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PubMed2004

Effect of enamel matrix derivative on collagen guided tissue regeneration-based root coverage procedure.

BACKGROUND: Enamel matrix derivative (EMD) has been shown to promote periodontal wound healing and/or regeneration when applied to tooth root surfaces in soft tissue dehiscence models. In addition, guided tissue regeneration (GTR)-based root coverage using collagen membrane (GTRC) has shown promising results. However, limited information is available regarding how EMD may influence GTRC outcome. METHODS: Twenty-six patients with Miller's Class I or II gingival recession defects of 2.5 mm were recruited for the study. Subjects were randomly assigned to receive either EMD + collagen (EMDC; test group) or collagen membrane (GTRC; control group). Clinical parameters, including plaque index (PI), gingival index (GI), relative clinical attachment levels (RCAL) to the stent, recession depth (RD), recession width (RW), probing depth (PD), gingival tissue thickness (GTT), and width of keratinized gingiva (KG) were assessed at baseline, and 3 and 6 months after surgery. A repeated measure of analysis of variance (ANOVA) was used to determine differences between treatment groups and time effect. RESULTS: Both treatments (GTRC and EMDC) resulted in a statistically significant decrease in RD and RW between baseline and 6 months (P <0.05). However, no difference was noted between treatment groups. The percent of root coverage after 6 months was 75% for GTRC and 63% for EMDC. Complete 100% root coverage was achieved in five patients in the GTRC group, compared to only one patient in the EMDC group. There was a statistically significant gain (P <0.05) in the clinical attachment level (CAL) between baseline and 6 months in both groups, as reflected on the RCAL data. No other significant differences were noted on other clinical parameters (PD, GTT, KG, GI, and PI). CONCLUSIONS: GTR-based root coverage utilizing collagen membrane, with or without enamel matrix derivative, can be successfully used in obtaining gingival recession coverage. The application of EMD during GTRC procedures did not add additional benefit to the final clinical outcome.

Absorbable Implants↗
PubMed2006

Impact of the CDC's Section 317 Immunization Grants Program funding on childhood vaccination coverage.

The Centers for Disease Control and Prevention's Section 317 Grants Program is the main source of funding for state and jurisdictional immunization programs, yet no study has evaluated its direct impact on vaccination coverage rates. Therefore, we used a fixed-effects model and data collected from 56 US jurisdictions to estimate the impact of Section 317 financial assistance immunization grants on childhood vaccination coverage rates from 1997 to 2003. Our results showed that increases in Section 317 funding were significantly and meaningfully associated with higher rates of vaccination coverage; a 10 dollars increase in per capita funding corresponded with a 1.6-percentage-point increase in vaccination coverage. Policymakers charged with funding public health programs should consider this study's findings, which indicate that money allocated to vaccine activities translates directly into higher vaccine coverage rates.

Centers for Disease Control and Prevention, U.S.↗
PubMed1979

A survey of mental health service coverage within health maintenance organizations.

This 1978 national survey of all operating Health Maintenance Organizations (HMOs) provided information on the current status of mental health services utilization and service coverage within HMOs. It achieved a 68 per cent response rate. Approximately 90 per cent (108) of the HMOs offered mental health services through basic or supplemental coverage plans; HMO organization characteristics reflected relative heterogeneity; the mean monthly costs for basic health plan coverage (physical and mental health services) were $33.85 (for individuals) and $95.15 (for families); HMOs reported lower physical and mental health hospital utilization and higher ambulatory utilization when compared to more traditional forms of health insurance coverage. The present coverage and uitlization of mental health services within HMOs reflect greater variability of benefits and utilization within HMOs. There is need for further studies of mental health utilization in relation to organizational structure and delivery pattern relationships within HMOs.

Delivery of Health Care↗
PubMed2003

Winners and losers: expansion of insurance coverage in Russia in the 1990s.

OBJECTIVES: This study sought to describe the evolution of the Russian compulsory health insurance system and to identify factors associated with noncoverage. METHODS: Data from successive waves of the Russian Longitudinal Monitoring Survey (1992-2000) were analyzed. RESULTS: Insurance coverage grew rapidly throughout the 1990s, although 11.8% of the country's citizens were still uninsured by 2000. Coverage initiation rates were greater at first among citizens who were better off, but this gap closed over the study period. Among individuals of working age, coverage rates diminished with age and were lower for the unemployed, for the self-employed, and for those residing outside Moscow or St. Petersburg. CONCLUSIONS: The growth of insurance coverage in Russia slowed toward the end of the 1990s, and gaps remain. Achievement of universal coverage will require new, targeted policies.

Adult↗
PubMed1995

Reconstruction and augmentation patients' reaction to the media coverage of silicone gel-filled implants: anxiety evaluated.

Media coverage tends to focus on sensational aspects. Especially prominent are controversial items related to public health and well-being. This research examined the response by breast-reconstruction and breast-augmentation patients to extensive media coverage regarding silicone gel-filled implants. Results of our survey suggested that media coverage influenced these women. Common concerns expressed by respondents included autoimmune disease, capsular contracture, leakage, increased risk of cancer, and anxiety. All respondents used consultation with their physicians as a primary means of coping with anxiety. Anxiety over media coverage led to some hesitancy concerning use of implants by surveyed patients. Patients who experienced difficulty with their reconstruction noted more anxiety associated with media coverage.

Adaptation, Psychological↗
PubMed1986

Effects on retention of reducing the palatal coverage of complete maxillary dentures.

Twenty patients with complete dentures in both jaws gave up their maxillary ones for experimental purposes for 4 weeks while new dentures were made. The experimental dentures were reduced palatally to a new U-shaped border situated approximately 10 mm from the dental arch. Denture retention, defined as the ability of a denture to remain seated on the supporting tissues under various conditions, was measured as resistance towards cranially directed tilting loads, using a miniature bite force recorder. Dislodgement-provoking loads were applied to the first bicuspid on both sides and to the central incisors. The retention measurements were performed before and immediately after reduction of the palatal coverage and, finally, after 4 weeks. Interview questions were posed concerning the subjects' experience of denture retention and some other aspects of oral comfort. The interviews were carried out before reduction of the palatal coverage and after 2 and 4 weeks. The results of the experimental dislodgement tests suggested that the ability to withstand tilting loads was insignificantly altered by reduction of the palatal coverage. This finding was in agreement with responses indicating that retention during meals remained unchanged. However, several individuals reported that denture retention between meals was impaired. Three denture wearers reported that reduction of the palatal coverage influenced their sense of taste positively, and one reported that an occasional gagging tendency had disappeared. At the end of the experiment the participants were given the choice of a new conventional denture or a new denture without palatal coverage.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2004

What do we know about 7vPCV coverage in Aboriginal and Torres Strait Islander children?

In 2001, a publicly funded pneumococcal conjugate vaccine (7vPCV) program commenced for Aboriginal and Torres Strait Islander children aged under two years. At present, there is very little knowledge about the uptake of 7vPCV vaccine amongst Aboriginal and Torres Strait Islander children. This study examined the rollout and use of 7vPCV vaccine in Australia and estimated immunisation coverage for Indigenous children at the age of 12 months for 7vPCV vaccine. To calculate 7vPCV coverage we chose four consecutive 3-month birth cohorts born between 1 October 2001 and 30 September 2002. The immunisation status of children in each birth cohort was assessed at 12 months for the third dose of 7vPCV vaccine. The largest absolute number of 7vPCV doses was given in Queensland, the Northern Territory and New South Wales. As the 7vPCV program matured, a progressively higher proportion of total doses was administered to children under the age of 12 months consistent with the introduction of the program. For all jurisdictions except the Northern Territory and Western Australia, where it has remained reasonably constant, estimated coverage increased over the most recent birth cohorts but was still less than 50 per cent for all states except the Northern Territory, Queensland, and Western Australia. This study provides the first national measure of 7vPCV immunisation coverage among Indigenous children in Australia. With the likely improvement over time in the recording of 7vPCV vaccinations and Indigenous status on the Australian Childhood Immunisation Register, the validity of coverage estimates is likely to increase.

Attitude to Health↗
PubMed1994

Housestaff coverage in a nonteaching community hospital.

In August 1992, a project team of senior medical and administrative personnel was formed (Housestaff Coverage Project Team) at the Park Ridge Health System, Rochester, N.Y.. The team was given a mandate to address housestaff coverage, primarily from an economic standpoint. Through total quality management (TQM), the project team sought to develop a house coverage plan that was sustainable, efficient, and effective. A plan was developed that includes three layers of service. A minimum "standard hospital coverage" would be available to all physicians and their patients and cover the basic needs of admission, crisis intervention, and issues of length of stay. A complete level of service would be available under the title of "case management" and would consist of total patient management, under the direction of the attending physician, from admission through discharge. The third level of service available to both "standard" and "case managed" patients would be a "consultative service." The latter would function as a traditional in-house medical service and would bill for its services. Park Ridge Hospital believes it has developed a system of housestaff coverage that is sustainable, efficient, and effective. An evaluation mechanism, primarily addressed at length of stay, will tell if we are correct in this assumption.

Hospitals, Community↗
PubMed1989

Medicare program; national coverage decisions--HCFA. General notice.

This notice lists those current Medicare national coverage decisions which have been issued in the Medicare Coverage Issues Manual (HCFA Pub. 6). These national coverage decisions are also widely distributed through the U.S. Government Printing Office, the National Technical Information Service, and private publishers such as the Commerce Clearing House. From time to time, some of the individual decisions have been published in the Federal Register. In this Federal Register notice, HCFA is publishing a compilation of these national coverage decisions. We will publish subsequent national coverage decisions in the Federal Register on a quarterly basis.

Aged↗
PubMed1982

Duplicate health insurance coverage: determinants of variation across states.

Although it is recognized that many people have duplicate private health insurance coverage, either through separate purchase or as health benefits in multi-earner families, there has been little analysis of the factors determining duplicate coverage rates. A new data source, the Survey of Income and Education, offers a comparison with the only previous source of state level data, the estimates from the Health Insurance Association of America. The R2 between the two sets is only .3 and certain problems can be traced to the methodology underlying the HIAA figures. Using figures for gross and net coverage, the ratio of total policies to people with private coverage ranges from .94 in Utah to 1.53 in Illinois. Measures of industry distribution, per capita income and employment explain a large portion of the variance, but it appears that these factors operate in opposite directions for group and non-group policies. Similar sociodemographic variables also explain net coverage. These findings have substantial implications for research and the structuring of employee health benefits.

Analysis of Variance↗
PubMed1998

Fracture strength of weakened human premolars restored with amalgam with and without cusp coverage.

PURPOSE: To determine the effect of cusp coverage with amalgam restorations on the fracture strength of weakened human maxillary premolars. MATERIALS AND METHODS: 30 extracted human maxillary premolars were divided into three groups; Group A (control): uncut teeth, Group B: wide MOD cavities prepared and the pulp chamber's roof removed. The teeth were restored with amalgam without cusp coverage, Group C: same as Group B plus cusp reduction and restored with amalgam. The teeth were included in metal rings with self-curing polystyrene resin and stored in water for 24 hrs. The restorations were refined with rubber points, polished and further stored in water for 24 hrs before being subjected to a compressive axial load in a Universal testing machine at 0.5 mm/min. RESULTS: The mean fracture strength obtained was: Group A: 173.3 Kgf, Group B: 47.3 Kgf and Group C: 127.7 Kgf. All values were statistically significantly different (P < 0.05). The amalgam restoration of weakened human premolars with cusp coverage amalgam significantly increased the fracture strength of the teeth (63%) as compared to teeth restored without cusp coverage. The results showed that cusp coverage with amalgam might be an option for restoring weakened endodontically-treated teeth.

Analysis of Variance↗
PubMed1999

National vaccination coverage levels among children aged 19-35 months--United States, 1998.

Sustained high vaccination coverage levels in the United States are necessary to decrease rates of vaccine-preventable diseases. Therefore, an important component of the U.S. vaccination program is the assessment of vaccination coverage. To assist in this assessment, in 1993, the Childhood Immunization Initiative (CII) was begun to increase vaccination coverage levels among children during the first 2 years of life to > or =90% by 1996 for universally recommended childhood vaccinations and to monitor trends in vaccination coverage. Vaccination objectives also were included in the national health objectives for 2000 initiative. Except for hepatitis B vaccine, the 90% coverage goals were achieved and maintained through implementation of CII by public- and private-sector organizations and health-care providers at the national, state, and local levels.

Child, Preschool↗
PubMed2000

Multiple dose vaccination against childhood diseases: high coverage with the first dose remains crucial for eradication.

The high vaccination coverage required to eradicate communicable diseases like measles, mumps and rubella, with a single dose of vaccine, has prompted many countries to introduce a second dose. In this paper we investigate the conditions to eradicate childhood diseases with multiple doses of vaccine by obtaining explicit analytical solutions to the classical compartment model that assumes an age-independent force of infection and conceptualizes the host population as divided into maternally protected (P), susceptibles (S), latents (E), infectious (I), and removed (R). The solutions allow a quantitative discussion of the long-term impact of vaccination schedules with an arbitrary number of doses of vaccine. It becomes possible to determine the effect of the number of doses, ages at vaccination, and coverage rates of vaccines against childhood diseases. In an example with a two-dose vaccination schedule against measles, we show that, in spite of a second dose, a high (> 90%) immunization coverage in the first dose is still crucial to achieve eradication. With a high first-dose coverage, however, eradication is relatively insensitive to the age of the second dose and requires only moderate coverage rates in the latter.

Child↗
PubMed2001

Improving influenza immunisation coverage in 2000-2001: a baseline survey, review of the evidence and sharing of best practice.

In May 2000 a new government target of 70% uptake in people aged 65 and over was introduced for influenza immunisation, with a minimum of 60% uptake in 2000-2001. A postal survey of influenza immunisation coverage in over 75 year olds during 1999-2000 was undertaken in our district's general practices. The evidence on interventions which improve coverage was compared to local practice. General Practitioners and their Primary Care Groups/Trust received feedback on their performance, and best practice was shared. The findings were used to inform the immunisation campaign for 2000-01. The survey response rate was 74%. The district coverage was 50%, ranging from 7% to 97% between practices. Practices achieving high coverage rates combined good patient identification with personalised patient invitation and well-organised clinics. The work that went on in the district achieved an overall influenza immunisation coverage of 62% in 2000-01.

Aged↗
PubMed2001

Failure of root coverage of shallow gingival recessions employing GTR and a bioresorbable membrane.

The aim of the present study was to compare the postsurgical outcome of two different modes of surgical root coverage of predominantly shallow, Class I or II, gingival recessions. Fourteen facial recessions in nine patients were subjected to a coronally repositioned flap in combination with a bioresorbable membrane, and 14 sites in 13 patients were treated with a connective tissue graft employing an envelope technique. Immediately before surgery and after 6 and 12 months, gingival dimensions as well as root coverage and attachment gain were assessed. At baseline, mean recession depths amounted to 2.77+/-1.67 mm and 2.49+/-1.07 mm for patients treated with a bioresorbable membrane and a free connective tissue graft, respectively. Acceptable and stable root coverage of 81% to 82% of baseline recession depth and 78% of its width was achieved by grafting. In contrast, guided tissue regeneration (GTR) resulted in only 50% coverage of recession depth and, after 12 months, only 11% of its width (P < 0.01). Logistic regression revealed that the odds of obtaining success, ie, at least 80% root coverage, were 3.3 times greater in cases treated with a connective tissue graft (P < 0.05). In addition, the odds ratio was 2.3 in cases of recessions below 2.5 mm compared to deeper recessions and 2 at canines compared to premolars. It was concluded that shallow recessions in the 1.5 to 3.5 mm range should not be treated with GTR. In these situations, predictable results are achieved with free connective tissue grafts employing an envelope technique.

Absorbable Implants↗
PubMed2002

Five years later: poor women's health care coverage after welfare reform.

The 1996 welfare reform law aims to increase poor women's participation in the work force and encourage their financial independence. Because women's ability to obtain and retain employment is affected by their health status, welfare reform's success is fundamentally tied to poor women's access to health care and to health insurance. Despite this, the rate of uninsurance among poor women with children has grown by half in recent years, leaving 37% of poor mothers uninsured in 2000. Coverage through employer-sponsored insurance has increased only slightly, and Medicaid participation has dropped. Although many factors contributed to this, welfare policies and procedures and low Medicaid eligibility levels had unintended yet significant negative effects on women's health care coverage. The sharp decline in poor women's health care coverage is likely to be one of several health-related issues that Congress will consider as it debates the reauthorization of the welfare law in 2002. Both public and private efforts will be necessary to improve coverage for poor women with children. Much progress has been made during the past 5 years in covering poor and near-poor children, but their parents have been left behind. The same efforts that proved successful for children, including broadening eligibility for coverage and simplifying the application process, can be used to improve the health and well-being of parents and to strengthen their ability to care for and support their families.

Adult↗
PubMedDate not supplied

Declining trend in routine UIP coverage.

Routine UIP coverage status in the state of West Bengal and three selected Municipal Corporation areas (Calcutta, Howrah and Siliguri) were studied during 1997-98 and 1998-99. Also, UIP coverage status in the 'high risk' areas of the State (areas which reported Polio cases during 1998) was studied during 1998-99. UIP coverage in the state of West Bengal was only 54.3% in 1997-98, which further declined to 48.1% in 1998-99. In the three urban areas, UIP coverage ranged between 57.3%-70.9% in 1997-98, which further declined to 29.6%-47.1% in 1998-99. Antigenwise coverage revealed very poor performance with DPT3, OPV3, and Measles in 1997-98 and further decline in 1998-99. Dropout rate was also very high. In 1998-99 drop-out rate ranged between 30.1% to 54.2% in different studied areas. Some other studies suggested that PPI activities, which are very visible and targetted programme, may adversely affect routine UIP services. There is urgent need for further probing to identify the reasons for such poor state of affairs, keeping PPI angle in mind and to initiate remedial measure urgently.

Antigens, Viral↗
PubMed2002

[Skin defect coverage with micro skin graft].

BACKGROUND: The aim of this study is to coverage of the large skin defect with microskin graft. METHODS: The wound coverage of the large skin defect may be difficult with auto skin graft. In these patients, split thickness skin graft may be used in a bloc shape or expanded skin graft shape and a stamp skin graft shape or expanded stamp skin graft shape. On the other hand, split thickness skin graft may be used as a micrograft shape after the mincing process, which reduces of the graft size in a few millimeters. In this study, 6 patients with skin defect was admitted in our clinic, and their skin defect was treated with micro skin graft. Expansion ratio was 1:15. RESULTS: Epithelialization on the wound surface was completed in 4 to 6 weeks and cobblestone appearance was observed after the wound coverage. CONCLUSION: Skin defect coverage with micrograft is an effective technique like the other skin graft coverage methods.

Adult↗