My Wife Is My Insurance Policy: Household Bargaining and Couples' Purchase of Long-Term Care Insurance.

This paper examines household decisions over long-term care insurance (LTCI) purchases through a bargaining lens. Long-term care insurance purchase is a discrete decision around which spouses' interests may diverge substantially. The cost of buying LTCI is typically borne by both spouses, but the benefits of LTCI go disproportionately to women, who are more likely to need long-term care for themselves, and to benefit from the asset protection and other support LTCI offers in the event their husband needs care.

Artificial zinc(II) complexes regulate cell cycle and apoptosis-related genes in tumor cell lines.

Various proteins involved in transcriptional regulation possess highly selective DNA-binding domains, known as zinc fingers. However, little is known about small-molecule zinc(II) complexes in the regulation of gene expression and programmed cell death. A new family of zinc(II) complexes is reported, which might be useful against human cancer cells.

Setup and characterization of a human head and neck squamous cell carcinoma xenograft model in nude rats.

Objective: To develop and characterize a new head and neck cancer animal model.

Study Design: A human head and neck squamous cell carcinoma (HNSCC) xenograft model in nude rats was established via subcutaneous inoculation of a human-origin HNSCC cell line, SCC-4. The tumor was evaluated for growth characteristics, pathologic features by hematoxylin-eosin (HE) staining, and immunohistochemistry of epidermal growth factor receptor (EGFR).

In vitro anticancer activities and optical imaging of novel intercalative non-cisplatin conjugates.

The first pi-conjugated macrocyclic diimine and triaza DNA-binding intercalators and their platinum(II) conjugates have been synthesized by direct Schiff base cyclocondensation. The in vitro anticancer activities of compounds 3, 4, and 5 were tested on five cancer cell lines: MCF-7, A549, P388, A2780, and A2780cisR. Ovarian tumors were included specifically to evaluate the new conjugates' ability to circumvent A2780cisR resistance.

Catalytic asymmetric cyclopropanation at a chiral platform.

Novel chiral Robson-type macrocyclic complexes M(2)-L [where M = Mn(II), Mn(III), Co(II) and Co(III) and L denotes tetra-Schiff base chiral ligands, L1 or L2] have been synthesized by metal template condensation of 2,6-diformyl-4-methyl-phenol, with 1R,2R-diaminocyclohexane (L1) or 1R,2R-diphenylethylenediamine (L2). The dinuclear Co(II) and Co(III) complexes catalyze asymmetric cyclopropanation of styrene with diazoacetate cooperatively and with high enantioselectivity.

Theoretical study of the influence of a heterogeneous activity distribution on intratumoral absorbed dose distribution.

Radioimmunotherapy of hematopoeitic cancers and micrometastases has been shown to have significant therapeutic benefit. The treatment of solid tumors with radionuclide therapy has been less successful. Previous investigations of intratumoral activity distribution and studies on intratumoral drug delivery suggest that a probable reason for the disappointing results in solid tumor treatment is nonuniform intratumoral distribution coupled with restricted intratumoral drug penetrance, thus inhibiting antineoplastic agents from reaching the tumor's center.

Novel chiral "calixsalen" macrocycle and chiral robson-type macrocyclic complexes.

A family of novel chiral "calixsalen" Schiff base macrocycles R,R-H(3)L4, R,R-H(3)L5, containing three chiral diamino moieties were synthesized by an efficient self-assembly and characterized by (1)H and (13)C NMR, mass spectrometry, and X-ray diffraction. The systematic synthesis, structure, and coordination properties of the [2 + 2] and [3 + 3] Robson-type Schiff base macrocyclic mono-, di-, tri-, and tetranuclear metal complexes were explored.

Successful modification of medical students' cardiovascular risk factors.

Modifying identified risk factors for cardiovascular disease should change an individual's risk. Educational interventions might change behavior to modify some risk factors. To evaluate this possibility, we evaluated the health and fitness status of freshman medical students at the University of Utah (n = 89) in 1983 and determined their cardiovascular risk factors.

Lead toxicity and iron deficiency in Utah migrant children.

We determined the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, ages 9-72 months, during the summer of 1985. There were no confirmed cases of lead toxicity. Thirteen per cent of those tested and 30 per cent of the children ages 9-23 months were iron deficient.

Effectiveness of implementing a trauma triage system on outcome: a prospective evaluation.

A 9-month prospective study was conducted in Salt Lake County to evaluate the efficacy of a field trauma triage system using the CRAMS score. Before the triage system was implemented trauma victims were taken to the nearest appropriate hospital. Post-implementation, trauma victims with field CRAMS scores of 1 through 6 were triaged to the Level I Trauma Center.

A prevention armamentarium for aeromedical practitioners.

Recent advances in preventive medicine offer practitioners exceptional opportunities to help patients and their families have longer, healthier, and more enjoyable lives. Those involved in aerospace medicine are uniquely qualified by their training and experience to apply this enhanced prevention armamentarium. The discussion considers a number of activities and techniques which can provide important patient benefits at acceptable costs.

A comparison of family practice clinics and free-standing emergency centers: organizational characteristics, process of care, and patient satisfaction.

Because of the increasing popularity of free-standing emergency care centers as a source of primary care services, this cross-sectional study was conducted to compare four of them with two family practice centers that provided extended hours. A total of 2,339 patient encounters were examined with data obtained from both physicians and patients. The factors that were found to be a basis for discrimination between the two types of practice were the cost of care and the patient's satisfaction with convenience and personal attention from the physicians.

Maternal-fetal pH difference and fetal scalp pH as predictors of neonatal outcome.

The purpose of this study was to determine if interpretation of fetal scalp pH values would be enhanced by concurrent measurement of maternal venous pH. The last fetal capillary pH obtained before delivery was compared with simultaneous maternal-fetal pH difference as predictors of neonatal outcome assessed by five-minute Apgar scores. Fetal scalp pH and maternal-fetal pH difference were significantly correlated with r = -0.

The role of the community-oriented primary care physician.

The role of community-oriented primary care is the subject of considerable debate and controversy, leading to confusion for both its practitioners and educators. This paper attempts to clarify this role by applying systems theory to the concept of community-oriented primary care as first-contact medical care for the patient, in the context of the community. Relationships between the primary care physician and the following entities are defined: the patient; the physician's and patient's community, culture, and society; the physician's office; the medical care system; and the physician's and patient's families.

Research skills development in family medicine fellows.

This study was conducted to identify factors that contribute to the development of research skills among Robert Wood Johnson Foundation (RWJF) family medicine fellows, and to relate this process to their overall training. All 23 of the 1981-82 RWJF fellows were surveyed. Most fellows believe they are being well prepared to conduct research, and estimate they will spend approximately one-fourth of their future time in research activities.

Neonatal mortality in Utah.

A cohort study of neonatal mortality (N = 106) in white singleton births (N = 14,486) in Utah for January-June 1975 was conducted. Using membership and activity in the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as a proxy for parental health practices, i.e.

Epidural anesthesia in low-risk obstetrical patients.

The use of epidural anesthesia in obstetrics has increased markedly in the last decade, and some authorities are now stating that epidural block may be the anesthetic method of choice for most women. In spite of this growth in popularity, no studies have been reported that deal with the outcomes of epidural anesthesia in low-risk obstetrical patients, that group of women for whom family physicians are most likely to provide care. A retrospective cohort study of factors associated with epidural anesthesia in a low-risk obstetrical population was performed.

Predicting rural health care utilization with archival data.

This study explored the usefulness of archival data in predicting rural health care utilization. A regression model was used to see how well observed utilization for local populations could be predicted by calculating expected values in advance from age- and sex-specific national rates applied to local age and sex profiles. Although the correlation between observed and expected utilization was reasonably high (r = 0.