Association between income inequality and mortality among US States: considering population at risk.
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Biomedical subjects
Publications and source records attributed to Andreas Muller.
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Data are presented on a fabrication approach that places an isolated single quantum dot at the center of a semiconductor microcavity. The microcavity is based on an all-epitaxial mesa-confined design that is mechanically robust and provides the thermal dissipation needed for a single photon source device technology. Microphotoluminescence is used to reveal single quantum dot emission with the essential optical properties of single quantum emitters.
OBJECTIVE: In order to assess the effect of deliberately delayed percutaneous fetoscopic tracheal occlusion on survival of fetuses with life-threatening congenital diaphragmatic hernia. METHODS: Eight fetuses with life-threatening congenital diaphragmatic hernia underwent fetoscopic tracheal balloon occlusion between 29 + 0 and 32 + 4 weeks of gestation. Delayed occlusion was chosen in order to minimize potentially negative pulmonary effects from premature delivery as a result of fetal surgery. In addition, we wanted to become able to provide all available postnatal intensive care treatment means in these patients. RESULTS: Six of the 8 fetuses survived to discharge from hospital. CONCLUSION: Delayed fetoscopic tracheal balloon occlusion may be rewarded with lung growth sufficient to allow survival of fetuses with life-threatening congenital diaphragmatic hernia.
PURPOSE: To assess the validity of a digital nonmydriatic fundus camera in detecting cataract as a cause of visual impairment. DESIGN: Diagnostic test comparison. METHODS: Photos of the anterior segment of 72 eyes were taken with a nonmydriatic fundus camera and assessed for cataract by two graders. Dilated biomicroscopy examination of the anterior segment of the same 72 eyes was then performed and cataract graded using the Wilmer scale. RESULTS: Grader 1 and 2 reported 90% and 94% sensitivity and 82% and 77% specificity, respectively, when the digital photos were compared with slit-lamp biomicroscopy in determining visually significant cataract. In addition, both graders showed similar substantial agreement between the digital photos and slit-lamp biomicroscopy when assessed for cataract (unweighted kappa 0.87 and 0.92, respectively, for graders 1 and 2). CONCLUSION: The nonmydriatic fundus camera may be an alternative method for screening for visually significant cataract in the community.
On July 1 2000, the State of Florida exempted adult motorcyclist and moped riders from wearing helmets provided they have medical insurance of 10,000 US dollars. Monthly time series of motorcycle occupant deaths are examined from 1/1994 to 12/2001. The interrupted time series analysis estimates a 48.6% increase in motorcycle occupant deaths the year after the law change. The impact estimate reduces to 38.2% and 21.3% when trends in travel miles and motorcycle registrations are controlled. Our findings suggest that the law's age exemption should be revoked.
Although his name is commonly recognized in conjunction with various corneal and anterior segment disorders, Ernst Fuchs' contribution to ophthalmology exceeds purely the delineation of ocular diseases and the detailed description of signs. Fuchs' collection of microscopic samples laid the foundation for anatomical and pathological understanding of blood vessels, muscles, and most other tissues of the eye. Additionally, Fuchs was able to pass on his unique knowledge, educating ophthalmologists at an international level. His textbook was, for many decades, the most extensively used reference book in the field of ophthalmology worldwide.
OBJECTIVE: To test whether the relation between income inequality and mortality found in US states is because of different levels of formal education. DESIGN: Cross sectional, multiple regression analysis. SETTING: All US states and the District of Columbia (n=51). DATA SOURCES: US census statistics and vital statistics for the years 1989 and 1990. MAIN OUTCOME MEASURE: Multiple regression analysis with age adjusted mortality from all causes as the dependent variable and 3 independent variables-the Gini coefficient, per capita income, and percentage of people aged >/=18 years without a high school diploma. RESULTS: The income inequality effect disappeared when percentage of people without a high school diploma was added to the regression models. The fit of the regression significantly improved when education was added to the model. CONCLUSIONS: Lack of high school education accounts for the income inequality effect and is a powerful predictor of mortality variation among US states.
This article reviews quality of health care initiatives beginning with the quality assessment/quality assurance movement of the 1970s. Conceptually, modern quality of care management is rooted in the intellectual work of Avedis Donabedian who defined quality of care as a combination of structure, process, and outcome. Donabedian's model is presented and some limitations are pointed out. In the late 1980s and 1990s. the health care industry adopted total quality management (TQM). More recently, the pursuit of health care quality has led to substantial performance measurement initiatives such as ORYX by the Joint Commission on Accreditation of Healthcare Organizations and MEDIS by the National Commission of Quality Assurance. The importance of CONQUEST, a freely available performance measurement database developed at the Harvard School of Public Health, is noted and discussed. The article concludes with a list of challenges facing public and private parties interests in health care quality improvement.