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Biomedical subjects

E Feinberg

Publications and source records attributed to E Feinberg.

At least 19 recordsLinked to original sources
PubMed2001

Family income and crowd out among children enrolled in Massachusetts Children's Medical Security Plan.

OBJECTIVE: To assess whether participation in a state publicly financed health insurance program, Massachusetts Children's Medical Security Plan (CMSP) , which is open to children regardless of income, was associated with disenrollment from private insurance. DATA SOURCES/STUDY DESIGN: A survey of participants in CMSP who were enrolled as of April 1998 was used. We conducted analyses to detect differences in access to and uptake of private insurance between Medicaid-eligible and in eligible children, and between children eligible for the State Children's Health insurance Program (SCHIP) and in eligible children. DATA COLLECTION METHODS: A stratified sample of children was drawn from administrative files. the sampling strategy allowed us to examine crowd out among children based on in come and eligibility for publicly funded coverage: those who were Medicaid-eligible (income pound 133 percent of the federal poverty level [FPL]) , those who were SCHIP-eligible (134-200 percent of FPL) , and those with family in comes that exceed SCHIP eligibility criteria (> 200 percent of FPL). The majority of telephone interviews were conducted with the child's parent/guardian between November 1998 and March 1999. The overall response rate was 61.8 percent , yielding a sample of 996 children. PRINCIPAL FINDINGS: Of the children in our sample whose recent health coverage was employer-sponsored insurance (59 percent), 70 percent were no longer eligible. Few children who had employer-sponsored insurance at enrollment dropped this coverage to enroll in CM SP (1 percent, 4 percent, and 2 percent by income). Compared to Medicaid-eligible children, children with incomes > 133 percent of FPL were significantly more likely to be eligible for employer-sponsored insurance but they were no more likely to have purchased offered coverage. Access to employer-sponsored insurance was limited (19 percent), and uptake was low (13 percent). We found no significant difference between SCHIP-eligible children and those whose family incomes exceeded SCHIP guidelines. CONCLUSIONS: The Massachusetts experience suggests that (1) coverage could be expanded to children with incomes up to 200 percent of FPL with little direct substitution of public coverage for private insurance, and (2) substitution among children with incomes > 200 percent of FPL, who paid a premium that may have restrained crowd out, did not differ from that among SCHIP-eligible children.

Adolescent↗
PubMed1995

Ultraviolet radiation increases tropoelastin accumulation by a post-transcriptional mechanism in dermal fibroblasts.

Chronically sun-damaged human skin is characterized by dermal connective tissue damage that includes the massive accumulation of abnormal elastic fibers. The content of elastin, the major protein component of elastic fibers, is increased two- to sixfold in sun-damaged skin. The aim of this study was to determine the mechanism responsible for the increase in elastin levels after ultraviolet (UV) irradiation. Confluent cultures of normal dermal fibroblasts were irradiated with 4.5 mJ/cm2 of UVB; sham-treated cells served as the control group. The accumulation of tropoelastin was determined at 5 d after treatment by measuring the incorporation of 14C-proline into radiolabeled tropoelastin isolated from cell layers and media. UV irradiation increased radiolabeled tropoelastin accumulation approximately twofold without affecting DNA content, the total amount of radiolabeled protein, or tropoelastin secretion. Moreover, the steady-state levels of tropoelastin mRNA, as determined by slot blot hybridizations, were unaffected by UV treatment. However, the translation of tropoelastin mRNA was increased when total RNA from irradiated cells was used in cell-free translation experiments. These results suggest that altered translational efficiency may account for the increase in tropoelastin accumulation after UV irradiation. In support of this hypothesis, nucleotide sequences were derived from tropoelastin mRNA isolated from UV-irradiated and nonirradiated dermal fibroblasts. Almost a 12% substitution rate was observed in nucleotide sequences derived from the 3' untranslated region of tropoelastin mRNA from the UV-treated cells. In contrast, a coding domain of tropoelastin did not contain base-substitution mutations. These multiple base substitutions in a noncoding domain of tropoelastin mRNA may be responsible for the post-transcriptional increase in tropoelastin accumulation after UV irradiation.

Base Sequence↗