RESUMO
Racism is an insidious problem with far-reaching effects on the lives of Black, Indigenous, and People of Color (BIPOC). The pervasive negative impact of racism on mental health is well documented. However, less is known about the potential downstream impacts of maternal experiences of racism on offspring neurodevelopment. This study sought to examine evidence for a biological pathway of intergenerational transmission of racism-related trauma. This study examined the effects of self-reported maternal experiences of racism on resting state functional connectivity (rsFC) in n = 25 neonates (13 female, 12 male) birthed by BIPOC mothers. Amygdala and hippocampus are brain regions involved in fear, memory, and anxiety, and are central nodes in brain networks associated with trauma-related change. We used average scores on the Experiences of Racism Scale as a continuous, voxel-wise regressor in seed-based, whole-brain connectivity analysis of anatomically defined amygdala and hippocampus seed regions of interest. All analyses controlled for infant sex and gestational age at the 2-week scanning session. More maternal racism-related experiences were associated with (1) stronger right amygdala rsFC with visual cortex and thalamus; and (2) stronger hippocampus rsFC with visual cortex and a temporo-parietal network, in neonates. The results of this research have implications for understanding how maternal experiences of racism may alter neurodevelopment, and for related social policy.
Assuntos
Tonsila do Cerebelo , Hipocampo , Imageamento por Ressonância Magnética , Racismo , Humanos , Feminino , Masculino , Tonsila do Cerebelo/fisiologia , Tonsila do Cerebelo/diagnóstico por imagem , Racismo/psicologia , Hipocampo/fisiologia , Recém-Nascido , Adulto , Descanso/fisiologia , Mães/psicologia , Vias Neurais/fisiologiaRESUMO
Parts of the Southwestern United States report arsenic levels in water resources that are above the United States Environmental Protection Agency's current drinking water limits. Prolonged exposure to arsenic through food and drinking water can contribute to significant health problems including cancer, developmental effects, cardiovascular disease, neurotoxicity, and diabetes. In order to understand exposure risks, water sampling and testing has been conducted throughout Arizona. This information is available to the public through often non-overlapping databases that are difficult to access and in impracticable formats. The current study utilized a systemic compilation of online databases to compile a spreadsheet containing over 33,000 water samples. The reported arsenic concentrations from these databases were collected from 1990-2017. Using ArcGIS software, these data were converted into a map shapefile and overlaid onto a map of Arizona. This visual representation shows that arsenic levels in surface and ground water exceed the United States Environmental Protection Agency's drinking water limits for many sites in several counties in Arizona, and there is an underrepresentation of sampling in several tribal jurisdictions. This information is useful for water managers and private well owners throughout the State for determining safe drinking water sources and limiting exposure to arsenic.
RESUMO
While some children with callous unemotional (CU) behaviours show difficulty recognizing emotional expressions, the underlying developmental pathways are not well understood. Reduced infant attention to the caregiver's face and a lack of sensitive parenting have previously been associated with emerging CU features. The current study examined whether facial emotion recognition mediates the association between infants' mother-directed gaze, maternal sensitivity, and later CU behaviours. Participants were 206 full-term infants and their families from a prospective longitudinal study, the Durham Child Health and Development Study (DCHDS). Measures of infants' mother-directed gaze, and maternal sensitivity were collected at 6 months, facial emotion recognition performance at 6 years, and CU behaviours at 7 years. A path analysis showed a significant effect of emotion recognition predicting CU behaviours (ß = -0.275, S.E. = 0.084, p = 0.001). While the main effects of infants' mother-directed gaze and maternal sensitivity were not significant, their interaction significantly predicted CU behaviours (ß = 0.194, S.E. = 0.081, p = 0.016) with region of significance analysis showing a significant negative relationship between infant gaze and later CU behaviours only for those with low maternal sensitivity. There were no indirect effects of infants' mother-directed gaze, maternal sensitivity or the mother-directed gaze by maternal sensitivity interaction via emotion recognition. Emotion recognition appears to act as an independent predictor of CU behaviours, rather than mediating the relationship between infants' mother-directed gaze and maternal sensitivity with later CU behaviours. This supports the idea of multiple risk factors for CU behaviours.
Assuntos
Emoções , Fixação Ocular/fisiologia , Comportamento do Lactente/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Criança , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Poder Familiar , Estudos ProspectivosRESUMO
BACKGROUND: The use of voice prostheses is currently the gold standard in voice rehabilitation after total laryngectomy. This method combines low complication rates and excellent rehabilitation results; however, approximately 30% of patients show periprosthetic leakage or severe fistula enlargement after laryngectomy and prosthetic voice restoration within the first 4 years. The development of this enlargement is controversially discussed in the literature but recently published studies have shown that high esophageal reflux plays a key role in this process, which leads to an inflammatory reaction and disturbs the intercellular tight junctions in the sense of an epithelial mesenchymal transition (EMT). MATERIAL AND METHODS: A total of 44 patients underwent 24 h pH monitoring, a sample biopsy from the region of the fistula and a subsequent biomolecular examination for intracellular junction proteins as well as a correlation between the severity of reflux and tracheoesophageal fistula problems before and after antireflux therapy with proton pump inhibitors (PPI). RESULTS: Immunohistochemical staining revealed decreases in membrane E-cadherin and ß-catenin and a significant increase in the cytoplasmic fraction, depending on the severity of inflammation in the fistula tissue. In patients with an improvement of clinical fistula problems under oral PPI treatment an increase of membrane E-cadherin could be shown, whereas patients with persisting fistula enlargement demonstrated a further decrease of E-cadherin. CONCLUSION: The data indicate a central role of EMT in the development of fistula enlargement after total laryngectomy. Patients with periprosthetic leakage showed a loss of membrane bound E-cadherin and ß-catenin with an up-regulation of vimentin expression. In patients with mild or no leakage problems EMT could be resolved by aggressive antireflux treatment, whereas patients without any effect of PPI treatment on the fistula showed no reversal of EMT. These data contribute to the understanding of treatment resistant fistula enlargement after total laryngectomy.
Assuntos
Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/patologia , Laringectomia/efeitos adversos , Laringectomia/reabilitação , Laringe Artificial/efeitos adversos , Junções Íntimas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Refluxo Gastroesofágico/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Proteínas de Junções Íntimas/metabolismo , Junções Íntimas/patologia , Resultado do TratamentoRESUMO
BACKGROUND: Invasion and metastatic dissemination of tumor cells defines the prognosis of patients with colorectal cancer (CRC). The Abelson interactor 1 (Abi1), a 65 kD substrate of the eponymous Abelson tyrosine kinase, interacts with phosphatidylinositol-3-kinase (PI3K) and heterogeneous nuclear ribonucleoprotein K (hnRNP K) and is a key regulator of cytoskeletal reorganization during synaptic maturation and cellular migration. AIM: The aim of this study was the analysis of Abi1 expression patterns and to elucidate the role in cytoskeletal reorganization in colorectal carcinoma cells. MATERIAL AND METHODS: The methods used in this study were immunohistochemistry; immunofluorescence microscopy; liposomal transfection and protein analysis by Western blotting. RESULTS: The results showed that Abi1 is expressed at the invasive front of colorectal carcinomas and localizes to the leading edge of lamellipodia in cultured colorectal carcinoma cells. A phosphorylated isoform of Abi1 that stains positively in these microcompartments disappears after treatment with the tyrosine kinase inhibitor STI571 (Glivec®). The RNA interference (RNAi) approach knockdown of Abi1 as well as treatment with STI571 induce a shift in cellular morphology from broad lamellipodia-like to thin filopodia-like cellular protrusions. DISCUSSION: The initial results support a central role for phosphorylated Abi1 in the formation of lamellipodia-like cellular protrusions as a prerequisite for cellular migration of colorectal carcinoma cells. As phosphorylation of Abi1 could be pharmaceutically targeted with STI571, this indicates a possible therapeutic option to prevent the gain of a metastatic phenotype in colorectal cancer. This possibility will be further evaluated in ongoing research.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/genética , Distinções e Prêmios , Movimento Celular/genética , Neoplasias Colorretais/genética , Neoplasias Colorretais/patologia , Proteínas do Citoesqueleto/genética , Plasticidade Neuronal/genética , Sinapses/genética , Sinapses/patologia , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/patologia , Citoesqueleto/genética , Citoesqueleto/patologia , Regulação Neoplásica da Expressão Gênica/genética , Técnicas de Silenciamento de Genes , Humanos , Microscopia de Fluorescência , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Células Tumorais CultivadasRESUMO
The human KIBRA gene has been linked to human cognition through a lead intronic single-nucleotide polymorphism (SNP; rs17070145) that is associated with episodic memory performance and the risk to develop Alzheimer's disease. However, it remains unknown how this relates to the function of the KIBRA protein. Here, we identified two common missense SNPs (rs3822660G/T [M734I], rs3822659T/G [S735A]) in exon 15 of the human KIBRA gene to affect cognitive performance, and to be in almost complete linkage disequilibrium with rs17070145. The identified SNPs encode variants of the KIBRA C2 domain with distinct Ca(2+) dependent binding preferences for monophosphorylated phosphatidylinositols likely due to differences in the dynamics and folding of the lipid-binding pocket. Our results further implicate the KIBRA protein in higher brain function and provide direction to the cellular pathways involved.
Assuntos
Cognição/fisiologia , Peptídeos e Proteínas de Sinalização Intracelular/genética , Mutação de Sentido Incorreto/genética , Fosfatidilinositóis/metabolismo , Fosfoproteínas/genética , Éxons/genética , Éxons/fisiologia , Feminino , Genótipo , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/fisiologia , Desequilíbrio de Ligação/genética , Desequilíbrio de Ligação/fisiologia , Metabolismo dos Lipídeos/genética , Metabolismo dos Lipídeos/fisiologia , Masculino , Pessoa de Meia-Idade , Mutação de Sentido Incorreto/fisiologia , Testes Neuropsicológicos , Fosfoproteínas/fisiologia , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
Recent research has found that the dopamine D4 receptor (DRD4) gene and maternal insensitivity may interact to predict externalizing behavior in preschoolers. The current study attempted to replicate and extend this finding in a sample of 18-30-month-old children. The current study examined two distinct dimensions of parenting (warm-responsive and negative-intrusive) as predictors of childhood externalizing and internalizing behavior. Further, race was investigated as a moderator of gene-environment relationships. Results revealed that high warm-responsive parenting was associated with decreased externalizing behavior only for African American children possessing the short polymorphism of DRD4. The data indicate that children may be differentially susceptible to different aspects of parenting depending on their genotype, and it is important to consider differences in racial composition when studying these relationships.
Assuntos
Comportamento Infantil , Relações Pais-Filho , Poder Familiar , Receptores de Dopamina D4/genética , Criança , Pré-Escolar , Meio Ambiente , Feminino , Genótipo , Humanos , Lactente , Masculino , Comportamento Materno , Polimorfismo Genético/genética , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
AIMS: To investigate socio-economic inequalities in diabetes complications, and to examine factors that may explain these differences. METHODS: Cross-sectional questionnaire survey of 770 individuals with diabetes among 40 general practices in Avon and Somerset. General practice, optometrist and eye hospital records over time (median 7 years) were analysed. Slope indices of inequality, odds ratios and incidence rate ratios were calculated to estimate the magnitude of inequality between the most and least educated, and the highest and lowest earning patients, adjusted for age, sex and type of diabetes, and clustering of outcomes within practices. RESULTS: The least educated patients were more likely than the most educated patients to have diabetic retinopathy [adjusted odds ratio (OR) 4.3; 95% confidence interval 0.8, 23.7] and heart disease (adjusted OR 3.6; 1.1, 11.8), had higher HbA1c levels (adjusted slope index of inequality 0.9; 0.3, 1.5), felt that diabetes more adversely affected their social and personal lives (adjusted slope index of inequality 0.8; 0.5, 1.1 Diabetes Care Profile units), were more likely to be recorded as non-compliant by their health professionals, and had lower rates of hospital attendance (adjusted rate ratio 0.43; 0.26, 0.71). However, they did not see themselves as less compliant, and had higher general practice attendance rates (adjusted rate ratio 1.5; 1.1, 2.2). CONCLUSIONS: Less educated and lower earning individuals with diabetes bear a larger burden of morbidity but use hospital care less. Health service resource allocation should reflect the distribution of chronic illness.
Assuntos
Diabetes Mellitus/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde , Idoso , Atitude Frente a Saúde , Estudos Transversais , Complicações do Diabetes , Retinopatia Diabética/epidemiologia , Educação , Inglaterra/epidemiologia , Medicina de Família e Comunidade , Feminino , Cardiopatias/epidemiologia , Hemoglobina A/análise , Humanos , Renda , Masculino , Cooperação do Paciente , Carência Psicossocial , Autocuidado , Fatores Sexuais , Classe Social , Fatores Socioeconômicos , Inquéritos e QuestionáriosAssuntos
Endossulfano/efeitos adversos , Hidrocarbonetos Clorados , Inseticidas/efeitos adversos , Notophthalmus viridescens/fisiologia , Feromônios/farmacologia , Olfato/efeitos dos fármacos , Animais , Relação Dose-Resposta a Droga , Glândulas Exócrinas/efeitos dos fármacos , Glândulas Exócrinas/fisiologia , Masculino , Comportamento Sexual AnimalRESUMO
Because chemicals introduced into the environment by humans can affect both long-term survivorship and reproduction of amphibians, discovering the specific mechanisms through which these chemicals act may facilitate the development of plans for amphibian conservation. We investigated the amphibian pheromonal system as a potential target of common environmental chemicals. By treating female red-spotted newts, Notophthalmus viridescens, to a commonly used insecticide, endosulfan, we found that the pheromonal system is highly susceptible to low-concentration exposure. The impairment of the pheromonal system directly led to disrupted mate choice and lowered mating success. There were no other notable physiologic or behavioral changes demonstrated by the animals at the insecticide concentrations administered. Our findings suggest that the amphibian pheromonal system is one of the systems subject to subtle negative effects of environmental chemicals.
Assuntos
Endossulfano/efeitos adversos , Hidrocarbonetos Clorados , Inseticidas/efeitos adversos , Notophthalmus viridescens/fisiologia , Atrativos Sexuais/fisiologia , Comportamento Sexual/efeitos dos fármacos , Olfato/efeitos dos fármacos , Animais , Relação Dose-Resposta a Droga , Exposição Ambiental , Feminino , Masculino , Dinâmica Populacional , Poluentes Químicos da Água/efeitos adversosRESUMO
Pheromones act as attractants and sexual stimulants in most vertebrates. For example, in red-spotted newts, Notophthalmus viridescens, female pheromones attract males, and male pheromones increase female receptivity. However, no studies have determined whether male vertebrates produce a pheromone that repels competing males. Through a series of olfactory mate selection tests, we found that sexually motivated male red-spotted newts produce a pheromone that functions to repel other approaching males. Our finding is the first report of a repelling function for pheromones in male vertebrates. The pheromones may act to increase both the sender's and receiver's mating success when the operational sex ratio (OSR) is male biased.
Assuntos
Notophthalmus , Atrativos Sexuais , Comportamento Sexual Animal , Animais , Masculino , MovimentoAssuntos
Atenção à Saúde , Seguro Saúde , Setor Privado , Opinião Pública , Setor Público , Fatores Socioeconômicos , Atenção à Saúde/economia , Atenção à Saúde/história , Atenção à Saúde/legislação & jurisprudência , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/história , Setor de Assistência à Saúde/legislação & jurisprudência , História do Século XX , Seguro Saúde/economia , Seguro Saúde/história , Seguro Saúde/legislação & jurisprudência , Setor Privado/economia , Setor Privado/história , Setor Privado/legislação & jurisprudência , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Saúde Pública/legislação & jurisprudência , Opinião Pública/história , Política Pública/economia , Política Pública/história , Política Pública/legislação & jurisprudência , Setor Público/economia , Setor Público/história , Setor Público/legislação & jurisprudência , Seguridade Social/economia , Seguridade Social/etnologia , Seguridade Social/história , Seguridade Social/legislação & jurisprudência , Seguridade Social/psicologia , Reino Unido/etnologiaRESUMO
Cloning of a proenkephalin cDNA from the pelobatid anuran amphibian, Spea multiplicatus, provides additional evidence that Leu-enkephalin, although present in the brain of anuran amphibians, is not encoded by the proenkephalin gene. The S. multiplicatus proenkephalin cDNA is 1375 nucleotides in length, and the open reading frame contains the sequences of seven opioid sequences. There are five copies of the Met-enkephalin sequence, as well as an octapeptide opioid sequence (YGGFMRNY) and a heptapeptide opioid sequence (YGGFMRF). In the proenkephalin sequence of S. multiplicatus the penultimate opioid is a Met-enkephalin sequence rather than the Leu-enkephalin present in mammalian sequences. The same order of opioid sequences also is observed for the proenkephalin sequence of the pipid anuran amphibian, Xenopus laevis. Hence, from a phylogenetic standpoint the organization of tetrapod proenkephalin has been remarkably conserved. What remains to be resolved is whether the Leu-enkephalin sequence found in mammalian proenkephalin is an ancestral trait or a derived trait for the tetrapods. Unlike the proenkephalin precursor of X. laevis, all of the opioid sequences in the S. multiplicatus proenkephalin cDNA are flanked by paired-basic amino acid proteolytic cleavage sites. In this regard the proenkephalin sequence for S. multiplicatus is more similar to mammalian proenkephalins than the proenkephalin sequence of X. laevis. However, a comparison of the proenkephalin sequences in human, X. laevis, and S. multiplicatus revealed several conserved features in the evolution of the tetrapod proenkephalin gene. By contrast, a comparison of tetrapod proenkephalin sequences with the partial sequence of a sturgeon proenkephalin cDNA indicates that the position occupied by the penultimate opioid sequence in vertebrate proenkephalins may be a highly variable locus in this gene.
Assuntos
Anuros/genética , Encéfalo/metabolismo , Encefalinas/genética , Precursores de Proteínas/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Clonagem Molecular , DNA Complementar , Encefalinas/biossíntese , Encefalinas/química , Peixes , Humanos , Dados de Sequência Molecular , Precursores de Proteínas/biossíntese , Precursores de Proteínas/química , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Xenopus laevisRESUMO
Under dehydrating conditions, many terrestrial vertebrates species exhibit increases in plasma osmolality and their drinking behavior. Under some circumstances, this behavioral change is accompanied by changes in plasma and central angiotensin concentrations, and it has been proposed that these changes in angiotensin levels induce the thirst-related behaviors. In response to dehydration, the spadefoot toad, Scaphiopus couchii, exhibits thirst-related behavior in the form of cutaneous drinking. This behavior has been termed water absorption response (WR) behavior. Spadefoot toads live in harsh desert environments and are subject annually to dehydrating conditions that may induce thirst-related behavior. We tested the hypothesis that an increase in WR behavior is associated with both an increase in plasma osmolality and an increase in plasma and brain angiotensin concentrations. First, we determined the degree of dehydration that was necessary to initiate WR behavior. Animals dehydrated to 85% of their standard bladder-empty weight via deprivation of water exhibited WR behavior more frequently than control toads left in home containers with water available. Next, using the same dehydration methods, we determined the plasma osmolality and sodium concentrations of dehydrated toads. Toads dehydrated to 85% standard weight also had a significant increase in plasma osmolality, but exhibited no overall change in plasma sodium concentrations, indicating that while an overall increase in plasma osmolality appears to be associated with WR behavior in S. couchii, changes in sodium concentrations alone are not sufficient to induce the behavior. Finally, plasma and brain angiotensin concentrations were measured in control toads and toads dehydrated to 85% standard weight. Plasma and brain angiotensin concentrations did not increase in dehydrated toads, indicating that dehydration-induced WR behavior that is associated with changes in plasma osmolality may not be induced by changes in endogenous angiotensin concentrations in S. couchii.
Assuntos
Angiotensina II/sangue , Comportamento Animal/fisiologia , Encéfalo/metabolismo , Bufonidae/fisiologia , Desidratação , Comportamento de Ingestão de Líquido/fisiologia , Angiotensina III/farmacologia , Animais , Masculino , Concentração Osmolar , Radioimunoensaio , Sódio/sangue , Privação de Água/fisiologiaRESUMO
Previous studies have demonstrated that both dehydration (intra and extracellular) and treatment with angiotensin II (A-II) induce changes in thirst-related behavior in the spadefoot toad, Scaphiopus couchii. One of the steps in determining a causal relationship between a hormone and a behavior is to determine that there is association between an animal's performance of the behavior and changes in endogenous hormonal concentrations. The hypothesis tested that plasma levels of the peptide hormone A-II would change as a result of dehydration known to induce water absorption response (WR) behavior in the spadefoot toad. Plasma samples were taken from toads dehydrated intracellularly by injection of hypertonic solutions of NaCl or sucrose at levels known to induce WR behavior. As an osmotic control, a group of animals was injected with urea, which has been demonstrated to not induce WR behavior. In order to determine the effects of extracellular dehydration on plasma, A-II levels in toads dehydrated by plasma volume depletion via cardiac puncture were compared to sham-punctured controls. None of the treatments in any experiment resulted in significant differences in plasma levels of angiotensin II among groups sampled at the time when WR behavior occurs. These results do not support the hypothesis that dehydration-induced thirst is stimulated by changes in plasma A-II concentrations at the onset of WR behavior. J. Exp. Zool. 286:343-349, 2000.
Assuntos
Angiotensina II/sangue , Bufonidae/fisiologia , Desidratação , Angiotensina II/farmacologia , Animais , Comportamento de Ingestão de LíquidoRESUMO
Due to the low degree of sequence similarity it has been speculated that murine and human S100A9 (MRP14), an inflammatory marker protein belonging to the S100 protein family, may have different cellular functions in mouse and man. The present study was undertaken to investigate the murine S100A9 protein (mS100A9) biochemically. We demonstrate that in murine peripheral CD11b+ cells up to 20% of the protein of the cytosolic fraction consists of mS100A9 and that several minor mS100A9 isoforms are present. Cell fractionation experiments with CD11b+ murine leukocytes showed that mS100A9 is found in the cytosol as well as in the insoluble fraction. Transient expression of a green fluorescence protein-mS100A9 fusion in mammalian cells revealed that mS100A9 is localized in neither the nucleus nor the vesicles. Recombinantly expressed murine S100A9 interacts in vitro with murine and human S100A8 in an in vitro glutathione S-transferase pull-down assay. Homodimerization was not observed. For further biochemical analysis the myeloid 32D cell line is presented as a suitable model, to study murine myeloid expressed S100 proteins. Both murine S100A9 and its dimerization partner mS100A8 are expressed at the onset of granulocyte-colony stimulating factor induced myeloid differentiation. Substantial amounts of this complex are constitutively secreted by granulocytic 32D cells into the medium. In summary, these data suggest, that the human and murine S100A9 may share a higher degree of functional homology than of sequence similarity.
Assuntos
Antígenos de Diferenciação/genética , Antígenos de Diferenciação/metabolismo , Granulócitos/metabolismo , Proteínas S100/genética , Proteínas S100/metabolismo , Animais , Antígenos de Diferenciação/efeitos dos fármacos , Western Blotting , Proteínas de Ligação ao Cálcio/metabolismo , Calgranulina A , Calgranulina B , Linhagem Celular , Citosol/metabolismo , Fator Estimulador de Colônias de Granulócitos/farmacologia , Humanos , L-Lactato Desidrogenase/metabolismo , Leucócitos/metabolismo , Camundongos , Testes de Precipitina , Isoformas de Proteínas/metabolismo , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Proteínas S100/efeitos dos fármacos , Homologia de Sequência de Aminoácidos , Frações SubcelularesRESUMO
Policy change has eroded the entitlement of UK residents to free state-provided health care, with a resulting rise in the use of the private sector. This paper examines the choice between public and private health care. It models the use of private health care as a function of its costs and benefits relative to state care and no care. The results indicate a difference between users of private care and other care, and the importance of past use as a predictor of current use. But they also show considerable movement between the public and private sectors, indicating a complex relationship in public and private sector use.