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1.
Effects of Price,Information, and Transactions Cost Interventions to Raise Voluntary Enrollment in a Social Health Insurance Scheme: A Randomized Experiment in the Philippines 下载免费PDF全文
Joseph J. Capuno Aleli D. Kraft Stella Quimbo Carlos R. Tan Jr. Adam Wagstaff 《Health economics》2016,25(6):650-662
A cluster randomized experiment was undertaken testing two sets of interventions encouraging enrollment in the Individually Paying Program (IPP), the voluntary component of the Philippines' social health insurance program. In early 2011, 1037 unenrolled IPP‐eligible families in 179 randomly selected intervention municipalities were given an information kit and offered a 50% premium subsidy valid until the end of 2011; 383 IPP‐eligible families in 64 control municipalities were not. In February 2012, the 787 families in the intervention sites who were still IPP‐eligible but had not enrolled had their vouchers extended, were resent the enrollment kits and received SMS reminders. Half the group also received a ‘handholding’ intervention: in the endline interview, the enumerator offered to help complete the enrollment form, deliver it to the insurer's office in the provincial capital, and mail the membership cards. The main intervention raised the enrollment rate by 3 percentage points (ppts) (p = 0.11), with an 8 ppt larger effect (p < 0.01) among city‐dwellers, consistent with travel time to the insurance office affecting enrollment. The handholding intervention raised enrollment by 29 ppts (p < 0.01), with a smaller effect (p < 0.01) among city‐dwellers, likely because of shorter travel times, and higher education levels facilitating unaided completion of the enrollment form. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd. 相似文献
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Ittel TH; Steinhausen C; Kislinger G; Kinzel S; Nolte E; Sieberth HG 《Nephrology, dialysis, transplantation》1997,12(7):1369-1375
BACKGROUND: Developments in accelerator mass spectrometry (AMS) now permit
the determination of femtogram amounts of 26Al in blood and in various
tissues with good precision and free of external contamination. METHODS: In
the present study we used trace quantities of 26Al to investigate the
intestinal absorption and compartmentalization of aluminium in rats with
renal failure (Nx, 5/6 nephrectomy) and in pair- fed controls (C). Single
oral doses of 20 ng 26Al were administered to six animals in each group
and, subsequently, 24-h post-load 26Al was analysed in serum, urine, bone,
liver, and spleen by means of AMS. RESULTS: Serum concentrations of 26Al
were significantly lower in uraemic rats compared to controls, whereas
urinary excretion was comparable (Nx, 7.11 +/- 5.78 pg/day vs C, 9.46 +/-
6.10 pg/day), suggesting a higher fraction of ultrafiltrable serum 26Al in
uraemia. The target tissues of cellular transferrin-mediated 26Al uptake,
liver and spleen, tended to show a larger degree of aluminium accumulation
in controls (0.26 +/- 0.31 pg/g vs Nx, 0.14 +/- 0.10 pg/g and 0.37 +/- 0.27
pg/g vs Nx, 0.25 +/- 0.27 pg/g respectively). In contrast, in bone, a site
of extracellular aluminium deposition, 26Al concentrations were more
elevated in uraemia (1.22 +/- 0.59 pg/g vs C: 0.68 +/- 0.30 pg/g).
Estimated total 26Al accumulation in all measured target tissues was
significantly higher in uraemic rats (28.15 +/- 9.90 pg vs C: 17.03 +/-
7.03 pg) and total recovery of 26Al from tissue and urine was 26.58 +/-
6.74 pg in controls and 35.75 +/- 7.03 pg in uraemic animals, suggesting a
fractional absorption of 0.133% and 0.175% respectively. CONCLUSIONS: Our
data suggest that fractional absorption from a dietary level dose of 26Al
is about 0.13%. Compartmentalization occurs in transferrin-dependent target
tissues such as liver and spleen; however, in quantitative terms
extracellular deposition in bone is more important. Uraemia has a
significant effect on the intestinal absorption and compartmentalization of
aluminium. It enhances fractional absorption and increases subsequent
extracellular deposition of aluminium in bone. However, at the same time
uraemia does not increase transferrin-dependent cellular accumulation of
aluminium in liver and spleen.
相似文献
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Restriction enzyme fingerprinting of enterobacterial plasmids: a simple strategy with wide application 总被引:3,自引:0,他引:3
Restriction enzyme fingerprints were generated from purified plasmid DNA from 324 clinical isolates that belonged to 7 enterobacterial genera and 88 single plasmids in Escherichia coli K 12 according to the following strategy. Purified plasmid DNA was digested with PstI. The number of fragments detected in a 0.8 agarose gel was used to determine which 2 of 6 restriction enzymes including PstI was most likely to provide a fingerprint comprising sufficient fragments to ensure specificity but sufficiently few to allow easy visual assessment and minimize coincidental matching. When PstI produced greater than 20 fragments, EcoRI and HindIII were used; when PstI generated less than 6 fragments Bsp 1286 and AvaII were used and SmaI was employed when between 6 and 20 fragments were obtained from PstI digests. Using a minimum of 12 fragments from a combination of 2 enzymes as the criterion for characterizing a strain/plasmid, satisfactory 2-enzyme fingerprints were obtained from 87% of the strains and plasmids studied using PstI and no more than two additional enzymes per strain. Of the remaining 54 strains, 51 harboured only small plasmids (less than 10 kb) and 3 produced satisfactory fingerprints when digested with a fourth enzyme. 相似文献
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A R Dresdale P L Kraft G Paone T McFarland T B Levine R delBusto S Lutz C Drost N A Silverman 《The Journal of cardiovascular surgery》1992,33(6):746-753
Allograft coronary artery disease (ACAD) is the major factor limiting long-term survival of cardiac transplant recipients (CTRs). Although cyclosporine based triple drug immunosuppression has not decreased the occurrence of ACAD, some preliminary data suggests that prophylactic antilymphocyte preparations may reduce the incidence of this problem. All CTRs at Henry Ford Hospital have uniformly received prophylactic Minnesota Antilymphocyte Globulin (ALG), thereby providing a unique opportunity to investigate this hypothesis. One hundred three CTRs were followed for a median duration of 34 months with annual angiograms begun one year after transplant. Patients who died without an angiogram were considered to have ACAD based on autopsy results or if their death was clinically suspicious. Ninety-two patients underwent at least one angiogram. Fourteen patients had abnormal angiograms. Nine patients were identified as having ACAD by non-angiographic criteria. Five had autopsy proven disease, 3 died suspiciously, and 1 underwent successful re-transplantation for ACAD. By Kaplan-Meier analysis, the risk of developing ACAD was 12% in 1 year, 16% in 2 years, 22% in 3 years, 26% in 4 years, and 29% in 5 years. Risk of ACAD increased with older recipient's age, higher triglyceride levels, and diabetes, but was not affected by active CMV infection, number of acute rejection episodes, and HLA mismatching. These results suggest that prophylactic ALG reduces the occurrence of ACAD. 相似文献
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Cranial dystonia, blepharospasm and hemifacial spasm: clinical features and treatment, including the use of botulinum toxin. 总被引:2,自引:0,他引:2 下载免费PDF全文
Blepharospasm, the most frequent feature of cranial dystonia, and hemifacial spasm are two involuntary movement disorders that affect facial muscles. The cause of blepharospasm and other forms of cranial dystonia is not known. Hemifacial spasm is usually due to compression of the seventh cranial nerve at its exit from the brain stem. Cranial dystonia may result in severe disability. Hemifacial spasm tends to be much less disabling but may cause considerable distress and embarrassment. Patients affected with these disorders are often mistakenly considered to have psychiatric problems. Although the two disorders are quite distinct pathophysiologically, therapy with botulinum toxin has proven very effective in both. We review the clinical features, proposed pathophysiologic features, differential diagnosis and treatment, including the use of botulinum toxin, of cranial dystonia and hemifacial spasm. 相似文献