The welfare state determinants of health: Implications of regimes and pathways

Background. Population health within and between nations is heavily influenced by political determinants, yet these determinants have received significantly less attention than socioeconomic factors in public health. It has been hypothesized that the welfare state, as a political variable, may play a particularly prominent role in affecting both health indicators and health disparities in developed countries. The research, however, provides conflicting evidence regarding the health impact of particular regimes over others and the mechanisms through which the welfare state can most significantly affect health.^ Objective. To perform a systematic review of the literature as a means of exploring what the current research indicates regarding the benefits or detriments of particular regimes styles and the pathways through which the welfare state can impact heath indicators and health disparities within developed countries.^ Methods. A thorough search of the EBSCO, Pubmed, Medline, Web of Science, and Scopus electronic databases was conducted and resulted in the identification of 15 studies that evaluated the association between welfare state regime and population health outcomes, and/or pathways through with the welfare state influences health. ^ Results. Social democratic countries tended to perform best when infant mortality rate (IMR) was the primary outcome of interest, whereas liberal countries performed strongly in relation to self perceived health. The results were mixed regarding welfare state effectiveness in mitigating health inequities, with Christian democratic countries performing as well as social democratic countries. In relation to welfare state pathways, public health spending and medical coverage were associated with positive health indicators. Redistributive impact of the welfare state was also consistently associated with better health outcomes while social security expenditures were not.^ Discussion/Conclusions. Studies consistently discovered a significant relationship between the welfare state and population health and/or health disparities, lending support to the hypothesis that the welfare state is, indeed, an important non-medical determinant of health. However, it is still fairly unclear which welfare state regime may be most protective for health, as results varied according to the measured health indicator. The research regarding welfare state pathways is particularly undeveloped, and does not provide much insight into the importance of in-kind service provision or cash transfers, or targeted or universal approaches to the welfare state. Suggestions to direct future research are provided.^

Comparing experience of diabetes care with chronic illness care in the primary care clinic using the Patient Assessment of Chronic Illness Care (PACIC)

Purpose. The overall purpose of the study was to evaluate the patient experience relevant to the Chronic Care Model as measured by the PACIC. Chronic illness care of patients with diabetes was compared to those with other chronic illnesses. In addition, chronic illness care of Hispanics was compared to those of other race/ethnicity. ^ Methods. The setting of this study was 20 primary care practices located in San Antonio, TX. The subjects in this study were consecutive adult patients age >18 yrs. Data was collected via a survey (PACIC) administered to 40-60 consecutive adult patients in each primary care clinic who presented for a scheduled appointment. ^ Results. Patient experience of the Chronic Care Model is different among those with diabetes than those with other chronic diseases: those with diabetes report a higher PACIC score. (P = 0.012) Although Hispanic patients report a higher PACIC score, patient experience of the Chronic Care Model among Hispanic patients is not significantly different than that of patients of other race/ethnicity regardless of chronic disease. (P = 0.053) After controlling for the patient characteristics of age, education, health status, and race/ethnicity, the diabetes status of the patient remains significantly associated with the outcome, the PACIC score. (P = 0.033) ^ Conclusions. Diabetes is associated with a greater experience of the Chronic Care model. Contributing factors to diabetes patients’ greater experience of the Chronic Care Model include the greater heath care use and higher self-care needs unique to individuals with diabetes. Special consideration must be given to the specific needs diabetic patients to ensure effective interventions, higher patient education, greater patient compliance, and lower health care costs. ^

Legal regulation of the food industry as a public health measure

Background. The Food and Drug Administration (FDA) is an agency of the federal government that is responsible for monitoring and maintaining public health through the regulation of many industries, including food safety. Through the Nutrition Labeling and Education Act of 1990, the FDA was granted authority over the implementation and regulation of nutrition labeling on packaged foods. Many nutrients are printed on nutrition labels as well as their percent Daily Values. Research has been undertaken to examine the evidentiary basis the FDA relied upon in making its determinations regarding which nutrients to include on nutrition labels as well as their Daily Values. ^ Methods. Relevant legal policies, scientific studies, and other published literature (either in print or electronic form) were used to collect data. ^ Results. Results demonstrated that the FDA did not employ one single method in its determination of which nutrients to select for inclusion on food labels. The agency relied upon current public heath studies of that time as well as recommendations from the U.S. Surgeon General.^

Proceedings of the Twenty-Sixth Annual Biochemical Engineering Symposium

This volume contains the Proceedings of the Twenty-Sixth Annual Biochemical Engineering Symposium held at Kansas State University on September 21, 1996. The program included 10 oral presentations and 14 posters. Some of the papers describe the progress of ongoing projects, and others contain the results of completed projects. Only brief summaries are given of some of the papers; many of the papers will be published in full elsewhere. A listing of those who attended is given below. ContentsForeign Protein Production from SV40 Early Promoter in Continuous Cultures of Recombinant CHO Cells - Gautam Banik, Paul Todd, and Dhinakar Kampala Enhanced Cell Recruitment Due to Cell-Cell Interactions - Brad Farlow and Matthias Nollert The Recirculation of Hybridoma Suspension Cultures: Effects on Cell Death, Metabolism and Mab Productivity - Peng Jin and Carole A. Heath The Importance of Enzyme Inactivation and Self-Recovery in Cometabolic Biodegradation of Chlorinated Solvents - Xi-Hui Zhang, Shanka Banerji, and Rakesh Bajpai Phytoremediation of VOC contaminated Groundwater using Poplar Trees - Melissa Miller, Jason Dana, L.C. Davis, Murlidharan Narayanan, and L.E. Erickson Biological Treatment of Off-Gases from Aluminum Can Production: Experimental Results and Mathematical Modeling - Adeyma Y. Arroyo, Julio Zimbron, and Kenneth F. Reardon Inertial Migration Based Separation of Chlorella Microalgae in Branched Tubes - N.M. Poflee, A.L. Rakow, D.S. Dandy, M.L. Chappell, and M.N. Pons Contribution of Electrochemical Charge to Protein Partitioning in Aqueous Two-Phase Systems - Weiyu Fan and Charles C. Glatz Biodegradation of Some Commercial Surfactants Used in Bioremediation - Jun Gu, G.W. Preckshot, S.K. Banerji, and Rakesh Bajpai Modeling the Role of Biomass in Heavy Metal Transport Ln Vadose Zone - K.V. Nedunuri, L.E. Erickson, and R.S. Govindaraju Multivariable Statistical Methods for Monitoring Process Quality: Application to Bioinsecticide Production by 73 89 Bacillus Thuringiensis - c. Puente and M.N. Karim The Use of Polymeric Flocculants in Bacterial Lysate Streams - H. Graham, A.S. Cibulskas and E.H. Dunlop Effect of Water Content on transport of Trichloroethylene in a Chamber with Alfalfa Plants - Muralidharan Narayanan, Jiang Hu, Lawrence C. Davis, and Larry E. Erickson Detection of Specific Microorganisms using the Arbitrary Primed PCR in the Bacterial Community of Vegetated Soil - X. Wu and L.C. Davis Flux Enhancement Using Backpulsing - V.T. Kuberkar and R.H. Davis Chromatographic Purification of Oligonucleotides: Comparison with Electrophoresis - Stephen P. Cape, Ching-Yuan Lee, Kevin Petrini, Sean Foree, Micheal G. Sportiello and Paul Todd Determining Singular Arc Control Policies for Bioreactor Systems Using a Modified Iterative Dynamic Programming Algorithm - Arun Tholudur and W. Fred Ramirez Pressure Effect on Subtilisins Measured via FTIR, EPR and Activity Assays, and Its Impact on Crystallizations - J.N. Webb, R.Y. Waghmare, M.G. Bindewald, T.W. Randolph, J.F. Carpenter, C.E. Glatz Intercellular Calcium Changes in Endothelial Cells Exposed to Flow - Laura Worthen and Matthias Nollert Application of Liquid-Liquid Extraction in Propionic Acid Fermentation - Zhong Gu, Bonita A. Glatz, and Charles E. Glatz Purification of Recombinant T4 Lysozyme from E. Coli: Ion-Exchange Chromatography - Weiyu Fan, Matt L. Thatcher, and Charles E. Glatz Recovery and Purification of Recombinant Beta-Glucuronidase from Transgenic Corn - Ann R. Kusnadi, Roque Evangelista, Zivko L. Nikolov, and John Howard Effects of Auxins and cytokinins on Formation of Catharanthus Roseus G. Don Multiple Shoots - Ying-Jin Yuan, Yu-Min Yang, Tsung-Ting Hu, and Jiang Hu Fate and Effect of Trichloroethylene as Nonaqueous Phase Liquid in Chambers with Alfalfa - Qizhi Zhang, Brent Goplen, Sara Vanderhoof, Lawrence c. Davis, and Larry E. Erickson Oxygen Transport and Mixing Considerations for Microcarrier Culture of Mammalian Cells in an Airlift Reactor - Sridhar Sunderam, Frederick R. Souder, and Marylee Southard Effects of Cyclic Shear Stress on Mammalian Cells under Laminar Flow Conditions: Apparatus and Methods - M.L. Rigney, M.H. Liew, and M.Z. Southard

Late Cenozoic silicoflagellate biostratigraphy, relative paleotemperature, and distribution of various genera and morphologic subgroups with remarks on noteworthy occurrences at DSDP Leg 86 Holes

A quantitative study of late Cenozoic silicoflagellates from the northwestern Pacific sites of Deep Sea Drilling Project Leg 86 shows a relative paleotemperature (Ts) gradient with lowest values (Ts = 30) in the north. Some new ecostratigraphic relations for the region are indicated, such as the last common occurrence of Dictyocha brevispina at 2.6 - 3.0 m.y. ago during a cool interval. Elements of North Pacific and low-latitude biostratigraphic zonations can be identified, but the mixing of cool- and warm-indicator taxa prompted the definition of the new Miocene Mesocena hexalitha Subzone and Pliocene Distephanus jimlingii Subzone. Scanning-electron microscope study of Leg 86 silicoflagellates was done to determine whether various types of skeletal surface texture are temperature dependent. To conduct the study we organized a new surface-texture descriptive code, which characterizes the apical structure/basal ring/spine sequence using new definitions of the terms crenulate (C), linear (L), nodular (N), reticulate (R), and smooth (S). One new silicoflagellate genus, Caryocha Bukry et Monechi, n. gen., is described and several new combinations are made.

Paleomagnetism at DSDP Sites 86-576 and 86-578

The upper sections of Deep Sea Drilling Project Sites 576 (32°21.4'N, 164°16.5'E) and 578 (33°55.6'N, 151°37.7'E) both have stable detrital remanence that can be correlated with the standard reversal stratigraphy. Site 576 contains all reversals above the base of the Gilbert Epoch (5 m.y.) at about 25 m, whereas Site 578 contains a remarkable section of about 60 reversals extending to Anomaly 5B (15 m.y.) at about 150 m sub-bottom depth. In both cases, the paleomagnetic stratigraphy breaks down when accumulation rates drop below 2 m/m.y. At both sites, authigenic manganiferous clays deposited from 70 to 16 m.y. ago accumulated at about 0.4 m/m.y. Similarly, at both sites, the Pleistocene pulse of eolian debris increased accumulation rates by about 6 m/m.y.**2. From 16 to 2 m.y. ago, however, sediment accumulated at Site 578 about five times as rapidly as at Site 576, apparently because of augmented input to the western site by bottom currents.

Chemical element contents and accumulation rates in metalliferous sediments from DSDP Hole 34-319, Bauer Deep, Southeast Pacific

Marked variations in the chemical and mineralogical composition of sediments at Site 319 have occurred during the 15 My history of sedimentation at this site. The change in composition through time parallels the variability observed in surface sediments from various parts of the Nazca Plate and can be related to variations in the proportion of hydrothermal, hydrogenous, detrital and biogenous phases reaching this site at different times. Metal accumulation rates at Site 319 reach a maximum near the basement for most elements, suggesting a strong hydrothermal contribution during the early history of this site. The hydrothermal contribution decreased rapidly as Site 319 moved away from the spreading center, although a subtle increase in this source is detectable about the time spreading began on the East Pacific Rise. The most recent sedimentation exhibits a strong detritalhydrogenous influence. Post-depositional diagenesis of amorphous phases has converted them to ironrich smectite and well-crystallized goethite without significantly altering the bulk composition of the sediment.

AMS radiocarbon dates and pollen analysis of ODP Hole 175-1078C

ODP Site 1078 situated under the coast of Angola provides the first record of the vegetation history for Angola. The upper 11 m of the core covers the past 30 thousand years, which has been analysed palynologically in decadal to centennial resolution. Alkenone sea surface temperature estimates were analysed in centennial resolution. We studied sea surface temperatures and vegetation development during full glacial, deglacial, and interglacial conditions. During the glacial the vegetation in Angola was very open consisting of grass and heath lands, deserts and semi-deserts, which suggests a cool and dry climate. A change to warmer and more humid conditions is indicated by forest expansion starting in step with the earliest temperature rise in Antarctica, 22 thousand years ago. We infer that around the period of Heinrich Event 1, a northward excursion of the Angola Benguela Front and the Congo Air Boundary resulted in cool sea surface temperatures but rain forest remained present in the northern lowlands of Angola. Rain forest and dry forest area increase 15 thousand years ago. During the Holocene, dry forests and Miombo woodlands expanded. Also in Angola globally recognised climate changes at 8 thousand and 4 thousand years ago had an impact on the vegetation. During the past 2 thousand years, savannah vegetation became dominant.

Sedimentation at Manop Site H in the eastern equatorial Pacific

Gravity cores recovered from Manganese Nodule Project site H (6°33'N, 92°49'W) show marked downcore variations in the abundance of calcium carbonate, organic carbon, opal, manganese, and other components deposited over the past 400,000 years. Variations in the downcore abundance of organic carbon, which ranges from 0.2 to 1.0%, can be used to hindcast redox conditions in the surface sediments over this time. The results indicate that the depth to the manganese redox boundary varied from about 5 to 25 cm below the seafloor during four major cycles. Downcore variations in solid phase Mn, Ni, and Cu can be produced by such changes in redox conditions. A model which predicts that solid phase Mn can be trapped and buried when the Mn redox boundary migrates rapidly upward is consistent with the observed organic carbon and Mn records and supports the reconstructed redox variations. The history of redox variations at site H can be explained by changes with time in surface water productivity. Major productivity variations at the site occur over 100-kyr cycles, with relatively higher productivity occurring during glacial stages. Thus Quaternary climate changes influence surface water productivity, redox conditions in sediments, and the cycling of transition metals.

Interferencias políticas e interinstitucionales al proyecto de centralización de la administración sanitaria nacional (1943-1945)

El objetivo de este trabajo es profundizar en las razones de los cambios que se operan en la estructura administrativa sanitaria nacional entre 1943 y 1945. Si bien la creación de la Dirección Nacional de Salud y Acción Social en 1943 responde a una larga demanda de los círculos académicos de centralización administrativa y de unificación de las funciones sanitarias y asistenciales, la corta duración del proyecto (menos de un año) expone consideraciones por afuera de la lógica administrativa. Analizamos aquellas que se vinculan con la complicada relación entre la repartición nacional con los gobiernos provinciales y las organizaciones de beneficencia, con la injerencia del gremialismo médico en el delineamiento de las políticas sanitarias y con el ascendiente de Juan Domingo Perón desde la Secretaría de Trabajo y Bienestar Social en la monopolización de la asistencia social como capital político.

Interferencias políticas e interinstitucionales al proyecto de centralización de la administración sanitaria nacional (1943-1945)

El objetivo de este trabajo es profundizar en las razones de los cambios que se operan en la estructura administrativa sanitaria nacional entre 1943 y 1945. Si bien la creación de la Dirección Nacional de Salud y Acción Social en 1943 responde a una larga demanda de los círculos académicos de centralización administrativa y de unificación de las funciones sanitarias y asistenciales, la corta duración del proyecto (menos de un año) expone consideraciones por afuera de la lógica administrativa. Analizamos aquellas que se vinculan con la complicada relación entre la repartición nacional con los gobiernos provinciales y las organizaciones de beneficencia, con la injerencia del gremialismo médico en el delineamiento de las políticas sanitarias y con el ascendiente de Juan Domingo Perón desde la Secretaría de Trabajo y Bienestar Social en la monopolización de la asistencia social como capital político.

Mineralogy and diagenesis: Their effect on acoustic and electrical properties of pelagic clays at DSDP Leg 86 Holes

Analysis of pelagic clay samples from Sites 576, 578, and 581 shows that physical, acoustic, and electrical trends with increasing burial depth are related to mineralogical and diagenetic changes. The properties of interest are bulk density (roo), porosity (phi), compressional-wave velocity (Vp) and velocity anisotropy (Ap), and electrical resistivity (Ro) and resistivity anisotropy (Ar). In general, as demonstrated in particular for the brown pelagic clay, the increase in roo, Vp, Ro, and to a lesser extent Ap and Ar with increasing depth is primarily caused by decreasing phi (and water content) as a result of compaction. The mineralogy and chemistry of the pelagic clays vary as a function of burial depth at all three sites. These variations are interpreted to reflect changes in the relative importance of detrital and diagenetic components. Mineralogical and chemical variations, however, play minor roles in determining variations in acoustic and electrical properties of the clays with increasing burial depth.