Posts Tagged ‘published’

Medicaid reimbursements may affect cancer screening rates among beneficiaries

Although Medicaid is a joint state-federal government health insurance program, each state sets the policies for its own Medicaid program within requirements set by the federal government. This includes setting how much providers are paid for health care services and who is allowed to enroll in Medicaid. To determine whether state Medicaid eligibility and reimbursement policies affect receipt of breast, cervical, and colorectal cancer screening among Medicaid beneficiaries, Michael Halpern, MD, PhD, MPH, of RTI International, and his colleagues analyzed 2007 Medicaid data from 46 states and Washington DC.

“Few studies have examined how state-specific differences in Medicaid policies might affect use of preventive care services, particularly for early detection of cancer,” said Dr. Halpern. “Our study was able to compare differences in cancer screening for Medicaid beneficiaries in almost all states, providing a broad, national picture of the effects of state-level Medicaid policies on receipt of these critical medical care services among a large group of underserved individuals.”

The researchers found that in states with higher payments for office visits, Medicaid beneficiaries were more likely to receive recommended screenings for early detection of all three types of cancer. In contrast, higher payments for cancer screening tests (such as colonoscopy, mammography, and Pap tests) were not always linked with increased screenings among Medicaid beneficiaries. The team also found that Medicaid beneficiaries in states that had an “asset test” (which considers an individual’s savings, property, or other items of worth to determine whether he or she could enroll in Medicaid) were less likely to be screened for cancer.

The association between higher Medicaid reimbursements for office visits and increased likelihood of receiving cancer screenings may reflect barriers in access to primary care physicians and other providers for Medicaid enrollees in states with lower reimbursements. Increasing reimbursements for office visits may facilitate access to primary care among Medicaid beneficiaries, and thereby increase the likelihood of receiving appropriate cancer screening tests. On the other hand, raising reimbursement for the screening tests themselves may be a less effective policy tool for increasing use of recommended screenings. The results also indicate that eliminating asset tests may increase the likelihood of receiving cancer screenings by helping low-income individuals remain enrolled in Medicaid.

“Due to multiple factors, including Health Care Reform and decreased state budgets, many states are changing their Medicaid policies, including how much health care providers are paid and who is allowed to enroll,” said Dr. Halpern. “Our findings can help state health care decision makers and policy leaders to develop new Medicaid policies that aid low income individuals in receiving recommended cancer screenings.”

source : http://www.sciencedaily.com/releases/2014/08/140825084929.htm

Self-assembling anti-cancer molecules created in minutes: Like a self-assembling ‘Lego Death Star’

The chemists, led by Professor Peter Scott at the University of Warwick, UK, have been able to produce molecules that have a similar structure to peptides which are naturally produced in the body to fight cancer and infection.

Published in Nature Chemistry, the molecules produced in the research have proved effective against colon cancer cells in laboratory tests, in collaboration with Roger Phillips at the Institute for Cancer Therapeutics, Bradford, UK.

Artificial peptides had previously been difficult and prohibitively expensive to manufacture in large quantities, but the new process takes only minutes and does not require costly equipment. Also, traditional peptides that are administered as drugs are quickly neutralised by the body’s biochemical defences before they can do their job.

A form of complex chemical self-assembly, the new method developed at Warwick addresses these problems by being both practical and producing very stable molecules. The new peptide mimics, called triplexes, have a similar 3D helix form to natural peptides.

“The chemistry involved is like throwing Lego blocks into a bag, giving them a shake, and finding that you made a model of the Death Star” says Professor Scott. “The design to achieve that takes some thought and computing power, but once you’ve worked it out the method can be used to make a lot of complicated molecular objects.”

Describing the self-assembly process behind the artificial peptides Professor Scott says: “When the organic chemicals involved, an amino alcohol derivative and a picoline, are mixed with iron chloride in a solvent, such as water or methanol, they form strong bonds and are designed to naturally fold together in minutes to form a helix. It’s all thermodynamically downhill. The assembly instructions are encoded in the chemicals themselves.”

“Once the solvent has been removed we are left with the peptide mimics in the form of crystals,” says Professor Scott. “There are no complicated separations to do, and unlike a Lego model kit there are no mysterious bits left over. In practical terms, the chemistry is pretty conventional. The beauty is that these big molecules assemble themselves. Nature uses this kind of self-assembly to make complex asymmetric molecules like proteins all the time, but doing it artificially is a major challenge.”

Whilst the peptide mimics created by the process have been successful in laboratory tests on colon cancer cells they will require further research before they can be used in clinical trials on patients. Nevertheless they are made of simple building blocks and in early tests the team have shown that they have very low toxicity to bacteria. “This is very unusual and promising selectivity,” says Professor Scott.

source : http://www.sciencedaily.com/releases/2014/08/140803193513.htm