An analysis of accreditation and its impact of receiving funding in mental health hospitals

This paper examines the accreditation of mental health hospitals and the receiving of funding. The funding sources examined are Medicare, Medicaid, Veterans Administration, private insurance, and client fees. Other factors were the type of ownership of the hospital and region. The conclusion is that accreditation is important. Different accreditations are important for different funding sources. Region is also important with the Northeast having less funding for most sources

Treating methicillin-resistant Staphylococcus aureus with the drug vancomycin in a home infusion therapy setting

The basic purpose of this paper is to examine the effects the home infusion therapy has on the cost, duration of, and effectiveness of treatment between those individuals under 60 and those 60 and over. The results show that those 60 and over had a slightly higher cost/day. The older age group had slightly smaller treatment duration, then the younger group. The number of adverse effects was small. The results suggest that home infusion therapy appears to be a viable alternative to hospitalization

Diol Dehydratase: Purification, Structural Characterization, and Mechanism of Action

Abstract to Chapter I A new isolation procedure for propanediol dehydratase increases by a factor of about 16 the yield of enzyme obtainable from Klebsiella pneumoniae; the enzyme thus isolated has a specific activity of 95 ± 4 units/mg. The apoenzyme consists of four different subunits with molecular weights of 60 K, 51 K, 29 K, and 15 K daltons in the ratio of 2:1:2:2, respectively. In this new procedure, care was taken to prevent the partial proteolysis of the propanediol dehydratase which seems to occur in earlier procedures. The other novel aspect recognizes that the enzyme is associated with the cell membrane. Accordingly, after gentle sonication, the membrane fragments are separated from cytosol, and the enzyme is solubilized by extraction with buffers containing detergent. The amino acid compositions and N-terminal amino acid sequences for each of the subunits was also determined. From the amino acid compositions of the individual subunits, diol dehydratase appears to be a peripheral membrane protein. Abstract to Chapter II When diol dehydratase holoenzyme is inactivated by reaction with radioactive glycerol, one mole of glycerol appears to become tightly associated with each 250,000 daltons of the holoenzyme complex with a significant loss of tritium from C-2 being observed. However, denaturation of the inactivated complex releases the modified glycerol from the protein, indicating that the protein is not covalently modified by the inactivator. Similar experiments were carried out with radioactive isobutylene glycol, but due to the high level of nonspecific labeling, the results were not as definitive. As described in Chapter I, former isolation procedures (Abeles, 1966; Poznanskaya et al., 1979) yielded enzyme which had been proteolysed. For this reason inactivation studies employing various deuterated derivatives of glycerol and isobutylene glycol, as well as a new class of inactivators represented by hydroxyacetone and dihydroxyacetone, were carried out with native enzyme to compare results from similar studies with proteolysed enzyme (Bachovchin et al., 1977; Moore, 1979). It was found that proteolysis had little effect on the constants associated with the glycerol inactivation, but an enormous effect on the constants describing the inactivation by isobutylene glycol. The results of the radiolabeling studies and kinetic experiments are consistent with the formation of a secondary alkylcobalamin upon inactivation of diol dehydratase by glycerol. Kinetic evidence also suggests that the inactivation of diol dehydratase by isobutylene glycol occurs after the abstraction of hydrogen from C-1, but before the substrate rearranges. Abstract to Chapter III A reinvestigation of trace label experiments with native diol dehydratase isolated by the method of McGee and Richards (1981) (see Chapter I) has shown that the probability of net intramolecular transfer for tritium is 0.33 ± 0.02 as opposed to the value of about 0.03 obtained earlier (Frey et al., 1967a) with an enzyme preparation obtained by a different method. Our observed value of 0.33 is about 20 times larger than what one would predict on the basis of the mechanism for the migration of hydrogen given in the Introduction to this thesis. In contrast, tritium washout experiments, similar to those conducted by Essenberg et al. (1971), yielded a value of kHH/kHT = 29 ± 2 which is approximately the value predicted by Moore et al. (1979). Also, tritium washout experiments were carried out in such a way that, in addition to the C-5' hydrogens of adenosylcobalamin containing tritium, any other multiple-hydrogen reservoirs should have contained tritium as well. These experiments yielded identical results to those in which only the C-5' hydrogens contained reactable tritium; therefore, it appears that only the C-5' hydrogens of C-5' deoxyadenosine participate directly in catalysis. Also, the tritium isotope effect on the first hydrogen transfer was determined to be 6.1 ± 0.5 by measuring the isotopic enrichment in unreacted [1-3H]-1,2-propanediol as a function of the extent of reaction. The results of our study suggest that the generally accepted pathway for catalysis, which proceeds through the C-5' deoxyadenosine hydrogen reservoir, constitutes about 95% of the catalytic events with unlabeled substrate; however, there appears to be an alternate catalytic pathway whose contribution to catalysis can be enhanced by isotopic substitution at C-1 of substrate.</p

Disparities in Disability Among Non-Hispanic Black Elders: Results From the National Interview Survey 2001–2003

A drastically increasing elderly population and disparity among disability poses a concern for the US health care industry. This retrospective cross-sectional study analyzed whether ADL and IADL disabilities were different among non-Hispanic white (NHW) and non-Hispanic black (NHB) populations age 65 and over. Data was retrieved from the 2001–2003 National Health Interview Survey (NHIS) for comparing NHBs and NHWs using chi-square analysis for bivariate comparisons. For both elderly NHBs and elderly NHWs, increased rates of disability were reported for being over 75, female, single, and having lower education. NHBs reported statistically higher disability rates for ADL, IADL, and for any disability, with 10.0%, 18.0%, and 19.3%, respectively, compared to NHWs. There is a need to increase the access for NHBs to nursing home, hospice, and assisted-living facilities. Of further concern is the finding of lower institutionalization rates in the NHB population despite the significant presence of increased disability. The growing NHB elderly population needs an urgent societal intervention to address the persistent disparity, which has been neglected for so many years

Employee Relations Ethics and the Changing Nature of the American Workforce

Much is being written today about the changing nature of the American workforce. This article summarizes 10 of these changes: (a) global competition; (b) the changing skills of work; (c) the declining impact of unions; (d) the altered human composition of the workforce; (e) the effects of continuous improvement, downsizing, and reengineering; (f) the growing use of part-time employees; (g) the widening income gap; (h) lessened employer and employee loyalty and commitment; (i) early retirement programs; and (j) telecommunications and virtual employees. Rather than just identifying and documenting these trends, this article discusses the ethical implications of such movements. In this article, employee relations ethics is defined as treating employees properly, with respect and dignity. The term employee relations ethics is used both individually and collectively to analyze the negative human results from a moral rather than an economic perspective. The age-old clash between bottom-line mentality (economics) versus higher order thinking (ethics) is revisited with a focus on employees, not owners (old theory) or customers (new theory)

Come-See-Me Festival Interview

In this April 21, 1978 interview, the origins and history of the Come-See-Me Festival are discussed. Included is an overview of the events for the 1978 event. This interview was conducted for inclusion into the Louise Pettus Archives and Special Collections Oral History Programhttps://digitalcommons.winthrop.edu/oralhistoryprogram/1265/thumbnail.jp

Benefits of adding fluticasone propionate/salmeterol to tiotropium in moderate to severe COPD

SummaryBackgroundCombining maintenance medications with different mechanisms of action may improve outcomes in COPD. In this study we evaluated the efficacy and safety of fluticasone/salmeterol (FSC) (250/50 mcg twice daily) when added to tiotropium (18 mcg once daily) (TIO) in subjects with symptomatic moderate to severe COPD.MethodsThis was a 24-week, randomized, double-blind, parallel group, multi-center study. Subjects 40 years or older with cigarette smoking history ≥10 pack-years and with the diagnosis of COPD and post-bronchodilator FEV1 ≥40 to ≤ 80% of predicted normal and FEV1/FVC of ≤0.70 were enrolled. Following a 4-week treatment with open-label TIO 18 mcg once daily, subjects were randomized in a double-blind fashion to either the addition of FSC 250/50 DISKUS twice daily or matching placebo. The primary efficacy endpoint was AM pre-dose FEV1 and secondary endpoints included other measures of lung function, rescue albuterol use, health status and exacerbations.ResultsThe addition of FSC to TIO significantly improved lung function indices including AM pre-dose FEV1, 2 h post-dose FEV1, AM pre-dose FVC, 2 h post-dose FVC and AM pre-dose IC compared with TIO alone. Furthermore, this combination was superior to TIO alone in reducing rescue albuterol use. However, there were no significant differences between the treatment groups in health status or COPD exacerbations. The incidence of adverse events was similar in both groups.ConclusionsThe addition of FSC to subjects with COPD treated with TIO significantly improves lung function without increasing the risk of adverse events. NCT00784550

In-situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole using 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. A unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. Birefringent light propagation has been examined as a possible explanation for this effect. The predictions of a first-principles birefringence model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties do not only include the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empirical corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the experimental signature of ice optical anisotropy observed in IceCube LED calibration data, the theory and parametrization of the birefringence effect, the fitting procedures of these parameterizations to experimental data as well as the inferred crystal properties.</p

In situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole. It uses 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. An unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. We examine birefringent light propagation through the polycrystalline ice microstructure as a possible explanation for this effect. The predictions of a first-principles model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties include not only the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empirical corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the experimental signature of ice optical anisotropy observed in IceCube light-emitting diode (LED) calibration data, the theory and parameterization of the birefringence effect, the fitting procedures of these parameterizations to experimental data, and the inferred crystal properties.Peer Reviewe