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PubMed2004

Resting and stimulated whole salivary flow rates in Sjögren's syndrome patients over time: a diagnostic aid for subsidized dental care?

The aim of the present study was to evaluate Swedish and Norwegian criteria currently applied in the assessment of eligibility for subsidized dental care of Sjogren's syndrome (SS) patients. These criteria are partly based on a single salivary test showing a resting whole salivary secretion rate of < or =0.1 mL/min. Thirty secondary Sjogren (SSS) patients (29 F and 1 M) participated for the duration of the study, in which resting (RWS) and stimulated (SWS) whole salivary flow rates were collected in the morning and afternoon, over 3 consecutive weeks, once per week, as well as at different times over a 5-year period. Twenty patients presented levels of RWS flow rates of < or =0.1 mL/min on one or more occasions over a 3-week period, while 8 of these also exceeded, on one or more occasions, the cut-off level of 0.1 mL/min, indicating that salivary flow rates varied over time. Six patients showed consistently low secretion rates of RWS as well as of SWS, estimated as < or =0.1 mL/min and <0.7 mL/min, respectively. Based on the results, salivary tests that are to be used as a diagnostic aid for SS diagnosis, and thus as a basis for inclusion within the subsidy net for dental care, must be taken on several occasions in order to more accurately give information about salivary gland function. In line with this, current regulations governing the eligibility of SS patients within subsidized dental care programs should be reviewed.

Adult↗
PubMed2002

Geographic inequalities in the availability of government-subsidized rental housing for low-income older persons in Florida.

PURPOSE: This article investigates the extent to which government-subsidized affordable rental units available to low-income older persons are unequally and unfairly distributed throughout Florida's counties. DESIGN AND METHODS: Primary data sources from the U.S. Department of Housing and Urban Development and the U.S. Census were analyzed using two location inequality statistical measures: quintile analysis and the Dissimilarity Index. Three comparison standards measuring the county locations of the community-wide low-income elderly and nonelderly populations were used to judge whether these patterns are geographically unfair. RESULTS: Compared with the overall locations of Florida's low-income older population, elder-occupied government-subsidized rental housing units are concentrated in fewer counties. On the basis of several standards, these affordable housing units are judged to be unfairly located, resulting in most of the state's low-income elderly population living in counties that are underserved by these accommodations. IMPLICATIONS: The findings offer other states and local areas guideposts to assess and compare the extent of geographic inequality and unfairness in the availability of their affordable senior housing opportunities. Why these inequalities exist and their implications for older persons are researchable questions.

Demography↗
PubMed2006

Spillover edge effects: the dispersal of agriculturally subsidized insect natural enemies into adjacent natural habitats.

The cross-edge spillover of subsidized predators from anthropogenic to natural habitats is an important process affecting wildlife, especially bird, populations in fragmented landscapes. However, the importance of the spillover of insect natural enemies from agricultural to natural habitats is unknown, despite the abundance of studies examining movement in the opposite direction. Here, we synthesize studies from various ecological sub-disciplines to suggest that spillover of agriculturally subsidized insect natural enemies may be an important process affecting prey populations in natural habitat fragments. This contention is based on (1) the ubiquity of agricultural-natural edges in human dominated landscapes; (2) the substantial literature illustrating that crop and natural habitats share important insect predators; and (3) the clear importance of the landscape matrix, specifically distance to ecological edges, in influencing predator impacts in agroecosystems. Further support emerges from theory on the importance of cross-boundary subsidies for within site consumer-resource dynamics. In particular, high productivity and temporally variable resource abundance in agricultural systems are predicted to result in strong spillover effects. More empirical work examining the prevalence and significance of such natural enemy spillover will be critical to a broader understanding of fragmentation impacts on insect predator-prey interactions.

Agriculture↗
PubMed1993

Subsidized elderly housing: public-private partnerships on the brink.

Starting in the early 1960s, the federal government joined with the private-sector housing developers in a partnership: in return for subsidized mortgages and tax benefits, developers would rent to low- and moderate-income tenants. Today, many elderly people live in these "publicly subsidized" units. The initial agreement, however, held out an escape clause: after 15 to 20 years, for-profit developers that wanted to end the partnership could prepay their mortgages, leaving tenants in those buildings "at risk" of rent increases and/or evictions. This article discusses that partnership, its options for dissolution, and the current solutions to the problem of the expiring agreements, including a moratorium, vouchers, and incentives. The compromise legislation responds to all interested parties--owners, current and would-be tenants, local governments, tax-payers--through a multi-stage sequence of dissolution, yet such a finely tuned, acutely sensitive legislative solution may not work easily or efficiently.

Aged↗
PubMed1999

Subsidence of a non-polished stem in revisions of the hip using impaction allograft. Evaluation with radiostereometry and dual-energy X-ray absorptiometry.

We revised 24 consecutive hips with loosening of the femoral stem using impaction allograft and a cemented stem with an unpolished proximal surface. Repeated radiostereometric examinations for up to two years showed a slow rate of subsidence with a mean of 0.32 mm (-2.0 to +0.31). Fifteen cases followed for a further year showed the same mean subsidence after three years, indicating stabilisation. A tendency to retroversion of the stems was noted between the operation and the last follow-up. Retroversion was also recorded when displacement of the stem was studied in ten of the patients after two years. Repeated determination of bone mineral density showed an initial loss after six months, followed by recovery to the postoperative level at two years. Defects in the cement mantle and malalignment of the stem were often noted on postoperative radiographs, but did not correlate with the degrees of migration or displacement. After one year, increasing frequency of trabecular remodelling or resorption of the graft was observed in the greater trochanter and distal to the tip of the stem. Cortical repair was noted distally and medially (Gruen regions 3, 5 and 6). Migration of the stems was the lowest reported to date, which we attribute to the improved grafting technique and to the hardness of the graft.

Absorptiometry, Photon↗
PubMed1994

Does subsidizing rural community health centers hurt private practice physicians?

One reason for the shortage of primary care physicians in rural areas may be these physicians' reluctance to compete for patients with federally subsidized Community Health Centers (CHCs). Yet little is known about the relationship between private practice physicians and physicians in federally subsidized practices who share service areas. We used surveys from a two-state subset of a nationally representative sample to compare practice characteristics of three types of physicians: those who work in CHCs; those in private practice within CHC service areas; and private practice physicians in other rural areas. We found that rural physicians who compete with CHCs earn incomes comparable to physicians in rural areas who do not compete with CHCs, and that the percentage of Medicaid and uninsured patients seen in private physician practices does not increase when a CHC is not in the county. We conclude that CHCs do not provide competitive barriers to physicians in private practice, although we do not know if the presence of a CHC inhibits new private physicians from entering practices in these communities.

Adult↗
PubMedDate not supplied

[Health insurance in the contributive and subsidized regimes and its impact on the service providers].

The performance of 18 private Health-promoting (EPS) and Family Compensation (CCF) entities, as well as their general balances for 1997, 1998 and 1999, were studied to determine the profit margins achieved by EPS's in their work of administering health insurance. The average behavior of each EPS balance sheet was analyzed to reduce the effect produced by extreme cases; each EPS's value was thus weighted by the number of its affiliated people. The expected behavior of the costs and expenses of companies whose main business is providing health insurance could thus become determined. The main source of operational income for a private EPS is the contributive regime's per capita unit of payment (UPC). Subsidized regime participation and that of other sources of income has decreased year by year. By contrast, public EPS's have shown decreasing participation in income obtained from UPC (contributive and subsidized) and growing dependence on other sources of income; this can be interpreted as being a symptom of weak commercial management. According to the balance sheets provided by the SNS, the EPS (public, private and Family Compensation entities), including the Social Security Institute (ISS), together obtained a total of 4.18 billion pesos operational income in 1999, an increase of 21.7% as compared to 1998. Income received from the ISS amounted to 1.93 billion dollars in 1999 (46% of the total). At 2000 prices, the total amount of operational income was 4.54 billion pesos in 1999 (15.6% real increase). Taking the behavior of 4 EPS's as our reference point (Sanitas, Humana Vivir, Coomeva and Famisanar), it can be concluded that an EPS whose main business is health insurance needs a 17.2% gross margin to cover its operational and non-operational costs and a 1.1% margin before tax.

Accounting↗
PubMed1996

Oral mucosal changes and associated factors among male industrial workers with or without access to subsidized dental care.

Oral mucosal changes and associated factors were studied among male industrial workers in southern Finland. Two groups, with or without access to an employer-provided dental benefit scheme, were compared. A multiple-choice questionnaire followed by clinical examinations was completed by 325 (81%) subsidized workers and 174 (69%) controls. In both groups 52% of the subjects had some oral mucosal change, and there were no significant differences between the groups in the location distribution of the changes. Smoking was significantly associated with redness of the oral mucosa (p < 0.001), coating (p < 0.001), and leukoplakia (p < 0.01), whereas denture wearing was associated with ulcers (p < 0.05), hyperplasia (p < 0.001), and redness (p < 0.001). Among denture wearers non-acceptable dentures were significantly associated with hyperplasia (p < 0.001). The subsidized group had better dentures, although this did not significantly benefit their oral mucosal status.

Adult↗
PubMed2003

Visceral hypersensitivity and altered colonic motility after subsidence of inflammation in a rat model of colitis.

AIM: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by visceral hypersensitivity and altered bowel motility. There is increasing evidence suggesting the role of inflammation in the pathogenesis of IBS, which addresses the possibility that formerly established rat model of colitis could be used as an IBS model after the inflammation subsided. METHODS: Colitis was induced by intracolonic instillation of 4% acetic acid in male Sprague-Dawley rats. The extent of inflammation was assessed by histological examination and myeloperoxidase (MPO) activity assay. After subsidence of colitis, the rats were subjected to rectal distension and restraint stress, then the abdominal withdrawal reflex and the number of stress-induced fecal output were measured, respectively. RESULTS: At 2 days post-induction of colitis, the colon showed characteristic inflammatory changes in histology and 8-fold increase in MPO activity. At 7 days post-induction of colitis, the histological features and MPO activity returned to normal. The rats at 7 days post-induction of colitis showed hypersensitive response to rectal distension without an accompanying change in rectal compliance, and defecated more stools than control animals when under stress. CONCLUSION: These results concur largely with the characteristic features of IBS, visceral hypersensitivity and altered defecation pattern in the absence of detectable disease, suggesting that this animal model is a methodologically convenient and useful model for studying a subset of IBS.

Acetic Acid↗
PubMedDate not supplied

[Focusing on the subsidized health regime in Colombia].

Based on the results of the project "Evaluation of the Processes of the Subsidized health regime" in Colombia, a reflection is presented about the beneficiary selection system--Sisben as a tool to affiliate people to the subsidized health regime. The multiple interpretations which have been given to the Sisben as an instrument to focalize the health services in the poorest populations, are documented and analyzed. This has been interpreted, amongst others, as a measure of the magnitude of poverty, as an approximate indicator of resources or income, or as an evaluation of fulfillment of needs. It was found that amongst the 19 million of poor people living in Colombia in 1997, less than half of them, 8.9 million, have been included in levels 1 and 2 of Sisben, which represents an exclusion error of 53.1%. Of the 10.6 million persons classified in these levels, 1.6% are not poor, giving an inclusion error of 14.9%. The exclusion errors are much more serious than the inclusion ones, because they mean a denial of equal rights and services for all those who are in similar conditions, according to the criteria for assignation of subsidies.

Colombia↗
PubMedDate not supplied

Problems in estimating the number of women in need of subsidized prenatal care.

For effective allocation of resources, public program planners need to know how many women require subsidized prenatal care and where they are located. Because sample surveys are expensive, indirect methods of estimation using secondary data sources are frequently used to arrive at quick annual estimates. Census data on poverty are often incorporated into such methods, but out study of the eight southeast States in Federal Region IV shows that available census data severely underestimate the proportion of pregnant women who are poor. Updated poverty data from the 1990 census will not solve this problem of underestimation. Alternative methods for estimating the number of women in need of subsidized prenatal care services, for measuring unmet need, and for doing estimates on the county level are presented and evaluated. Such considerations are especially important, given the new Title V block grant reporting requirements.

Female↗
PubMed1979

A study of scrotal biopsy in subsided cases of lepromatous leprosy.

Scrotal biopsies were obtained from 38 cases of lepromatous leprosy who were clinically subsided and had negative skin smears. Twenty six (68.4%) of these cases revealed bacilli in the dartos muscle. None except one showed a specific lesion in the dartos. Bacilli obtained from 2 out of 7 cases multiplied in the mouse foot-pad. Bacilli were found to be persisting in the dartos muscle despite prolonged treatment before as well as after clinical subsidence of the disease. The persisting bacilli in this situation could be a cause of relapses.

Adolescent↗
PubMed1998

[Small cell lung cancer associated with subacute sensori-motor neuropathy in a patient whose symptoms subsided during chemotherapy].

A 71-year-old man was referred to us with diplopia, left peripheral facial nerve dysfunction, ataxic gait and dysesthesia of the extremities. Neurological examination revealed mild reduction of sensation to pinprick and light touch in the left dominant lower leg. His standing position was wide based, and he showed Romberg's sign. The patient also presented signs of left peripheral facial, bilateral abducent, and left oculomotor nerve dysfunction. Serum levels of CEA, CA 19-9, and proGRP were high. 67Gallium scintigraphy showed an accumulation of radioactivity at the hilum of the right lung, and the findings of bronchofiberscopy were compatible with the diagnosis of small cell lung cancer. Because the symptoms gradually worsened to the point that the patient could not move by himself, chemotherapy and radiotherapy were initiated 3 months after the onset of symptoms. While under chemotherapy, symptoms of neuropathy subsided and the patient was able to walk with the aid of a walking stick. Although all symptoms were indicative of carcinomatous neuropathy, no antineuronal antibodies were detected in the patient's serum by immunohistochemical techniques. However, because the lung cancer deteriorated gradually despite therapy, the patient died of respiratory failure. At autopsy, tumor metastases were found in the pericardium, left lung, both adrenal glands, right hilum lymph nodes, and mediasternal lymph nodes. No microscopic signs of metastases were found in the frontal, parietal, temporal, or occipital lobes, or in the basal ganglia, thalamus, midbrain, pons, cerebellar vermis and hemispheres, or upper medulla. Histopathologically, there was no degeneration of neuronal cell bodies in cerebellar or cervical dorsal root ganglia; however, almost total loss of myelinated fibers or variegated demyelination of myelinated fibers was observed in the anterior, lateral and posterior funiculus at both cervical segments of the spinal cord. The number of myelinated fibers was smaller in the 5th and 6th cervical left ventral roots. The reason why the patient's symptoms subsided during chemotherapy was probably a suppression of antineuronal antigen by chemotherapy and the repair of myelinated fibers.

Aged↗
PubMed2005

Subsidized housing and children's nutritional status: data from a multisite surveillance study.

BACKGROUND: A critical shortage of affordable housing for low-income families continues in the United States. Children in households that are food insecure are at high risk for adverse nutritional and health outcomes and thus may be more vulnerable to the economic pressures exerted by high housing costs. Only about one fourth of eligible families receive a federally financed housing subsidy. Few studies have examined the effects of such housing subsidies on the health and nutritional status of low-income children. OBJECTIVE: To examine the relationship between receiving housing subsidies and nutritional and health status among young children in low-income families, especially those that are food insecure. DESIGN: Cross-sectional observational study. SETTING AND PARTICIPANTS: From August 1998 to June 2003, the Children's Sentinel Nutrition Assessment Program interviewed caregivers of children younger than 3 years in pediatric clinics and emergency departments in 6 sites (Arkansas, California, Maryland, Massachusetts, Minnesota, and Washington, DC). Interviews included demographics, perceived child health, the US Household Food Security Scale, and public assistance program participation. Children's weight at the time of the visit was documented. The study sample consisted of all renter households identified as low income by their participation in at least 1 means-tested program. MAIN OUTCOME MEASURES: Weight for age, self-reported child health status, and history of hospitalization. RESULTS: Data were available for 11 723 low-income renter families; 27% were receiving a public housing subsidy, and 24% were food insecure. In multivariable analyses, stratified by household food security status and adjusted for potential confounding variables, children of food-insecure families not receiving housing subsidies had lower weight for age (adjusted mean z score, -0.025 vs 0.205; P<.001) compared with children of food-insecure families receiving housing subsidies. Compared with children in food-insecure, subsidized families, the adjusted odds ratio (95% confidence interval) for weight-for-age z score more than 2 SDs below the mean was 2.11 (1.34-3.32) for children in food-insecure, nonsubsidized families. CONCLUSIONS: In a large convenience sentinel sample, the children of low-income renter families who receive public housing subsidies are less likely to have anthropometric indications of undernutrition than those of comparable families not receiving housing subsidies, especially if the family is not only low income but also food insecure.

Body Weight↗
PubMed1986

Institutional subsidization of medical-school based continuing medical education.

The changing financial structure of health care is prompting review of medical school resources allocated to CME units. This study examined the types of subsidization provided to CME by medical schools and the methods of allocation of CME revenue within medical schools. Data are presented for 21 medical schools from different geographic areas of the United States. Medical schools often provide appreciable financial support to CME offices, particularly office space, faculty time, and space for CME meetings. However, the amount of support varies greatly from school to school. Revenue distribution arrangements also vary. Medical schools can use the description of arrangements at other schools in reviewing the appropriateness of their own current arrangements.

Data Collection↗
PubMed1989

Postpartum subsidence of hepatitis B viral replication in HBeAg-positive carrier mothers.

To elucidate the effects of pregnancy and delivery on hepatitis B e antigen (HBeAg)-positive carrier mothers, 31 HBeAg-positive carrier mothers were followed-up postpartum 1 year, with 30 HBeAg-positive nonpregnant female carriers as controls. Serum hepatitis B surface antigen (HBsAg), HBeAg titer, and hepatitis B virus (HBV)-DNA concentration were studied at defined intervals. The results revealed that in the control group HBeAg titers and HBV-DNA concentrations fluctuated, whereas the HBsAg titers showed little change, but HBeAg clearance or seroconversion to anti-HBe were not noted on follow-up. In contrast, one carrier mother seroconverted to anti-HBe during pregnancy and the antibody persisted thereafter. Five of the remaining 30 carrier mothers cleared HBeAg postpartum, and among these five cases, one also seroconverted to anti-HBe. In addition, in another five of the 30 cases, the HBV-DNA fell to undetectable level (less than 0.04 ng/ml). All these ten cases had a common tendency of showing a decrease in HBeAg titers and/or HBV-DNA concentrations 1-2 months after delivery. The HBeAg titers and HBV-DNA concentrations in the other 11 cases remained unchanged, whereas the remaining nine cases had increased levels. It is concluded that subsidence of HBV replication is precipitated by delivery in one-third of HBeAg-positive carrier mothers in Taiwan, and this occurs most frequently 1-2 months postpartum.

Adult↗
PubMed2003

Managing a subsidized predator population: reducing common raven predation on desert tortoises.

Human communities often are an inadvertent source of food, water, and other resources to native species of wildlife. Because these resources are more stable and predictable than those in a natural environment, animals that subsist on them are able to increase in numbers and expand their range, much to the detriment of their competitors and species they prey upon. In the Mojave Desert, common ravens (Corvus corax) have benefited from human-provided resources to increase in population size precipitously in recent years. This trend has caused concern because ravens prey on juvenile desert tortoises (Gopherus agassizi), a federally threatened species. In this paper, I discuss management strategies to reduce raven predation on desert tortoises. The recommendations fall into three categories: (1) managing raven populations by reducing access to anthropogenic resources; (2) removing offending ravens or other birds in specially targeted tortoise management zones; and (3) continuing research on raven ecology, raven behavior, and methods of reducing raven predation on tortoises. I also recommend approaching the problem within an adaptive management framework: management efforts should first be employed as scientific experiments--with replicates and controls--to yield an unbiased assessment of their effectiveness. Furthermore, these strategies should be implemented in concert with actions that reduce other causes of desert tortoise mortality to aid the long-term recovery of their populations. Overall, the approaches outlined in this paper are widely applicable to the management of subsidized predators, particularly where they present a threat to a declining species of prey.

Animals↗