7,336 research outputs found

    The Nonprofit Hospital and the Union

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    Why Lead Labor?: Projects and Pathways in California Unions, 1984-2001

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    This paper explores how union leadership has developed over the last 20 years. While other studies have focused on the careers of top leaders or new recruits, we examine the careers of rising leaders over time. Finding that demographics is not enough to account for their career paths, we attend to the ways these leaders articulate their motivations, goals, and means of achieving themā€”what we call their ā€œprojects.ā€ Projectsā€”and how they change over timeā€”help us explain not only why they joined unions, but why some stayed and others left

    Disabled adults in sheltered employment: an assessment of dental needs and costs.

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    In this dental survey of a multi-disability sheltered industry, 233 adults were examined. When compared to adjusted North Carolina values, the workers exhibited poorer oral hygiene with higher rates and severity of periodontal disease. DMF-T totals were equal to those statewide; however, workers had more decayed and fewer missing teeth. Significant unmet restorative and prosthodontic needs were found. Treatment cost estimates at 1983 fees were 421percapita,withamedianfeeof421 per capita, with a median fee of 240

    The Mixing Rate of the Arterial Blood Pressure Waveform Markov Chain is Correlated with Shock Index during Hemorrhage in Anesthetized Swine

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    Identifying the need for interventions during hemorrhage is complicated due to physiological compensation mechanisms that can stabilize vital signs until a significant amount of blood loss. Physiological systems providing compensation during hemorrhage affect the arterial blood pressure waveform through changes in dynamics and waveform morphology. We investigated the use of Markov chain analysis of the arterial blood pressure waveform to monitor physiological systems changes during hemorrhage. Continuous arterial blood pressure recordings were made on anesthetized swine (N=7) during a 5 min baseline period and during a slow hemorrhage (10 ml/kg over 30 min). Markov chain analysis was applied to 20 sec arterial blood pressure waveform segments with a sliding window. 20 ranges of arterial blood pressure were defined as states and empirical transition probability matrices were determined for each 20 sec segment. The mixing rate (2nd largest eigenvalue of the transition probability matrix) was determined for all segments. A change in the mixing rate from baseline estimates was identified during hemorrhage for each animal (median time of 13 min, ~10% estimated blood volume, with minimum and maximum times of 2 and 33 min, respectively). The mixing rate was found to have an inverse correlation with shock index for all 7 animals (median correlation coefficient of -0.95 with minimum and maximum of -0.98 and -0.58, respectively). The Markov chain mixing rate of arterial blood pressure recordings is a novel potential biomarker for monitoring and understanding physiological systems during hemorrhage

    South African university staff and studentsā€™ perspectives, preferences, and drivers of hesitancy regarding COVID-19 vaccines: A multi-methods study

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    COVID-19 vaccine hesitancy poses a threat to the success of vaccination programmes currently being implemented. Concerns regarding vaccine effectiveness and vaccine-related adverse events are potential barriers to vaccination; however, it remains unclear whether tailored messaging and vaccination programmes can influence uptake. Understanding the preferences of key groups, including students, could guide the implementation of youth-targeted COVID-19 vaccination programmes, ensuring optimal uptake. This study examined university staff and studentsā€™ perspectives, preferences, and drivers of hesitancy regarding COVID-19 vaccines. A multi-methods approach was usedā€”an online convenience sample survey and discrete choice experiment (DCE)ā€”targeting staff and students at the University of KwaZulu-Natal, South Africa. The survey and DCE were available for staff and students, and data were collected from 18 November to 24 December 2021. The survey captured demographic characteristics as well as attitudes and perspectives of COVID-19 and available vaccines using modified Likert rating questions adapted from previously used tools. The DCE was embedded within the survey tool and varied critical COVID-19 vaccine programme characteristics to calculate relative utilities (preferences) and determine trade-offs. A total of 1836 staff and students participated in the study (541 staff, 1262 students, 33 undisclosed). A total of 1145 (62%) respondents reported that they had been vaccinated against COVID-19. Vaccination against COVID-19 was less prevalent among students compared with staff (79% of staff vs. 57% of students). The vaccineā€™s effectiveness (22%), and its safety (21%), ranked as the two dominant reasons for not getting vaccinated. These concerns were also evident from the DCE, with staff and students being significantly influenced by vaccine effectiveness, with participants preferring highly effective vaccines (90% effective) as compared with those listed as being 70% or 50% effective (Ī² = āˆ’3.72, 95% CI = āˆ’4.39 to āˆ’3.04); this characteristic had the strongest effect on preferences of any attribute. The frequency of vaccination doses was also found to have a significant effect on preferences with participants deriving less utility from choice alternatives requiring two initial vaccine doses compared with one dose (Ī² = āˆ’1.00, 95% CI = āˆ’1.42 to āˆ’0.58) or annual boosters compared with none (Ī² = āˆ’2.35, 95% CI = āˆ’2.85 to āˆ’1.86). Notably, an incentive of ZAR 350 (USD 23.28) did have a positive utility (Ī² = 1.14, 95% CI = 0.76 to 1.53) as compared with no incentive. Given the slow take-up of vaccination among youth in South Africa, this study offers valuable insights into the factors that drive hesitancy among this population. Concerns have been raised around the safety and effectiveness of vaccines, although there remains a predilection for efficient services. Respondents were not enthusiastic about the prospect of having to take boosters, and this has played out in the roll-out data. Financial incentives may increase both the uptake of the initial dose of vaccines and see a more favourable response to subsequent boosters. Universities should consider tailored messaging regarding vaccine effectiveness and facilitate access to vaccines, to align services with the stated preferences of staff and students

    Reassessing the impact of smoking on preeclampsia/eclampsia: Are there age and racial differences?

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    To investigate the association between cigarette use during pregnancy and pregnancy-induced hypertension/preeclampsia/eclampsia (PIH) by maternal race/ethnicity and age.This retrospective cohort study was based on the U.S. 2010 natality data. Our study sample included U.S. women who delivered singleton pregnancies between 20 and 44 weeks of gestation without major fetal anomalies in 2010 (nā€Š=ā€Š3,113,164). Multivariate logistic regression models were fit to estimate crude and adjusted odds ratios and the corresponding 95% confidence intervals.We observed that the association between maternal smoking and PIH varied by maternal race/ethnicity and age. Compared with non-smokers, reduced odds of PIH among pregnant smokers was only evident for non-Hispanic white and non-Hispanic American Indian women aged less than 35 years. Non-Hispanic Asian/Pacific Islander women who smoked during pregnancy had increased odds of PIH regardless of maternal age. Non-Hispanic white and non-Hispanic black women 35 years or older who smoked during pregnancy also had increased odds of PIH.Our study findings suggest important differences by maternal race/ethnicity and age in the association between cigarette use during pregnancy and PIH. More research is needed to establish the biologic and social mechanisms that might explain the variations with maternal age and race/ethnicity that were observed in our study
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