Incidence and prevalence of idiopathic inflammatory myopathies among commercially insured, Medicare supplemental insured, and Medicaid enrolled populations: an administrative claims analysis

Background: Idiopathic inflammatory myopathies (IIMs) are a rare group of autoimmune syndromes characterized by chronic muscle inflammation and muscle weakness with no known cause. Little is known about their incidence and prevalence. This study reports the incidence and prevalence of IIMs among commercially insured and Medicare and Medicaid enrolled populations in the US. Methods: We retrospectively examined medical claims with an IIM diagnosis (ICD-9-CM 710.3 [dermatomyositis (DM)], 710.4 [polymyositis (PM)], 728.81[interstitial myositis]) in the MarketScan® databases to identify age- and gender-adjusted annual IIM incidence and prevalence for 2004–2008. Sensitivity analysis was performed for evidence of a specialist visit (rheumatologist/ neurologist/dermatologist), systemic corticosteroid or immunosuppressant use, or muscle biopsy. Results: We identified 2,990 incident patients between 2004 and 2008 (67% female, 17% Medicaid enrollees, 27% aged ≥65 years). Overall adjusted IIM incidence for 2004–2008 for commercial and Medicare supplemental groups combined were 4.27 cases (95% CI, 4.09-4.44) and for Medicaid, 5.23 (95% CI 4.74-5.72) per 100,000 person-years (py). Disease sub-type incidence rates per 100,000-py were 1.52 (95% CI 1.42-1.63) and 1.70 (1.42-1.97) for DM, 2.46 (2.33-2.59) and 3.53 (3.13-3.94) for PM, and 0.73 (0.66-0.81) and 0.78 (0.58-0.97) for interstitial myositis for the commercial/Medicare and Medicaid cohorts respectively. Annual incidence fluctuated over time with the base MarketScan populations. There were 7,155 prevalent patients, with annual prevalence ranging from 20.62 to 25.32 per 100,000 for commercial/Medicare (83% of prevalent cases) and from 15.35 to 32.74 for Medicaid. Conclusions: We found higher IIM incidence than historically reported. Employer turnover, miscoding and misdiagnosing, care seeking behavior, and fluctuations in database membership over time can influence the results. Further studies are needed to confirm the incidence and prevalence of IIM

Being on the Mat: A Process Evaluation of Trauma-Informed Yoga for Women with Substance Use Disorders

Yoga practice is associated with positive health outcomes, including benefits related to managing substance use disorders and trauma symptomology. However, low-income vulnerable communities have limited access to yoga. This process evaluation of a trauma-informed yoga program for women with substance use disorders demonstrates the feasibility and utility of using noncertified yoga instructors to offer a basic yoga in community-based agencies. Participants describe outcomes related to relaxation, mindfulness, and movement that are well-aligned with their recovery needs. Study findings suggest the utilization of instructors with minimal training has the potential to expand research about and access to yoga among marginalized communities

Building Workforce Capability in Nonprofit Organizations

Leaders of nonprofit organizations in the United States must build workforce capabilities to meet increasing demands for services. This single-case study explored strategies nonprofit leaders used to build workforce capability to address increasing service demands. The conceptual lens for this study was the full-range leadership theory. Data were collected through semistructured interviews from a purposeful sample of 3 senior executives of a single nonprofit organization located in the midwestern region of the United States. Information from internal and external documents and publicly available documents also provided data. Information and data sources included internal organizational and workforce performance data, strategy plans and analysis, internal and external financial documents, organizational website, and nonprofit data and information websites. Data and information from internal and external documents, interviews, and publicly available information were manually coded. Findings were validated through data triangulation and member checking. Using thematic analysis, 4 themes emerged related to building workforce capability: an emphasis on employee development, the expansion of technology systems, a concentration on developing a culture of autonomy and trust, and the introduction of processes and measurements. The findings from this study might contribute to positive social change by providing nonprofit leaders with strategies and data to support a deeper understanding of how to effectively build workforce capability to address increasing service demands

Cafeteria, Commissary and Cooking: Foodways and Negotiations of Power and Identity in a Women’s Prison

This study uses foodways theory to build knowledge about the lived experience of incarceration by analyzing women’s narratives about prison food and eating. Semi-structured interviews were conducted with 30 formerly incarcerated women in New Haven, CT. The interviews were digitally recorded and transcribed. Findings explain the different ways that inmates collect, prepare, distribute and consume food, and the centrality of these activities to incarcerated life. By shedding light on these daily routines, the world of prison life comes into greater focus. Thematic analysis of the data further illuminates the prison experience by suggesting the positive and negative ways that food impacts inmate’s perceptions of themselves, their social networks and the State. Negative foodways humiliated the women, accentuated their powerlessness, and reinforced their perceptions of the State as nonsensical and apathetic towards their needs. Positive foodways illustrated the inmates’ capacity to resist State power, build/maintain relationships and construct positive self-narratives. Racialized foodways narratives began to reveal how food stories may be deployed to reinforce prison’s racial character and construct the identities of self and other. Foodways interventions to support the rehabilitative goals of correctional facilities are proposed. These data suggest that inmates want to build positive relationships and identities and that prison food systems could do more to help women realize these intentions

Challenges in Developing Evidence‐Based Drug Dosing Guidelines for Adults and Children Receiving Renal Replacement Therapy

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/110047/1/cptclpt2009150.pd

The Prevalence of the Q-fever Agent Coxiella burnetii in Ticks Collected from an Animal Shelter in Southeast Georgia

Author\u27s abstract: Q-fever is a zoonosis caused by a worldwide-distributed bacterium Coxiella burnetii. Ticks are vectors of the Q-fever agent but play a secondary role in transmission because the agent is also transmitted via aerosols. Most Q-fever studies have focused on farm animals but not ticks collected from dogs in animal shelters. In order to detect the Q-fever agent in these ticks, a nested PCR technique targeting the 16S rDNA of Coxiella burnetii was used. A collection of 450 ticks from the animal shelter were screened via nested PCR and 144 (32%) were positives. The positive PCR products were also confirmed by DNA sequencing. This is the first report of the prevalence of the Q-fever agent in ticks from an animal shelter. The results are significant to public health. Highly infected ticks in animal shelters may transmit the Q-fever agent to humans via its feces, excretion, or by biting

Do residents’ perceptions of being well-placed and objective presence of local amenities match? A case study in West Central Scotland, UK

Background:<p></p> Recently there has been growing interest in how neighbourhood features, such as the provision of local facilities and amenities, influence residents’ health and well-being. Prior research has measured amenity provision through subjective measures (surveying residents’ perceptions) or objective (GIS mapping of distance) methods. The latter may provide a more accurate measure of physical access, but residents may not use local amenities if they do not perceive them as ‘local’. We believe both subjective and objective measures should be explored, and use West Central Scotland data to investigate correspondence between residents’ subjective assessments of how well-placed they are for everyday amenities (food stores, primary and secondary schools, libraries, pharmacies, public recreation), and objective GIS-modelled measures, and examine correspondence by various sub-groups.<p></p> Methods:<p></p> ArcMap was used to map the postal locations of ‘Transport, Health and Well-being 2010 Study’ respondents (n = 1760), and the six amenities, and the presence/absence of each of them within various straight-line and network buffers around respondents’ homes was recorded. SPSS was used to investigate whether objective presence of an amenity within a specified buffer was perceived by a respondent as being well-placed for that amenity. Kappa statistics were used to test agreement between measures for all respondents, and by sex, age, social class, area deprivation, car ownership, dog ownership, walking in the local area, and years lived in current home.<p></p> Results:<p></p> In general, there was poor agreement (Kappa <0.20) between perceptions of being well-placed for each facility and objective presence, within 800 m and 1000 m straight-line and network buffers, with the exception of pharmacies (at 1000 m straight-line) (Kappa: 0.21). Results varied between respondent sub-groups, with some showing better agreement than others. Amongst sub-groups, at 800 m straight-line buffers, the highest correspondence between subjective and objective measures was for pharmacies and primary schools, and at 1000 m, for pharmacies, primary schools and libraries. For road network buffers under 1000 m, agreement was generally poor.<p></p> Conclusion:<p></p> Respondents did not necessarily regard themselves as well-placed for specific amenities when these amenities were present within specified boundaries around their homes, with some exceptions; the picture is not clear-cut with varying findings between different amenities, buffers, and sub-groups

Hope, Courage, and Resilience in the Lives of Transgender Women of Color

There is a lack of qualitative and strengths-based knowledge about the lived experience of transgender women of color in the US. To address this research gap, a Photovoice project was undertaken with five transgender women living in a small urban area. Thematic analysis of the participants’ discussion of their photographs identified three major themes: hope, courage, and resilience. Analysis suggests a framework for understanding these women’s lived experiences and the psychosocial tools that they use to negotiate their daily lives and persevere in the face of interpersonal and structural oppression