Employment Changes Play Major Role in Access to Employer Health Coverage

Highlights findings on the factors that drive short-term changes in employer-sponsored health insurance coverage, including the rising cost of health insurance and changes in employment rates and availability of better jobs during macroeconomic cycles

The structural distortion in antiferromagnetic LaFeAsO investigated by a group-theoretical approach

As experimentally well established, undoped LaFeAsO is antiferromagnetic below 137K with the magnetic moments lying on the Fe sites. We determine the orthorhombic body-centered group Imma (74) as the space group of the experimentally observed magnetic structure in the undistorted lattice, i.e., in a lattice possessing no structural distortions in addition to the magnetostriction. We show that LaFeAsO possesses a partly filled "magnetic band" with Bloch functions that can be unitarily transformed into optimally localized Wannier functions adapted to the space group Imma. This finding is interpreted in the framework of a nonadiabatic extension of the Heisenberg model of magnetism, the nonadiabatic Heisenberg model. Within this model, however, the magnetic structure with the space group Imma is not stable but can be stabilized by a (slight) distortion of the crystal turning the space group Imma into the space group Pnn2 (34). This group-theoretical result is in accordance with the experimentally observed displacements of the Fe and O atoms in LaFeAsO as reported by Clarina de la Cruz et al. [nature 453, 899 (2008)]

The reason why doping causes superconductivity in LaFeAsO

The experimental observation of superconductivity in LaFeAsO appearing on doping is analyzed with the group-theoretical approach that evidently led in a foregoing paper (J. Supercond 24:2103, 2011) to an understanding of the cause of both the antiferromagnetic state and the accompanying structural distortion in this material. Doping, like the structural distortions, means also a reduction of the symmetry of the pure perfect crystal. In the present paper we show that this reduction modifies the correlated motion of the electrons in a special narrow half-filled band of LaFeAsO in such a way that these electrons produce a stable superconducting state

Physician–Patient Communication About Prescription Medication Nonadherence: A 50-state Study of America’s Seniors

CONTEXT: Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006. OBJECTIVE: To determine the prevalence of physician–patient dialogue about medication cost and medication adherence among elderly adults nationwide. DESIGN: Cross-sectional survey. PARTICIPANTS: National stratified random sample of community-dwelling Medicare beneficiaries aged 65 and older. MAIN OUTCOME MEASURES: Rates of physician–patient dialogue about nonadherence and cost-related medication switching. RESULTS: Forty-one percent of seniors reported taking five or more prescription medications, and more than half has 2 or more prescribing physicians. Thirty-two percent overall and 24% of those with 3 or more chronic conditions reported not having talked with their doctor about all their different medicines in the last 12 months. Of seniors reporting skipping doses or stopping a medication because of side effects or perceived nonefficacy, 27% had not talked with a physician about it. Of those reporting cost-related nonadherence, 39% had not talked with a physician about it. Thirty-eight percent of those with cost-related nonadherence reported switching to a lower priced drug, and in a multivariable model, having had a discussion about drug cost was significantly associated with this switch (odds ratio [OR] 5.04, 95% confidence interval [CI] 4.28–5.93, P < .001). CONCLUSIONS: We show that there is a communication gap between seniors and their physicians around prescription medications. This communication problem is an important quality and safety issue, and takes on added salience as physicians and patients confront new challenges associated with coverage under new Medicare prescription drug plans. Meeting these challenges will require that more attention be devoted to medication management during all clinical encounters