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Biomedical subjects

K Swartz

Publications and source records attributed to K Swartz.

70 records · Page 4Linked to original sources

Interpreting the estimates from four national surveys of the number of people without health insurance.

Four national surveys conducted between 1977 and 1980 seem to yield four different estimates of the number of people under 65 years old who lack health insurance. In this paper four explanations for the different estimates are assessed. The sample framework designs and methods for ex post weighting of the surveys' respondents are very similar. Nonresponses to the health insurance questions on the surveys were handled differently, and this remains a possible explanation of some of the differences in the estimates. But the most likely explanation of the differences is the following. Three of the four surveys ask people about their health insurance at the time of the interview. The fourth, the Current Population Survey, asks people about their health insurance during the previous year. But the Current Population Survey estimate of the uninsured population is remarkably close to the point-in-time estimates from the other three surveys. The same holds true for the surveys' estimates of the Medicaid population and people covered by private health insurance. Hence, if we assume that the Current Population Survey respondents are answering the health insurance questions with respect to when they are interviewed, the four surveys' estimates of the uninsured population at a point in time are very similar.

Adolescent↗

Effect of porcine relaxin on the human umbilical artery.

Relaxin decreases human myometrial contractions in vitro; that effect is synergized by progesterone. We examined the effects of porcine relaxin on the contractility of isolated perfused human umbilical arterial strips in vitro. One experimental group received relaxin (1.5 micrograms/mL), the second received progesterone (500 ng/mL) plus relaxin, and the control strips received neither. Both resting and agonist-stimulated (KCl or serotonin) isometric tension were compared with profile analysis for all groups. Relaxin had no effect on either resting or agonist-stimulated tension either with or without progesterone. Neither higher concentrations of relaxin nor longer exposures altered contractility. Therefore, the human umbilical artery, unlike the cervix and myometrium, is not sensitive to porcine relaxin. Porcine relaxin could be used as a tocolytic or cervical ripening agent without adversely affecting fetal placental circulation.

Animals↗

Increased turnover of proteins from the sarcoplasmic reticulum of dystrophic chicken muscle cells in tissue culture.

Chicken myoblasts were cultured from the pectoralis muscles of dystrophic and normal 11-day-old embryos. Cells were allowed to grow to fusion (differentiation) and exposed to [35S]methionine for a short period. Subsequently, the decay of labeled proteins in the presence of cycloheximide was measured for various cellular fractions as well as individual proteins isolated from the sarcoplasmic reticulum and separated by gel electrophoresis. Some dystrophic material showed an increased decay when compared to normal material. The most significant (p less than 0.005) difference was found in a Mr = 65,000 component of the sarcoplasmic reticulum. This same component accumulates label at an accelerated rate in the presence of the protease inhibitor leupeptin. Increased turnover of this protein, possibly calsequestrin, may be a manifestation of the genetic disease.

Animals↗

A national survey of endotracheal suctioning techniques in the pediatric population.

OBJECTIVE: To examine the current suctioning practices nationally of experienced pediatric intensive care unit (PICU) nurses. DESIGN: A written survey method was used for this descriptive study. POPULATION: All PICUs in the 92 hospitals listed in the 1991 National Association of Children's Hospitals and Related Institutions directory. PARTICIPANTS: Staff nurses with more than 3 years experience were requested to complete the questionnaire in relation to their endotracheal suctioning practices of PICU patients. RESULTS: The questionnaire was returned by 80 (90%) PICUs. A wide range of suctioning techniques were used. Most respondents reported hyperoxygenation, hyperventilation, and/or hyperinflation of the patient's respiratory system before suctioning. Nursing judgment and the patient's clinical condition were used to determine when a suctioning procedure was needed. Most respondents (71%) indicated inserting the suction catheter until resistance was met. Normal saline-solution irrigant was used by all but one respondent. A manual resuscitation bag was used routinely during suctioning. Eighty percent of respondents reported that few patients displayed an adverse response to the suctioning procedure. RECOMMENDATIONS: The study should be replicated with direct observations of actual PICU suctioning practices. Suctioning techniques should be examined in relation to specific groups of PICU patients. Further research is needed to determine the optimal practice for rates of hyperventilation, percentage of oxygen increase during hyperoxygenation, and pressure increase during hyperinflation.

Adult↗

Insurance agents: ignored players in health insurance reform.

In this paper we use the reforms to the individual health insurance market in New Jersey to illustrate the intricate interaction between insurance agents and insurance reform initiatives. Until recently, policymakers who designed reforms to the health insurance market largely ignored the role of agents in selling individual health insurance policies. These reforms have the potential to overturn the agent's traditional role, and agents can influence how the reforms are implemented.

Chi-Square Distribution↗

The effect of change of health insurance on access to care.

This study examines how changes in health insurance status affect patients and their care. Results show that, controlling for socioeconomic factors, condition, age, and urgency, patients who lost insurance and patients who changed insurance were more likely to delay seeking care within the four months after visiting an emergency department than people whose health insurance status did not change. Patients who lost coverage were more likely to report no primary care provider and were less likely to have recommended follow-up care within the four-month period. Loss of insurance also was associated with lower likelihood of vaccine use and check-ups in the prior year. The study confirms that a loss or change in health insurance in the prior year has a measurable effect on access to health care. The greatest impact was among patients who lost insurance, though patients who changed health plans also were more likely to delay seeking care than patients whose health insurance status did not change.

Boston↗

Community rating: an idea whose time has come (again).

The 20-year movement away from community rating of health insurance premiums in favor of experience rating has produced extreme inequities in the availability and affordability of health insurance coverage in the U.S. Current rating practices also have contributed to a rapid shift among employers to self-insure, thus allowing them to rewrite their benefit plans. By returning to a community rating system, the nation would eliminate many of these current market distortions.

Actuarial Analysis↗

A challenging time.

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Forecasting↗

It takes a nation.

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Child↗