Biomedical subjects
Publications and source records attributed to J F Newman.
This report describes the dental visit patterns of adults aged 65 and older. The analyses compare dental visit patterns by socioeconomic factors, perceived health status and dentate status.
Having a regular pattern of care should be an indicator of access to and periodic use of preventive and health maintenance services. The analyses reported in this study are intended to provide a better understanding of the factors related to having a regular pattern of preventive dental care. The data were collected in 1981 as part of a U.S. household survey, 'A Study of Dental Health Related and Process Outcomes Associated with Prepaid Dental Care', the most comprehensive cross-sectional data base available in dentistry. Descriptive analyses of a constructed variable, representing perceived and realized access and a preventive orientation, indicate that 53% of the population had a regular pattern of preventive care. Those with a regular pattern of care were more likely to be white, younger, have dental insurance, have no cost barriers, have more than 12 years of education, be dentate, have no perceived symptoms, and no fear of pain. Logistic regressions indicated that there was an increased probability of having a regular pattern of preventive care if individuals had no economic access problems, had positive attitudes, had higher income, reported few oral symptoms, and were non-Black. Overall, the descriptive models used suggested that individuals with resources in the form of finances and education, and a sense of self-efficacy as expressed in attitudes toward oral health, had the greatest probability of having a regular pattern of preventive care.
Data from the 1989 National Health Interview Survey show oral health activities for U.S. children aged 2-17. Key population subgroups neither received optimal preventive care nor visited a dentist regularly.
Short chain fatty acids inhibit the replication of bovine enterovirus but are almost ineffective against poliovirus type 1, coxsackievirus B5, encephalomyocarditis virus and human rhinovirus 1B. Lauric acid binds to bovine enterovirus, thereby stabilizing the virus particle to heat degradation. Fatty acid-bound virions attach to susceptible cells but fail to undergo cell-mediated uncoating. The inhibitory effect is reversible with chloroform and may result from a hydrophobic interaction between the fatty acid and a specific site on the virus particle.
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Experimental vaccines have been made by co-polymerizing virus particles and virus subunits into rabbit serum albumin beads. When injected into rabbits these model vaccines induced specific humoral antibody production and mimicked vaccines prepared using Freund's incomplete adjuvant. No adverse reactions occurred in experimental rabbits and no antibodies reacting with polymerized rabbit serum albumin beads were found. Immunostimulation is attributed to a slow release of antigen coinciding with the gradual breakdown of bead structure.
Model vaccines have been made by covalently linking Clostridium botulinum type D toxin and Klebsiella pneumoniae capsular polysaccharide antigen to polymerized rabbit serum albumin beads. When injected into rabbits these bead vaccines induced an enhanced production of specific humoral antibody without causing adverse reactions. The adjuvant effect is due to a slow release from the bead structure and offers an alternative to oil emulsions and mineral salt adsorbents.
The Australian bluetongue virus (BTV-20) was compared with six serotypes isolated in southern Africa and North America by peptide mapping of the virus proteins with group antigen properties. The p7 group antigens from each of the seven serotypes analysed did not have identical primary structures and a comparison of shared and unique tryptic peptides has been used as a means of estimating virus relationships. Whereas serological studies have suggested that BTV-20 is closely related to BTV serotypes 4 and 17, comparative peptide mapping of p7 indicates a different set of relationships with viruses from both southern Africa and North America. In contrast with cross-immune precipitation results, peptide mapping of p3 suggest that this protein is not a group specific antigen.
In an experimental vaccine, virus particles were chemically cross-linked into rabbit serum albumin beads. This vaccine was injected into rabbits without adverse reactions and the humoral antibody levels achieved were comparable to those obtained using virus emulsified in Freund's adjuvant. The antibodies produced were capable of neutralizing virus infectivity.
To measure the patterns of medical expenditures under conventional modes of cancer care for the terminally ill, we examined Blue Cross and Blue Shield Plan claims records for care during the 12 months preceding the deaths of 1,054 nonelderly patients diagnosed as having breast, colon-rectal, or lung cancer. Expenditures averaged +21,219 for the terminal year and grew exponentially as death approached, with +6,161 (29%) being spent in the final month alone. We found very few significant differences in spending or utilization by diagnosis, age, or sex of the terminal patient, but sizable differences by state of residence and between nonmetropolitan and metropolitan area residents. Our findings represent a baseline against which experience under new hospital payment strategies and alternative delivery systems might be compared.
Between 1968 and 1979, there occurred a steady decrease in the hospital admission rate for Blue Cross Plan members, in contrast to the steady increase in the admission rate for the under-65 U.S. population as a whole. Four general factors were studied to explore the reasons for this relative decrease: utilization control and cost containment activities instituted by Blue Cross Plans, the decline in Plan nongroup membership, duplicate coverage within families, and deficiencies in the family factor technique to estimate overall Plan membership. With some interesting exceptions within one of the factors, all four offer plausible explanations for the decline in the admission rate among Blue Cross Plan members.
Blue Cross of North Dakota, Blue Cross of Massachusetts, and the Blue Cross and Blue Shield Association, along with 10 hospitals, developed and implemented the Hospital Capitation Payment Project as a novel approach for containing escalating hospital costs. The hospital is paid a prospective, fixed amount for each person covered; in exchange, it assumes responsibility to provide or pay for all covered services needed by that individual. This responsibility extends to payment for covered care provided by other hospitals. The new tools and incentives created by the program, notably an innovative management information system, are designed to help hospitals better manage the health care needs and related costs of a defined population.
In July 1979, Oregon Physicians' Service and Providence Medical Center (PMC) entered into a contract that established the Providence Plan, a prepaid health care delivery system. The most innovative feature of the plan is the method of paying for hospital service: PMC is paid a prospectively fixed amount per enrolled person per month to cover the total costs of hospital inpatient and outpatient care. From this capitation-based fund, PMC pays other hospitals for services it cannot provide directly. The Providence Plan marks the first cooperative effort in Portland between a single hospital, its active medical staff, and an insuring organization for the organization and operation of a fully functioning health care delivery system in competition with existing formal and informal delivery systems.
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Soluble group antigen isolated from bluetongue virus infected BHK cells has been shown to be a single protein with a molecular weight of 38,000 and to comigrate on polyacrylamide gels with protein 7 isolated from virus particles. Purification by exclusion chromatography and isoelectric focussing yields a protein that appears to be antigenicaly identical to the native group antigen found in virus harvests; it is non infectious for sheep and is thought to be largely free from host cell and other virus specified proteins. It is suggested that this antigen could be used in diagnostic procedures with safety.
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The RNA-dependent RNA polymerase induced in BHK 21 cells by infection with foot-and-mouth disease virus has been isolated from the replication complex. It contains a major, virus-coded protein with mol. wt. 56 000 which appears from serological studies and tryptic peptide mapping to be the same as the virus infection associated (VIA) antigen and the protein P56 found in cells infected with the virus. Other virus coded proteins and a host cell protein were present in the partially purified replication complex but were removed by digestion with ribonuclease T1, leaving only the major virus coded protein. The tryptic peptide maps of the VIA antigen of the seven serotypes of the virus were similar, suggesting a high level of conservation in that region of the genome coding for the RNA polymerase of each type.