mm demonstrating a clinically significant change. A statistically significant (Wilcoxon signed rank test < 0.001) reduction in post-pain scores was also identified. CONCLUSION: We identified a statistically and clinically significant reduction in post-analgesic pain scores for patients. Improving pain management can have a positive impact on patients in moderate pain who experience extended waiting times prior to medical assessment.

Acetaminophen↗

PubMed2003

Sailing SCHIP through troubled waters.

As the State Children's Health Insurance Program (SCHIP) enters its sixth year of operation, states have continued their commitment to children's coverage and to reaching out to the uninsured. This issue brief explores the current status of SCHIP in light of fiscal pressures that have been created by the state budget crisis. It highlights some of the key successes in the program thus far and notes several examples of state initiatives to serve particularly vulnerable populations and collect outcomes data and information about access to care.

Black People↗

PubMed2003

Dually eligible for Medicare and Medicaid: two for one or double jeopardy?

This issue brief describes the characteristics of the population of individuals known as "dual eligibles," who are eligible for health insurance coverage through both Medicare and Medicaid. It also looks at the differences between "full Medicaid" and "supplemental Medicaid" dual eligibles and the ongoing challenges associated with enrollment and eligibility, integration and coordination, and managed care. The paper presents several examples of integrated care programs designed to better serve the dual-eligible population, including the Program of All-Inclusive Care for the Elderly, Evercare, social health maintenance organizations, and state/federal initiatives such as the Wisconsin Partnership Program, Texas STAR+PLUS, and others. Finally, it considers the implications for dual eligibles of the House and Senate Medicare prescription drug proposals.

Aged↗

PubMed2003

TRAF2 exerts its antiapoptotic effect by regulating the expression of Krüppel-like factor LKLF.

Tumor necrosis factor receptor (TNFR)-associated factor 2 (TRAF2) is one of the key factors that mediate TNF signaling. The deletion of TRAF2 renders cells more sensitive to TNF-induced apoptosis. Although TRAF2 is known to be required for TNF-induced JNK and NF-kappaB activation, the underlying mechanism of the increased sensitivity of TRAF2 null cells (TRAF2(-/-)) to TNF-induced apoptosis is not fully understood. To study the underlying mechanism, we examined the difference in gene expression between TRAF2(-/-) and wild-type fibroblast cells by using microarray technology. We found that one of the genes whose expression was dramatically decreased in TRAF2(-/-) cells was the lung Krüppel-like factor (LKLF). Our results indicate that the expression of LKLF requires TRAF2 but is independent of TNF signaling. Although it appears that TRAF2 regulates the expression of the LKLF gene at the transcription level, TRAF2 does not function as a transcription factor itself. Our results suggest that TRAF2 regulates LKLF expression through the mitogen-activated protein kinase p38 pathway. More importantly, ectopic expression of LKLF in TRAF2(-/-) cells protected cells against TNF-induced apoptosis. These results reveal a novel aspect of TRAF2 function: by regulating the expression of genes, such as LKLF, TRAF2 controls cell sensitivity to apoptosis.

Animals↗