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PREDICTORS OF NURSING HOME COVID-19 CASES: A COMMUNITY VULNERABILITY APPROACH. Innov Aging 2022. [PMCID: PMC9765282 DOI: 10.1093/geroni/igac059.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study examined facility and community factors that were related to incident COVID-19 cases in nursing facilities. N=12,473 US nursing facilities were included in this study. Data from June 2020 - January 2021 from several sources were combined to create a dataset that included facility and community factors. Results indicated that higher staff shortages, poorer facility rating, for-profit ownership, proportionally more Medicaid and non-white residents were all significantly associated with higher COVID case rates over 8 months (all P < 0.0001). Community level predictors of higher cases included urban setting and higher Social Vulnerability Index (SVI). SVI was the strongest predictor of COVID case counts. This study assists in determining critical facility and community factors that predict increasing COVID burden in nursing facilities. Particularly, SVI is an important factor in determining facility and public health policy, and for targeting resources in large scale health crises such as the COVID-19 pandemic.
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Predictors of Nursing Home Covid-19 Cases: a Community Vulnerability Approach. Innov Aging 2021. [PMCID: PMC8992189 DOI: 10.1093/geroni/igab046.3635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It is well known that the Covid-19 pandemic has placed considerable burden on nursing homes, including from resident, facility, and community perspectives, among others. This study examined facility and community factors that were related to incident Covid-19 cases in nursing home facilities. N=12,473 US nursing homes were included in this study. Data from June 2020 - January 2021 from several publicly available sources were combined to create a dataset that included facility name, size, ownership, mortality rate, Covid case rate, personal protective equipment (PPE) and staff shortages, % white residents, and % Medicaid residents. Community factors included core-based statistical area (CBSA) Covid case rates, urban/rural, CBSA death rates, and the CDC’s Social Vulnerability Index (SVI). Zero-inflated Poisson regression models were used to determine predictors of 8-month Covid case counts, normalized by facility size. Results indicated that higher staff shortages, poorer facility rating, for-profit ownership, proportionally more Medicaid and non-white residents were all significantly associated with higher Covid case rates over 8 months (all P < 0.0001). Significant community level predictors of higher cases included urban setting and higher SVI. PPE shortages was not associated with higher case counts. Of all the factors included, SVI was the strongest predictor of Covid case counts. This large US study assists in determining critical facility and community factors that predict increasing Covid burden in nursing homes. Particularly, SVI is an important factor in determining facility and public health policy, and targeting resources in large scale health crises such as the Covid-19 pandemic.
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The Infodemic within the Pandemic. J Am Med Dir Assoc 2021; 22:517-518. [PMID: 33516673 DOI: 10.1016/j.jamda.2020.12.044] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022]
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Validating a Commercial Device for Continuous Activity Measurement in the Older Adult Population for Dementia Management. ACTA ACUST UNITED AC 2017; 5-6:51-62. [PMID: 29915807 DOI: 10.1016/j.smhl.2017.11.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
With the introduction of the large number of fitness devices on the market, there are numerous possibilities for their use in managing chronic diseases in older adults. For example, monitoring people with dementia using commercially available devices that measure heart rate, breathing rate, lung volume, step count, and activity level could be used to predict episodic behavioral and psychological symptoms before they become distressing or disruptive. However, since these devices are designed primarily for fitness assessment, validation of the sensors in a controlled environment with the target cohort population is needed. In this study, we present validation results using a commercial fitness tracker, the Hexoskin sensor vest, with thirty-one participants aged 65 and older. Estimated physiological measures investigated in this study are heart rate, breathing rate, lung volume, step count, and activity level of the participants. Findings indicate that while the processed step count, heart rate, and breathing rate show strong correlations to the clinically accepted gold standard values, lung volume and activity level do not. This indicates the need to proceed cautiously when making clinical decisions using such sensors, and suggests that users should focus on the three strongly correlated parameters for further analysis, at least in the older population. The use of physiological measurement devices such as the Hexoskin may eventually become a non-intrusive way to continuously assess physiological measures in older adults with dementia who are at risk for distressing behavioral and psychological symptoms.
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P2‐273: EXPANDING A PERSON‐CENTERED MEDICAL HOME FOR PEOPLE WITH DEMENTIA. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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O2–13–05: Developing a person‐centered medical home for people living with dementia. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The Medical Director's Role in the State Survey and Dispute Resolution. J Am Med Dir Assoc 2013; 14:4-5. [DOI: 10.1016/j.jamda.2012.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 05/02/2012] [Indexed: 10/28/2022]
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Indications and Contraindications for Anti-Thrombotic Therapy to Prevent Venous Thromboembolism (VTE): Observations in Long-Term Care Facilities (LTCF) based on Clinical Practice Guidelines (CPG). J Am Med Dir Assoc 2010. [DOI: 10.1016/j.jamda.2009.12.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Prevention of Venous Thrombo-Embolism in Long Term Care: Multi-Center Project to Study Practice Patterns and Implement Clinical Practice Guidelines. J Am Med Dir Assoc 2010. [DOI: 10.1016/j.jamda.2009.12.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE The purpose of this qualitative study was to consider the current beliefs of nursing assistants and directors of nursing about management of urinary incontinence (UI) among the residents in nursing homes. DESIGN This was a qualitative study using purposive sampling and a focus group methodology. SETTING AND SUBJECTS Three focus groups including 38 participants were held in 2 different regions. Two of the focus groups comprised nursing assistants and 1 comprised directors of nursing. METHOD The focus groups were facilitated by 2 different advanced practice nurses (BR and LJK), and 2 similar interview guides were used: 1 for the nursing assistants and 1 for the nurses. The interviews were tape recorded and transcribed verbatim; data were analyzed via content analysis. RESULTS Ten themes were identified from the data; 3 focused on resident factors that influence UI, 4 related to staff and family contributors to UI, and 3 focused on recommendations to improve UI management in the nursing home setting. CONCLUSIONS The findings from this study can be used to guide interventions to decrease or eliminate barriers to continence care and thereby facilitate the implementation of clinical practice guidelines and evidence-based interventions to improve urinary continence among nursing home residents.
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Abstract
Older adults who visit the primary care physician's office often exhibit depressive symptoms. The challenge for the physician and other office staff is to determine what these symptoms mean: Loneliness? Fear? Grief? A consequence of a coexisting medical condition? A DSM depressive disorder? Or something else? Addressing ambiguous symptoms that may represent a depressive disorder may be difficult in the busy office setting. The findings of one recent study suggest that it is not lack of knowledge that impedes the recognition of depression but rather the conditions under which clinical decision making occurs. The process of ruling out medical diagnoses and opening the door to consider a mental health diagnosis can be time-consuming and circuitous, especially if the clinician is not already familiar with the patient or if the clinician who is familiar with the patient perceives insufficient time to deal with the issues raised by opening the door. The fundamental challenge for the primary care clinician as aging baby boomers inundate the health care system is to restructure office practice to recognize, assess, and manage geriatric syndromes including depression. The underlying principle for successful restructuring is acknowledging that these syndromes have multiple causes requiring multifaceted interventions. Operationally, doing simple things consistently and well may have significant impact. By consistently recognizing biologic and psychosocial risk factors for depression, by taking a careful history (including the two-question screen), and by conducting a thorough physical examination, the office-based clinician will generally have a strong clinical hunch about the presence or absence of a depressive disorder and any comorbid medical and neuropsychiatric conditions. Armed with this information, additional laboratory and brain imaging studies and subsequent management strategies are straightforward.
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Abstract
OBJECTIVES To determine (1) the point prevalence of do not hospitalize (DNH) policies in nursing facilities directed by members of the American Medical Directors Association (AMDA) Foundation Long-term Care Research Network, (2) the frequency with which physicians are writing DNH orders, and (3) respondent perceptions about the appropriateness of the number of DNH orders as too few or too many and reasons for such perceptions. DESIGN Online survey of members of the AMDA Foundation Long-term Care Research Network. SETTING Nursing facilities. PARTICIPANTS All members of the AMDA Foundation Long-term Research Network on July 1, 2003 were eligible for participation (N = 293). INTERVENTION None. MEASUREMENTS Demographic information regarding census, region, setting, governance, presence of teaching and/or hospice affiliation, prevalence of DNH orders, and qualitative information regarding the use of DNH orders in each facility. RESULTS The response rate was 32% (n = 95). DNH policies were in place for 62% of facilities and the prevalence of DNH orders ranged from 12% to 23% when facilities were stratified by size. Percentage of residents with documented DNH orders ranged from 0% to 99% at individual facilities. No significant differences were found although trends were noted as follows: chain facilities had fewer DNH policies (RR = 0.8; 95% CI = 0.6-1.1) whereas rural facilities (RR = 1.1, 95% CI = 0.8-1.5) and those associated with a teaching institution (RR = 1.1, 95% CI = 0.8-1.5) were more likely to have a DNH policy. Of respondents, 80% indicated that physicians in their facilities were writing DNH orders but 77% believed that the number of DNH orders was too few. Respondents cited overly optimistic prognosis and lack of knowledge about DNH orders as barriers to writing more DNH orders. CONCLUSION The prevalence of DNH orders in this investigation is higher than previous estimates from national data samples. Most facilities had a DNH policy and although respondents indicated that physicians do write DNH orders, they believed that DNH orders were not utilized frequently enough. There is a large variation in prevalence of DNH orders across the facilities included in this survey. Barriers to use, as perceived by medical directors, included unrealistic expectations by family, fear of litigation, and staff discomfort with managing residents who experience clinical decline. Nevertheless, DNH orders are used extensively in some facilities associated with members of the AMDA Foundation Long-term Care Research Network.
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Differences in Diabetes Management of Nursing Home Patients Based on Functional and Cognitive Status. J Am Med Dir Assoc 2005; 6:375-82. [PMID: 16286058 DOI: 10.1016/j.jamda.2005.05.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To describe practice patterns regarding diabetes management among nursing home (NH) physicians and to identify variation in this practice based on patient characteristics. DESIGN Mailed survey. PARTICIPANTS Nursing home physicians from the American Medical Directors Association (AMDA) Foundation Long-Term Care Research Network (n = 142), as well as other members of AMDA who were Certified Medical Directors (CMD) (n = 68) and members who were not CMD certified (n = 45). Response rates to the survey were 51%, 33%, and 23%, respectively. MEASUREMENTS Physician and facility characteristics were queried. Responses to 12 items pertaining to diabetes management and 5 items pertaining to use of specific oral diabetes medications were evaluated in the context of 3 different patient profiles that reflected different combinations of functional and cognitive impairment. Responses were based on the physicians' perception of how they manage diabetes under these specified patient profiles. RESULTS Responses from members of the Research Network indicated highly significant variability (P < .01) between the 3 patient profiles for all of the 12 management items. Ordering a special diet, monitoring lipid panel, and ordering routine ophthalmology was less likely for the patient profile with both functional and cognitive impairment (P < .01). These differences among the patient profiles for these 3 interventions were present in the responses from all 3 categories of physicians (Research Network, CMD, and non-CMD members of AMDA). There was no statistically significant variability among the 3 patient profiles for any of the 3 physician groups regarding the likelihood of using of any of the 5 classes of oral diabetic medications. Non-CMD physicians were more likely to have less NH experience; otherwise, there were no differences among the 3 physician groups. CONCLUSIONS Nursing home physicians appear to alter the approach to diabetes management based on the functional and/or cognitive status of the patient. This was particularly true for those physicians who were members of the AMDA Foundation Research Network. These findings have implications for initiatives designed to guide clinical practice as well as efforts by regulatory bodies to evaluate appropriate care. Further research is needed to measure the actual impact of different approaches to diabetes management on relevant outcomes in this population.
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The effects of preexisting depression on cerebrovascular health outcomes in geriatric continuing care. J Gerontol A Biol Sci Med Sci 2005; 60:915-9. [PMID: 16079217 DOI: 10.1093/gerona/60.7.915] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous studies have investigated depression as the cause and outcome of vascular deficit in elderly persons. METHODS The authors wanted to determine whether baseline depression is predictive of subsequent cardiovascular events in very elderly persons residing in a continuing care retirement community (n = 181). RESULTS Controlling for demographic factors, both depression and the number of cardiovascular risk factors (CVRFs) at baseline were strongly predictive of stroke, whereas only CVRFs strongly predicted myocardial infarctions. Depression accounted for 12% of the variance in stroke incidence, beyond the contribution of CVRFs. Path analysis indicated that depression was also a partial moderator of the effect of CVRFs. CONCLUSIONS In support of the vascular depression hypothesis, the study findings indicate that, for the oldest old, depression may be a strong predictor of future stroke. The presence of depression in elderly patients should alert physicians to carefully investigate other stroke risk factors and to integrate depression into an overall intervention regimen for reducing patients' risks for stroke.
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Abstract
The influx of older patients into the office-based primary care setting is a demographic reality for most practices. A shift from the disease-driven model of care delivery to one that focuses on function and quality of life should occur if primary care clinicians are to provide appropriate services to their aging patients, especially as those patients reach a state of vulnerability as defined in the ACOVE studies. Incremental functional assessment may be a first step in making the shift and probably can be implemented in most office-based practices. The specter of dementia, however, is beginning to materialize and affect the approach to addressing the needs of older adults and the expected outcomes of care.
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Care of the Older Adult in the Office Setting. Prim Care 2005. [DOI: 10.1016/j.pop.2005.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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A Daughter's Duty. J Am Board Fam Med 2005; 18:57-62. [PMID: 15709065 DOI: 10.3122/jabfm.18.1.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Improving the quality of nurse assistants in nursing homes: report of an attending physician survey and an AMDA Symposium. J Am Med Dir Assoc 2001; 2:141-5. [PMID: 12812569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
OBJECTIVES To describe views of attending physicians regarding nurse assistants as part of a multidisciplinary seminar on nurse assistants at the 1997 American Medical Directors Association (AMDA) Annual Symposium. DESIGN Mailed survey. PARTICIPANTS AMDA members. MEASUREMENTS Attitudes regarding nurse assistants and the role of attending physicians with regard to enhancing the role of nurse assistants. RESULTS Respondents rated the importance of quality nurse assistants with a mean of 4.85 and a mode of 5 (5 being very important). They also thought it was important for the medical director attending physicians to support, train, or otherwise assist in the professional development of nurse assistants (mean 4.07, mode 5). Respondents recommended enhanced training, reduced workload, increased salary and benefits, and building more effective relationships as strategies for improving the quality of care provided by nurse assistants. CONCLUSION Physicians can be important in enhancing the role of the nursing assistant. Some activities may include acknowledging the nurse assistant, providing support and feedback, and supporting policy changes that enhance continuity, nonhierarchical management, and creative training programs.
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Abstract
OBJECTIVES To describe the prescribing and use of antiepileptic drug (AED) therapy in nursing facility residents. DESIGN A retrospective, multicenter drug use evaluation. SETTING A total of 85 nursing facilities (average size, 119 beds) in five states. PARTICIPANTS 1132 residents of the total 10,168 residents screened were prescribed at least one AED. MEASURES Demographic information, primary indication for AED, comorbid conditions, prescribing physician's specialty, concomitant medications, and AED dosage regimen information were collected. Laboratory tests obtained in the most recent 6 months and seizure occurrence and seizure-related diagnostic assessments made in the most recent 3 months were also recorded. RESULTS Of 1132 residents receiving AED therapy, 892 (78.8%) were prescribed AED therapy for a seizure-related diagnosis although 86% of seizure types were unspecified. Another 215 residents (19.0%) were prescribed AEDs for nonseizure diagnoses, and 25 (2.2%) had no indication for AED therapy. AEDs most frequently prescribed were phenytoin (56.8%), carbamazepine (23.0%), phenobarbital (15.6%), and valproic acid (13.1%). For residents with a seizure diagnosis, the most frequently prescribed monotherapy agents were phenytoin (52.0%), carbamazepine (12.2%), and phenobarbitol (7.1%). Almost 25% of residents with a seizure diagnosis took a combination of AEDs; more than 50% of all combinations included phenobarbital. About 9% of residents with a seizure diagnosis had one or more documented seizures during a 3-month review period. CONCLUSION Among the substantial percentage of residents treated with AEDs, the lack of diagnosis of seizure type has serious implications for the choice of AED therapy. Opportunities exist for prescribing physicians, consultant pharmacists, and nursing staff to improve the medical management of nursing facility residents with seizures and of others receiving AEDs.
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Abstract
A review of the literature of the 1980s reveals that women living in rural American are at risk for receiving inadequate prenatal and maternal care. Documented risk factors include poverty and concomitant lack of medical insurance, residence in the most restrictive Medicaid states, and loss of local services including the closure of obstetric units of rural hospitals and the decision by local physicians to discontinue obstetrics. A prominent factor in a physician's decision to stop providing maternity care is the escalating cost of medical liability insurance; however, other forces are also at work, including interference with personal and family activities, disruption of other aspects of professional life (e.g., office schedule), inadequate reimbursement, and an inability to keep up with advancing technology. A research agenda for the 1990s should be consistent with previous recommendations and must stimulate the development of new programs that will induce the maximum number of providers to again offer high quality perinatal care to rural women. Other items on the 1990s research agenda include: (1) the clarification of the impact of lost perinatal services in rural areas, (2) the effects of travel time and distance on perinatal outcomes and cost of care, (3) the effect of loss of obstetric services on other health care services for women and children, and (4) comparisons of regionalized versus centralized systems for the provision of perinatal services.
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Obstetric care in rural Missouri: the loss of rural general and family practitioners. MISSOURI MEDICINE 1990; 87:92-5. [PMID: 2304448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Family and general practitioners have historically provided a substantial portion of obstetric care in rural parts of the United States, including Missouri. The authors surveyed 328 rural general physicians to determine their participation in obstetrics. Their findings show a dramatic loss of physician obstetric services in rural Missouri and suggest that the dilemma is not likely to be easily remedied.
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Abstract
We studied 65 rural hospitals in Missouri that provided obstetric services in 1986. The hospitals were divided into three groups on the basis of their physician obstetric staff: family or general practitioners only (38 hospitals), family practitioners and obstetricians (22 hospitals), and obstetricians only (five hospitals). From birth certificate data, we detected a decline in the mean number of births in all groups of rural hospitals comparing 1980-1983 with 1984-1987. Births in family practice only hospitals declined most over the past four years (35%), whereas there was only a 4 percent decline in the number of births to rural Missouri women. In 1987, 10 of the 38 family practice only hospital obstetric units closed due to loss of physician services, whereas none of the other hospitals stopped providing obstetric care (X2 = 8.40, p less than 0.005). These findings suggest that rural hospitals with family and general practitioners exclusively on their obstetric staffs are at significant risk of closing their obstetric units.
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Abstract
As family and general practitioners who provide a substantial portion of the obstetric care in rural areas quit their obstetric practice, small rural hospital obstetric units are at risk of closing. Using a case study design, we examined the impact of the loss of obstetric services at a small rural hospital in Missouri. This unit was the site of delivery for less than one-half of the infants born to women living within its service area. However, it was the most likely source of care for women who were young, undereducated and unmarried (p less than 0.01). Evidence derived from birth certificates showed that women who delivered there had good perinatal outcomes compared with local women who delivered at larger hospitals. A gradual decline in the number of physicians providing obstetric care preceded the closing of the hospital unit. Women from the hospital service area who presented late for prenatal care were twice as likely to have had a low birthweight infant in the year after the local hospital unit closed (16.7% versus 7.4%), although this difference and other comparisons of outcomes were not statistically significant.
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Cyanocobalamin injections for patients without documented deficiency. Reasons for administration and patient responses to proposed discontinuation. JAMA 1989; 261:1920-3. [PMID: 2926928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We reviewed the records of 1222 patients who attended a newly acquired rural satellite clinic and found that 120 (10%) had been receiving regular cyanocobalamin injections, but that only 4 (3%) met accepted criteria for its administration. Open-ended interviews with 48 of these patients revealed that they had been receiving cyanocobalamin injections for a mean of 9.9 years for 3.3 symptoms each and with a mean effectiveness rating of 2.9 (scale, 0 to 4). After receiving education regarding the appropriate indications for cyanocobalamin injections, 25 (52%) of the patients were willing to stop receiving them at least temporarily. However, 18 patients (38%) who were younger and who reported greater symptom relief would actively seek a physician who would continue to administer cyanocobalamin. Our findings suggest that some patients who have been receiving cyanocobalamin injections but who do not have a documented deficiency will stop receiving the injections when presented with reasonable alternatives.
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Gene D5 product of bacteriophage T5: DNA-binding protein affecting DNA replication and late gene expression. J Virol 1979; 29:322-7. [PMID: 219226 PMCID: PMC353123 DOI: 10.1128/jvi.29.1.322-327.1979] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gene D5 is not only necessary for replication of bacteriophage T5 DNA and for shutoff of expression of some early genes, but has been found to be necessary also for the expression of late T5 genes. The polypeptide product of gene D5 has been identified, an intragenic map of gene D5 has been constructed, and the direction of transcription of gene D5 has been established. The polypeptide coded by gene D5 has been shown to be a DNA-binding protein with affinity for both double- and single-stranded DNA.
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The health of farmers. JOURNAL OF THE IOWA MEDICAL SOCIETY 1976; 66:409-18. [PMID: 987116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Transfection of Escherichia coli spheroplasts. II. Relative infectivity of native, denatured, and renatured lambda, T7, T5, T4, and P22 bacteriophage DNAs. J Virol 1973; 12:733-40. [PMID: 4591046 PMCID: PMC356691 DOI: 10.1128/jvi.12.4.733-740.1973] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The change of infectivity of phage DNAs after heat and alkali denaturation (and renaturation) was measured. T7 phage DNA infectivity increased 4- to 20-fold after denaturation and decreased to the native level after renaturation. Both the heavy and the light single strand of T7 phage DNA were about five times as infective as native T7 DNA. T4 and P22 phage DNA infectivity increased 4- to 20-fold after denaturation and increased another 10- to 20-fold after renaturation. These data, combined with other authors' results on the relative infectivity of various forms of phiX174 and lambda DNAs give the following consistent pattern of relative infectivity. Covalently closed circular double-stranded DNA, nicked circular double-stranded DNA, and double-stranded DNA with cohesive ends are all equally infective and also most highly infectious for Escherichia coli lysozyme-EDTA spheroplasts; linear or circular single-stranded DNAs are about 1/5 to 1/20 as infective; double-stranded DNAs are only 1/100 as infective. Two exceptions to this pattern were noted: lambda phage DNA lost more than 99% of its infectivity after alkaline denaturation; this infectivity could be fully recovered after renaturation. This behavior can be explained by the special role of the cohesive ends of the phage DNA. T5 phage DNA sometimes showed a transient increase in infectivity at temperatures below the completion of the hyperchròmic shift; at higher temperatures, the infectivity was completely destroyed. T5 DNA denatured in alkali lost more than 99.9% of its infectivity; upon renaturation, infectivity was sometimes recovered. This behavior is interpreted in terms of the model of T5 phage DNA structure proposed by Bujard (1969). The results of the denaturation and renaturation experiments show higher efficiencies of transfection for the following phage DNAs (free of single-strand breaks): T4 renatured DNA at 10(-3) instead of 10(-5) for native DNA; renatured P22 DNA at 3 x 10(-7) instead of 3 x 10(-9) for native DNA; and denatured T7 DNA at 3 x 10(-6) instead of 3 x 10(-7) for native DNA.
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Rapid bacteriophage sedimentation in the presence of polyethylene glycol and its application to large-scale virus purification. Virology 1970; 40:734-44. [PMID: 4908735 DOI: 10.1016/0042-6822(70)90218-7] [Citation(s) in RCA: 1184] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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