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A Potential Treatment For Gastric Motility Disorders
GES or pacing has been under investigation as a potential therapy for gastrointestinal motility disorders. Conventionally, GES is performed using a single pair of electrodes or single-channel GES. However, few studies have investigated the effects of two-channel GES with trains of pulses on gastric motility, such as gastric slow waves and gastric emptying.
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NYT Examines Effects Of Illegal Abortion On Maternal Mortality In Tanzania
The New York Times on Tuesday examined how botched abortion procedures contribute to maternal mortality in Tanzania, in the second of a three-part series on pregnancy- and childbirth-related deaths in the country. The Times reports that the lack of abortion rights in Tanzania -- where the procedure is illegal except in cases where the woman"s life or health is at risk -- has prompted pregnant women and girls to seek the procedure from people who have not been trained to perform such procedures. In some cases, these untrained providers give the pregnant women herbs before performing abortions by punching the pregnant women"s stomachs or inserting objects into the vagina and uterus. Local hospitals in Tanzania often have to correct mistakes made by the untrained abortion providers. For example, during the month of January, 17 of the 31 minor surgical procedures performed at one Tanzanian hospital were to correct the results of "incomplete abortions."Africa has the world"s highest maternal mortality rate -- at least 100 times that of developed countries -- making pregnancy and childbirth among the most serious health dangers that African women face, according to the Times. Abortion accounts for a significant portion of those deaths. Tanzania has a maternal mortality rate of 950 deaths for every 100,000 births, a figure that is "neither the best nor the worst in Africa," the Times reports.Because most abortions in Tanzania are performed illegally, there are no reliable abortion figures for the country. However, the World Health Organization estimates that Eastern Africa, where Tanzania is located, has the world"s second-highest rate of unsafe abortions. Abortion rates typically decrease with increased contraceptive use, the Times reports. Only about one-quarter of Tanzanians use contraception in part because of misinformation that girls receive about the safety of condoms and hormonal contraceptives. By comparison, Kenya and South Africa both have higher contraception use and lower maternal mortality. However, in countries such as Sierra Leone and Nigeria, where abortion is not available on request, contraception use is lower than in Tanzania, and maternal mortality is much higher (Grady, New York Times, 6/2).
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Potential Patient Safety Risks Among Methadone Maintenance Treatment Patients Identified By Researchers
Boston Medical Center (BMC) researchers have identified potential safety risks among methadone maintenance treatment (MMT) patients due to the quantity and accuracy of medical record documentation. Improved communication and coordination among substance use treatment and medical providers could mitigate and manage the potential adverse effects of methadone and interacting medications. The BMC study appears in the July issue of Journal of General Internal Medicine.
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The Importance Of Medicaid Continuity For Former Inmates

It is time for states to suspend, rather than terminate, the Medicaid benefits of inmates while they are incarcerated, say correctional health care experts from The Miriam Hospital in a commentary published online by the Journal of General Internal Medicine. Although federal law does not mandate Medicaid termination for prisoners, 90 percent of states have implemented policies that withdraw inmates" enrollment upon incarceration, which the authors say leaves a vulnerable population uninsured following release. In the article, Josiah D. Rich, MD, MPH, notes that each year, the United States releases more than 10 million people from the nation"s correctional facilities. Re-entry into the community for former inmates is a vulnerable time - especially for those with mental illness - and is marked by difficulties adjusting and increased drug use. In addition, the risk for dying is sharply increased in the first two weeks after release, with drug overdose, cardiovascular disease, homicide and suicide among the leading causes of death. "We know that having Medicaid at the time of release leads to increased access to and utilization of services, as well as decreased drug use and re-incarceration. However, without coverage, former inmates face tremendous, and potentially fatal, health risks and are forced to rely on emergency rooms for medical care, placing the burden of cost on hospitals and state agencies," says Rich, co-director of the Center for Prisoner Health and Human Rights at The Miriam Hospital and The Warren Alpert Medical School of Brown University. He also points out that releasing inmates without medical coverage can contribute to an increased spread of infectious diseases, since many prisoners with hepatitis C, HIV and tuberculosis pass through the correctional system. Other communicable diseases, such as influenza, are commonly spread in prisons. Although Medicaid has prohibited the use of federal funds to cover medical, mental health or substance use treatment costs incurred by inmates in jails and prisons, Rich says that Medicaid law does not require that states terminate recipients" enrollment while incarcerated. Unfortunately, federal rules establish only the minimum requirements and states have the freedom to enact tougher regulations. "This leaves many inmates potentially facing months of reenrollment paperwork and bureaucracy upon release before they can get any medical coverage," he says, noting that the process - which also involves meeting with Social Security Income and Medicaid representatives to determine eligibility - can often take up to three months. Former inmates with mental health issues, who are often struggling with addiction, lack of transportation and homelessness, have the most difficulty with the complicated Medicaid re-enrollment process. Coincidentally, Medicaid is the single largest payer for mental health services and is a crucial re for the 16 percent of inmates reporting current mental illness, as well as for the additional 14 percent reporting past psychiatric treatment. Rich suggests that states follow the lead of New York, which passed Medicaid Suspension Legislation in 2007, requiring the state to suspend Medicaid for those who are enrolled at the time of incarceration and permitting immediate reinstatement upon release. "With the United States now leading the world in the number of incarcerated individuals and length of sentences, the issue of Medicaid termination is critical, not just to the nearly 10 million people in our correctional system but to the communities and health care systems to which they return," Rich says. Rich is an infectious disease specialist at The Miriam Hospital and associate professor of medicine and community health at Alpert Medical School. Commentary co-authors include Sarah E. Wakeman, a medical student at Alpert Medical School, and Margaret E. McKinney, MD, from Stanford University School of Medicine. The work was supported in part by grants from the National Institute on Drug Abuse and the Center for AIDS Research, both affiliated with the National Institutes of Health. Jessica Collins Grimes Lifespan


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