Lassitercrowley3866

Community retail pharmacies offer multiple public health services to meet the health care needs of medically underserved rural communities. Many rural residents are enrolled in Medicaid insurance, and it is important that pharmacies contract with Medicaid to meet the health care needs of these people. The objective of this study was to evaluate disparities in access to Medicaid-contracted pharmacies across the rural-urban continuum in Washington State.

We linked data on licensed community retail pharmacies in Washington State in 2017 to lists of state Medicaid-contracted pharmacies. We classified pharmacies as being located in small rural, large rural, suburban, and urban areas by using rural-urban commuting area (RUCA) codes. We evaluated the likelihood of zip code-level access to at least 1 pharmacy that was contracted with a Medicaid insurance plan across the rural-urban continuum by using descriptive statistics and modified Poisson regression models, adjusted for zip code-level community characteristics.

Of 1,145 pharmacies in our study sample, 8.4% (n = 96) were not contracted with a Medicaid plan. Compared with urban core zip codes, small rural zip codes (adjusted relative risk [ARR] = 0.64; 95% CI, 0.46-0.91) and large rural zip codes (ARR = 0.68; 95% CI, 0.49-0.95) were significantly less likely to have access to a Medicaid-contracted pharmacy. Suburban zip codes did not differ significantly from urban core areas in their access to Medicaid-contracted pharmacies.

In Washington State, the likelihood of access to a Medicaid-contracted pharmacy decreased significantly as rurality increased. Policy efforts should aim to improve access for Medicaid enrollees, especially those outside urban centers.

In Washington State, the likelihood of access to a Medicaid-contracted pharmacy decreased significantly as rurality increased. Policy efforts should aim to improve access for Medicaid enrollees, especially those outside urban centers.A Gram stain-positive, non-spore-forming, non-motile and rod-shaped actinomycete, strain 5221T, was isolated from the sediment of a river collected at Ronggui in the Pearl River Delta, PR China. Phylogenetic analysis based on 16S rRNA gene sequences revealed that the strain formed a distinct lineage within the genus Brevibacterium and had the highest sequence similarity to Brevibacterium pityocampae Tp12T (96.7 %), followed by Brevibacterium daeguense 2C6-41T (96.5 %), Brevibacterium samyangense SST-8T (96.0 %) and Brevibacterium ravenspurgense 20T (95.9 %). The results of chemotaxonomic analyses, including detecting anteiso-C15  0, anteiso-C17  0, and C16  0 as the major cellular fatty acids, diphosphatidylglycerol, phosphatidylglycerol and three phosphoglycolipids as the polar lipids, MK-8(H2) as the major menaquinone, and a DNA G+C content of 72.4 mol%, supported that strain 5221T is a member of the genus Brevibacterium. Furthermore, low sequence similarities of 16S rRNA gene sequences, differences in fatty acid compositions and differential physiological characteristics such as enzyme activity and carbon sources utilization ability distinguished the isolate from its close relatives. Therefore, strain 5221T represents a novel species of the genus Brevibacterium, for which the name Brevibacterium rongguiense sp. nov. is proposed, with the type strain 5221T (=GDMCC 1.1766T=KACC 21700T).A Gram-stain-positive, endospore-forming, motile and rod-shaped bacterium, designated as strain DSL-17T, was isolated from a tidal sediment of the East China Sea and characterized phylogenetically and phenotypically. The strain could grow at 16-47 °C (optimum 37 °C), at pH 6.0-10.0 (optimum 6.0) and with 1-7% (w/v) NaCl (optimum 3 %). Phylogenetic analysis based on 16S rRNA gene sequences showed that strain DSL-17T was related to members of the genus Metabacillus and shared the highest similarity with Metabacillus litoralis SW-211T (98.6 %), followed by Metabacillus halosaccharovorans E33T (97.9 %), Metabacillus crassostreae JSM 100118T (97.7 %), Metabacillus niabensis 4T19T (97.7 %) and Metabacillus malikii NCCP-662T (97.5 %). 16S rRNA gene sequence similarities between strain DSL-17T and other members of the genus Metabacillus were below 96.6 %. The sole respiratory quinone was MK-7. Strain DSL-17T had a cell-wall peptidoglycan based on meso-diaminopimelic acid. The polar lipids were diphosphatidylglycerol (DPG), phosphatidylglycerol (PG), three unidentified glycolipids and six unidentified lipids. The strain had iso-C15  0, anteiso-C15  0, iso-C14  0, C16  0 and iso-C16  0 as major fatty acids. The G+C content of the genomic DNA was 35.7 mol%. The combined genotypic and phenotypic data indicated that strain DSL-17T represents a novel species of the genus Metabacillus, for which the name Metabacillus sediminilitoris sp. nov. is proposed The type strain is DSL-17T (=MCCC 1K03777T=DSM 109843T).Two novel Gram-stain-negative, aerobic and non-motile rods bacteria, designated TQ8ST and ZH2ST, were isolated from salt marsh sediment collected from the Tibetan Plateau. Strain TQ8ST was found to grow at 10-40 °C (optimum, 30 °C), pH 6.0-11.0 (optimum, pH 8.0-9.0) and in the presence of 2-12 % (w/v) NaCl (optimum, 6-8 %). Strain ZH2ST was found to grow at 15-40 °C (optimum, 30 °C), pH 7.0-10.0 (optimum pH 9.0) and in the presence of 2-10 % (w/v) NaCl (optimum, 4-6 %). Phylogenetic analysis based on the 16S rRNA gene sequences showed that strains TQ8ST and ZH2ST shared 99.07 % sequence similarity between each other and were affiliated with the genus Halomonas, sharing 97.48 % and 97.41 % of sequence similarity to their closest neighbour Halomonas sulfidaeris Esulfide1T, respectively. DNA-DNA hybridization analyses showed 61.0 % relatedness between strains TQ8ST and ZH2ST. The average nucleotide identity and the average amino acid identity values between the two genomes were 92.33 and 92.84 %, respectively. The values between the two strains and their close phylogenetic relatives were all below 95 %. selleck kinase inhibitor The major respiratory quinones of strain TQ8ST were Q-9 and Q-8, while that of ZH2ST was Q-9. The main fatty acids shared by the two strains were C18  1 ω6c and/or C18  1 ω7c, C16  1 ω6c and/or C16  1 ω7c, C16  0 and C12  0 3-OH. Strain ZH2ST can be distinguished from TQ8ST by a higher proportion of C19  0 cyclo ω8c. The G+C content of the genomic DNA of strains TQ8ST and ZH2ST were 57.20 and 57.14 mol%, respectively. On the basis of phenotypic distinctiveness and phylogenetic divergence, the two isolates are considered to represent two novel species of the genus Halomonas, for which the names Halomonas rituensis sp. nov (type strain TQ8ST=KCTC 62530T=CICC 24572T) and Halomonas zhuhanensis sp. nov (type strain ZH2ST=KCTC 62531T=CICC 24505T) are proposed.