Physicians' perceptions of risk adjustment and health policy formation in Minnesota.

A questionnaire was used to assess Minnesota physicians' knowledge of and opinions about risk adjustment, a policy designed to modify payments to health providers based on the relative "sickness" level of the provider's patient population. Additionally, attitudes toward this policy were measured to examine physicians' perceptions of health policy formation in Minnesota. Although familiarity with this policy appears low, respondents support the concept of diagnosis-based risk adjustment. Physicians are divided on whether to further modify risk-adjusted rates with a conversion factor; their written comments suggest a mistrust of the policymaking process. Physicians most often listed the Minnesota Medical Association as a primary source for health policy information, while few respondents reported any communication with state legislators in health policy matters. Respondents perceive an imbalance in the influence wielded by various entities in health policy formation. Only 5% believe individual physicians have significant influence in policymaking. Increased communication between physicians and their legislators may be one way for physicians to gain such influence.

Influence of short-term aluminum exposure on demineralized bone matrix induced bone formation.

The effects of aluminum exposure on bone formation employing the demineralized bone matrix (DBM) induced bone development model were studied using 4-week-old Sprague-Dawley rats injected with a saline (control) or an aluminum chloride (experimental) solution. After 2 weeks of aluminum treatment, 20-mg portions of rat DBM were implanted subcutaneously on each side in the thoracic region of the control and experimental rats. Animals were killed 7, 12, or 21 days after implantation of the DBM and the developing plaques removed. No morphological, histochemical, or biochemical differences were apparent between plaques from day 7 control and experimental rats. Plaques from day 12 control and experimental rats exhibited cartilage formation and alkaline phosphatase activity localized in osteochondrogenic cells, chondrocytes, osteoblasts, and extracellular matrix. Unlike the plaques from control rats that contained many osteoblastic mineralizing fronts, the plaques from the 12-day experimental group had a preponderance of cartilaginous tissue, no evidence of mineralization, increased levels of alkaline phosphatase activity, and a reduced calcium content. Plaques developing for 21 days in control animals demonstrated extensive new bone formation and bone marrow development, while those in the experimental rats demonstrated unmineralized osteoid-like matrix with poorly developed bone marrow. Alkaline phosphatase activity of the plaques continued to remain high on day 21 for the control and experimental groups. Calcium levels were significantly reduced in the experimental group. These biochemical changes correlated with histochemical reductions in bone calcification.(ABSTRACT TRUNCATED AT 250 WORDS)

Binding properties of purified adult and fetal bovine serum albumin.

Fetal and adult bovine serum albumin were purified by standard techniques and then treated with activated charcoal at pH 2.75 to remove small molecular weight legands. The two proteins were compared and found to be identical by the following criteria: isoelectric focusing, electrophoresis on cellulose acetate and polyacrylamide gel, by the binding of bromcresol green, salicylic acid, diphenylhydantoin, and six different fatty acids (palmitic, stearic, oleic, elaidic, linoleic, and arachidonic). Reports of marked differences in the capacities of fatal and ault plasma to bind bilirubin and various drugs have usually been attributed to the presence of a "fetal" albumin. Our results, however, are consistent with the view that there is no difference between adult and fetal albumin and that the observed altered binding properties of fetal plasma are due to the tight binding of a ligand to fetal albumin in blood, which modifies the protein's affinity for lipophilic compounds.