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Biomedical subjects

R P Stewart

Publications and source records attributed to R P Stewart.

6 recordsLinked to original sources

Ability to pay for retiree health benefits.

This paper examines retired persons who received employer-provided health benefits in 1987. The sociodemographic, health, and economic characteristics of these elderly persons are compared to the total elderly population. Two methods of estimating retiree insurance purchase are considered and indicate 13% to 20% of retirees would be unable to afford benefits without an employer subsidy. The percentage of persons unable to purchase the employer-provided benefits drops significantly if some subsidy is maintained. The results indicate substantial differences in ability to purchase insurance by sociodemographic characteristics. The future of retiree health benefits in a reformed health care system is discussed.

Aged↗

Guanyl nucleotide regulation of human chorionic gonadotropin binding to rat luteal tissue.

Guanyl nucleotides are known to have a dual effect on most hormone-sensitive adenylate cyclase systems, regulating activation of the adenylate cyclase enzyme and binding of hormone to receptor. In the ovary, guanyl nucleotides have been shown to be required for hCG stimulation of luteal adenylate cyclase, but no effect on binding has been observed. Evidence has been obtained which suggests that guanyl nucleotide regulation of hCG binding is masked in most luteal membrane preparations by the presence of a large excess of unregulated receptor. A highly purified urea-washed membrane fraction has been prepared. Binding of hCG to this preparation was decreased (approximately 45%) in the presence of 5'-guanylylimidodiphosphate (GMPPnP). The maximal effect of GMPPnP occurred at 10 microM, with the half-maximal effect at 0.2 microM. These levels compare favorably with the GTP concentrations required for hCG stimulation of luteal adenylate cyclase. Analysis of equilibrium binding experiments showed that GMPPnP acted by reducing the number of binding sites by 45%. However, kinetic experiments suggested that this effect was due to a significant decrease in the affinity of a fraction of the hCG-binding sites. Association of hCG and its receptor was unaffected by the presence of GMPPnP (100 microM), whereas the dissociation of 40-50% of bound hormone was significantly accelerated (30-fold) by its presence. The guanyl nucleotide effect required the presence of MG+2; other divalent cations (Ca+2, Mn+2, and Co+2 could not be substituted. The ratio of beta-adrenergic to hCG-binding sites in the urea-washed heavy membrane preparation was elevated, suggesting that a sizable fraction of uncoupled hCG receptor had been removed. The results show that hCG binding to its luteal receptor is modulated by guanyl nucleotide and suggest that the modulation only occurs in those receptors that are directly coupled to the adenylate cyclase enzyme.

Animals↗

Demand for insurance by elderly persons: private purchases and employer provision.

Studies of the demand for health insurance by elderly persons often inadequately address the distinctions between those who receive insurance through a former employer and those who purchase insurance on their own. The failure to distinguish these two modes of supplementing Medicare can lead to an inability to identify the effects of important independent variables. Using data from the Survey of Income and Program Participation this paper examines the demand for employer provided health insurance among retired pensioners using a bivariate probit model with partial observability and compares these results to other models of insurance demand among elderly persons. The results indicate that unobserved factors reducing the probability of being offered employer provided insurance are associated with increased acceptance. A comparison of the employer provided results with results from other models of the demand for privately purchased insurance indicates that different independent variables may determine the probability of having these types of insurance. Previous studies of insurance that have not distinguished between these two types of insurance may not provide reliable estimates of the relationship between independent variables and the probability of insurance coverage.

Aged↗

Building alliance between the family and the institution.

A social work model for building a family-institution alliance as distinguished from a therapeutic alliance is presented. The model is based on a conceptualization of the family's needs at four successive stages in the early period of its relationship with the institution, beginning with the family's decision to admit a family member and concluding with an assessment of the type of therapeutic alliance indicated for the family. A review of the pertinent literature is also presented.

Hospital Bed Capacity, 100 to 299↗