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Biomedical subjects

R W Peterson

Publications and source records attributed to R W Peterson.

15 recordsLinked to original sources
PubMed1999

Increased helix and protein stability through the introduction of a new tertiary hydrogen bond.

In an effort to quantify the importance of hydrogen bonding and alpha-helix formation to protein stability, a capping box motif was introduced into the small phosphocarrier protein HPr. Previous studies had confirmed that Ser46, at the N-cap position of the short helix-B in HPr, serves as an N-cap in solution. Thus, only a single-site mutation was required to produce a canonical S-X-X-E capping box: Lys49 at the N3 position was substituted with a glutamic acid residue. Thermal and chemical denaturation studies on the resulting K49E HPr show that the designed variant is approximately 2 kcal mol-1 more stable than the wild-type protein. However, NMR studies indicate that the side-chain of Glu49 does not participate in the expected capping H-bond interaction, but instead forms a new tertiary H-bond that links helix-B to the four-stranded beta-sheet of HPr. Here, we demonstrate that a strategy in which new non-native H-bonds are introduced can generate proteins with increased stability. We discuss why the original capping box design failed, and compare the energetic consequences of the new tertiary side-chain to main-chain H-bond with a local (helix-capping) side-chain to main-chain H-bond on the protein's global stability.

Amino Acid Substitution↗
PubMed1992

Family reunification following shelter placement: child, family, and program correlates.

Factors associated with family reunification following a short-term stay in a shelter for runaway and troubled youth were examined. Children who were not reunified with their caretakers following their stay reported more family problems, appeared to be at higher risk of suicide, and stayed longer in the shelter. Implications for delivery of shelter service programs are discussed.

Adolescent↗
PubMed1984

Assessment of level of care: implications of interrater reliability on health policy.

In Wisconsin, level-of-care assessments are used to set Medicaid reimbursement and determine nursing home eligibility. This study examined three methods of assessing level of care: 1) the Wisconsin quality assurance project (QAP) method, based on observations of patients, patient records, and staff interviews; 2) the Wisconsin standard (STD) method, based primarily on a clinical record review; and, 3) an adaptation of New York's "DMS-I," a checklist with numerical weights used to set level of care. Results address interrater reliability, the agreement between assessments by research teams and actual levels of care set by the State, and the implications that agreement has for reimbursement.

Costs and Cost Analysis↗
PubMed1984

Differences in the direct costs of public and private acute inpatient psychiatric services.

This exploratory study examined differences in the direct costs of acute inpatient psychiatric services in seven public county-operated specialty hospital units and six private community general hospital units in Wisconsin. There were no significant or substantial differences in measures of severity of patients between the public and private systems. Direct costs per stay and per day were significantly lower in the private units, although charges may have been higher in the private units. These differences in costs appear to be the result of private units having a significantly higher average daily census, more goal emphasis for cost containment, and more psychiatrist influence on how the unit was run. Our findings suggest that mental health system managers examine opportunities for achieving economies of scale and that they set and manage goals for efficiency.

Cost Control↗
PubMed1983

Management, cost, and quality of acute inpatient psychiatric services.

A common objective of health services is to provide high quality care at the least cost, yet some services achieve these objectives better than others. Moreover, there are questions about relationships between cost and quality: do higher expenditures usually result in higher quality, or, conversely, is it possible to provide higher quality of care at expenditure levels that may be lower than other institutions? This paper reports on a study of 13 acute inpatient psychiatric units in which a range of quality and direct cost outcomes was found. Some units had higher quality and lower direct costs than the others. Some had higher quality and higher direct cost, some had lower direct costs and lower quality as well, while another group had lower quality and higher direct costs. Differences in costs and quality were found to be related more to management than to patient, staff, environmental, or institutional characteristics of these units. The findings of this study suggest that proactive management that focuses on organizational outcomes, that makes consequences of operation visible, and that promotes mutual coordination will achieve higher quality and efficient performance.

Costs and Cost Analysis↗