Self vs. Parent: Factors Influencing Likelihood of Hiring a Healthcare Advocate

Objective: To determine how the factors that may lead an individual to hire a healthcare advocate to aid him/herself in navigating the healthcare system when dealing with chronic or complex health issues differ from the factors that are considered when deciding to hire a healthcare advocate for one’s parent.Methods: 1,740 randomly selected participants completed a brief vignette-based questionnaire that indicated their likelihood of hiring an HCA for oneself or a parent. Confirmatory factor analysis and structural equation modeling were used to test the effects of predisposing, enabling, and illness factors on the predicted likelihood.Results: Although neither model fit well statistically, both fit well descriptively. The direct path from predisposing to enabling factors and the indirect path from predisposing factors to illness level were significant in both models. Discussion: Understanding the factors that influence the decision to hire an HCA could help health providers target patients who are most likely to use HCA services, thereby reducing the burden on the healthcare system and improving quality of care

Sediment budget in a deep-sea core from the central equatorial Pacific

Stratigraphic, mineralogic, chemical, and geochronologic measurements on a core from 8°20\u27N, 153°W show that sediment has been accumulating at a rate of 160 g/cm2/106 years. Of this, 125 g is fresh Quaternary sediment while the remainder is lower and middle Tertiary material eroded from nearby outcrops...

A conserved morphogenetic mechanism for epidermal ensheathment of nociceptive sensory neurites.

Interactions between epithelial cells and neurons influence a range of sensory modalities including taste, touch, and smell. Vertebrate and invertebrate epidermal cells ensheath peripheral arbors of somatosensory neurons, including nociceptors, yet the developmental origins and functional roles of this ensheathment are largely unknown. Here, we describe an evolutionarily conserved morphogenetic mechanism for epidermal ensheathment of somatosensory neurites. We found that somatosensory neurons in Drosophila and zebrafish induce formation of epidermal sheaths, which wrap neurites of different types of neurons to different extents. Neurites induce formation of plasma membrane phosphatidylinositol 4,5-bisphosphate microdomains at nascent sheaths, followed by a filamentous actin network, and recruitment of junctional proteins that likely form autotypic junctions to seal sheaths. Finally, blocking epidermal sheath formation destabilized dendrite branches and reduced nociceptive sensitivity in Drosophila. Epidermal somatosensory neurite ensheathment is thus a deeply conserved cellular process that contributes to the morphogenesis and function of nociceptive sensory neurons

Effects of Age, Mental Health, and Comorbidity on the Perceived Likelihood of Hiring a Healthcare Advocate

Background and Purpose: The projected increase in chronically ill older adults may overburden the healthcare system and compromise the receipt of quality and coordinated health care services. Healthcare advocates (HCAs) may help to alleviate the burden associated with seeking and receiving appropriate health care. We examined whether having dementia or depression, along with hypertension and arthritis, or having no comorbid medical conditions, and being an older adult, affected the perceived likelihood of hiring an HCA to navigate the health care system. Method: Participants (N = 1,134), age 18 or older, read a vignette and imagined themselves as an older adult with either a mood or cognitive disorder, and comorbid medical conditions or as otherwise being physically healthy. They were then asked to complete a questionnaire assessing their perceived likelihood of hiring an HCA. Results: Participants who imagined themselves as having dementia reported a greater likelihood of hiring an HCA than participants who imagined themselves as having depression (p < .001). Conclusion: It is imperative that health care professionals attend to the growing and ongoing needs of older adults living with chronic conditions, and HCAs could play an important role in meeting those needs

Factors Related to the Likelihood of Hiring a Health Advocate

This study was designed to explore factors related to the likelihood of hiring a health advocate. Independent variables were selected from the health service use model to capture predisposing, enabling, and illness-level factors. Participants were 889 adults (M age = 50.9 years, SD = 17.9 years, 52% female) recruited from a large cultural park in San Diego, California during the spring and summer of 2008. Participants read a description of a health advocate and completed a brief set of questions on age, gender, confidence in health care, effort maintaining health, self-rated health, and the likelihood of hiring a health advocate. Hierarchical regression analysis revealed that participants age 40-64 , non-Caucasians , participants who exerted more effort maintaining their health , and participants 65 and older who were less satisfied with their social support reported greater likelihood of hiring a health advocate. Findings were similar to those of studies that applied the health service use model to predict use of other health services, such as medical visits. These findings suggest factors that health care organizations offering health advocacy services could consider when targeting potential clients

Characterization of the Surface of High-Area Ni(OH)2 and NiO

The surface propertij:ls of Ni(OH)2, and the mechanism of decomposition of Ni(OH)2 to NiO were investigated by a variety , of experimental approaches including gas adsorption, heats of immersion and diffuse ir reflectance. The N~(OHh samples were prepared by bubbling ammonia gas through a Ni(N03)2 solution at different temperatures. Ni(OHh is relatively hydrophobic while NiO is completely hydrophilic. A relatiQIIlShip was estabhlshed between the specific surface areas of rthe parent Ni(OH)2 and Its decomposition product NiO which supports a mechanism of dehydration at 200 °c involving separation along the hexagona~ planes. This mechanism was confirmed by electron micrographs during decomposmon of Ni(OHh to NiO. Gravimetric studies of the decomposition of Ni(OH)2 at 200 °c iindicated that approximately 14°/o of the hydroxyl groups are not removed. Diffuse ir reflectance studies showed that surface hydroxyls were not removed. Physical adsorption of water vapor on Ni(OHh as a function of surface area supports the hypo·thesis that the basal planes are hydrophobic and the crystal edges are hydrophilic

The carbon concentrating mechanism in Chlamydomonas reinhardtii: Finding the missing pieces

The photosynthetic, unicellular green alga, Chlamydomonas reinhardtii, lives in environments that often contain low concentrations of CO2 and HCO3-, the utilizable forms of inorganic carbon (Ci). C. reinhardtii possesses a carbon concentrating mechanism (CCM) which can provide suitable amounts of Ci for growth and development. This CCM is induced when the CO2 concentration is at air levels or lower and is comprised of a set of proteins that allow the efficient uptake of Ci into the cell as well as its directed transport to the site where Rubisco fixes CO2 into biomolecules. While several components of the CCM have been identified in recent years, the picture is still far from complete. To further improve our knowledge of the CCM, we undertook a mutagenesis project where an antibiotic resistance cassette was randomly inserted into the C. reinhardtii genome resulting in the generation of 22,000 mutants. The mutant collection was screened using both a published PCR-based approach (Gonzalez-Ballester et al. 2011) and a phenotypic growth screen. The PCR-based screen did not rely on a colony having an altered growth phenotype and was used to identify colonies with disruptions in genes previously identified as being associated with the CCM-related gene. Eleven independent insertional mutations were identified in eight different genes showing the usefulness of this approach in generating mutations in CCM-related genes of interest as well as identifying new CCM components. Further improvements of this method are also discussed. © 2014 Springer Science+Business Media Dordrecht