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This study assesses the potential cost savings associated with the use of community health centers, based on econometric analyses of the 2006 Medical Expenditure Panel Survey. After controlling for health status, health insurance coverage, income, age, and other factors, this study finds that patients who receive a majority of their ambulatory care at community health centers have significantly lower annual overall medical expenditures (24%) and ambulatory expenditures (25%) than those who do not. These results are consistent with other studies indicating that, by providing good quality primary care, community health centers can reduce the utilization of other medical services. [ABSTRACT FROM AUTHOR]

We present CopeOpi, an opinion-analysis system, which extracts from the Web opinions about specific targets, summarizes the polarity and strength of these opinions, and tracks opinion variations over time. Objects that yield similar opinion tendencies over a certain time period may be correlated due to the latent causal events. CopeOpi discovers relationships among objects based on their opinion-tracking plots and collocations. Event bursts are detected from the tracking plots, and the strength of opinion relationships is determined by the coverage of these plots. To evaluate opinion mining, we use the NTCIR corpus annotated with opinion information at sentence and document levels. CopeOpi achieves sentence- and document-level f-measures of 62% and 74%. For relationship discovery, we collected 1.3M economics-related documents from 93 Web sources over 22 months, and analyzed collocation-based, opinion-based, and hybrid models. We consider as correlated company pairs that demonstrate similar stock-price variations, and selected these as the gold standard for evaluation. Results show that opinion-based and collocation-based models complement each other, and that integrated models perform the best. The top 25, 50, and 100 pairs discovered achieve precision rates of 1, 0.92, and 0.79, respectively. [ABSTRACT FROM AUTHOR]

The American Board of Genetic Counseling (ABGC) performed a genetic counseling practice analysis (PA) to determine the content of the certification examination. The ABGC-appointed PA Advisory Committee worked with psychometricians to develop a survey which was distributed to 2,038 genetic counselors in the United States and Canada. The survey was also accessible on the ABGC website. Multiple criteria were used to establish the significance of the tasks included in the survey. A total of 677 responses were used in the analysis, representing a 37.1% corrected response rate. Five major content domains with 143 tasks were identified in the PA. New certification test specifications were developed on the basis of PA results and will be used in developing future examination forms. In keeping with credentialing standards, ABGC plans to conduct a PA on a regular basis so that the content of the examination reflects current practice. [ABSTRACT FROM AUTHOR]

Introduction: Orthogeriatric care for hip fractures has demonstrated resounding success over past two decades. Until recently, non-hip fragility lower limb fractures had been largely excluded from orthogeriatric care. Several recent studies showed that this group of fragility fractures contribute significantly to healthcare and socioeconomic burden with loss of quality of life and excess mortality exceeding that of hip fractures. As a leading centre in orthogeriatric care, we expanded our multi-faceted highly protocolised orthogeriatric care to include major non-hip lower limb fragility fractures. Methods: Admitted patients with major non-hip lower fragility fractures (femur, patella, tibia, ankle, periprosthetic, peri-implant, acetabulum) aged 60 years and older were targets for orthogeriatric intervention. Key data (length of stay, inpatient mortality, 30-day readmission, complications) on these patients was collected during the 4-month pre-intervention (Usual Care group) and 5-month post-intervention (Orthogeriatric Care group) period. Secondary outcomes tracked were falls assessment, bone health evaluation, inpatient referrals, and discharge destination. These outcomes were compared between the 2 groups. Results: Both groups were comparable in mean age and proportion of patients operated. Operated patients had shorter length of stay of almost 2 days under orthogeriatric care (Orthogeriatric Care 9.8 days, Usual Care 12.1 days). Patients in Orthogeriatric Care group had fewer complications (Orthogeriatric Care 0.1 per patient, Usual Care 0.28 per patient) with relative risk reduction of 64%. In the Orthogeriatric Care group, all patients received falls assessment, more had completed assessment of bone health, and higher proportion discharged to community hospital for rehabilitation. There were no differences in inpatient mortality, 30-day read-missions and number of inpatient referrals across the 2 groups. Conclusion: Orthogeriatric care should be expanded to major lower limb fragility fractures, resulting in better care, shorter acute hospital stays and fewer complications. [ABSTRACT FROM AUTHOR]

The article presents a medical research on spontaneous correction of lumbar curve in the treatment of major thoracic-compensatory C modifier lumbar curve pattern in idiopathic scoliosis. The study presented that selective thoracic fusion for Lenke Type 1C or 2C idiopathic scoliosis curves can either enhance or impair the capacity for spontaneous compensation and correction of the lumbar curve. It reveals that the use of cantilever bending technique facilitates 3-dimensional control.

Documents discussing public affairs, common themes, interesting products, and so on, are reported and distributed on the Web. Positive and negative opinions embedded in documents are useful references and feedbacks for governments to improve their services, for companies to market their products, and for customers to purchase their objects. Web opinion mining aims to extract, summarize, and track various aspects of subjective information on the Web. Mining subjective information enables traditional information retrieval (IR) systems to retrieve more data from human viewpoints and provide information with finer granularity. Opinion extraction identifies opinion holders, extracts the relevant opinion sentences, and decides their polarities. Opinion summarization recognizes the major events embedded in documents and summarizes the supportive and the nonsupportive evidence. Opinion tracking captures subjective information from various genres and monitors the developments of opinions from spatial and temporal dimensions. To demonstrate and evaluate the proposed opinion mining algorithms, news and bloggers' articles are adopted. Documents in the evaluation corpora are tagged in different granularities from words, sentences to documents. In the experiments, positive and negative sentiment words and their weights are mined on the basis of Chinese word structures. The f-measure is 73.18% and 63.75% for verbs and nouns, respectively. Utilizing the sentiment words mined together with topical words, we achieve f-measure 62.16% at the sentence level and 74.37% at the document level. [ABSTRACT FROM AUTHOR]

Research amply documents that language barriers impede access to health care, compromise quality of care, and increase the risk of adverse health outcomes among patients with limited English proficiency. Federal civil rights policy obligates health care providers to supply language services, but wide gaps persist because insurers typically do not pay for interpreters, among other reasons. Health care financing policies should reinforce existing medical research and legal policies: Payers, including Medicaid, Medicare, and private insurers, should develop mechanisms to pay for interpretation services for patients who speak limited English. [ABSTRACT FROM AUTHOR]

[Purpose/significance] The strategy of data-driven research has been brought up to a national level. It’s one of urgent issues to explore specific methods and practical ways regarding libraries’ RDM. This article is expected to possess relevant experience and references from the investigation on the implementation of TIB’s strategic plan through its four main product lines. [Method/process] Based on literature review and case study, according to the logical clue in the management field of “strategy-tactics-operation”, this article made observation and analysis of the development practice of TIB from the top down. It summarized main features of TIB’s product lines and made a comparison with China’s library services. [Result/conclusion] The development of strategic plans should rely on specific tactic arrangements and program operations. China’s RDM should take the non-textual materials as seriously as text. The operations of programs should make positive interaction with the growth of workforce.

Recent policy changes have limited immigrants' access to insurance and to health care. Fewer noncitizen immigrants and their children (even U.S.-born) have Medicaid or job-based insurance, and many more are uninsured than is the case with native citizens or children of citizens. Noncitizens and their children also have worse access to both regular ambulatory and emergency care, even when insured. Immigration status is an important component of racial and ethnic disparities in insurance coverage and access to care. [ABSTRACT FROM AUTHOR]

Physical activity promotes metabolic and cardiovascular health benefits that derive in part from the transcriptional responses to exercise that occur within skeletal muscle and other organs. There is interest in discovering a pharmacologic exercise mimetic that could imbue wellness and alleviate disease burden. However, the molecular physiology by which exercise signals the transcriptional response is highly complex, making it challenging to identify a single target for pharmacological mimicry. The current studies evaluated the transcriptome responses in skeletal muscle, heart, liver, and white and brown adipose to novel small molecule activators of AMPK (pan-activators for all AMPK isoforms) compared to that of exercise. A striking level of congruence between exercise and pharmacological AMPK activation was observed across the induced transcriptome of these five tissues. However, differences in acute metabolic response between exercise and pharmacologic AMPK activation were observed, notably for acute glycogen balances and related to the energy expenditure induced by exercise but not pharmacologic AMPK activation. Nevertheless, intervention with repeated daily administration of short-acting activation of AMPK was found to mitigate hyperglycemia and hyperinsulinemia in four rodent models of metabolic disease and without the cardiac glycogen accretion noted with sustained pharmacologic AMPK activation. These findings affirm that activation of AMPK is a key node governing exercise mediated transcription and is an attractive target as an exercise mimetic.

Objective: Protection from both sexually transmitted diseases and pregnancy is best obtained by the combined use of male condoms and effective female contraceptive methods. This research examines dual contraceptive method use among teenage men. Method: Analyzed data from the 1995 National Survey of Adolescent Males, a nationally representative survey of 15 to 19-year-old males. Used bivariate analyses and logistic regression to examine the correlates of combined use of condoms and female methods. Results: At last intercourse, 17% of sexually active males reported use of a condom and a female method of contraception. Condom use, alone and in combination with a female method, was positively associated with talking with the partner about contraception and condoms, believing that males have a responsibility for contraception, and being in an earlier stage of a relationship. Only high levels of worry about sexually transmitted diseases differentially influenced dual method use, increasing the likelihood of using a condom with a female method, but not using condoms alone. Conclusions: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method. Providing information to young males about the high prevalence and serious consequences of sexually transmitted diseases may increase dual method use among adolescents. [ABSTRACT FROM AUTHOR]

CONTEXT: Changes in the sexual behavior of teenagers can have a significant impact on levels of adolescent pregnancy and transmission of sexually transmitted diseases (STDs). Understanding the role played by attitudes and educational efforts will provide critical prevention information. METHODS: Data on the sexual behavior, sexual attitudes, educational experiences and demographics of 2,087 never-married metropolitan males aged 17-19 from the 1979 National Survey of Young Men and the 1988 and 1995 waves of the National Survey of Adolescent Males were analyzed through multivariate methods to examine factors that predict sexual behavior as well as those that predict sexual attitudes. RESULTS: The percentage of males aged 17-19 who had ever had sex increased from 66% in 1979 to 76% in 1988 and then decreased to 68% in 1995. The frequency of sexual intercourse in the year prior to the survey increased significantly over time, although the lifetime number of sexual partners did not. Acceptance of premarital sex increased significantly from 1979 to 1988, then decreased significantly from 1988 to 1995. Over time, young men were increasingly likely to prefer having and supporting a baby to marriage, abortion or adoption as the resolution to a nonmarital pregnancy. Trends in attitudes were strongly associated with sexual behaviors, with more conservative attitudes predicting less sexual activity. AIDS education, which was nearly universal in 1995, was associated with decreased sexual activity, although not among black youths. CONCLUSIONS: More conservative sexual attitudes and increased exposure to AIDS education are key predictors of decreased sexual activity among adolescent males. However, broader societal factors, such as fear of AIDS and increased awareness of problems associated with teenage pregnancy and STDs, may underlie both attitudinal and behavioral changes. [ABSTRACT FROM AUTHOR]

Analyses of a nationally representative survey of 1,880 15- to 19-year-old men were conducted to examine factors associated with (a) the age when first sexual intercourse occurred and (b) whether a condom or other contraceptive method was used at first intercourse. Discrete time-event history models assessed factors influencing their age until first intercourse. Black males began sexual activity significantly earlier than white or Hispanic males. Males who had been held back in school also began sexual activity earlier. If a respondent's mother had been a teenager when she first gave birth, or if his mother was employed during his childhood, he was more likely to initiate intercourse early. A variety of combinations of AIDS and sex education topics were examined for their association with one's age at the time of first intercourse: two topics were associated with earlier intercourse, and one was associated with delays in first intercourse. Logistic regression models examined correlates of using a condom or any effective male or female method of contraception at first intercourse: having received education about birth control was marginally associated with increased probability of using a condom or any effective male or female contraceptive method at first intercourse. These findings indicate the relevance of integrated approaches to school-based sex and AIDS education in delaying intercourse and promoting use of contraceptive methods. [ABSTRACT FROM AUTHOR]

Analyses of the 1988 National Survey of Adolescent Males indicate the prevalence of risk behaviors related to acquired immunodeficiency syndrome, including sexual, contraceptive, and drug use behaviors, among 15- to 19-year-old men. About three-fifths had sexual intercourse, indicating that a majority of teenage men have at least some potential exposure to the human immunodeficiency virus (HIV) or sexually transmitted disease. From a behavioral perspective, the average sexually active teenage man used a condom more than half the time in the 12 months before the interview. Those with most experience with sexual intercourse, however, used condoms least frequently. More important from an epidemiologic perspective, a third of all acts of intercourse in the prior year were protected using condoms. Further, behaviors with the greatest direct risks for HIV infection, such as homosexual intercourse, use of intravenous drugs, and sex with intravenous drug users or prostitutes, appear to be relatively uncommon. Teenage men who demonstrate high-risk behavior, including both sexual and substance abuse, compound their risks, because risks generally are correlated. Condom use is a preventive behavior that is negatively correlated with most risk behaviors; those who have multiple partners, or who are substance abusers, tend to use condoms least. The convergence of risks for multi-problem teenage men indicates the relevance of interventions directed to high-risk youths. [ABSTRACT FROM AUTHOR]