Diane McFadden | PubMed Health

PubMed2006

The capsular dynamics of Cryptococcus neoformans.

Cryptococcus neoformans is a soil-dwelling fungus that causes life-threatening illness in immunocompromised individuals and latently infects many healthy individuals. C. neoformans, unlike other human pathogenic fungi, is surrounded by a polysaccharide capsule that is essential for survival and enables C. neoformans to thwart the mammalian immune system. The capsule is a dynamic structure that undergoes changes in size and rearranges during budding. Here, the latest information and unresolved questions regarding capsule synthesis, structure, assembly, growth and rearrangements are discussed along with the concept that self-assembly is important in capsular dynamics.

Cell Wall↗

PubMed2004

Barriers to patient-physician communication about out-of-pocket costs.

BACKGROUND: Though many patients and physicians believe that they should discuss out-of-pocket costs, research suggests that they infrequently do. OBJECTIVE: To examine barriers preventing patient-physician communication about out-of-pocket costs among study subjects recalling a time when they wanted to discuss these costs but did not do so. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional surveys of 133 general internists and 484 of their patients from 3 academic and 18 community practices in a large midwestern metropolitan region. MEASUREMENTS: Patient- and physician-reported barriers to discussing out-of-pocket costs. MAIN RESULTS: Overall, 54 patients (11%) and 27 physicians (20%) were able to recall a specific time when they wanted to discuss out-of-pocket costs but did not do so. Among patients, a wide variety of barriers were reported including their own discomfort (19%), insufficient time (13%), a belief that their physician did not have a viable solution (11%), and concerns about the impact of discussions on quality of care (9%). Among physicians, the most common barriers reported were insufficient time (67%) and a belief that they did not have a solution to offer (19%). CONCLUSIONS: Efforts to promote discussions of out-of-pocket costs should emphasize the legitimacy of patients' concerns and brief actionable alternatives that physicians can take to address them.

Adolescent↗