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Scholarly Works (2 results)

  • Article
Reports on Industry Activity from Outside UCSF (2003)

Executive Summary

Introduction

Tobacco use is the leading cause of preventable death in the United States, responsible for over 400,000 deaths annually. In Nebraska each year, 2,400 adults die prematurely because of cigarette smoking.1 It is estimated that 45,000 Nebraskans now under the age of 18 will eventually die prematurely from cigarette smoking. Cigarette smoking is responsible for $419 million of Nebraska's annual health care costs (representing approximately 7 percent of the state's annual health care costs including 12 percent of Nebraska's annual Medicaid expenditures), and smoking-related mortality results in over $400 million in forgone future earnings in the state per year.

In 2000, the Nebraska State Legislature took an important step towards addressing the state's most significant public health problem by enacting Legislative Bill 1436, which appropriated $21 million from the Tobacco Settlement Trust Fund to support statewide tobacco prevention and cessation efforts. This funding enabled the Nebraska Health and Human Services System's (NHHSS) existing tobacco program, Tobacco Free Nebraska (TFN), to establish a comprehensive statewide tobacco program and greatly expand its efforts. The funding marked a turning point for the program, resulting in the Centers for Disease Control and Prevention (CDC) citing TFN as one of the model tobacco prevention and cessation programs in the nation. In 2002, the State Legislature took another important step towards eliminating tobacco use in Nebraska by passing a 30-cent increase in the state's cigarette tax. TFN’s achievements as a model program have been previously documented in the 2001 and 2002 State Snapshots and through a variety of other reports developed by an independent evaluation team.2 These reports, including this State Snapshot, provide information on statewide progress in tobacco control efforts to NHHSS, national, state, and local policymakers, and other interested parties.

    Cover page: Progress in Reducing Tobacco Use Across Nebraska
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2024)
    BACKGROUND: Up to one third of survivors of AKI that required dialysis (AKI-D) during hospitalization remain dialysis dependent at hospital discharge. Of these, 20%-60%, depending on the clinical setting, eventually recover enough kidney function to stop dialysis, and the remainder progress to ESKD. METHODS: To describe the challenges facing those still receiving dialysis on discharge, the AKINow Committee conducted a group discussion comprising 59 participants, including physicians, advanced practitioners, nurses, pharmacists, and patients. The discussion was framed by a patient who described gaps in care delivery at different transition points and miscommunication between care team members and the patient. RESULTS: Group discussions collected patient perspectives of ( 1 ) being often scared and uncertain about what is happening to and around them and ( 2 ) the importance of effective and timely communication, a comfortable physical setting, and attentive and caring health care providers for a quality health care experience. Provider perspectives included ( 1 ) the recognition of the lack of evidence-based practices and quality indicators, the significant variability in current care models, and the uncertain reimbursement incentives focused on kidney recovery and ( 2 ) the urgency to address communication barriers among hospital providers and outpatient facilities. CONCLUSIONS: The workgroup identified key areas for future research and policy change to ( 1 ) improve communication among hospital providers, dialysis units, and patients/care partners; ( 2 ) develop tools for risk classification, subphenotyping, and augmented clinical decision support; ( 3 ) improve education to providers, staff, and patients/care partners; ( 4 ) identify best practices to improve relevant outcomes; ( 5 ) validate quality indicators; and ( 6 ) assess the effect of social determinants of health on outcomes. We urge all stakeholders involved in the process of AKI-D care to align goals and work together to fill knowledge gaps and optimize the care to this highly vulnerable patient population.
      Cover page: Challenges in the Care of Patients with AKI Receiving Outpatient Dialysis: AKINow Recovery Workgroup Report.
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