FACTORS INFLUENCING THE PATTERNS OF PHYSICIAN VISITS TO NURSING HOME RESIDENTS

This study was designed to identify some of the factors related to patterns of physician visits to nursing home residents. The relationship of ten resident and organizational characteristics to patterns of physician visits was investigated through secondary analysis of data abstracted from the 1973-74 National Nursing Home Survey of the National Center for Health Statistics. The study sample was composed of 11,135 of the 19,013 nursing home residents who participated in the survey.^ The analytic results revealed that all ten variables had a statistically significant relationship to patterns of physician visits, mainly due to the large sample size. The degrees of association between the variables, measured by the Cramer's V statistic, ranged from moderate to very weak.^ Certification status of the nursing home under Medicare and/or Medicaid was shown to be most strongly related to patterns of physician visits, followed by primary source of payment for nursing home care, and residence prior to nursing home admission. Several variables thought to be related to patterns of physician visits were found to have a very weak relationship: age of the resident, marital status, length of stay, primary diagnosis, number of chronic conditions, activities of daily living status, and levels of care.^ In order to get a more precise picture of the relative influence of certification status and primary source of payment when the other variables were statistically controlled, these two variables were combined into a single variable. The results revealed that the combined effects of certification status and primary source of payment were sustained, regardless of differences in the residents' personal, utilization, and health status characteristics, and the levels of care that they received. The results also indicated that the five groups created by combining the two variables differed in patterns of physician visits. For example, private pay residents in intermediate care facilities (ICF's) and non-certified facilities were more likely to receive unscheduled visits than private pay residents in skilled nursing homes (SNH's), residents in SNH's supported by Medicare or Medicaid, and residents in ICF's supported by Medicaid. ^

Bacterial biomasses and activities in the Northwest African upwelling region

During the 'Meteor' expedition SUBTROPEX '82, sediment samples were taken at 14 stations in different water depths at 35, 29, 25, 21 and 17 °N, and measurements of bacterial biomasses and activities were carried out in these different upwelling-intensity areas. Highest densities and biomasses by AODC (2.2 x 10**8 cells, corresponding to 14.8 µg C/g sediment dry wt) were recorded at 21 °N, year-round upwelling, at 1200 and 800 m, but at 500 m biomass was still 4.3 µg C/g dry wt. Relatively high densities and biomasses (6.5 and 6.8 µg C/g dry wt) were found at 17 °N, upwelling mostly in winter and spring, at 1200 and 800 m. AODC were 2 to 3 orders of magnitude higher than viable counts, incubation at 2 or 20 °C. For deep-water sediments, counts at 2 °C were higher than at 20 °C. Biomass and ATP concentrations were highest in the 0 to 2 cm sediment layers; they decreased with sediment depth. Bacterial biomasses were correlated with organic carbon and ATP concentrations. The fractions of Bacterial ATP were calculated to be 2 to 24% of ATP-biomass. On the basis of organic carbon, however, fractions of Bacterial Organic Carbon were only 0.02 to 0.06%. For microbial communities, the conversion factor 0.004 for BOC to BATP seems 2 orders of magnitude too high. Maximum AEC ratios of 0.53 to 0.70 were found at 21 and 17 °N; the other stations had AEC ratios of 0.21 to 0.47. Numbers of bacteria with respiratory ETS were between 0.5 and 10.5 % of AODC. An exception was the shelf station at 35 °N with 34.2% of AODC.

PEECE II mesocosm experiment: Dynamics of extracellular enzyme activities in seawater under changed atmospheric pCO2, 2011

As part of the PeECE II mesocosm project, we investigated the effects of pCO2 levels on the initial step of heterotrophic carbon cycling in the surface ocean. The activities of microbial extracellular enzymes hydrolyzing 4 polysaccharides were measured during the development of a natural phytoplankton bloom under pCO2 conditions representing glacial (190 µatm) and future (750 µatm) atmospheric pCO2. We observed that (1) chondroitin hydrolysis was variable throughout the pre-, early- and late-bloom phases, (2) fucoidanase activity was measurable only in the glacial mesocosm as the bloom developed, (3) laminarinase activity was low and constant, and (4) xylanase activity declined as the bloom progressed. Concurrent measurements of microbial community composition, using denaturing-gradient gel electrophoresis (DGGE), showed that the 2 mesocosms diverged temporally, and from one another, especially in the late-bloom phase. Enzyme activities correlated with bloom phase and pCO2, suggesting functional as well as compositional changes in microbial communities in the different pCO2 environments. These changes, however, may be a response to temporal changes in the development of phytoplankton communities that differed with the pCO2 environment. We hypothesize that the phytoplankton communities produced dissolved organic carbon (DOC) differing in composition, a hypothesis supported by changing amino acid composition of the DOC, and that enzyme activities responded to changes in substrates. Enzyme activities observed under different pCO2 conditions likely reflect both genetic and population-level responses to changes occurring among multiple components of the microbial loop.