The Long-term Coercive Effect of State Community Benefit Laws on Hospital Community Health Orientation

This study is an examination of the long-term coercive effect of state community benefit laws (CB Laws) on the provision of community health activities in U.S. acute care hospitals. The sample included all the not-for-profit and investor owned acute care hospitals for which 1994 and 2006 AHA Annual Survey data were available. A panel design was used to longitudinally examine the effect that state CB Laws had on hospital community health orientation activities and the provision of health promotion services, after controlling for the influence of other organizational and environmental variables that might affect these activities and services. The authors found that both CB Law state and non CB Law state hospitals increased their number of orientation activities and promotion services from 1994 to 2006. However, there was no significant difference in the gains in these activities and services between these two groups of hospitals. These results suggest that other environmental and organizational factors may mediate the effect of the state CB Laws over time

Financial Position and Adoption of Electronic Health Records: A Retrospective Longitudinal Study

AIM: Financial barriers are a major factor of slow electronic health record (EHR) adoption among US hospitals. All existing literature focuses on relationships between current or short-term financial position and EHR adoption. This study examines relationship between financial position in previous years and the current level of EHR adoption. METHODS: Retrospective longitudinal data were extracted from (1) the 2009 American Hospital Association (AHA) EHR implementation survey; (2) the 2002 and 2006 Centers for Medicare & Medicaid Cost Reports; and (3) the 2002 and 2006 AHA Annual Survey containing organizational and operational data. The final sample was 2,701 acute care hospitals in the United States. General ordinal logistic regression was used for data analysis with a three-level dependent variable to measure adoption, five independent variables to measure financial position, and 11 control variables to measure structure and environment. RESULTS: For 2006, higher total margin was significantly and positively associated with EHR adoption, but higher asset turnover was significantly and negatively associated with EHR adoption. For 2002, higher total margin was significantly and positively associated with EHR adoption, but higher asset turnover and higher equity multiplier were both significantly and negatively associated with EHR adoption. In addition, lower net days revenue in accounts receivable was significantly and positively associated with EHR adoption. For both the 2002 and 2006 control variables, human resource intensity and bed size were significant and positively related to adoption, and percentage Medicare patients and investor ownership were significant and negatively related to adoption. CONCLUSIONS: Financial position does relate to EHR adoption in mid-term and long-term planning

Austeridad y Desigualdad. Evaluación del Impacto de los Recortes en Reino Unido por Género y Edad

Across Europe and North America, governments responded to the financial crisis of 2007-8 by taking on the debt of banks and insurance companies. Subsequent austerity programmes to reduce that debt have cut the living standards of all but the richest. Yet governments insist cuts are necessary and that they are fairly distributed. In this review of austerity policies in the UK, these claims are challenged, first by assessing the impact on key population groups of cuts in welfare spending and second by showing how specific reforms, including those planned before the financial crash, are likely to affect current and future pensioners, especially women and those living on low incomes. Finally, I review the effectiveness of austerity policies in tackling the deficit, outlining alternative policies that have been put forward by critics. I conclude that the cuts are not only unfair, exacerbating the social division between the very wealthy and the rest of society but are also counterproductive to the aim of restoring economic activity and reducing the deficit.En Europa y en Norte América, los gobiernos han respondido a la crisis financiera de 2007-8 asumiendo la deuda de los bancos y de las compañías de seguros. Los consecuentes programas de austeridad para reducir esa deuda han recortado los niveles de vida de todas las personas excepto de las más ricas. Los gobiernos insisten en que los recortes son necesarios y están distribuidos justamente. En esta revisión de las políticas de austeridad en UK, estas pretensiones son desafiadas, en primer lugar, valorando el impacto de los recortes del gasto social sobre algunos grupos de población clave y, en segundo lugar, mostrando cómo ciertas reformas específicas, incluso aquéllas proyectadas con anterioridad a la crisis financiera, tienden a afectar a las y los pensionistas actuales y futuros, especialmente a las mujeres y a las personas con ingresos más bajos. Finalmente, reviso la efectividad de las políticas de austeridad que pretenden hacer frente al déficit, y esbozo políticas alternativas que han sido propuestas por algunos críticos. Concluyo que los recortes no sólo son injustos, ya que empeoran la división social entre los muy ricos y el resto de la sociedad, sino también contraproducentes de cara al objetivo de recuperar la actividad económica y reducir el déficit.

Pension reform and the socioeconomic status of older people in Britain and Germany

The paper outlines in short the development of old age security systems in the United Kingdom and Germany and shows the current state of the socio-economic status of the elderly. We start with a brief and only the basic conception characterizing description of the old age security systems, followed by a presentation of the political discussion and the development of the law since 2000. Then the current old age policy is evaluated on the basis of four criteria: Income adequacy for pensioners, degree of inequality of pensioner incomes, sustainability of pension schemes and maintenance of incentives to save. This is followed by a brief outline of the emerging challenges over the next ten years. Finally some conclusions are drawn, which occur from the analysis.old age security system; socio-economic status; old age policy; elderly

Reformen der Alterssicherung und der sozioökonomische Status Älterer in Großbritannien und Deutschland

Der Beitrag gibt einen kurzen Überblick über die Entwicklung der Alterssicherungssysteme in Großbritannien und Deutschland und zeigt den derzeitigen sozioökonomischen Status der älteren Menschen an. Ausgehend von einer sehr kurzen und nur die Grundkonzeption charakterisierenden Darstellung der Alterssicherungssysteme werden die politische Diskussion und die Entwicklung der Gesetzesgrundlagen vor allem seit der Jahrtausendwende dargestellt. Anschließend wird anhand der vier Kriterien: Angemessenheit, Ungleichheit, Nachhaltigkeit und Aufrechterhaltung der Sparanreize die gegenwärtige Alterssicherungspolitik evaluiert, bevor die sich abzeichnenden Herausforderungen in den nächsten zehn Jahren skizziert werden. Den Abschluß bilden einige sich aus der Analyse ergebende Folgerungen. -- The paper outlines in short the development of old age security systems in the United Kingdom and Germany and shows the current state of the socio-economic status of the elderly. SWe start with a brief and only the basic conception characterizing description of the old age security systems, followed by a presentation of the political discussion and the development of the law since 2000. Then the current old age policy is evaluated on the basis of four criteria: Income adequacy for pensioners, degree of inequality of pensioner incomes, sustainability of pension schemes and maintenance of incentives to save. This is followed by a brief outline of the emerging challenges over the next ten years. Finally some conclusions are drawn, which occur from the analysis.

Reformen der Alterssicherung und der sozioökonomische Status Älterer in Großbritannien und Deutschland

The paper outlines in short the development of old age security systems in the United Kingdom and Germany and shows the current state of the socio-economic status of the elderly. We start with a brief and only the basic conception characterizing description of the old age security systems, followed by a presentation of the political discussion and the development of the law since 2000. Then the current old age policy is evaluated on the basis of four criteria: Income adequacy for pensioners, degree of inequality of pensioner incomes, sustainability of pension schemes and maintenance of incentives to save. This is followed by a brief outline of the emerging challenges over the next ten years. Finally some conclusions are drawn, which occur from the analysis

Reformen der Alterssicherung und der sozioökonomische Status Älterer in Großbritannien und Deutschland

The paper outlines in short the development of old age security systems in the United Kingdom and Germany and shows the current state of the socio-economic status of the elderly. We start with a brief and only the basic conception characterizing description of the old age security systems, followed by a presentation of the political discussion and the development of the law since 2000. Then the current old age policy is evaluated on the basis of four criteria: Income adequacy for pensioners, degree of inequality of pensioner incomes, sustainability of pension schemes and maintenance of incentives to save. This is followed by a brief outline of the emerging challenges over the next ten years. Finally some conclusions are drawn, which occur from the analysis

Reformen der Alterssicherung und der sozioökonomische Status Älterer in Großbritannien und Deutschland

"Der Beitrag gibt einen kurzen Überblick über die Entwicklung der Alterssicherungssysteme in Großbritannien und Deutschland und zeigt den derzeitigen sozioökonomischen Status der älteren Menschen auf. Ausgehend von einer sehr kurzen und nur die Grundkonzeption charakterisierenden Darstellung der Alterssicherungssysteme werden die politische Diskussion und die Entwicklung der Gesetzesgrundlagen vor allem seit der Jahrtausendwende dargestellt. Anschließend wird anhand der vier Kriterien: Angemessenheit, Ungleichheit, Nachhaltigkeit und Aufrechterhaltung der Sparanreize die gegenwärtige Alterssicherungspolitik evaluiert, bevor die sich abzeichnenden Herausforderungen in den nächsten zehn Jahren skizziert werden. Den Abschluss bilden einige sich aus der Analyse ergebende Folgerungen." (Autorenreferat)"The paper outlines in short the development of old age security systems in the United Kingdom and Germany and shows the current state of the socio-economic status of the elderly. The authors start with a brief and only the basic conception characterizing description of the old age security systems, followed by a presentation of the political discussion and the development of the law since 2000. Then the current old age policy is evaluated on the basis of four criteria: Income adequacy for pensioners, degree of inequality of pensioner incomes, sustainability of pension schemes and maintenance of incentives to save. This is followed by a brief outline of the emerging challenges over the next ten years. Finally some conclusions are drawn, which occur from the analysis." (author's abstract

The Aerotactic Response of Caulobacter crescentus

Many motile microorganisms are able to detect chemical gradients in their surroundings to bias their motion toward more favorable conditions. In this study, we observe the swimming patterns of Caulobacter crescentus, a uniflagellated bacterium, in a linear oxygen gradient produced by a three-channel microfluidic device. Using low-magnification dark-field microscopy, individual cells are tracked over a large field of view and their positions within the oxygen gradient are recorded over time. Motor switching events are identified so that swimming trajectories are deconstructed into a series of forward and backward swimming runs. Using these data, we show that C. crescentus displays aerotactic behavior by extending the average duration of forward swimming runs while moving up an oxygen gradient, resulting in directed motility toward oxygen sources. Additionally, the motor switching response is sensitive both to the steepness of the gradient experienced and to background oxygen levels, exhibiting a logarithmic response

Protection of early phase hepatic ischemia-reperfusion injury by cholinergic agonists

BACKGROUND: Cytokine production is critical in ischemia/reperfusion (IR) injury. Acetylcholine binds to macrophages and inhibits cytokine synthesis, through the cholinergic anti-inflammatory pathway. This study examined the role of the cholinergic pathway in cytokine production and hepatic IR- injury. METHODS: Adult male mice underwent 90-min of partial liver ischemia followed by reperfusion. The AChR agonists (1,1-dimethyl-4-phenyl-L-pioperazinium-iodide [DMPP], and nicotine) or saline-vehicle were administered i.p. before ischemia. Plasma cytokine tumor necrosis factor (TNF)-α, macrophage inflammatory protein-2, and Interleukin-6 were measured. Liver injury was assessed by plasma alanine transaminase (ALT) and liver histopathology. RESULTS: A reperfusion time-dependent hepatocellular injury occurred as was indicated by increased plasma-ALT and histopathology. The injury was associated with marked elevation of plasma cytokines/chemokines. Pre-ischemic treatment of mice with DMPP or nicotine significantly decreased plasma-ALT and cytokines after 3 h of reperfusion. After 6 h of reperfusion, the protective effect of DMPP decreased and reached a negligible level by 24 h of reperfusion, despite significantly low levels of plasma cytokines. Histopathology showed markedly diminished hepatocellular injury in DMPP- and nicotine-pretreated mice during the early-phase of hepatic-IR, which reached a level comparable to saline-treated mice at late-phase of IR. CONCLUSION: Pharmacological modulation of the cholinergic pathway provides a means to modulate cytokine production and to delay IR-induced heaptocellular injury