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At least 1,657 records · Page 92Linked to original sources
PubMed2004

The demands of 24/7 coverage: using faculty perceptions to measure fairness of the schedule.

OBJECTIVES: Ensuring fair, equitable scheduling of faculty who work 24-hour, 7-day-per-week (24/7) clinical coverage is a challenge for academic emergency medicine (EM). Because most emergency department care is at personally valuable times (evenings, weekends, nights), optimizing clinical work is essential for the academic mission. To evaluate schedule fairness, the authors developed objective criteria for stress of the schedule, modified the schedule to improve equality, and evaluated faculty perceptions. They hypothesized that improved equality would increase faculty satisfaction. METHODS: Perceived stress was measured for types of clinical shifts. The seven daily shifts were classified as weekday, weekend, or holiday (plus one unique teaching-conference coverage shift). Faculty assigned perceived stress to shifts (ShiftStress) utilizing visual analog scales (VAS). Faculty schedules were measured (ShiftScores) for two years (1998-1999), and ShiftScore distribution of faculty was determined quarterly. Schedules were modified (1999) to reduce interindividual ShiftScore standard deviation (SD). The survey was performed pre- and postintervention. RESULTS: Preintervention, 26 faculty (100% of eligible) assigned VAS to 22 shifts. Increased stress was perceived in progression (weekday data, 0-10 scale) from day to evening to night (2.07, 5.00, 6.67, respectively) and from weekday to weekend to holiday (day-shift data, 2.07, 4.93, 5.87). The intervention reduced interindividual ShiftScore SD by 21%. Postintervention survey revealed no change in perceived equality or satisfaction. CONCLUSIONS: Faculty perceived no improvement despite scheduling modifications that improved equality of the schedule and provided objective measures. Other predictors of stress, fairness, and satisfaction with the demanding clinical schedule must be identified to ensure the success of EM faculty.

Attitude of Health Personnel↗
PubMed2003

Cancer coverage in North American publications targeting seniors.

BACKGROUND: Print media are widely used for disseminating cancer information to seniors. It is important that older adults receive accurate and understandable cancer information since age is the major risk factor for most common cancers. METHODS: This study evaluated the volume and scope of cancer coverage in mass circulating print media that specifically target seniors. Eight English-language seniors' publications (551 issues) were assessed for cancer coverage. RESULTS: Between 1990 and 2000, 226 cancer articles were identified. Significant differences in the inclusion of mobilizing information by cancer site were found, with the highest percentage found in articles about breast cancer (67%). The SMOG test indicated a mean readability score of grade 12.47. CONCLUSIONS. The findings suggest the need for lower article readability levels and inclusion of more mobilizing information in cancer articles targeting seniors.

Aged↗
PubMed1998

A plasticity window for blood vessel remodelling is defined by pericyte coverage of the preformed endothelial network and is regulated by PDGF-B and VEGF.

Little is known about how the initial endothelial plexus is remodelled into a mature and functioning vascular network. Studying postnatal remodelling of the retina vasculature, we show that a critical step in vascular maturation, namely pericyte recruitment, proceeds by outmigration of cells positive for (alpha)-smooth muscle actin from arterioles and that coverage of primary and smaller branches lags many days behind formation of the endothelial plexus. The transient existence of a pericyte-free endothelial plexus coincides temporally and spatially with the process of hyperoxia-induced vascular pruning, which is a mechanism for fine tuning of vascular density according to available oxygen. Acquisition of a pericyte coating marks the end of this plasticity window. To substantiate that association with pericytes stabilizes the vasculature, endothelial-pericyte associations were disrupted by intraocular injection of PDGF-BB. Ectopic PDGF-BB caused the detachment of PDGF-beta receptor-positive pericytes from newly coated vessels, presumably through interference with endogenous cues, but had no effect on mature vessels. Disruption of endothelial-pericyte associations resulted in excessive regression of vascular loops and abnormal remodelling. Conversely, intraocular injection of VEGF accelerated pericyte coverage of the preformed endothelial plexus, thereby revealing a novel function of this pleiotropic angiogenic growth factor. These findings also provide a cellular basis for clinical observations that vascular regression in premature neonates subjected to oxygen therapy [i.e. in retinopathy of prematurity] drops precipitously upon maturation of retina vessels and a mechanistic explanation to our previous findings that VEGF can rescue immature vessels from hyperoxia-induced regression.

Actins↗
PubMed2002

Extreme sports: injuries and medical coverage.

Extreme sports (including in-line skating, snowboarding, mountain bicycling, extreme skiing, rock climbing, indoor tackle football, kickboxing, skateboarding, and ultra-endurance racing) are growing in popularity. Often these sports are designed to expose athletes to greater thrills and risks than are found in traditional sporting activities. Despite this increased risk of injury, athletes competing in these sports often have little or no formal medical coverage. This article reviews what is known about this emerging area of sports medicine to assist physicians in preparing for medical coverage of these athletes and their competitions.

Athletic Injuries↗
PubMed2006

Enhanced sequence coverage in tryptic fragment analysis by two-dimensional HPLC/MS using a monolithic silica capillary column.

The HPLC/MS system, in which a monolithic silica capillary column is directly connected to an electronspray-ionization mass spectrometer, showed superior performance at high mobile phase linear velocity. A two-dimensional (2D) HPLC/MS system was established, using an ion-exchange particle-packed capillary column at the first dimension and a monolithic silica capillary column at the second dimension. In an analysis of tryptic fragments from bovine serum albumin, an 81% sequence coverage, obtained by the 2D-HPLC/MS system, increased by 23% as compared to a 1D-HPLC/MS system. This 2D-HPLC/MS system using a monolithic silica capillary column should be useful for enhancing sequence coverage of tryptic fragments in proteomics.

Amino Acid Sequence↗
PubMed1997

Lack of colon cancer coverage in seven women's magazines.

Women's magazines are an important source of health information. To evaluate the relevancy of articles in these publications to known disease risks, seven women's magazines were reviewed to assess their coverage of colon cancer, the third leading cause of cancer mortality in U.S. women. Specifically, the amount of coverage devoted to colon cancer as well as the presentation of issues in the prevention, risks, treatment, diagnosis and genetics of colon cancer were recorded. Twenty articles were published on colon cancer in these magazines during the years 1987-1995. Compared to five other cancers that also affect women, colon cancer was the focus of the fewest articles in the seven magazines analyzed.

Colonic Neoplasms↗
PubMed1998

The media and AIDS: health elite perspectives of coverage.

Most writers assessing AIDS have been critical of the media's coverage of this epidemic. To ascertain the views of key elites on media coverage of AIDS, the authors surveyed chief state public health officers, chairs of legislative health committees, and directors of hospital associations. In general, these groups tended to reject criticisms that media handling of AIDS is unbalanced. Conversely, however, they also generally rate the media as not doing a good job of educating the public about AIDS. The media's success in accurately communicating professional perspectives regarding AIDS might have accounted for their relative lack of independent influence in AIDS policymaking. The media exhibited a "guard dog" role-protecting the health professionals' positions-instead of an agenda-setting role-dictating to the decision-makers what issues they should be addressing.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Do determinants of medicare supplemental coverage choice vary by income.

Using data from the Community Tracking Study Household Survey (1998-99), we estimate the relationship between Medigap premiums and senior Medicare beneficiaries' supplemental coverage decisions. All seniors are more likely to be enrolled in an HMO in markets with higher Medigap prices. Lower income seniors are particularly sensitive to Medigap premiums and are more likely to have no supplemental coverage when faced with higher Medigap premiums. As Medicare supplemental options evolve in response to the 2003 Medicare Modernization Act, it is important to consider that lower income beneficiaries may respond to price changes and other factors differently than their higher income counterparts.

Aged↗
PubMed2005

Universal health care coverage for children: impact on pediatric health care providers.

A Northern California county expanded health coverage to cover nearly all children in the state through a new insurance program. In two years, 75,500 children entered a health care system near capacity. We hypothesized that the influx of thousands of previously uninsured children into the health system would affect providers in many ways. This cross-sectional study sought to investigate how this influx affected provider practices, job satisfaction, access to specialists, and overarching views about the program. Qualitative analyses of expert interviews were performed. Providers reported improved access to health care, specialists, and medications for patients. They cited increased job satisfaction for providers due to fewer limits on care, improved referral process, and decreased patient family financial stress. Providers noted the persistence of long appointment wait times for specialist care. After moving to near universal coverage, safety net providers described increased job satisfaction. Because this study examined safety-net providers, future research requires a more representative sample of providers.

Attitude of Health Personnel↗
PubMed2006

Sky coverage estimates for adaptive optics systems from computations in Zernike space.

A sky coverage model for laser guide star adaptive optics systems is proposed. The atmosphere is considered to consist of a finite number of phase screens, which are defined by Zernike basis polynomials, located at different altitudes. These phase screens are transformed to the aperture plane, where they are converted to laser and natural guide star wavefront sensing measurements. These transformations incorporate the cone effect due to guide stars at finite heights, anisoplanatism due to guide stars off axis with respect to the science object, and adaptive optics systems with multiple guide stars. The wavefront error is calculated tomographically with minimum variance estimators derived from the transformation matrices and the known statistical properties of the atmosphere. This sky coverage model provides fast Monte Carlo simulations over random natural guide star configurations, irrespective of telescope diameter. The Monte Carlo simulations outlined show that inclusion of a finite outer scale for the atmosphere significantly reduces the median wavefront error, that increasing the number of laser guide stars in the asterism reduces the median wavefront error, and that a larger natural guide star patrol field provides a smaller median wavefront error when there is a low star density in the field.

Journal Article↗
PubMed2004

Extension of fourier transform vibrational circular dichroism into the near-infrared region: continuous spectral coverage from 800 to 10 000 cm(-1).

We report the first vibrational circular dichroism (VCD) spectra with continuous coverage from 800 cm(-1) in the mid-infrared (MIR) region to 10 000 cm(-1) in the near-infrared (NIR) region. This coverage is illustrated with MIR and NIR absorbance and VCD spectra of 2,2-dimethyl-dioxolane-4-methanol (DDM), alpha-pinene, and camphor that serve as calibration samples over this entire region. Commercially available, dual-source Fourier transform (FT) MIR and NIR VCD spectrometers were equipped with appropriate light sources, optics, and detectors, and were modified for dual-polarization-modulation (DPM) operation. The combination of liquid-nitrogen- and thermoelectric-cooled HgCdTe (MCT) detectors, as well as InGaAs and Germanium (Ge) detectors operating at room temperature, permitted collection of the desired absorbance and VCD spectra across the range of vibrational fundamental, combination band, and overtone frequencies. The spectra of DDM and alpha-pinene were measured as neat liquids and recorded for both enantiomers in the various spectral regions. Spectra for camphor were all measured in CCl(4) solution at a concentration of 0.6 M, except for the carbonyl-stretching region, where a more dilute concentration was used. The typical anisotropy ratios (g) of the three molecules were estimated with respect to their strongest VCD bands in each spectral region. It was found that for all three molecules in the spectral regions above 2000 cm(-1), anisotropy ratios are approximately the same order (10(-5)) of magnitude. However, in the MIR region, the typical anisotropy ratios are significantly different for the three molecules. This study demonstrates that with modern FT-VCD spectrometers modified for DPM operation, VCD spectra can be measured continuously across a wide spectral range from the MIR to nearly the visible region with an unsurpassed combination of signal-to-noise ratio and spectral resolution.

Bicyclic Monoterpenes↗
PubMed2026

Development of a low-coverage whole genome sequencing screen for apomixis using a diverse set of Malus germplasm.

In the past decade, plant biologists have made several major discoveries pertaining to the genetic basis of apomixis (clonal propagation by seed) that have shown promise in preserving high-value hybrid rice and sorghum genotypes. This progress was made possible by foundational gene discovery efforts in model species and natural apomicts, but pleiotropic obstacles still limit its broad agricultural adoption, especially in eudicots. Thus, it follows that investigations of novel apomicts should lead to the development of new molecular tools for plant breeding. The two most common ways to identify clonal seed production are flow-cytometry seed screens and genome sequencing to compare the DNA sequences of the maternal parent and progeny, traditionally using low-throughput markers. While flow-cytometry has been the dominant method for more than two decades, it provides indirect information on the genetics of a resulting embryo and can be ineffective in certain species. Here we developed a method using short-read whole-genome sequencing at moderately low coverage (averaging 3X and 6X) to screen diverse Malus genotypes maintained in a USDA germplasm collection for clonal seed production. In total, we sequenced 55 genotypes, 1,216 of their embryos, and identified 17 previously undescribed apomictic genotypes. Several more were detected with the flow cytometry seed screen, which helped resolve certain types of reproduction and sources of noise in low-coverage datasets. This low-pass screening-by-sequencing method is a relatively low-cost, rapid method for detecting apomictic genotypes in diverse plant germplasm and when used thoughtfully in conjunction with flow cytometry, provides a new way to visualize the genetic outcomes of sexual and asexual reproduction in plants.

Apomixis↗
PubMedDate not supplied

The uninsured 'access gap' and the cost of universal coverage.

This study estimates the effect of universal coverage on the use and cost of health services by the uninsured. Adults lacking insurance for a full year have about 60 percent as many ambulatory contacts and about 70 percent of the inpatient hospital days they would have if they were covered by insurance. This "access gap" is only slightly smaller for children. Providing universal coverage would increase ambulatory contacts and inpatient days by less than 4 percent a year. The dollar cost of these new services is estimated to be $19.9 billion--a 2 percent increase in health spending.

Adult↗
PubMed1996

Trends in health insurance coverage in California, 1989-1993.

California's uninsurance rate of 22.7 percent is higher than the national average. The state's rate of employment-based insurance coverage--below the national average--is declining because of rising health insurance premiums, falling family incomes, and the changing structure of the economy and the labor market. Growing Medicaid coverage, fostered by expanded eligibility and falling incomes, has prevented rapid growth in the state's uninsured population. Anticipated cutbacks in federal Medicaid funding, however, would increase California's uninsurance rate. Continuing cutbacks in health services for the uninsured would reduce their access to health care and increase stress on many private health services.

Adolescent↗
PubMedDate not supplied

Building a consensus for expanding health coverage.

Despite a flourishing economy and recent growth in employment-based health coverage, forty-three million Americans remain uninsured. Extending coverage to the uninsured is not an intractable public policy problem but could be addressed if the various health care stakeholders could only find common ground. We argue that to win broad-based support from across the ideological and political spectra, a meaningful proposal should achieve a balance between public- and private-sector approaches, focus attention on those who are most in need of assistance (low-income workers), and build on systems that work today. With the aim of pulling together a political coalition, we present a proposal specific enough to attract support but whose details will arise later, in the context of the legislative process.

Attitude to Health↗
PubMedDate not supplied

Health status and the cost of expanding insurance coverage.

This paper uses data on health spending and health status from the Medical Expenditure Panel Survey (MEPS) to estimate the differences in health spending across different types of insurance and across incomes that are attributable solely to health status differences. The results show that the uninsured are less costly than those on Medicaid, based on health status alone, but are more costly than those with employer-sponsored insurance. Adults and children with private nongroup coverage are also less expensive than average, because of better-than-average health. Finally, the data show that expenditures fall (health status improves) with income, regardless of type of coverage.

Adult↗
PubMedDate not supplied

Addressing coverage gaps for low-income parents.

This paper examines how rates of uninsurance for low-income parents have been changing over time and the extent to which expanding coverage to parents through Medicaid and the State Children's Health Insurance Program (SCHIP) could help them. We find that uninsurance rates have been rising for low-income parents, especially those living in poverty, and that Medicaid and SCHIP could greatly reduce uninsurance among parents and would likely increase their access to care. Such expansions would still leave many noncitizen parents uninsured and would require reaching and enrolling families whose children have remained uninsured despite being eligible for public coverage.

Child↗