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Article ; Online: Health Insurance For People Younger Than Age 65: Expiration Of Temporary Policies Projected To Reshuffle Coverage, 2023-33.

Hanson, Caroline / Hou, Claire / Percy, Allison / Vreeland, Emily / Minicozzi, Alexandra

2023 Volume 42, Issue 6, Page(s) 742–752

Abstract: The Congressional Budget Office estimates that in 2023, 248 million people in the US who are younger than age sixty-five have health insurance coverage (mostly through employment-based plans), and twenty-three million people, or 8.3 percent of that age ... ...

Abstract	The Congressional Budget Office estimates that in 2023, 248 million people in the US who are younger than age sixty-five have health insurance coverage (mostly through employment-based plans), and twenty-three million people, or 8.3 percent of that age group, are uninsured-with significant variations in coverage by income and, to a lesser extent, by race and ethnicity. The unprecedented low uninsurance rate is largely attributable to temporary policies that kept beneficiaries enrolled in Medicaid and enhanced the subsidies available through the health insurance Marketplaces during the COVID-19 pandemic. As the continuous eligibility provisions unwind in 2023 and 2024, an estimated 9.3 million people in that age group will transition to other forms of coverage, and 6.2 million will become uninsured. If the enhanced subsidies expire after 2025, 4.9 million fewer people are estimated to enroll in Marketplace coverage, instead enrolling in unsubsidized nongroup or employment-based coverage or becoming uninsured. By 2033 the uninsurance rate is projected to be 10.1 percent, which is still below the 2019 rate of about 12 percent.
MeSH term(s)	United States ; Humans ; Aged ; Pandemics ; Insurance Coverage ; COVID-19 ; Insurance, Health ; Medicaid ; Medically Uninsured ; Policy
Language	English
Publishing date	2023-05-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.2023.00325
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Article ; Online: Let me pay taxes!

Minicozzi, Alessia

Narrative inquiry in bioethics

2013 Volume 3, Issue 3, Page(s) 210–213

MeSH term(s)	Attitude ; Disabled Persons ; Employment ; Humans
Language	English
Publishing date	2013
Publishing country	United States
Document type	Journal Article
ZDB-ID	2632728-4
ISSN	2157-1740 ; 2157-1732
ISSN (online)	2157-1740
ISSN	2157-1732
DOI	10.1353/nib.2013.0081
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Article ; Online: Ensuring no patient is lost along the way - a single-centre experience of the clinical genetics referral pathways for Lynch syndrome.

El-Shakankery, Karim Hussien / Balogh, Petra / Grantham, Marianne / Minicozzi, Anna / Diamantis, Nikolaos

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 25, Issue 5, Page(s) 838–842

Abstract: Lynch syndrome (LS), caused by heterozygous germline mutation in one of the key mismatch repair (MMR) genes, is the primary cause of inherited colorectal cancer (CRC). LS also increases susceptibility to several other cancers. It is estimated that just 5% ...

Abstract	Lynch syndrome (LS), caused by heterozygous germline mutation in one of the key mismatch repair (MMR) genes, is the primary cause of inherited colorectal cancer (CRC). LS also increases susceptibility to several other cancers. It is estimated that just 5% of patients with LS are aware of their diagnosis. Therefore, in an attempt to increase the identification of cases within the UK population, the 2017 NICE guidelines recommend offering immunohistochemistry for MMR proteins or microsatellite instability (MSI) testing to all people with CRC when first diagnosed. Following identification of MMR deficiency, eligible patients should be assessed for underlying causes, including potential referral to the genetics service and/or germline LS testing (if appropriate). In our regional centre for CRC, we audited local pathways to identify what proportion of patients are being correctly referred, in line with national guidelines. Reflecting on these results, we highlight our practical concerns by identifying the pitfalls and issues faced with the recommended referral pathway. We also propose possible solutions to improve the efficacy of the system for both referrers and patients. Finally, we discuss the ongoing interventions that national bodies and regional centres are implementing to improve and further streamline this process.
MeSH term(s)	Humans ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; Colorectal Neoplasms/genetics ; Neoplastic Syndromes, Hereditary ; Microsatellite Instability ; Germ-Line Mutation ; DNA Mismatch Repair/genetics
Language	English
Publishing date	2023-02-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16496
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Article: Transition to adult care: another view.

Minicozzi, A

Pediatric nursing

2000 Volume 26, Issue 4, Page(s) 411–412

MeSH term(s)	Adaptation, Psychological ; Adolescent ; Adult ; Autobiography as Topic ; Child ; Female ; Humans ; Long-Term Care/psychology ; Nurse's Role ; Patient Care Team ; Patient Transfer ; Sick Role ; Spinal Muscular Atrophies of Childhood/nursing ; Spinal Muscular Atrophies of Childhood/psychology
Language	English
Publishing date	2000-07
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	752968-5
ISSN	0097-9805
ISSN	0097-9805
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Article: Medical savings accounts: what story do the data tell?

Minicozzi, Alexandra

Health affairs (Project Hope)

2006 Volume 25, Issue 1, Page(s) 256–267

Abstract: Fewer than a quarter-million tax units had reported a medical savings account (MSA) by the end of 2001. Nearly one-quarter of those having an MSA reported being previously uninsured. The tax data support the prediction that higher-income taxpayers are ... ...

Abstract	Fewer than a quarter-million tax units had reported a medical savings account (MSA) by the end of 2001. Nearly one-quarter of those having an MSA reported being previously uninsured. The tax data support the prediction that higher-income taxpayers are more likely than others to be MSA consumers. Surprisingly, the middle-aged had the greatest predicted MSA demand, even after income and marginal tax rate were controlled for. There is mixed evidence as to whether the account was treated as a savings vehicle. For those who continued their accounts, their build-up was generally sufficient to offset a year or two of future medical expenses below the deductible.
MeSH term(s)	Humans ; Income Tax/statistics & numerical data ; Medical Savings Accounts/trends ; Medical Savings Accounts/utilization ; Middle Aged ; Social Class ; United States
Language	English
Publishing date	2006-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	632712-6
ISSN	1544-5208 ; 0278-2715
ISSN (online)	1544-5208
ISSN	0278-2715
DOI	10.1377/hlthaff.25.1.256
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Article: Management of distal rectal cancer: results from a national survey.

Melotti, G / De Antoni, E / Habr-Gama, A / Minicozzi, A

Updates in surgery

2013 Volume 65, Issue 1, Page(s) 43–52

Abstract: Owing to the complexity of distal rectal cancer its management requires a multidisciplinary approach. The diagnosis and the response after neoadjuvant chemoradiotherapy are not easy to assess and therefore the surgical approach is heterogeneous. The ... ...

Abstract	Owing to the complexity of distal rectal cancer its management requires a multidisciplinary approach. The diagnosis and the response after neoadjuvant chemoradiotherapy are not easy to assess and therefore the surgical approach is heterogeneous. The purpose of this survey is to evaluate the experiences of members of the Italian Society of Surgery in diagnosis and treatment strategies for rectal cancer and compare it with international practice. A questionnaire was devised comprising 18 questions with 11 sub-items making a total of 29 questions and submitted online to all the 2,500 members of the SIC starting from July 2010. The survey was completed in June 2011. The overall response rate was 17.8 % (444). The majority of the Italian surgeons' responses were in line with the international consensus reflecting the complex management of distal rectal cancer. Other opinions, especially those on staging, diverge from the common view of MRI being the gold standard in the assessment of loco-regional diffusion of the disease and on the superiority of FDG PET-CT versus CT for systemic staging. The timing for the re-staging and for surgery following neoadjuvant chemoradiotherapy does not reflect the international opinion. Italian surgeons are also exposed to the common difficulties encountered internationally in the management of distal rectal cancer. Probably, the implementation of an Italian rectal cancer registry and of many national and international multicentre studies may improve the management of rectal cancer in Italy.
MeSH term(s)	Humans ; Italy ; Practice Patterns, Physicians' ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Surveys and Questionnaires ; Treatment Outcome
Language	English
Publishing date	2013-01-19
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-012-0192-x
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Article ; Online: New method for internal anal sphincter measurements: feasibility study.

Sboarina, A / Minicozzi, A / Cordiano, C

International journal of computer assisted radiology and surgery

2010 Volume 5, Issue 5, Page(s) 515–525

Abstract: Purpose: The aim of this paper is to provide a method for measuring the internal anal sphincter on the basis of the quantitative analysis of three-dimensional endosonographic images. A software calculates a large set of measurements which are able to ... ...

Abstract	Purpose: The aim of this paper is to provide a method for measuring the internal anal sphincter on the basis of the quantitative analysis of three-dimensional endosonographic images. A software calculates a large set of measurements which are able to describe the three-dimensional shape of the muscle. Methods: A software provides four types of measurements: thickness, length, area and volume. The different magnitudes are estimated using the same reference system. The measurements obtained are modeled by functions that describe their spatial trend. The precision and reproducibility of the method was tested on a phantom before a study was performed on fifteen healthy patients. The measurements were carried out by two different operators. The inter-observer variability were assessed. Results: In the phantom measurements the mean errors and the standard deviation were: 0.05 +/- 0.1 mm for the thickness, 0.02 +/- 0.12 mm for the length, -4.43 +/- 2.4 mm(2) for the area, -20.69 +/- 20.83 mm(3) for the volume. The maximum absolute differences between the measurements carried out by the two operators was: 0.18 mm for the thickness (in the 95% of the case), 1.69 mm(2) for the area (in the 95% of the case), and 0.25 mm for the length, and 29.46 mm(3) for the volume. The human IAS assessments were evaluated on each segment. The mean of the all tissue measurements carried out were (mean +/- SD): 1.71 +/- 0.34 mm for the thickness, 33.24 +/- 6.10 mm for the length, 111.28 +/- 29.08 mm(2) for the area. The mean of the volume measurements of the entire tissue was: 4124 +/- 1160 mm(3). Inter-observer variability was observed only in the anterior proximal segment for the thickness measurements by Wilcoxon's signed rank test (P value = 0.048) and for the volume assessments by the limits of agreement method (-118 to 78 mm(3)). The mean percentage errors and the limit of agreement for the measurements of the entire tissue were: 0.27 and (-0.11 to 0.12 mm) for the thickness, -2.32 and (-3.88 to 2.33 mm) for the length, -0.05 and (-9.71 to 9.83 mm(2)) for the area, -1.89 and (-366 to 240 mm(3)) for the volume. Conclusion: The assessments of accuracy and precision of the method result satisfactory for all four type of measurements. The reproducibility analysis confirms very good inter-observer agreement for the phantom measurements and for the most part of the IAS segments evaluations. Inter-observer variability was seen only for the thickness and volume measurements of the anterior-proximal segment. Our method provides a high number of measurements with good accuracy enabling a very detailed study of IAS morphology.
MeSH term(s)	Anal Canal/diagnostic imaging ; Endosonography/methods ; Feasibility Studies ; Humans ; Imaging, Three-Dimensional ; Phantoms, Imaging ; Reproducibility of Results
Language	English
Publishing date	2010-02-24
Publishing country	Germany
Document type	Comparative Study ; Journal Article
ZDB-ID	2365628-1
ISSN	1861-6429 ; 1861-6410
ISSN (online)	1861-6429
ISSN	1861-6410
DOI	10.1007/s11548-010-0406-y
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Book ; Thesis: Baby doctors

Minicozzi, Alessia

the socialization and the bioethics of the first-year attending

2006

Author's details	Alessia Minicozzi
MeSH term(s)	Medical Staff, Hospital/psychology ; Medical Staff, Hospital/ethics ; Socialization ; Professional Autonomy
Keywords	United States
Language	English
Size	v, 146 p.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Thesis (Ph. D.)--University of Pennsylvania, 2006
Database	Catalogue of the US National Library of Medicine (NLM)

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Article ; Online: Morphogenetic events in the perinodal connective tissue in a metastatic cancer model.

Conti, G / Minicozzi, A / Merigo, F / Marzola, P / Osculati, F / Cordiano, C / Sbarbati, A

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie

2013 Volume 67, Issue 1, Page(s) 1–6

Abstract: Background: The modifications of connective tissue surrounding metastatic lymph nodes in a murine model of rectal cancer are described.: Methods: Athymic nude mice (n=36) were inoculated with 10×10(5) ht-29 cancer cells into the submucosal layer of ... ...

Abstract	Background: The modifications of connective tissue surrounding metastatic lymph nodes in a murine model of rectal cancer are described. Methods: Athymic nude mice (n=36) were inoculated with 10×10(5) ht-29 cancer cells into the submucosal layer of the rectum. Control mice (n=5) were treated with a sterile buffer. Tumor and the involved lymph nodes were visualized in vivo by magnetic resonance imaging at 1 to 4 weeks after cell injection. After the sacrifice, the excised samples were processed for histology. Results: After one week from cell injection all treated animals developed rectal cancer. Since the first week, neoplastic cells were visible in the nodes. In the surrounding connective tissue, the diameter of the adipocytes was reduced and a mesenchymal-like pattern with stellate cells embedded in an oedematous environment was visible. Since the second week, in the perinodal connective an enlargement of the stroma was present. The tissue was organized in cords and areas with extracellular accumulation of lipids were found. At the fourth week, we observed an enlargement of multilocular areas and lobules of elongated elements almost devoid of lipid droplets. In control animals, in absence of neoplastic masses, pelvic nodes were surrounded by a typical connective tissue characterized by unilocular adipocytes with groups of multilocular adipocytes. Conclusions: We have developed a model of rectal cancer with nodal metastases. Using this model, the work demonstrates that around secondary lesions, the morphogenetic events follow a standard evolution characterized by an early phase with lipolysis and mesenchymalization and later phases with a brown-like phenotype acquisition.
MeSH term(s)	Adipocytes/pathology ; Animals ; Connective Tissue/metabolism ; Connective Tissue/pathology ; Extracellular Space ; HT29 Cells ; Humans ; Lipid Metabolism ; Lipolysis ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Mice ; Mice, Nude ; Neoplasms, Experimental/pathology ; Rectal Neoplasms/pathology
Language	English
Publishing date	2013-02
Publishing country	France
Document type	Journal Article
ZDB-ID	392415-4
ISSN	1950-6007 ; 0753-3322 ; 0300-0893
ISSN (online)	1950-6007
ISSN	0753-3322 ; 0300-0893
DOI	10.1016/j.biopha.2012.08.002
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Article ; Online: Understanding the increasingly popular itemized deduction for medical expenses.

Lurie, Ithai Z / Minicozzi, Alexandra

Medical care research and review : MCRR

2010 Volume 67, Issue 6, Page(s) 707–721

Abstract: Itemized deduction for medical expenses has existed in one form or another for more than 60 years. One justification for this tax deduction is that it reduces the burden for taxpayers with catastrophic expenses. Currently it shields more out-of-pocket ... ...

Abstract	Itemized deduction for medical expenses has existed in one form or another for more than 60 years. One justification for this tax deduction is that it reduces the burden for taxpayers with catastrophic expenses. Currently it shields more out-of-pocket spending on health care from taxes than any other tax provision. Based on a repeated cross section from 1999 to 2005 and a 5-year panel of tax returns, we find that filers aged 65 years or older claim the deduction more often, deduct larger amounts, and do so more persistently than younger taxpayers. Augmenting tax data with information from the MEPS, we find that no more than 41% of all tax units with non-tax preferred medical expenditures exceeding 10% of income claimed the deduction in 2005. Even for those claiming the deduction, the average tax benefit of the deduction offsets less than 10% of medical expenditures.
MeSH term(s)	Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Financing, Personal/economics ; Health Expenditures/statistics & numerical data ; Humans ; Income/statistics & numerical data ; Income Tax/economics ; Middle Aged ; Tax Exemption ; United States
Language	English
Publishing date	2010-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1232314-7
ISSN	1552-6801 ; 1077-5587
ISSN (online)	1552-6801
ISSN	1077-5587
DOI	10.1177/1077558710370037
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